Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique.

Background

Although adolescents are at a lower risk of developing scaphoid non-union than adults, this complication is not uncommon in younger patients. The current gold standard for surgical treatment is non-vascularized bone grafting from the iliac crest or distal radius, and it is often considered the first-line option. However, non-union can persist in 10-20% of cases, and failure rates can reach up to 50% when the proximal pole is necrotic.

Methods

We evaluated a modified vascularized bone graft surgical technique in selected adolescent patients, with the goal of avoiding growth-related complications. Our experience is based on three cases of scaphoid non-union treated surgically between June 2019 and June 2022. Results and

Conclusions

The modified surgical technique has shown promising results in the selected cases and carries no risk of donor site morbidity. It enables preservation of severely compromised scaphoid bones, prevents early-onset wrist osteoarthritis, and facilitates the return to sports activities for young patients.