When to Use Vascularized Bone? An Algorithm for Scaphoid Nonunion Surgery.

The surgical treatment of scaphoid nonunions possesses a high risk of surgical failure. There are numerous surgical techniques described, each supported by some evidence of clinical efficacy. To assist hand surgeons in developing a cogent approach to the various clinical scenarios that they may encounter, this manuscript examines the pertinent considerations and available evidence surrounding this topic. These considerations provide guidelines for the creation of an evidence-based surgical algorithm.