Primary Vascularized Bone Graft for the Extruded Scaphoid Proximal Pole: A Case Report.

CASE: A 52-year-old man sustained a radiocarpal dislocation with extrusion of the scaphoid proximal pole, which was completely detached from the soft tissue. To reduce the risk of avascular necrosis (AVN), treatment involved simultaneous anatomic reduction and internal fixation of the fracture and vascularized bone graft (VBG) for the scaphoid proximal pole. At 4 months, magnetic resonance imaging and 36 months of follow-up radiography showed a healed scaphoid and revealed no evidence of AVN in the scaphoid proximal pole.

CONCLUSION

If the risk of AVN is high, we recommend considering the combination of internal fixation and VBG for the fresh scaphoid fracture.