Dorsal vascularized grafting for scaphoid nonunion: a comparison of two surgical techniques.

OBJECTIVES

To compare the radiographic and functional outcomes of 2 surgical techniques for treating scaphoid nonunion.

DESIGN

Randomized prospective study.

PATIENTS/

PARTICIPANTS

Researchers assessed the outcomes every 2 weeks until bone healing and at discharge.

INTERVENTIONS: (1) Vascularized bone grafting (VBG) using the 1, 2 intercompartmental suprareticular artery and (2) a distal radius nonvascularized bone graft.

MAIN OUTCOMES/INTERVENTIONS: Time to union (primary), union rate, and functional outcomes.

RESULTS

Seventy-five patients were followed for 29 months; 2 were lost to final follow-up. Both groups had similar baseline characteristics. The VBG group reached bone union earlier by 12 days (P = 0.002), but union rates were similar (P = 0.312). There was also less ulnar deviation in the VBG group (P = 0.03). There were no other differences between either intervention groups.

CONCLUSIONS

Although the VBG group attained earlier union, this may not be clinically meaningful, nor justify the greater technical difficulty and use of resources associated with this intervention.

LEVEL OF EVIDENCE: Therapeutic Level II. See instructions for authors for a complete description of levels of evidence.