[Treatment of old scaphoid fracture with transposition of vascularized periosteal flap and internal fixation].

OBJECTIVE

To introduce an effective method of treating old scaphoid fracture.

METHODS

From April 1995 to April 2002, 11 patients with old scaphoid fracture were treated with transposition of vascularized periosteal flap and internal fixation; if necessary, the radial styloid was removed. Out of 11 patients( 8 males and 3 females, aged from 17 to 46 years), the fracture sites were medial scaphoid in 7, the proximal one in 2 and the distal one in 2. The X-ray films showed separated fracture lines. The fracture lines were less than 1 mm in 4 patients and more than 1 mm in 3 patients. Sclerosis of skeleton ends and cystoid degeneration occurred in 2 patients, respectively.

RESULTS

After a follow-up of 3 to 24 months, the fracture healing was obtained within 4 months in 9 cases and within 6 to 7 months in 2 cases. Internal fixation was taken out 3 months after bone healing. The carpal joint pain and weakness vanished in all cases.

CONCLUSION

Transposition of vascularized periosteal flap and internal fixation have many advantages, such as easy dissection, rich blood supply, quick new bone formation, short time of fracture healing and satisfactory function recovery of carpal joint.