Treatment of scaphoid non-union with 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) vascularised graft

Ong HS, Tan G, Chew WYC
Correspondence: Dr Ong Hang Shyan, hang_shyan_ong@ttsh.com.sg

ABSTRACT
Introduction The purpose of this paper is to share the outcome of cases of scaphoid non-union treated with 1,2 intercompartmental supra-retinacular artery (1,2 ICSRA) vascularised graft at our institution, as well as to identify the possible factors for the failure of the procedure.
Methods This was a retrospective review of 13 cases of scaphoid fracture non-union treated with 1,2 ICSRA vascularised bone grafting from October 2000 to March 2003. A clinical and radiological review was conducted. Linear regression was performed in order to identify the factors associated with a negative outcome.
Results Out of the 13 patients with scaphoid non-union, ten (77 percent) had avascular necrosis of the proximal pole. The patients were followed up for a mean duration of 13 (range 3–28) months. Ten out of the 13 (77 percent) patients achieved union.
Conclusion Our results are comparable to those reported by other studies and indicate that avascular necrosis was associated with failure to achieve union.

Keywords: avascular necrosis, bone grafting, non-union, scaphoid
Singapore Med J 2011; 52(9): 658–661