Pronator quaratus pedicled bone graft for treatment of scaphoid non-union

ABSTRACT

Twenty male patients with scaphoid nonunion were treated with the use of a pronator quadratus pedicled bone graft. The ages of the patients ranged from 20 to 48 years [average 33 years]. The average duration of nonunion was 10 months [range 6 to 25 months]. Ten nonunions were in the middle third, 8 in the proximal third and 2 in the distal third of the scaphoid. In 7 patients, there was avascular necrosis of the proximal fragment of the scaphoid, which was confirmed radiographically and clinically. The average duration of follow-up period was 32 months [range 23 to 41 months]. Union was achieved in 19 patients at an average period of 12 weeks [range 8 to 15 weeks] postoperatively. According to the modified Mayo Clinic Wrist Scoring System, 17 patients had excellent and good results, 2 patients had fair results and one patient had poor results. Postoperative complications included pin track infection in 2 patients, superficial wound infection in one patient and persistent nonunion in one patient. Pronator quadratus pedicled bone graft is a simple and effective procedure as primary treatment for scaphoid nonunion with or without avascular necrosis and does not need special equipments and produces union in a shorter time compared to conventional Russe graft