ABSTRACT
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.