TREATMENT OF SCAPHOID NON-UNION FRACTURE BY PRONATOR QUADRATUS PEDICLE BONE GRAFT TRANSFIXED WITH KIRSCHNER WIRE
Dr. Thamer Khalaf Yaseen* and Fouad Jahil Al-Hilali
ABSTRACT
Background: Treatment of scaphoid non-union fractures is controversial and challengeable in orthopaedic practice. Moreover, it is widespread of all fractures of the carpal bones. Scaphoid collapse and distortion may trend to develop after fractures. Furthermore, the questionable vascular anatomy of the scaphoid, the characteristic biomechanical instability of scaphoid fractures, and the struggle of radiographic finding are the reasons of nonunion. One common method for treating scaphoid nonunion with angular deformity is length restoration using a wedge bone graft. Objective: By this prospective study, we have highlighted and compared the outcomes of 3 fixation Kirschner wire for scaphoid non-union fracture. Methods: A prospective study that achieved on 8 patients who have scaphoid non-union fractures. The patients were treated at Al-Nu 'man Teaching Hospital and our private clinic in Baghdad, Iraq between March 2014 and April 2017. The scaphoid non-union fractures were treated by vascularized pronator quadrates muscle with bone from distal radius and transfixed by Kirschner wire. Results: The most common age (20-30) years with 8 patients. However, 7 male and 1 female were treated by vascularised pronator quadrates muscle pedicle bone graft fixed at fracture scaphoid by tunnel in fracture site with wire. The end result was excellent in 7 patients. Unfortunately, one female patient has got re-fracture who is treated by splint. Conclusions: Kirschner K-wire transfixation, which is a relatively simple, alternative operative procedure to manage a scaphoid non-union fracture. Moreover, all the patients had a well union that achieved stability and vascularity for fractures.
Keywords: Scaphoid non-union fracture, Kirschner wire, Pronator Quadratus Pedicle Bone Graft.
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