Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

The purpose of this prospective study is to document the use of pedicled vascularized bone graft from the base of the 2nd metacarpal bone in the treatment of nonunited fracture proximal pole of the scaphoid with fixation of the fracture by headless compression titanium 3mm screw through dorsal approach. Thirty four patients were treated, 3 patients were nonunited, One patient were excluded as we found out that only cartilaginous part of the proximal pole were injured and treated only by stitches, while 31 patients (91%) reached full union, all patients were men, with mean delay time of 18.8 months ranging from 6 to 60 months, The mean union time was 5.98 months ranging from 3 to 18 months.This study proves that the use of the 2nd dorsal metacarpal artery is a reliable and easy way to take pedicled graft due to its large diameter ranging 1 - 1.5 mm, and it can gives pedicle length up to 4-6 cm which can easily reach the fracture site, Dorsal approach of the scaphoid allows us to have good vision of the proximal pole and also allows us by extending the wound distally by about 4 - 5 cm to reach the graft donor site and harvest the graft easily

Issued also as CD