Pedicled vascularized versus non‐vascularized bone grafts in the treatment of scaphoid non‐union: a meta‐analysis of comparative studies

2021 ◽  
Author(s):  
Hanyu Zhang ◽  
Jiaxiang Gu ◽  
Hongjun Liu ◽  
Chaoqun Yuan
Keyword(s):  
Comparative Studies ◽  
Meta Analysis ◽  
Bone Grafts ◽  
Non Union ◽  
Vascularized Bone

Bone Grafts for Scaphoid Nonunion: An Overview

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 222-227 ◽  
Author(s):  
Steven E.R. Hovius ◽  
Tim de Jong
Keyword(s):  
Surgical Treatment ◽  
Bone Graft ◽  
Bone Grafts ◽  
Good Position ◽  
Vascularized Bone Graft ◽  
Scaphoid Nonunion ◽  
Non Union ◽  
Non Surgical Treatment ◽  
Vascularized Bone

The scaphoid is the most common fractured bone in the wrist. Despite adequate non-surgical treatment, around 10% to 15% of these fractures will not heal. Untreated scaphoid non-union can cause a scaphoid non-union advance collapse (SNAC), this is a progressive deformity and can cause degenerative changes in the wrist. Surgery is focused on achieving consolidation, pain reduction and a good position of the scaphoid while preventing osteoarthritis in the long-term. Surgery consists of reduction and fixation of the scaphoid with a non-vascularized or vascularized bone graft. An overview of the most used vascularized and non-vascularized bone grafts and their indications are presented.

scholarly journals Vascularized bone grafts for post-traumatic defects in the upper extremity

2021 ◽  
Vol 48 (1) ◽  
pp. 84-90
Author(s):  
Giovanna Petrella ◽  
Daniele Tosi ◽  
Filippo Pantaleoni ◽  
Roberto Adani
Keyword(s):  
Upper Extremity ◽  
Bone Grafting ◽  
Femoral Condyle ◽  
Bone Grafts ◽  
Bone Defects ◽  
Tissue Loss ◽  
Surgical Reconstruction ◽  
Non Union ◽  
Post Traumatic ◽  
Vascularized Bone

Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5–6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

scholarly journals Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668429 ◽  
Author(s):  
Christoph Hirche ◽  
Lingyun Xiong ◽  
Christian Heffinger ◽  
Matthias Münzberg ◽  
Sebastian Fischer ◽  
...  
Keyword(s):  
Treatment Algorithm ◽  
Bone Grafts ◽  
Level Of Evidence ◽  
Non Union ◽  
Delayed Treatment ◽  
Appropriate Treatment ◽  
Active Range Of Motion ◽  
Sf 36 ◽  
Scaphoid Reconstruction ◽  
Vascularized Bone

Introduction: Conventional non-vascularized bone grafts as well as vascularized bone grafts are used to treat scaphoid non-union (SN). Due to limited available studies, the field of application using both grafts for SN still remains controversial. The aim of this study was to evaluate a treatment algorithm for the use of both vascularized versus non-vascularized bone grafts based on clinical outcomes and quality of life (QoL) to improve the level of evidence. Materials and Methods: Based on a retrospective cohort study, including 28 patients with vascularized and 45 patients with conventional bone grafts, functional parameters, radiological outcome, Mayo-wrist-score, and QoL by SF-36 were applied to statistically compare the outcome of these two techniques. Results: Time between last procedure or trauma and study group scaphoid reconstruction was almost double in the vascularized bone grafting group. Comparable union rates were achieved with vascularized as well as non-vascularized bone grafts. Significant differences were observed between both groups for grip strength and radial-ulnar active range of motion. Further functional outcomes, radiological outcomes as well as QoL were found similar for both techniques in patients with surgical union. Discussion and conclusions: In order to achieve comparable and appropriate treatment results, vascularized bone grafts are recommended for patients with delayed treatment, impaired scaphoid vascularity, and revision surgery. Even in preselected, complex cases, the results are comparable to conventional grafts, which are the basis for further patient education and approve the powerful role of surgical angiogenesis of vascularized bone grafts.

Mandibular Reconstruction Using Vascularized Bone Grafts

1991 ◽  
Vol 24 (6) ◽  
pp. 1391-1418 ◽  
Author(s):  
Daniel B. Kuriloff ◽  
Michael J. Sullivan
Keyword(s):  
Bone Grafts ◽  
Mandibular Reconstruction ◽  
Vascularized Bone

Some Available Vascularized Bone Grafts in Posttraumatic Hand Reconstruction

2005 ◽  
Vol 21 (07) ◽  
Author(s):  
Alexandru Georgescu ◽  
Ovidiu Ivan ◽  
Adrian Avram ◽  
Ileana Matei ◽  
Irina Capota
Keyword(s):  
Bone Grafts ◽  
Hand Reconstruction ◽  
Vascularized Bone

Minimally Invasive Pancreaticoduodenectomy: What is the Best “Choice”? A Systematic Review and Network Meta-analysis of Non-randomized Comparative Studies

2017 ◽  
Vol 42 (3) ◽  
pp. 788-805 ◽  
Author(s):  
Claudio Ricci ◽  
Riccardo Casadei ◽  
Giovanni Taffurelli ◽  
Carlo Alberto Pacilio ◽  
Marco Ricciardiello ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Comparative Studies ◽  
Meta Analysis

scholarly journals Simultaneous implant placement with autogenous onlay bone grafts: a systematic review and meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Guoqiang Ma ◽  
Chaoan Wu ◽  
Miaoting Shao
Keyword(s):  
Meta Analysis ◽  
Survival Rates ◽  
Bone Grafts ◽  
Implant Survival ◽  
Analysis Model ◽  
Implant Placement ◽  
Significant Difference ◽  
Delayed Implant Placement ◽  
Onlay Grafts

AbstractSeveral authors have suggested that implants can be placed simultaneously with onlay bone grafts without affecting outcomes. Therefore, the purpose of this study was to answer the following clinical questions: (1) What are the outcomes of implants placed simultaneously with autogenous onlay bone grafts? And (2) is there a difference in outcomes between simultaneous vs delayed placement of implants with autogenous onlay bone grafts? Databases of PubMed, Embase, and Google Scholar were searched up to 15 November 2020. Data on implant survival was extracted from all the included studies (single arm and comparative) to calculate point estimates with 95% confidence intervals (CI) and pooled using the DerSimonian–Laird meta-analysis model. We also compared implant survival rates between the simultaneous and delayed placement of implants with data from comparative studies. Nineteen studies were included. Five of them compared simultaneous and delayed placement of implants. Dividing the studies based on follow-up duration, the pooled survival of implant placed simultaneously with onlay grafts after <2.5 years of follow-up was 93.1% (95% CI 82.6 to 97.4%) and after 2.5–5 years was 86% (95% CI 78.6 to 91.1%). Implant survival was found to be 85.8% (95% CI 79.6 to 90.3%) with iliac crest grafts and 95.7% (95% CI 83.9 to 93.0%) with intra-oral grafts. Our results indicated no statistically significant difference in implant survival between simultaneous and delayed placement (OR 0.43, 95% 0.07, 2.49, I2=59.04%). Data on implant success and bone loss were limited. Data indicates that implants placed simultaneously with autogenous onlay grafts have a survival rate of 93.1% and 86% after a follow-up of <2.5 years and 2.5–5years respectively. A limited number of studies indicate no significant difference in implant survival between the simultaneous and delayed placement of implants with onlay bone grafts. There is a need for randomized controlled trials comparing simultaneous and delayed implant placement to provide robust evidence.

Rigid Fixation of Vascularized Bone Grafts in Mandibular Reconstruction

1995 ◽  
Vol 121 (1) ◽  
pp. 70-76 ◽  
Author(s):  
N. D. Futran ◽  
M. L. Urken ◽  
D. Buchbinder ◽  
J. F. Moscoso ◽  
H. F. Biller
Keyword(s):  
Bone Grafts ◽  
Mandibular Reconstruction ◽  
Rigid Fixation ◽  
Vascularized Bone
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