{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:43:39Z","timestamp":1787031819832,"version":"build-2736575974"},"reference-count":20,"publisher":"Universa BV","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:p>We aimed to compare the union rate and clinical outcome of autologous bone graft versus pronator quadratus vascularized pedicled muscle flap in treatment of scaphoid nonunion. Forty patients with a diagnosis of scaphoid nonunion who underwent unilateral pseudarthrosis surgery were included in this study. Notably, the scaphoid nonunion was unilateral, and the contralateral wrist was asymptomatic with normal function, per the physical and radiological examinations. Pronator quadratus vascularized pedicled muscle flap was used in 16 patients (group 1), and autologous bone graft was used in 24 patients (group 2). Patients were compared used Scapholunate angles, Natrass carpal height ratio and Mayo wrist score pre and postoperatively. Fifteen of the 16 (93.3%) patients in group 1 and 19 of the 24 (79.2%) patients in group 2 achieved bone union. Four of twelve patients in group 2 with avascular necrosis (AVN) and one of eight in group 1 with AVN were not able to achieve union. The group 2 (34%) had higher nonunion rate than group 1 (12%) in AVN patients. The scapholunat angle was significantly decreased and the Natress ratio was significantly increased postoperatively compared to the preoperative measurement in both group. There was no statistically significant difference in the postoperative measurement. The postoperative Mayo wrist score showed no statistically significant differences between both groups. The pronator quadratus vascularized pedicled muscle flap was superior to non-vascularized bone grafting in the treatment of scaphoid nonunion with AVN. However, management of the patients without avascular necrosis is not requiring the vascularized pedicled muscle flap technique.<\/jats:p>","DOI":"10.52628\/88.3.0001","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T17:58:25Z","timestamp":1676397505000},"page":"447-455","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of clinical outcomes of autologous bone graft versus pronator quadratus pedicled vascularized bone graft in the treatment of scaphoid nonunion"],"prefix":"10.52628","volume":"88","author":[{"given":"Mustafa Abdullah","family":"\u00d6zdemir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serkan","family":"Bayram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6mer","family":"Ayik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuna","family":"Pehlivanoglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Salduz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turgut","family":"Akg\u00fcl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayati","family":"Durmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27062","published-online":{"date-parts":[[2023,1]]},"reference":[{"key":"ref0","unstructured":"Wolfe SW, HotchkissRN, Pederson WC, KozinSH, Cohen MS. Green\u2019s operative hand surgery. 7th ed. Philadelphia: Elsevier; 2017."},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg. 1980;5:508\u2013513.","DOI":"10.1016\/S0363-5023(80)80087-6"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Buijze GA, Ochtman L, Ring D. Management of scaphoid nonunion. J Hand Surg Am. 2012;37:1095\u20131100.","DOI":"10.1016\/j.jhsa.2012.03.002"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Pao VS, Chang J. Scaphoid nonunion: diagnosis and treatment. Plast Reconstr Surg. 2003;112:1666\u20131669.","DOI":"10.1097\/01.PRS.0000086090.43085.66"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Leixnering M, Pezzei C, Weninger P et al. First experiences with a new adjustable plate for osteosynthesis of scaphoid nonunions. J Trauma Inj Infect Crit Care. 2011;71:933\u2013938.","DOI":"10.1097\/ta.0b013e3181f65721"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Kawamura K, Chung KC. Treatment of scaphoid fractures and nonunions. J Hand Surg Am. 2008;33:988\u2013997.","DOI":"10.1016\/j.jhsa.2008.04.026"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Zaidemberg C, Siebert JW, Angrigiani C. A new vascularized bone graft for scaphoid nonunion. J Hand Surg Am. 1991;16:474-778.","DOI":"10.1016\/0363-5023(91)90017-6"},{"key":"ref7","unstructured":"Braun R N. Pronator pedicle bone grafting in the forearm and proximal row. Orthop Trans 1983;7:35."},{"key":"ref8","unstructured":"Ritter K, Giachino AA. The treatment of pseudoarthrosis of the scaphoid by bone grafting and three methods of internal fixation. Can J Surg. 2000;43:118-124."},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Bechtol CO. Grip test; the use of a dynamometer with adjustable handle spacings. J Bone Joint Surg Am. 1954;36:820-824.","DOI":"10.2106\/00004623-195436040-00013"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney WP. 3rd, Linscheid RL. Scaphoid malunion. J Hand Surg Am. 1989;14:679-687.","DOI":"10.1016\/0363-5023(89)90191-3"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Nattrass GR, King GJ, Mc Murtry RY, Brant RF. An alternative method for determination of the carpal height ratio. J Bone Joint Surg Am. 1994;76:88\u201394.","DOI":"10.2106\/00004623-199401000-00011"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Sheetz KK, Bishop AT, Berger RA. The arterial blood supply of the distal radius and ulna and its potential use in vascularized pedicled bone grafts. J Hand Surg Am 1995;20:902-914.","DOI":"10.1016\/s0363-5023(05)80136-4"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Dailiana ZH, Malizos KN, Zachos V et al. Vascularized bone grafts from the palmar radius for the treatment of waist nonunions of the scaphoid. J Hand Surg Am. 2006;31:397-404.","DOI":"10.1016\/j.jhsa.2005.09.021"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Merrell GA, Wolfe SW, Slade JF. 3rd. Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg Am. 2002;27:685\u2013691.","DOI":"10.1053\/jhsu.2002.34372"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Ferguson DO, Shanbhag V, Hedley H, Reichert I, Lipscombe S, Davis TR. Scaphoid fracture non-union: a systematic review of surgical treatment using bone graft. J Hand Surg Eur 2016;41:492\u2013500","DOI":"10.1177\/1753193415604778"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Caporrino FA, Dos Santos JB, Penteado FT, de Moraes VY, Belloti JC, Faloppa F. Dorsal vascularized grafting for scaphoid nonunion: a comparison of two surgical techniques. J Orthop Trauma. 2014;28:e44\u201348.","DOI":"10.1097\/bot.0b013e3182a4a91a"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Kawai H, Yamamoto K. Pronator quadratus pedicled bone graft for old scaphoid fractures. J Bone Joint Surg Br. 1998;70:829-831.","DOI":"10.1302\/0301-620x.70b5.3192587"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Noaman HH, Shiha AE, Ibrahim AK. Functional outcomes of nonunion scaphoid fracture treated by pronator quadratus pedicled bone graft. Ann Plast Surg. 2011;66:47-52.","DOI":"10.1097\/sap.0b013e3181d375f9"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Lee SK, Park JS, Choy WS. Scaphoid fracture nonunion treated with pronator quadratus pedicled vascularized bone graft and headless compression screw. Ann Plast Surg. 2015;74(6):665-671","DOI":"10.1097\/sap.0000000000000025"}],"container-title":["Acta Orthopaedica Belgica"],"original-title":[],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T17:58:32Z","timestamp":1676397512000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.actaorthopaedica.be\/archive\/volume-88\/issue-3\/original-studies\/comparison-of-clinical-outcomes-of-autologous-bone-graft-versus-pronator-quadratus-pedicled-vascular\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":20,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,1]]},"published-print":{"date-parts":[[2022,9]]}},"URL":"https:\/\/doi.org\/10.52628\/88.3.0001","relation":{},"ISSN":["0001-6462"],"issn-type":[{"value":"0001-6462","type":"print"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}