Scaphoid Nonunion Bone Graft

Icsra Bone GraftScaphoid Nonunion Bone Graft
Figure 58—6. (A) Osteotomy often used for a humpback deformity. (B) Compression screw fixation in a fibrous union. (C,D) Donor harvest iliac crest corticocancellous graft to be used to maintain position and length for a scaphoid nonunion. (C) artwork and (D) in vivo.

bone graft based on the 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) pedicle with K-wire fixation was selected for this patient (Fig. 58-7).

The surgery can be performed under general or axillary block anesthesia, and general anesthesia was used. The patient was placed in the supine position, a brachial tourniquet was placed, and perioperative intravenous first-generation cephalosporin was administered. The right upper extremity was exsanguinated by elevation rather than by using an esmarch, so the vascular pedicle could be more readily identified. A curvilinear "lazy S-shaped" incision was made, with the distal limb aligned with the palmar aspect of the first dorsal compartment, the oblique transverse midportion aligned with the radioscaphoid joint, and the proximal limb aligned with the second dorsal compartment. Branches of the superficial branch of

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