Results of pronator quadratus pedicle bone graft as primary procedure for treatment of scaphoid nonunion

Pedicle bone graft as primary procedure for treatment of scaphoid nonunion. Pedicle bone graft use in delayed and nonunion of fractures and avascular necrosis scaphoid fracture. The most common indications for Pedicle bone graft have been for scaphoid nonunion, lunatomalacia (Kienböck's disease), and osteonecrosis of the scaphoid (Preiser's disease). Advantages over non vascularized bone graft have been established. Pedicle bone graft provide improved blood flow, osteocyte preservation, and accelerated healing rates. Local pedicle VBGs are the most commonly used methods. They are technically less demanding than are free VBGs and are associated with less morbidity. In managing osteonecrosis, most surgeons would agree that VBG should be reserved for scaphoid nonunion with an intact cartilaginous shell and no collapse. In treating scaphoid pathology, indications for pedicle bone graft include fractures/nonunions with proximal pole avascular necrosis and/or small proximal pole fragments.