Vascularized Thumb Metacarpal Periosteal Flap (VTMPF) for Scaphoid Nonunion

Description

This video presentation discusses the surgical treatment of a persistent scaphoid nonunion in a 15-year-old male patient who sustained a fracture six months prior. It details the patient's history, including his initial treatment with immobilization, which failed to alleviate his chronic wrist pain. A pre-operative assessment revealed avascular necrosis and significant bone loss in the scaphoid. The proposed surgical approach incorporates a dual methodology: accessing the scaphoid via a dorsal approach and employing a vascularized periosteal flap from the first metacarpal. The surgical procedure consists of meticulous flap dissection, autologous bone grafting from the distal radius, and the stabilization of the scaphoid with a headless compression screw. Post-operative care emphasizes gradual mobilization and rehabilitation, ultimately leading to recovery with successful bone integration observed in X-ray follow-ups. The video serves as a comprehensive guide for orthopedic surgeons dealing with complex hand injuries, particularly scaphoid fractures with associated complications.

Specialties

Paper Links

https://bit.ly/ASSH_Hande