Use of pedicled bone grafts in the treatment of nonunion of the scaphoid.

The purpose of this article is to present some contemporary views regarding the treatment of scaphoid nonunion using pedicled bone grafts. Based on a review of the literature, the authors discuss surgical technique, including the advantages and disadvantages of various methods and their modifications, as well as outcomes. Among the methods discussed are pronator quadratus pedicled bone grafts, grafts pedicled on arteries (radial artery branches), and free vascularized bone grafts. Experimental studies of the use of free vascularised bone-ligament-bone autografts for the reconstruction of the scapholunate ligament are described. The clinical application of scaphoid allograft is also discussed.