J Reconstr Microsurg 2008; 24(8): 559-564
DOI: 10.1055/s-0028-1090621
© Thieme Medical Publishers

Vascularized Scapular Grafting for Treatment of Osteonecrosis of the Humeral Head

Kenji Kawamura1 , Kenji Kawate1 , Hiroshi Yajima1 , Yasunori Kobata1 , Yoshinori Takakura1
  • 1Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
Weitere Informationen


15. Oktober 2008 (online)


Eight dissections in four embalmed cadavers were performed to investigate the possibility of vascularized scapular grafting for osteonecrosis of the humeral head. When the angular branch was used as the nutrient vessel, the mean length of the vascular pedicle was 12.4 cm, which was sufficient for transferring the scapula into the humeral head. Based on the anatomical study, a 27-year-old man with corticosteroid-induced osteonecrosis of the right humeral head was treated by vascularized scapular grafting. The pedicled vascularized scapula was successfully transferred into the humeral head using the angular branch. The patient's right shoulder pain disappeared following surgical recovery. He had no limitations of right shoulder motion 3 years after the surgery. Magnetic resonance imaging at 1 year after the surgery indicated revascularization of the humeral head. The humeral head did not collapse during a 3-year follow-up with radiographic evaluation. This procedure has the potential to be a new joint-preserving procedure for osteonecrosis of the humeral head.


Kenji KawamuraM.D. 

Department of Orthopaedic Surgery, Nara Medical University

840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan

eMail: kkenji@naramed-u.ac.jp