When to Use Vascularized Bone? An Algorithm for Scaphoid Nonunion Surgery

Abstract

The surgical treatment of scaphoid nonunions possesses a high risk of surgical failure. There are numerous surgical techniques described, each supported by some evidence of clinical efficacy. To assist hand surgeons in developing a cogent approach to the various clinical scenarios that they may encounter, this manuscript examines the pertinent considerations and available evidence surrounding this topic. These considerations provide guidelines for the creation of an evidence-based surgical algorithm.

Keywords

bone grafting - distal radius - proximal pole - scaphoid nonunion - vascularized bone

Note

All work was completed at The Curtis National Hand Center located in MedStar Union Memorial Hospital in Baltimore, MD.

Ethical Approval

Institutional review board approval was not required for this submission because it is a review.

Publication History

Received: 19 February 2024

Accepted: 16 June 2025

Article published online:
03 July 2025

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