Download PDF
J Hand Microsurg 2022; 14(04): 322-335
DOI: 10.1055/s-0041-1735349
Original Article

Predictors of Failure for Vascularized and Nonvascularized Bone Grafting of Scaphoid Nonunions: A Systematic Review

Schneider K. Rancy
1   Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, United States
,
Scott W. Wolfe
2   Division of Hand and Upper Extremity, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, United States
,
J. Terrence Jose Jerome
3   Department of Orthopedics, Hand & Reconstructive Microsurgery, Olympia Hospital & Research Centre, Trichy, Tamil Nadu, India
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Objective This article compares predictors of failure for vascularized (VBG) and nonvascularized bone grafting (NVBG) of scaphoid nonunions.

Methods We conducted a systematic literature review of outcomes after VBG and NVBG of scaphoid nonunion. Fifty-one VBG studies (N = 1,419 patients) and 81 NVBG studies (N = 3,019 patients) met the inclusion criteria. Data were collected on surgical technique, type of fixation, time from injury to surgery, fracture location, abnormal carpal posture (humpback deformity and/or dorsal intercalated segmental instability [DISI]), radiographic parameters of carpal alignment, prior failed surgery, smoking status, and avascular necrosis (AVN) as defined by punctate bleeding, magnetic resonance imaging (MRI) with contrast, MRI without contrast, X-ray, and histology. Meta-analysis of proportions was conducted with Freeman–Tukey double arcsine transformation. Multilevel mixed-effects analyses were performed with univariable and multivariable Poisson regression to identify confounders and evaluate predictors of failure.

Results The pooled failure incidence effect size was comparable between VBG and NVBG (0.09 [95% confidence interval [CI] 0.05–0.13] and 0.08 [95% CI 0.06–0.11], respectively). Humpback deformity and/or DISI (incidence-rate radios [IRRs] 1.57, CI: 1.04–2.36) and lateral intrascaphoid angle (IRR 1.21, CI: 1.08–1.37) were significantly associated with an increased VBG failure incidence. Time from injury to surgery (IRR 1.09, CI: 1.06–1.12) and height-to-length (H/L) ratio (IRR 53.98, CI: 1.16–2,504.24) were significantly associated with an increased NVBG failure incidence, though H/L ratio demonstrated a wide CI. Decreased proximal fragment contrast uptake on MRI was a statistically significant predictor of increased failure incidence for both VBG (IRR 2.03 CI: 1.13–3.66) and NVBG (IRR 1.39, CI: 1.16–1.66). Punctate bleeding or radiographic AVN, scapholunate angle, radiolunate angle, and prior failed surgery were not associated with failure incidence for either bone graft type (p > 0.05).

Conclusion Humpback deformity and/or DISI and increasing lateral intrascaphoid angle may be predictors of VBG failure. Time from injury to surgery may be a predictor of NVBG failure. AVN as defined by decreased contrast uptake on MRI may be a marker of increased failure risk for both bone graft types.

Keywords

scaphoid nonunion - scaphoid reconstruction - humpback deformity - DISI - avascular necrosis - proximal pole - vascularity - vascularized bone graft - nonvascularized bone graft


Publication History

Article published online:
25 August 2021

© 2021. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Pinder RM, Brkljac M, Rix L, Muir L, Brewster M. Treatment of scaphoid nonunion: a systematic review of the existing evidence. J Hand Surg Am 2015; 40 (09) 1797-1805.e3
    CrossrefPubMedGoogle Scholar
  • 2 Munk B, Larsen CF. Bone grafting the scaphoid nonunion: a systematic review of 147 publications including 5,246 cases of scaphoid nonunion. Acta Orthop Scand 2004; 75 (05) 618-629
    CrossrefPubMedGoogle Scholar
  • 3 Ferguson DO, Shanbhag V, Hedley H, Reichert I, Lipscombe S, Davis TR. Scaphoid fracture non-union: a systematic review of surgical treatment using bone graft. J Hand Surg Eur Vol 2016; 41 (05) 492-500
    CrossrefPubMedGoogle Scholar
  • 4 Rancy SK, Schmidle G, Wolfe SW. Does anyone need a vascularized graft?. Hand Clin 2019; 35 (03) 323-344
    CrossrefPubMedGoogle Scholar
  • 5 Zaidemberg C, Siebert JW, Angrigiani C. A new vascularized bone graft for scaphoid nonunion. J Hand Surg Am 1991; 16 (03) 474-478
    CrossrefPubMedGoogle Scholar
  • 6 Ribak S, Medina CE, Mattar Jr R, Ulson HJ, Ulson HJ, Etchebehere M. Treatment of scaphoid nonunion with vascularised and nonvascularised dorsal bone grafting from the distal radius. Int Orthop 2010; 34 (05) 683-688
    CrossrefPubMedGoogle Scholar
  • 7 Jones Jr DB, Rhee PC, Shin AY. Vascularized bone grafts for scaphoid nonunions. J Hand Surg Am 2012; 37 (05) 1090-1094
    CrossrefPubMedGoogle Scholar
  • 8 Kollitz KM, Pulos N, Bishop AT, Shin AY. Primary medial femoral condyle vascularized bone graft for scaphoid nonunions with carpal collapse and proximal pole avascular necrosis. J Hand Surg Eur Vol 2019; 44 (06) 600-606
    CrossrefPubMedGoogle Scholar
  • 9 Aibinder WR, Wagner ER, Bishop AT, Shin AY. Bone grafting for scaphoid nonunions: is free vascularized bone grafting superior for scaphoid nonunion?. Hand (N Y 2019; 14 (02) 217-222
    CrossrefPubMedGoogle Scholar
  • 10 Pulos N, Kollitz KM, Bishop AT, Shin AY. Free vascularized medial femoral condyle bone graft after failed scaphoid nonunion surgery. J Bone Joint Surg Am 2018; 100 (16) 1379-1386
    CrossrefPubMedGoogle Scholar
  • 11 Jones Jr DB, Bürger H, Bishop AT, Shin AY. Treatment of scaphoid waist nonunions with an avascular proximal pole and carpal collapse. A comparison of two vascularized bone grafts. J Bone Joint Surg Am 2008; 90 (12) 2616-2625
    CrossrefPubMedGoogle Scholar
  • 12 Fernandez DL. A technique for anterior wedge-shaped grafts for scaphoid nonunions with carpal instability. J Hand Surg Am 1984; 9 (05) 733-737
    CrossrefPubMedGoogle Scholar
  • 13 Dinah AF, Vickers RH. Smoking increases failure rate of operation for established non-union of the scaphoid bone. Int Orthop 2007; 31 (04) 503-505
    CrossrefPubMedGoogle Scholar
  • 14 Herbert TJ, Fisher WE. Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg Br 1984; 66 (01) 114-123
    CrossrefPubMedGoogle Scholar
  • 15 Bynum EB, Culp RW, Bonatus TJ, Alexander CE, McCarroll HR. Repeat Russe bone grafting after failed bone graft surgery for scaphoid non-union. J Hand Surg [Br] 1995; 20 (03) 373-378
    CrossrefPubMedGoogle Scholar
  • 16 Muramatsu K, Bishop AT. Cell repopulation in vascularized bone grafts. J Orthop Res 2002; 20 (04) 772-778
    CrossrefPubMedGoogle Scholar
  • 17 Kakinoki R, Bishop AT, Tu YK, Matsui N. Detection of the proliferated donor cells in bone grafts in rats, using a PCR for a Y-chromosome-specific gene. J Orthop Sci 2002; 7 (02) 252-257
    CrossrefPubMedGoogle Scholar
  • 18 Green DP. The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion. J Hand Surg Am 1985; 10 (05) 597-605
    CrossrefPubMedGoogle Scholar
  • 19 Bain GI, Bennett JD, MacDermid JC, Slethaug GP, Richards RS, Roth JH. Measurement of the scaphoid humpback deformity using longitudinal computed tomography: intra- and interobserver variability using various measurement techniques. J Hand Surg Am 1998; 23 (01) 76-81
    CrossrefPubMedGoogle Scholar
  • 20 ten PW Berg, Dobbe JG, Strackee SD, Streekstra GJ. Quantifying scaphoid malalignment based upon height-to-length ratios obtained by 3-dimensional computed tomography. J Hand Surg Am 2015; 40 (01) 67-73
    CrossrefPubMedGoogle Scholar
  • 21 Amadio PC, Berquist TH, Smith DK. Ilstrup DM, Cooney WP III, Linscheid RL. Scaphoid malunion. J Hand Surg Am 1989; 14 (04) 679-687
    CrossrefPubMedGoogle Scholar
  • 22 Linscheid RL, Dobyns JH, Beabout JW, Bryan RS. Traumatic instability of the wrist. Diagnosis, classification, and pathomechanics. J Bone Joint Surg Am 1972; 54 (08) 1612-1632
    CrossrefPubMedGoogle Scholar
  • 23 Kitay A, Wolfe SW. Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am 2012; 37 (10) 2175-2196
    CrossrefPubMedGoogle Scholar
  • 24 Sotereanos DG, Darlis NA, Dailiana ZH, Sarris IK, Malizos KN. A capsular-based vascularized distal radius graft for proximal pole scaphoid pseudarthrosis. J Hand Surg Am 2006; 31 (04) 580-587
    CrossrefPubMedGoogle Scholar
  • 25 Braga-Silva J, Peruchi FM, Moschen GM, Gehlen D, Padoin AV. A comparison of the use of distal radius vascularised bone graft and non-vascularised iliac crest bone graft in the treatment of non-union of scaphoid fractures. J Hand Surg Eur Vol 2008; 33 (05) 636-640
    CrossrefPubMedGoogle Scholar
  • 26 Korompilias AV, Lykissas MG, Kostas-Agnantis IP, Gkiatas I, Beris AE. An alternative graft fixation technique for scaphoid nonunions treated with vascular bone grafting. J Hand Surg Am 2014; 39 (07) 1308-1312
    CrossrefPubMedGoogle Scholar
  • 27 Rahimnia A, Rahimnia AH, Mobasher-Jannat A. Clinical and functional outcomes of vascularized bone graft in the treatment of scaphoid non-union. PLoS One 2018; 13 (05) e0197768
    CrossrefPubMedGoogle Scholar
  • 28 Tsumura T, Matsumoto T, Matsushita M, Doi H, Shiode H, Kakinoki R. Correction of humpback deformities in patients with scaphoid nonunion using 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting with a dorsoradial approach. J Hand Surg Am 2020; 45 (02) 160.e1-160.e8
    CrossrefPubMedGoogle Scholar
  • 29 Caporrino FA, Dos Santos JB, Penteado FT, de Moraes VY, Belloti JC, Faloppa F. Dorsal vascularized grafting for scaphoid nonunion: a comparison of two surgical techniques. J Orthop Trauma 2014; 28 (03) e44-e48
    CrossrefPubMedGoogle Scholar
  • 30 Arora R, Lutz M, Zimmermann R, Krappinger D, Niederwanger C, Gabl M. Free vascularised iliac bone graft for recalcitrant avascular nonunion of the scaphoid. J Bone Joint Surg Br 2010; 92 (02) 224-229
    CrossrefPubMedGoogle Scholar
  • 31 Mathoulin C, Brunelli F. Further experience with the index metacarpal vascularized bone graft. J Hand Surg [Br] 1998; 23 (03) 311-317
    CrossrefPubMedGoogle Scholar
  • 32 Malizos KN, Dailiana ZH, Kirou M, Vragalas V, Xenakis TA, Soucacos PN. Longstanding nonunions of scaphoid fractures with bone loss: successful reconstruction with vascularized bone grafts. J Hand Surg [Br] 2001; 26 (04) 330-334
    CrossrefPubMedGoogle Scholar
  • 33 Malizos KN, Dailiana Z, Varitimidis S, Koutalos A. Management of scaphoid nonunions with vascularized bone grafts from the distal radius: mid- to long-term follow-up. Eur J Orthop Surg Traumatol 2017; 27 (01) 33-39
    CrossrefPubMedGoogle Scholar
  • 34 Kumta S, Warrier S, Jain L, Ummal R, Menezes M, Purohit S. Medial femoral condyle vascularised corticoperiosteal graft: a suitable choice for scaphoid non-union. Indian J Plast Surg 2017; 50 (02) 138-147
    Article in Thieme ConnectPubMedGoogle Scholar
  • 35 Waitayawinyu T, McCallister WV, Katolik LI, Schlenker JD, Trumble TE. Outcome after vascularized bone grafting of scaphoid nonunions with avascular necrosis. J Hand Surg Am 2009; 34 (03) 387-394
    CrossrefPubMedGoogle Scholar
  • 36 Sommerkamp TG, Hastings II H, Greenberg JA. Palmar radiocarpal artery vascularized bone graft for the unstable humpbacked scaphoid nonunion with an avascular proximal pole. J Hand Surg Am 2020; 45 (04) 298-309
    CrossrefPubMedGoogle Scholar
  • 37 Uerpairojkit C, Leechavengvongs S, Witoonchart K. Primary vascularized distal radius bone graft for nonunion of the scaphoid. J Hand Surg [Br] 2000; 25 (03) 266-270
    CrossrefPubMedGoogle Scholar
  • 38 Kawai H, Yamamoto K. Pronator quadratus pedicled bone graft for old scaphoid fractures. J Bone Joint Surg Br 1988; 70 (05) 829-831
    CrossrefPubMedGoogle Scholar
  • 39 Morris MS, Zhu AF, Ozer K, Lawton JN. Proximal pole scaphoid nonunion reconstruction with 1,2 intercompartmental supraretinacular artery vascularized graft and compression screw fixation. J Hand Surg Am 2018; 43 (08) 770.e1-770.e8
    CrossrefPubMedGoogle Scholar
  • 40 Werdin F, Jaminet P, Naegele B, Pfau M, Schaller HE. Reconstruction of scaphoid nonunion fractures of the proximal one third with a vascularized bone graft from the distal radius. Eplasty 2014; 14: e24
    PubMedGoogle Scholar
  • 41 Lee SK, Park JS, Choy WS. Scaphoid fracture nonunion treated with pronator quadratus pedicled vascularized bone graft and headless compression screw. Ann Plast Surg 2015; 74 (06) 665-671
    CrossrefPubMedGoogle Scholar
  • 42 Tambe AD, Cutler L, Stilwell J, Murali SR, Trail IA, Stanley JK. Scaphoid non-union: the role of vascularized grafting in recalcitrant non-unions of the scaphoid. J Hand Surg [Br] 2006; 31 (02) 185-190
    CrossrefPubMedGoogle Scholar
  • 43 Straw RG, Davis TRC, Dias JJ. Scaphoid nonunion: treatment with a pedicled vascularized bone graft based on the 1,2 intercompartmental supraretinacular branch of the radial artery. J Hand Surg [Br] 2002; 27 (05) 413
    CrossrefPubMedGoogle Scholar
  • 44 Malizos KN, Zachos V, Dailiana ZH. et al. Scaphoid nonunions: management with vascularized bone grafts from the distal radius: a clinical and functional outcome study. Plast Reconstr Surg 2007; 119 (05) 1513-1525
    CrossrefPubMedGoogle Scholar
  • 45 Chen AC, Chao EK, Tu YK, Ueng SW. Scaphoid nonunion treated with vascular bone grafts pedicled on the dorsal supra-retinacular artery of the distal radius. J Trauma 2006; 61 (05) 1192-1197
    CrossrefPubMedGoogle Scholar
  • 46 Özalp T, Öz Ç, Kale G, Erkan S. Scaphoid nonunion treated with vascularised bone graft from dorsal radius. Injury 2015; 46 (Suppl. 02) S47-S52
    CrossrefPubMedGoogle Scholar
  • 47 Boyer MI, von Schroeder HP, Axelrod TS. Scaphoid nonunion with avascular necrosis of the proximal pole. Treatment with a vascularized bone graft from the dorsum of the distal radius. J Hand Surg [Br] 1998; 23 (05) 686-690
    CrossrefPubMedGoogle Scholar
  • 48 Chaudhry T, Uppal L, Power D, Craigen M, Tan S. Scaphoid nonunion with poor prognostic factors: the role of the free medial femoral condyle vascularized bone graft. Hand (N Y 2017; 12 (02) 135-139
    CrossrefPubMedGoogle Scholar
  • 49 Koutalos AA, Papatheodorou L, Kontogeorgakos V, Varitimidis SE, Malizos KN, Dailiana ZH. Scaphoid nonunions in adolescents: treatment with vascularized bone grafts. Injury 2019; 50 (Suppl. 05) S50-S53
    CrossrefPubMedGoogle Scholar
  • 50 Dodds SD, Halim A. Scaphoid plate fixation and volar carpal artery vascularized bone graft for recalcitrant scaphoid nonunions. J Hand Surg Am 2016; 41 (07) e191-e198
    CrossrefPubMedGoogle Scholar
  • 51 Waters PM, Stewart SL. Surgical treatment of nonunion and avascular necrosis of the proximal part of the scaphoid in adolescents. J Bone Joint Surg Am 2002; 84 (06) 915-920
    CrossrefPubMedGoogle Scholar
  • 52 Özkan Y, Akalin Y, Çevik N, Cansabuncu G, Öztürk A. The efficacy of 1,2- intercompartmental supraretinacular artery pedicled vascularised bone graft for scaphoid proximal end non-union and avascular necrosis. Acta Orthop Belg 2017; 83 (04) 589-598
    PubMedGoogle Scholar
  • 53 Surendran S, Karuppal R, Valoor HT. The management of proximal pole scaphoid nonunion with avascular necrosis using 1, 2 intercompartmental supraretinacular arterial bone graft and radial styloidectomy: a midterm outcome study. Int J Orthop Sci 2018; 4 (04) 138-143
    CrossrefPubMedGoogle Scholar
  • 54 Rashed RE. The use of pedicled vascularized bone graft from the dorsum of distal radius for the treatment of scaphoid nonunion. Egypt Orthop J 2015; 50 (03) 187-194
    CrossrefPubMedGoogle Scholar
  • 55 Papatheodorou LK, Sotereanos DG. Treatment for proximal pole scaphoid nonunion with capsular-based vascularized distal radius graft. Eur J Orthop Surg Traumatol 2019; 29 (02) 337-342
    CrossrefPubMedGoogle Scholar
  • 56 Lim TK, Kim HK, Koh KH, Lee HI, Woo SJ, Park MJ. Treatment of avascular proximal pole scaphoid nonunions with vascularized distal radius bone grafting. J Hand Surg Am 2013; 38 (10) 1906-12.e1
    CrossrefPubMedGoogle Scholar
  • 57 Ong HS, Tan G, Chew WYC. Treatment of scaphoid non-union with 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) vascularised graft. Singapore Med J 2011; 52 (09) 658-661
    PubMedGoogle Scholar
  • 58 Bertelli JA, Peruchi FM, Rost JR, Tacca CP. Treatment of scaphoid non-unions by a palmar approach with vascularised bone graft harvested from the thumb. J Hand Surg Eur Vol 2007; 32 (02) 217-223
    CrossrefPubMedGoogle Scholar
  • 59 Jaminet P, Götz M, Gonser P, Schaller HE, Lotter O. Treatment of scaphoid nonunion: radiologic outcome of 286 patients in 10 years. Eplasty 2019; 19 (01) e5
    PubMedGoogle Scholar
  • 60 Cavit A, Civan O, Capkin S, Kaleli T, Ozcanli H, Ozdemir H. Treatment of scaphoid nonunion with 1,2 intercompartmental supraretinacular artery vascularized graft and compression screw fixation. Injury 2020; •••: S0020-S1383
    PubMedGoogle Scholar
  • 61 Yuceturk A, Isiklar ZU, Tuncay C, Tandogan R. Treatment of scaphoid nonunions with a vascularized bone graft based on the first dorsal metacarpal artery. J Hand Surg [Br] 1997; 22 (03) 425-427
    CrossrefPubMedGoogle Scholar
  • 62 Kapoor AK, Thompson NW, Rafiq I, Hayton MJ, Stillwell J, Trail IA. Vascularised bone grafting in the management of scaphoid non-union - a review of 34 cases. J Hand Surg Eur Vol 2008; 33 (05) 628-631
    CrossrefPubMedGoogle Scholar
  • 63 Kirkeby L, Baek Hansen T. Vascularised bone graft for the treatment of non-union of the scaphoid. Scand J Plast Reconstr Surg Hand Surg 2006; 40 (04) 240-243
    CrossrefPubMedGoogle Scholar
  • 64 Sawaizumi T, Nanno M, Nanbu A, Ito H. Vascularised bone graft from the base of the second metacarpal for refractory nonunion of the scaphoid. J Bone Joint Surg Br 2004; 86 (07) 1007-1012
    CrossrefPubMedGoogle Scholar
  • 65 Gabl M, Reinhart C, Lutz M. et al. Vascularized bone graft from the iliac crest for the treatment of nonunion of the proximal part of the scaphoid with an avascular fragment. J Bone Joint Surg Am 1999; 81 (10) 1414-1428
    CrossrefPubMedGoogle Scholar
  • 66 Mathoulin C, Haerle M. Vascularized bone graft from the palmar carpal artery for treatment of scaphoid nonunion. J Hand Surg [Br] 1998; 23 (03) 318-323
    CrossrefPubMedGoogle Scholar
  • 67 Gras M, Mathoulin C. Vascularized bone graft pedicled on the volar carpal artery from the volar distal radius as primary procedure for scaphoid non-union. Orthop Traumatol Surg Res 2011; 97 (08) 800-806
    CrossrefPubMedGoogle Scholar
  • 68 Dailiana ZH, Malizos KN, Zachos V, Varitimidis SE, Hantes M, Karantanas A. Vascularized bone grafts from the palmar radius for the treatment of waist nonunions of the scaphoid. J Hand Surg Am 2006; 31 (03) 397-404
    CrossrefPubMedGoogle Scholar
  • 69 Korompilias AV, Gkiatas IS, Lykissas MG, Beris AE, Kostas-Agnantis IP. Vascularized pedicled graft from distal radius for scaphoid nonunion with double stabilization: a long term follow up study. Injury 2019; 50 (Suppl. 05) S59-S63
    CrossrefPubMedGoogle Scholar
  • 70 Park HY, Yoon JO, Jeon IH, Chung HW, Kim JS. A comparison of the rates of union after cancellous iliac crest bone graft and Kirschner-wire fixation in the treatment of stable and unstable scaphoid nonunion. Bone Joint J 2013; 95-B (06) 809-814
    CrossrefPubMedGoogle Scholar
  • 71 Sakuma M, Nakamura R, Imaeda T. Analysis of proximal fragment sclerosis and surgical outcome of scaphoid non-union by magnetic resonance imaging. J Hand Surg [Br] 1995; 20 (02) 201-205
    CrossrefPubMedGoogle Scholar
  • 72 Fernandez DL. Anterior bone grafting and conventional lag screw fixation to treat scaphoid nonunions. J Hand Surg Am 1990; 15 (01) 140-147
    CrossrefPubMedGoogle Scholar
  • 73 Cognet JM, Louis P, Martinache X, Schernberg F. Arthroscopic grafting of scaphoid nonunion - surgical technique and preliminary findings from 23 cases. Hand Surg Rehabil 2017; 36 (01) 17-23
    CrossrefPubMedGoogle Scholar
  • 74 Gvozdenovic R, Joergensen RW, Joerring S, Jensen CH. Arthroscopically assisted bone grafting reduces union time of scaphoid nonunions compared to percutaneous screw fixation alone. J Wrist Surg 2020; 9 (01) 13-18
    Article in Thieme ConnectPubMedGoogle Scholar
  • 75 Choi ES, Cha SM, Shin HD. Autogenous bone graft with Kirschner wire fixation could be a reliable treatment option for scaphoid nonunion in adolescents. J Pediatr Orthop 2020; 40 (08) e708-e711
    CrossrefPubMedGoogle Scholar
  • 76 Trumble TE. Avascular necrosis after scaphoid fracture: a correlation of magnetic resonance imaging and histology. J Hand Surg Am 1990; 15 (04) 557-564
    CrossrefPubMedGoogle Scholar
  • 77 Kirkham SG, Millar MJ. Cancellous bone graft and Kirschner wire fixation as a treatment for cavitary-type scaphoid nonunions exhibiting DISI. Hand (N Y 2012; 7 (01) 86-93
    CrossrefPubMedGoogle Scholar
  • 78 Ek ET, Johnson PR, Bohan CM, Padmasekara G. Clinical outcomes of double-screw fixation with autologous bone grafting for unstable scaphoid delayed or nonunions with cavitary bone loss. J Wrist Surg 2021; 10 (01) 9-16
    Article in Thieme ConnectPubMedGoogle Scholar
  • 79 Jeon I-H, Kochhar H, Micic ID, Oh S-H, Kim S-Y, Kim PT. Clinical result of operative treatment for scaphoid non-union in the skeletally immature: percutaneous versus open procedure. Hand Surg 2008; 13 (01) 11-16
    CrossrefPubMedGoogle Scholar
  • 80 Gereli A, Nalbantoglu U, Sener IU, Kocaoglu B, Turkmen M. Comparison of headless screws used in the treatment of proximal nonunion of scaphoid bone. Int Orthop 2011; 35 (07) 1031-1035
    CrossrefPubMedGoogle Scholar
  • 81 Kim JK, Yoon JO, Baek H. Corticocancellous bone graft vs cancellous bone graft for the management of unstable scaphoid nonunion. Orthop Traumatol Surg Res 2018; 104 (01) 115-120
    CrossrefPubMedGoogle Scholar
  • 82 Sukul DM, Johannes EJ, Marti RK. Corticocancellous grafting and an AO/ASIF lag screw for nonunion of the scaphoid. A retrospective analysis. J Bone Joint Surg Br 1990; 72 (05) 835-838
    CrossrefPubMedGoogle Scholar
  • 83 Daly K, Gill P, Magnussen PA, Simonis RB. Established nonunion of the scaphoid treated by volar wedge grafting and Herbert screw fixation. J Bone Joint Surg Br 1996; 78 (04) 530-534
    CrossrefPubMedGoogle Scholar
  • 84 Reigstad O, Thorkildsen R, Grimsgaard C, Reigstad A, Rokkum M. Excellent results after bone grafting and K-wire fixation for scaphoid nonunion surgery in skeletally immature patients: a midterm follow-up study of 11 adolescents after 6.9 years. J Orthop Trauma 2013; 27 (05) 285-289
    CrossrefPubMedGoogle Scholar
  • 85 Barton NJ. Experience with scaphoid grafting. J Hand Surg [Br] 1997; 22 (02) 153-160
    CrossrefPubMedGoogle Scholar
  • 86 McInnes CW, Giuffre JL. Fixation and grafting after limited debridement of scaphoid nonunions. J Hand Surg Am 2015; 40 (09) 1791-1796
    CrossrefPubMedGoogle Scholar
  • 87 Luchetti TJ, Rao AJ, Fernandez JJ, Cohen MS, Wysocki RW. Fixation of proximal pole scaphoid nonunion with non-vascularized cancellous autograft. J Hand Surg Eur Vol 2018; 43 (01) 66-72
    CrossrefPubMedGoogle Scholar
  • 88 Megerle K, Worg H, Christopoulos G, Schmitt R, Krimmer H. Gadolinium-enhanced preoperative MRI scans as a prognostic parameter in scaphoid nonunion. J Hand Surg Eur Vol 2011; 36 (01) 23-28
    CrossrefPubMedGoogle Scholar
  • 89 Hong J, Choi Y-R, Koh I-H, Oh W-T, Shin J, Kang H-J. Headless screw fixation through the dorsal rough surface for proximal-pole scaphoid-nonunion: a report of 15 patients. J Hand Surg Eur Vol 2020; 45 (09) 965-973
    CrossrefPubMedGoogle Scholar
  • 90 Reigstad O, Thorkildsen R, Grimsgaard C, Reigstad A, Røkkum M. Healing of ununited scaphoid fractures by Kirschner wires and autologous structural bone grafts. Scand J Plast Reconstr Surg Hand Surg 2010; 44 (02) 106-111
    CrossrefPubMedGoogle Scholar
  • 91 Filan SL, Herbert TJ. Herbert screw fixation of scaphoid fractures. J Bone Joint Surg Br 1996; 78 (04) 519-529
    CrossrefPubMedGoogle Scholar
  • 92 Lee SK, Byun DJ, Roman-Deynes JL, Model Z, Wolfe SW. Hybrid Russe procedure for scaphoid waist fracture nonunion with deformity. J Hand Surg Am 2015; 40 (11) 2198-2205
    CrossrefPubMedGoogle Scholar
  • 93 Robbins RR, Ridge O, Carter PR. Iliac crest bone grafting and Herbert screw fixation of nonunions of the scaphoid with avascular proximal poles. J Hand Surg Am 1995; 20 (05) 818-831
    CrossrefPubMedGoogle Scholar
  • 94 Tambe AD, Cutler L, Murali SR, Trail IA, Stanley JK. In scaphoid non-union, does the source of graft affect outcome? Iliac crest versus distal end of radius bone graft. J Hand Surg [Br] 2006; 31 (01) 47-51
    CrossrefPubMedGoogle Scholar
  • 95 Kang HJ, Chun Y-M, Koh IH, Park JH, Choi YR. Is arthroscopic bone graft and fixation for scaphoid nonunions effective?. Clin Orthop Relat Res 2016; 474 (01) 204-212
    CrossrefPubMedGoogle Scholar
  • 96 Reigstad O, Thorkildsen R, Grimsgaard C, Reigstad A, Røkkum M. Is revision bone grafting worthwhile after failed surgery for scaphoid nonunion? Minimum 8 year follow-up of 18 patients. J Hand Surg Eur Vol 2009; 34 (06) 772-777
    CrossrefPubMedGoogle Scholar
  • 97 Hegazy G, Alshal E, Abdelaal M. et al. Kirschner wire versus Herbert screw fixation for the treatment of unstable scaphoid waist fracture nonunion using corticocancellous iliac bone graft: randomized clinical trial. Int Orthop 2020; 44 (11) 2385-2393
    CrossrefPubMedGoogle Scholar
  • 98 Goyal T, Sankineani SR, Tripathy SK. Local distal radius bone graft versus iliac crest bone graft for scaphoid nonunion: a comparative study. Musculoskelet Surg 2013; 97 (02) 109-114
    CrossrefPubMedGoogle Scholar
  • 99 Huang Y-C, Liu Y, Chen T-H. Long-term results of scaphoid nonunion treated by intercalated bone grafting and Herbert's screw fixation–a study of 49 patients for at least five years. Int Orthop 2009; 33 (05) 1295-1300
    CrossrefPubMedGoogle Scholar
  • 100 Meisel E, Seal A, Yao CA, Ghiassi A, Stevanovic M. Management of scaphoid nonunion with iliac crest bone graft and K-wire fixation. Eur J Orthop Surg Traumatol 2017; 27 (01) 23-31
    CrossrefPubMedGoogle Scholar
  • 101 Yassaee F, Yang SS. Mini-incision fixation of nondisplaced scaphoid fracture nonunions. J Hand Surg Am 2008; 33 (07) 1116-1120
    CrossrefPubMedGoogle Scholar
  • 102 Farsetti P, Caterini R, Potenza V, Dragoni M, Ippolito E. Modified Murray technique for carpal navicular nonunion. Orthopedics 2015; 38 (09) e766-e772
    CrossrefPubMedGoogle Scholar
  • 103 Finsen V, Hofstad M, Haugan H. Most scaphoid non-unions heal with bone chip grafting and Kirschner-wire fixation. Thirty-nine patients reviewed 10 years after operation. Injury 2006; 37 (09) 854-859
    CrossrefPubMedGoogle Scholar
  • 104 Zhou PY, Jiang LQ, Xia DM, Wu JH, Ye Y, Xu SG. Nickel-titanium arched shape-memory alloy connector combined with bone grafting in the treatment of scaphoid nonunion. Eur J Med Res 2019; 24 (01) 27
    CrossrefPubMedGoogle Scholar
  • 105 Han SH, Lee HJ, Hong IT, Kim U, Lee SJ. Non-structural cancellous bone graft and headless compression screw fixation for treatment of scaphoid waist non-union. Orthop Traumatol Surg Res 2017; 103 (01) 89-93
    CrossrefPubMedGoogle Scholar
  • 106 Trumble TE, Clarke T, Kreder HJ. Non-union of the scaphoid. Treatment with cannulated screws compared with treatment with Herbert screws. J Bone Joint Surg Am 1996; 78 (12) 1829-1837
    CrossrefPubMedGoogle Scholar
  • 107 Matsuki H, Ishikawa J, Iwasaki N, Uchiyama S, Minami A, Kato H. Non-vascularized bone graft with Herbert-type screw fixation for proximal pole scaphoid nonunion. J Orthop Sci 2011; 16 (06) 749-755
    CrossrefPubMedGoogle Scholar
  • 108 Kim J, Park JW, Chung J. Jeong Bae K, Gong HS, Baek GH. Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis. J Hand Surg Eur Vol 2018; 43 (01) 24-31
    CrossrefPubMedGoogle Scholar
  • 109 Chen C-Y, Chao E-K, Lee S-S, Ueng SW-N. Osteosynthesis of carpal scaphoid nonunion with interpositional bone graft and Kirschner wires: a 3- to 6-year follow-up. J Trauma 1999; 47 (03) 558-563
    CrossrefPubMedGoogle Scholar
  • 110 Putnam JG, Mitchell SM, DiGiovanni RM, Stockwell EL, Edwards SG. Outcomes of unstable scaphoid nonunion with segmental defect treated with plate fixation and autogenous cancellous graft. J Hand Surg Am 2019; 44 (02) 160.e1-160.e7
    CrossrefPubMedGoogle Scholar
  • 111 Putnam JG, DiGiovanni RM, Mitchell SM, Castañeda P, Edwards SG. Plate fixation with cancellous graft for scaphoid nonunion with avascular necrosis. J Hand Surg Am 2019; 44 (04) 339.e1-339.e7
    CrossrefPubMedGoogle Scholar
  • 112 Inoue G, Kuwahata Y. Repeat screw stabilization with bone grafting after a failed Herbert screw fixation for acute scaphoid fractures and nonunions. J Hand Surg Am 1997; 22 (03) 413-418
    CrossrefPubMedGoogle Scholar
  • 113 Morgan WJ, Breen TF, Coumas JM, Schulz LA. Role of magnetic resonance imaging in assessing factors affecting healing in scaphoid nonunions. Clin Orthop Relat Res 1997; (336) 240-246
    CrossrefPubMedGoogle Scholar
  • 114 Carpentier E, Sartorius C, Roth H. Scaphoid nonunion: treatment by open reduction, bone graft, and staple fixation. J Hand Surg Am 1995; 20 (02) 235-240
    CrossrefPubMedGoogle Scholar
  • 115 Nakamura R, Horii E, Watanabe K, Tsunoda K, Miura T. Scaphoid non-union: factors affecting the functional outcome of open reduction and wedge grafting with Herbert screw fixation. J Hand Surg [Br] 1993; 18 (02) 219-224
    CrossrefPubMedGoogle Scholar
  • 116 Mani KC, Acharya P. Scaphoid nonunion: does open reduction, bone grafting and Herbert screw fixation justify the treatment?. Int Orthop 2018; 42 (05) 1099-1106
    CrossrefPubMedGoogle Scholar
  • 117 Zarezadeh A, Moezi M, Rastegar S, Motififard M, Foladi A, Daneshpajouhnejad P. Scaphoid nonunion fracture and results of the modified Matti-Russe technique. Adv Biomed Res 2015; 4 (01) 39
    CrossrefPubMedGoogle Scholar
  • 118 Takami H, Takahashi S, Ando M. Scaphoid nonunion treated by open reduction, anterior inlay bone grafting, and Kirschner-wire fixation. Arch Orthop Trauma Surg 2000; 120 (3-4) 134-138
    CrossrefPubMedGoogle Scholar
  • 119 Beris AE, Soucacos PN, Xenakis T. et al. Scaphoid nonunion treated with bone graft and Herbert screw. 23 of 28 fractures healed. Acta Orthop Scand Suppl 1997; 275 (275) 60-64
    CrossrefPubMedGoogle Scholar
  • 120 Rancy SK, Swanstrom MM, DiCarlo EF, Sneag DB, Lee SK, Wolfe SW. Scaphoid Nonunion Consortium. Success of scaphoid nonunion surgery is independent of proximal pole vascularity. J Hand Surg Eur Vol 2018; 43 (01) 32-40
    CrossrefPubMedGoogle Scholar
  • 121 Zakzouk S. Scaphoid nonunions treated with corticocancellous graft and Herbert screw fixation: results at the 10-year follow-up. Egypt Orthop J 2014; 49 (04) 292-298
    CrossrefPubMedGoogle Scholar
  • 122 Talia AJ, Fraval A, Halliday L, McKie G, Paiva J, Thai DM. Scaphoid specific volar locking plate and non-vascularised iliac crest bone graft in scaphoid non-union. A comparative cohort study. J Orthop 2019; 16 (04) 337-341
    CrossrefPubMedGoogle Scholar
  • 123 Cohen MS, Jupiter JB, Fallahi K, Shukla SK. Scaphoid waist nonunion with humpback deformity treated without structural bone graft. J Hand Surg Am 2013; 38 (04) 701-705
    CrossrefPubMedGoogle Scholar
  • 124 Kamrani RS, Zanjani LO, Nabian MH. Suture anchor fixation for scaphoid nonunions with small proximal fragments: report of 11 cases. J Hand Surg Am 2014; 39 (08) 1494-1499
    CrossrefPubMedGoogle Scholar
  • 125 Lee Y-K, Choi K-W, Woo S-H, Ho PC, Lee M. The clinical result of arthroscopic bone grafting and percutaneous K-wires fixation for management of scaphoid nonunions. Medicine (Baltimore 2018; 97 (13) e9987
    CrossrefPubMedGoogle Scholar
  • 126 Euler S, Erhart S, Deml C, Kastenberger T, Gabl M, Arora R. The effect of delayed treatment on clinical and radiological effects of anterior wedge grafting for non-union of scaphoid fractures. Arch Orthop Trauma Surg 2014; 134 (07) 1023-1030
    CrossrefPubMedGoogle Scholar
  • 127 Ramamurthy C, Cutler L, Nuttall D, Simison AJM, Trail IA, Stanley JK. The factors affecting outcome after non-vascular bone grafting and internal fixation for nonunion of the scaphoid. J Bone Joint Surg Br 2007; 89 (05) 627-632
    CrossrefPubMedGoogle Scholar
  • 128 Bokhari S, Hadi S, Hossain F, Ketzer B. The outcome of using a Jamshidi biopsy trocar needle in a novel technique for bone grafting in percutaneous internal fixation of scaphoid non-union. Open Access Maced J Med Sci 2018; 6 (03) 506-510
    CrossrefPubMedGoogle Scholar
  • 129 Ritter K, Giachino AA. The treatment of pseudoarthrosis of the scaphoid by bone grafting and three methods of internal fixation. Can J Surg 2000; 43 (02) 118-124
    PubMedGoogle Scholar
  • 130 Ghoneim A. The unstable nonunited scaphoid waist fracture: results of treatment by open reduction, anterior wedge grafting, and internal fixation by volar buttress plate. J Hand Surg Am 2011; 36 (01) 17-24
    CrossrefPubMedGoogle Scholar
  • 131 Inaparthy PK, Nicholl JE. Treatment of delayed/nonunion of scaphoid waist with Synthes cannulated scaphoid screw and bone graft. Hand (N Y 2008; 3 (04) 292-296
    CrossrefPubMedGoogle Scholar
  • 132 del Piñal F. Treatment of nonunion of the scaphoid by a limited combined approach. J Bone Joint Surg Br 2001; 83 (01) 78-82
    CrossrefPubMedGoogle Scholar
  • 133 Megerle K, Keutgen X, Müller M, Germann G, Sauerbier M. Treatment of scaphoid non-unions of the proximal third with conventional bone grafting and mini-Herbert screws: an analysis of clinical and radiological results. J Hand Surg Eur Vol 2008; 33 (02) 179-185
    CrossrefPubMedGoogle Scholar
  • 134 Schreuder M, Degreef I, De Smet L. Treatment of scaphoid non-unions with a corticocancellous graft and Herbert screw fixation: results at five years follow-up. Acta Orthop Belg 2008; 74 (01) 24-28
    PubMedGoogle Scholar
  • 135 Richards RR, Regan WD. Treatment of scaphoid nonunion by radical curettage, trapezoidal iliac crest bone graft, and internal fixation with a Herbert screw. Clin Orthop Relat Res 1991; (262) 148-158
    PubMedGoogle Scholar
  • 136 Burgos FH, Nakamoto JC, Nakamoto HA, Iwase FDC, Mattar R. Treatment of scaphoid nonunion with volar locked plate. Acta Ortop Bras 2019; 27 (03) 141-145
    CrossrefPubMedGoogle Scholar
  • 137 Neder Jr AT, Franceschini ET, Pardini Jr AG, Riberto M, Mazzer N. Treatment of scaphoid nonunion with olecranon bone graft and compression screw. Acta Ortop Bras 2016; 24 (03) 159-163
    CrossrefPubMedGoogle Scholar
  • 138 Poggetti A, Rosati M, Castellini I. et al. Treatment of scaphoid waist nonunion using Olecranon bone graft and Stryker Asnis micro cannulated screw: a retrospective study-80 case studies and 6 years of follow-up. J Wrist Surg 2015; 4 (03) 194-199
    Article in Thieme ConnectPubMedGoogle Scholar
  • 139 Inoue G, Miura T. Treatment of ununited fractures of the carpal scaphoid by iliac bone grafts and Herbert screw fixation. Int Orthop 1991; 15 (04) 279-282
    CrossrefPubMedGoogle Scholar
  • 140 Stark HH, Rickard TA, Zemel NP, Ashworth CR. Treatment of ununited fractures of the scaphoid by iliac bone grafts and Kirschner-wire fixation. J Bone Joint Surg Am 1988; 70 (07) 982-991
    CrossrefPubMedGoogle Scholar
  • 141 Eggli S, Fernandez DL, Beck T. Unstable scaphoid fracture nonunion: a medium-term study of anterior wedge grafting procedures. J Hand Surg [Br] 2002; 27 (01) 36-41
    CrossrefPubMedGoogle Scholar
  • 142 Inoue G, Shionoya K, Kuwahata Y. Ununited proximal pole scaphoid fractures. Treatment with a Herbert screw in 16 cases followed for 0.5-8 years. Acta Orthop Scand 1997; 68 (02) 124-127
    CrossrefPubMedGoogle Scholar
  • 143 Eng K, Gill S, Hoy S. Shridar V, Van Zyl N, Page R. Volar scaphoid plating for nonunion: a multicenter case series study. J Wrist Surg 2020; 9 (03) 225-229
    Article in Thieme ConnectPubMedGoogle Scholar
  • 144 Liu B, Wu F, Ng CY. Wrist arthroscopy for the treatment of scaphoid delayed or nonunions and judging the need for bone grafting. J Hand Surg Eur Vol 2019; 44 (06) 594-599
    CrossrefPubMedGoogle Scholar
  • 145 Merrell GA, Wolfe SW, Slade JF II. Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg Am 2002; 27 (04) 685-691
    CrossrefPubMedGoogle Scholar
  • 146 Simmons DJ, Daum WJ, Totty W, Murphy WA. Correlation of MRI images with histology in avascular necrosis in the hip. A preliminary study. J Arthroplasty 1989; 4 (01) 7-14
    CrossrefPubMedGoogle Scholar
  • 147 Brody AS, Strong M, Babikian G, Sweet DE, Seidel FG, Kuhn JP. John Caffey Award paper. Avascular necrosis: early MR imaging and histologic findings in a canine model. AJR Am J Roentgenol 1991; 157 (02) 341-345
    CrossrefPubMedGoogle Scholar
  • 148 Bowlus RA, Armbrust LJ, Biller DS, Hoskinson JJ, Kuroki K, Mosier DA. Magnetic resonance imaging of the femoral head of normal dogs and dogs with avascular necrosis. Vet Radiol Ultrasound 2008; 49 (01) 7-12
    CrossrefPubMedGoogle Scholar
  • 149 Obara Y, Nakamura T, Shinmoto H. et al. Time course of osteonecrosis in rabbit articular intercalated bone: line scan spectroscopic imaging and correlation with histology. Magn Reson Med Sci 2015; 14 (01) 57-64
    CrossrefPubMedGoogle Scholar
  • 150 Urban MA, Green DP, Aufdemorte TB. The patchy configuration of scaphoid avascular necrosis. J Hand Surg Am 1993; 18 (04) 669-674
    CrossrefPubMedGoogle Scholar
  • 151 Nadel SN, Debatin JF, Richardson WJ. et al. Detection of acute avascular necrosis of the femoral head in dogs: dynamic contrast-enhanced MR imaging vs spin-echo and STIR sequences. AJR Am J Roentgenol 1992; 159 (06) 1255-1261
    CrossrefPubMedGoogle Scholar
  • 152 Vande Berg B, Malghem J, Labaisse MA, Noel H, Maldague B. Avascular necrosis of the hip: comparison of contrast-enhanced and nonenhanced MR imaging with histologic correlation. Work in progress. Radiology 1992; 182 (02) 445-450
    CrossrefPubMedGoogle Scholar
  • 153 Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg Am 1980; 5 (05) 508-513
    CrossrefPubMedGoogle Scholar
  • 154 Morsy M, Sabbagh MD, van NA Alphen, Laungani AT, Kadar A, Moran SL. The vascular anatomy of the scaphoid: new discoveries using micro-computed tomography imaging. J Hand Surg Am 2019; 44 (11) 928-938
    CrossrefPubMedGoogle Scholar
  • 155 Kulkarni RW, Wollstein R, Tayar R, Citron N. Patterns of healing of scaphoid fractures. The importance of vascularity. J Bone Joint Surg Br 1999; 81 (01) 85-90
    CrossrefPubMedGoogle Scholar
  • 156 Schmidle G, Ebner HL, Klima G. et al. Time-dependent changes in bone healing capacity of scaphoid fractures and non-unions. J Anat 2018; 232 (06) 908-918
    CrossrefPubMedGoogle Scholar
  • 157 Watson H, Ottoni L, Pitts EC, Handal AG. Rotary subluxation of the scaphoid: a spectrum of instability. J Hand Surg [Br] 1993; 18 (01) 62-64
    CrossrefPubMedGoogle Scholar
  • 158 de Roo MGA, Dobbe JGG, van der Horst CMAM, Streekstra GJ, Strackee SD. Carpal kinematic changes after scaphoid nonunion: an in vivo study with four-dimensional CT imaging. J Hand Surg Eur Vol 2019; 44 (10) 1056-1064
    CrossrefPubMedGoogle Scholar
  • 159 Rainbow MJ, Wolff AL, Crisco JJ, Wolfe SW. Functional kinematics of the wrist. J Hand Surg Eur Vol 2016; 41 (01) 7-21
    CrossrefPubMedGoogle Scholar
  • 160 Fisk GR. Carpal instability and the fractured scaphoid. Ann R Coll Surg Engl 1970; 46 (02) 63-76
    PubMedGoogle Scholar
  • 161 Smith DK, Cooney III WP, An KN, Linscheid RL, Chao EY. The effects of simulated unstable scaphoid fractures on carpal motion. J Hand Surg Am 1989; 14 (2 Pt 1) 283-291
    CrossrefPubMedGoogle Scholar
  • 162 Kim JH, Lee KH, Lee BG, Lee CH, Kim SJ, Choi WS. Dorsal intercalated segmental instability associated with malunion of a reconstructed scaphoid. J Hand Surg Eur Vol 2017; 42 (03) 240-245
    CrossrefPubMedGoogle Scholar
  • 163 Smith DK, Gilula LA, Amadio PC. Dorsal lunate tilt (DISI configuration): sign of scaphoid fracture displacement. Radiology 1990; 176 (02) 497-499
    CrossrefPubMedGoogle Scholar
  • 164 Nagatani Y, Imamura K, Hirano E. Natural history of chronic scaphoid fractures. In: Nakamura R, Linscheid RL, Miura T. eds. Wrist Disorders: Current Concepts and Challenges. 1st ed.. Tokyo: Springer-Verlag; 1992: 171-175
    Google Scholar
  • 165 Nakamura R, Imaeda T, Tsuge S, Watanabe K. Scaphoid non-union with D.I.S.I. deformity. A survey of clinical cases with special reference to ligamentous injury. J Hand Surg [Br] 1991; 16 (02) 156-161
    CrossrefPubMedGoogle Scholar
  • 166 Braun NS, Berger RA, Wolfe SW. Defining DISI and VISI. J Hand Surg Eur Vol 2021; 46 (05) 566-568
    CrossrefPubMedGoogle Scholar