Mike Hayton along with other senior surgeons from Wrightington Hospital have recently reported revascularisation techniques in scaphoid non unions. Here is the abstract as it appears in Pub Med
J Hand Surg Eur Vol. 2008 Oct;33(5):628-31.
Vascularised bone grafting in the management of scaphoid non-union - a review of 34 cases.
Kapoor AK, Thompson NW, Rafiq I, Hayton MJ, Stillwell J, Trail IA.
Centre for Hand and Upper Limb Surgery, Wrightington Hospital, Wigan, UK. email@example.com
We reviewed the outcomes of 34 patients who had undergone vascularised bone grafting for a chronic scaphoid non-union. Mean age was 27 years (range 16-46 years). The dominant hand was involved in 17 cases. Eleven patients were smokers. In 18 cases the fracture involved the proximal and in 16 cases the middle third of the scaphoid. In 26 patients the proximal scaphoid fragment was deemed avascular. Sixteen patients had previously undergone scaphoid fixation and non-vascularised bone grafting. At a follow-up of 1 to 3 years (mean 1.6 years), 15 of the 34 scaphoid non-unions had united. Injury to the dominant hand and duration of the non-union significantly increased the risk of failure. Persistent non-union was more common in proximal third fractures and in the presence of an avascular proximal pole but these findings did not reach statistical significance.