The Authors report their experience in the treatment of scaphoid non-union recurring to the vascularised bone graft technique as described by Zeidemberg. The patients have been treated between the 1999 and 2004. The authors report 22 cases (21 males and 1 female) with an average age of 31 years (from 17 to 42). 10 cases the involved wrist was the right one and in the other 12 cases was the left one. 18 patients presented an avascular necrosis of the proximal fragment of the scaphoid, recognised by the MNR. Two patients have been previously treated by the traditional bone graft technique as described by Matti-Russe, using a cannulated screw for the stabilization of the graft. 16 patients have been controlled at the follow-up (mean 23 months, from 3 to 65). The authors, looking at the good results obtained at the follow-up, feel that this technique might be a very useful one in the treatment of the established scaphoid non-union, mainly in presence of an avascular necrosis of the proximal third of the scaphoid. This technique might also be useful in the treatment of the failure of the classic bone graft technique.
The authors report their results of “extension-block Kirschner wire fixation” for the treatment of mallet finger fracture. This technique should be considered in presence of a large bone fragment involving more than the 30% of the articular surface, with or without palmar subluxation of the distal phalanx. A modification of the extension-block technique is described reducing the fragment to 0° extension of the distal interphalangeal joint. The results confirmed the better outcomes of this modification, minimizing the postoperative extension lag at the distal interphalangeal joint. The Wehbe and Schneider method was used to classify the mallet finger fractures and the results were graded according to Crawford’s criteria (66,6% excellent and 33,4% good). The extension-block K wire technique, when properly applied, is a very helpful procedure avoiding the risks and complications of the open surgery and achieving a good indirect anatomical reduction of the fracture.
