Original CommunicationsExperimental carpal reverse-flow pedicle vascularized bone grafts. Part II: Bone blood flow measurement by radioactive-labeled microspheres in a canine model*,**,*,**,♢,♢♢,♦
Section snippets
Preparation of animals
Sixteen adult mongrel dogs of either sex (weight, 22.5–30.0 kg) were divided into 2 groups of 8 each. X-rays demonstrated closure of the distal radius epiphysis. Blood flow was measured before and immediately after elevation of pedicle grafts in group 1. The other 8 dogs (group 2) were studied following a 2-week survival period by measuring and comparing the bone blood flow of isolated conventional and vascularized pedicle distal radius bones. Throughout the investigation, all animals were
Results
Elevation of the VBGs from the distal radius was successful in all 16 dogs, as demonstrated by pulsation of the vascular pedicle and bleeding from the bone graft. The average interval between induction of anesthesia and first microsphere injection was 108 minutes in group 1 and 95 minutes in group 2. The time used for each bolus microsphere injection ranged from 41 to 57 seconds (mean, 48.5 seconds). The measurement of right to left coefficient of variation allows quantitation of error for any
Discussion
Avascular necrosis of the lunate (Kienböck's disease)31, 32, 33, 34 and scaphoid, either spontaneous (Preiser's disease) or associated with fracture or nonunion, are difficult challenges for hand surgeons.35, 36, 37, 38, 39 Clinical solutions to these problems include efforts to prevent bony collapse by altering the biomechanics of wrist and direct revascularization of ischemic bone.28, 31, 40 The latter may be achieved with VBGs. They also may allow superior rates of bone healing and improved
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Cited by (46)
Vascularized Bone Flaps for the Treatment of Kienböck Disease
2022, Hand ClinicsCitation Excerpt :Owing to similarities in the anatomy of the distal radius, canine models have been used to study osteonecrosis of the proximal pole of the scaphoid. Compared with nonvascularized grafts, reverse-flow vascularized pedicled flaps increased blood flow to the previously necrotic area and demonstrated higher levels of trabecular osteoblasts and osteoid on histologic analysis.30,31 Hori and colleagues32 demonstrated neovascularization and new bone formation after transplanting an isolated neurovascular bundle into the canine tibia.
Biomaterials and Structural Fat Grafting
2021, Plastic Surgery - Principles and PracticeThe Role of Vascularized Bone Grafting in Scaphoid Nonunion
2019, Hand ClinicsCitation Excerpt :Sunagawa and colleagues35 demonstrated that blood flow rates at the proximal pole was significantly higher in VBGs at 6 weeks when compared with nonvascularized bone grafts in a canine model, suggesting quicker revascularization of previously avascular segments of bone with VBGs. Increased perfusion over time and influx of both osteogenic and angiogenic factors are additional cited benefits of using VBGs in the management of scaphoid nonunions.35–38 Al-Jabri and colleagues39 performed a systematic review of free vascularized bone grafting in which 12 studies, with a total of 245 cases of scaphoid nonunion, were included.
The 1,2-intercompartmental supraretinacular artery vascularized bone graft for scaphoid nonunion: Management and clinical outcome
2014, Journal of Hand SurgeryCitation Excerpt :The scaphoid's blood supply was compromised after previous nonvascularized transplantation, which was disputed by Chang et al.23 In our study, patients who had undergone previous operations with standard iliac crest bone grafts were included. It was expected that the VBG rather than any avascular graft may improve bone regeneration and trigger union owing to its effects on revascularization of bone fragments.31,32 Previous standard iliac crest bone graft was not found to be a risk factor for nonunion after 1,2-ICSRA-VBG in our study.
Dorsal Distal Radius Pedicled Vascularized Bone Grafting for Avascular Necrosis of the Carpus
2012, Operative Techniques in Orthopaedics
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*Present address: Department of Orthopedics, Chang Gung Memorial Hospital, Keelung, Taiwan.
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†Present address: Department of Orthopedics, Kumamoto University, Kumamoto, Japan.
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Supported in part by research grant AR-38671 from the National Institutes of Health.
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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
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Reprint requests: Allen T. Bishop, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
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0363-5023/00/25A01-0011$3.00/0
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J Hand Surg 2000;25A:46–54.