Volar Pedicled Corticoperiosteal Vascularized Bone Graft Based on the Pronator Quadratus Pedicle for Scaphoid Nonunion: A Retrospective Case Series

Scaphoid nonunion, a common complication following wrist fractures, can lead to progressive joint degeneration and functional impairment. Among surgical options, vascularized bone grafting offers biological and mechanical advantages in restoring bone continuity. This retrospective study evaluates outcomes of scaphoid nonunion treated using a volar pedicled corticoperiosteal graft based on the pronator quadratus pedicle, perfused by the anterior interosseous artery. Eight patients without signs of avascular necrosis underwent the procedure with fixation by Kirschner wires. At a 12-month mean follow-up, union was achieved in 87.5% of cases, with significant improvements in pain, grip strength, and range of motion. The technique proves to be an effective and reproducible option in cases of nonunion resistant to conservative or non-vascularized surgical treatment.