Vascularized second metacarpal-base bone graft in scaphoid non-union by the palmar approach.

Vascularized second metacarpal-base bone grafting from the palmar side for scaphoid non-union was performed in seven patients (six males and one female, with a mean age of 26 years). In all patients, bone union was obtained at a mean of 10.2 weeks. In six of the seven patients, preoperative dorsal intercalated segment instability (DISI) was corrected. The results were excellent in three patients, good in two patients, and fair in two patients, showing that more than 80 percent of the patients had satisfactory results. In this procedure, the second dorsal metacarpal artery, with a large vascular diameter, is used as the pedicle, and the second metacarpal base, which is abundant in cancellous bone, is elevated on the dorsal side and grafted on the open-wedged scaphoid non-union on the palmar side. This procedure is reliable and useful, particularly for scaphoid non-union with DISI.