Vascularized scapular grafting for treatment of osteonecrosis of the humeral head

Eight dissections in four embalmed cadavers were performed to investigate the possibility of vascularized scapular grafting for osteonecrosis of the humeral head. When the angular branch was used as the nutrient vessel, the mean length of the vascular pedicle was 12.4 cm, which was sufficient for tr...

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Bibliographic Details
Published inJournal of reconstructive microsurgery Vol. 24; no. 8; p. 559
Main Authors Kawamura, Kenji, Kawate, Kenji, Yajima, Hiroshi, Kobata, Yasunori, Takakura, Yoshinori
Format Journal Article
LanguageEnglish
Published United States 01.11.2008
Subjects
Adrenal Cortex Hormones - adverse effects
Adult
Femur Head Necrosis - chemically induced
Femur Head Necrosis - complications
Femur Head Necrosis - surgery
Fluoroscopy
Follow-Up Studies
Humans
Humerus - diagnostic imaging
Humerus - surgery
Magnetic Resonance Imaging
Male
Osteonecrosis - chemically induced
Osteonecrosis - surgery
Range of Motion, Articular
Recovery of Function
Scapula - blood supply
Scapula - transplantation
Shoulder Joint - physiology
Surgical Flaps - blood supply
Time Factors
Transplantation, Autologous
Treatment Outcome
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Summary:Eight dissections in four embalmed cadavers were performed to investigate the possibility of vascularized scapular grafting for osteonecrosis of the humeral head. When the angular branch was used as the nutrient vessel, the mean length of the vascular pedicle was 12.4 cm, which was sufficient for transferring the scapula into the humeral head. Based on the anatomical study, a 27-year-old man with corticosteroid-induced osteonecrosis of the right humeral head was treated by vascularized scapular grafting. The pedicled vascularized scapula was successfully transferred into the humeral head using the angular branch. The patient's right shoulder pain disappeared following surgical recovery. He had no limitations of right shoulder motion 3 years after the surgery. Magnetic resonance imaging at 1 year after the surgery indicated revascularization of the humeral head. The humeral head did not collapse during a 3-year follow-up with radiographic evaluation. This procedure has the potential to be a new joint-preserving procedure for osteonecrosis of the humeral head.
ISSN:0743-684X
1098-8947
DOI:10.1055/s-0028-1090621