Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique

Bandinelli, Diletta; Pagnotta, Alessia; Piperno, Alessandro; Marsiolo, Martina; Aulisa, Angelo Gabriele; Falciglia, Francesco

doi:10.3390/children12091135

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Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique

by

Diletta Bandinelli

^1,*

,

Alessia Pagnotta

²,

Alessandro Piperno

²,

Martina Marsiolo

¹,

Angelo Gabriele Aulisa

^1,3

and

Francesco Falciglia

¹

U.O.C. of Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy

²

Hand and Microsurgery Unit, Jewish Hospital, 00148 Rome, Italy

³

Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy

^*

Author to whom correspondence should be addressed.

Children 2025, 12(9), 1135; https://doi.org/10.3390/children12091135

Submission received: 12 June 2025 / Revised: 29 July 2025 / Accepted: 27 August 2025 / Published: 27 August 2025

(This article belongs to the Special Issue Pediatric Upper Extremity Pathology)

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Abstract

Background: Although adolescents are at a lower risk of developing scaphoid non-union than adults, this complication is not uncommon in younger patients. The current gold standard for surgical treatment is non-vascularized bone grafting from the iliac crest or distal radius, and it is often considered the first-line option. However, non-union can persist in 10–20% of cases, and failure rates can reach up to 50% when the proximal pole is necrotic. Methods: We evaluated a modified vascularized bone graft surgical technique in selected adolescent patients, with the goal of avoiding growth-related complications. Our experience is based on three cases of scaphoid non-union treated surgically between June 2019 and June 2022. Results and Conclusions: The modified surgical technique has shown promising results in the selected cases and carries no risk of donor site morbidity. It enables preservation of severely compromised scaphoid bones, prevents early-onset wrist osteoarthritis, and facilitates the return to sports activities for young patients.

Keywords: scaphoid; non-union; graft; vascularized; bone graft; children; adolescents; fracture

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MDPI and ACS Style

Bandinelli, D.; Pagnotta, A.; Piperno, A.; Marsiolo, M.; Aulisa, A.G.; Falciglia, F. Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique. Children 2025, 12, 1135. https://doi.org/10.3390/children12091135

AMA Style

Bandinelli D, Pagnotta A, Piperno A, Marsiolo M, Aulisa AG, Falciglia F. Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique. Children. 2025; 12(9):1135. https://doi.org/10.3390/children12091135

Chicago/Turabian Style

Bandinelli, Diletta, Alessia Pagnotta, Alessandro Piperno, Martina Marsiolo, Angelo Gabriele Aulisa, and Francesco Falciglia. 2025. "Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique" Children 12, no. 9: 1135. https://doi.org/10.3390/children12091135

APA Style

Bandinelli, D., Pagnotta, A., Piperno, A., Marsiolo, M., Aulisa, A. G., & Falciglia, F. (2025). Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique. Children, 12(9), 1135. https://doi.org/10.3390/children12091135

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique

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