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World J Orthop. Nov 18, 2020; 11(11): 475-482
Published online Nov 18, 2020. doi: 10.5312/wjo.v11.i11.475
Radiographic evaluation of vascularity in scaphoid nonunions: A review
Hena S Cheema, Adnan N Cheema
Hena S Cheema, Department of Diagnostic Radiology, University of Pennsylvania, Philadelphia, PA 19104, United States
Adnan N Cheema, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
Author contributions: Cheema AN contributed to formulation of research question, literature search, procurement of images/figures, writing and editing of manuscript, formatting of manuscript; Cheema HS contributed to formulation of research question, literature search, procurement of images/figures, writing and editing of manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Adnan N Cheema, MD, Doctor, Department of Orthopaedic Surgery, University of Pennsylvania, 3737 Market St FL 6, Philadelphia, PA 19104, United States. ancheema29@gmail.com
Received: March 16, 2020
Peer-review started: March 16, 2020
First decision: September 24, 2020
Revised: October 1, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: November 18, 2020
Processing time: 242 Days and 19.2 Hours
Core Tip

Core Tip: This paper aims to summarize the modern radiographic methodologies available to clinicians to assess the vascularity of scaphoid nonunions, as it crucial in decision-making for future treatment plans. For example, a scaphoid nonunion with preserved vascularity at the proximal pole may be amenable to simple bone grafting and open reduction internal fixation. In cases with compromised perfusion, significantly more extensive surgical intervention involving vascularized bone transfer may be required. Given the drastic differences in treatment algorithms, review papers such as this are needed to better educate the medical community to improve treatment of this complex orthopedic disease process.