Ross PR, et al. - Researchers conducted a large population analysis in order to determine the prevalence of vascularized bone grafting in the treatment of scaphoid nonunion and to compare healing using vascularized bone grafting vs standard non-vascularized techniques. Further, they compared the procedures regarding resource utilization and sought for factors linked with nonunion repair failure. The Truven MarketScan databases yielded data from 4,177 eligible patients who were diagnosed with scaphoid nonunion; of these, 358 underwent nonunion repair with vascularized bone graft and 3,819 patients received non-vascularized bone grafting from 2009 to 2017. This suggests that vascularize bone grafting is not performed in most scaphoid nonunion repairs. The failure rate requiring revision surgery was 5.0% vs 6.1% for vascularized repair and non-vascularized surgery, respectively. The raised time and technical demands of vascularized bone grafting may not be justified with typical nonunions, and traditional repair should remain the first-line treatment for scaphoid nonunions without additional risk factors.