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T Jaehn, R Sievers, A Wanninger, J Kaiser, A Kaiser, B Reichert
Osteoid osteomas are benign bone tumors which rarely occur in the hand and impose severe diagnostic problems. The course of the disease is often protracted before the patient receives an adequate surgical treatment. The case of an osteoid osteoma in the scaphoid bone of a 15-year-old patient is presented, who was completely symptom free after a true diagnostic odyssey by resection of the nidus and reconstruction by crest bone graft and spongiosaplasty.
March 19, 2018: Der Unfallchirurg
Ravikant Jain, Nikhil Jain, Tanveer Sheikh, Charanjeet Yadav
PURPOSE: Wrist has a complex anatomy and undergoes complex injuries. Scaphoid fracture is one of such injuries. It is the most common fracture in carpal bone. Most of the scaphoid fractures are missed on initial X-rays. Magnetic resonance imaging (MRI) is considered as a gold standard for diagnosing scaphoid fractures. Ultrasonography (USG) is emerging as a good alternative to make an early diagnosis of scaphoid fractures. Our aim is to throw light upon the role of USG in detection of scaphoid fractures...
January 31, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Michalis Michaelides, Elena Drakonaki, Elia Petridou, Maria Pantziara, Cleanthis Ioannides
Osteoid osteomas of the wrist are relatively rare and the diagnosis is challenging due to atypical clinical features. We describe a case of an osteoid osteoma of the scaphoid bone associated with calcific tendinitis of the adjacent flexor carpi radialis tendon and periarticular soft tissue calcifications in a 21-year-old man presenting with radial-sided wrist pain. The lesion was successfully treated with CT-guided RF ablation. To our knowledge, this is the first description of an osteoid osteoma of the wrist associated with calcific tendinitis and periarthritis...
March 14, 2018: Skeletal Radiology
Jonathan Porter, Robert Porter, Kevin Joseph Chan
OBJECTIVES: The purpose of this study is to determine the predictive value of clinical suspicion for scaphoid fracture in children aged 4 to 11 years, to look at the efficiency and practicality of current management of children presenting to the emergency department, and to help quantify the burden of the treatment strategy of immobilization for 10 to 14 days on clinical grounds despite negative or equivocal x-rays on presentation. METHODS: We performed a retrospective chart review study of a consecutive sample of all children aged 4 to 11 years old who presented to a tertiary pediatric emergency department from January 1, 2009, to December 31, 2013, within 24 hours of a wrist injury, with a clinical suspicion sufficient to order a scaphoid x-ray...
March 12, 2018: Pediatric Emergency Care
Christopher Klifto, Austin Ramme, Anthony Sapienza, Nader Paksima
Scaphoid nonunions are challenging injuries to manage and the optimal treatment algorithm continues to be debated. Most scaphoid fractures heal when appropriately treated; however, when nonunions occur, they require acute treatment to prevent future complications like scaphoid nonunion advanced collapse. Acute nonunion treatment technique depends on nonunion location, vascular status of the proximal pole, fracture malalignment, and pre-existing evidence of arthrosis. Bone grafting and vascular grafts are common in nonunion management...
March 2018: Bulletin of the Hospital for Joint Diseases
Young Ho Shin, Jihyeung Kim, Goo Hyun Baek
PURPOSE: The purpose of this study was to present a new radiograph of peritrapezial view and examine whether this view could supply clear and reliable radiographs of the joints around trapezium. METHODS: The radiographs of peritrapezial and Robert views were taken on both hands of the 30 healthy volunteers (15 men and 15 women). The four peritrapezial joints were evaluated by two trained hand surgeons to find out whether these views could clearly show the joint spaces around the trapezium...
January 2018: Journal of Orthopaedic Surgery
Michel D Crema, Catherine Phan, Anne Miquel, Celine Quach, Lionel Arrivé, Yves Menu
OBJECTIVES: Our primary aim was to evaluate the distribution and severity of cartilage damage in a sample of patients with scaphoid nonunion advanced collapse (SNAC), assessed on MDCT arthrography, with regard to two well-known SNAC staging systems. Secondarily, we wanted to see if the degree of cartilage damage varied with the location of the nonunion. METHODS: We retrospectively included 35 patients with a history of SNAC who had undergone MDCT arthrography. The location of the fracture was defined as the proximal, middle, or distal third of the scaphoid...
March 8, 2018: Skeletal Radiology
M Gurger, M Yilmaz, E Yilmaz, S Altun
Background: Percutaneous screw fixation is widely used in acute fractures of the scaphoid. In this study, we aimed to present our results with volar percutaneous screw fixation in patients with scaphoid nonunions. Methodology: A total of 12 patients with scaphoid nonunion (≥13 weeks) that underwent volar percutaneous screw fixation were evaluated retrospectively. Two of the patients were female, and 10 were male. Mean age was 27 years (range = 19-41). The mean time that elapsed between the fracture and surgical procedure was 7...
March 2018: Nigerian Journal of Clinical Practice
J M Gómez-Canedo
Tibialis anterior tendon rupture is a relatively rare injury, with diverse etiologies, that can cause significant deficits in the functionality of the ankle. These injuries are sometimes diagnosed too late, being in many occasions the alteration in walking the symptom that makes the patient go to the doctor. The six weeks will mark the limit between acute and chronic injury, requiring different therapeutic approaches, along with other parameters such as age, functional demand or concomitant pathologies. OBJECTIVE: To present two cases of acute rupture, with different etiology, the surgical technique used and the final results...
September 2017: Acta Ortopédica Mexicana
Ricardo Kaempf de Oliveira, Pedro José Delgado, Samuel Ribak, Jayme Augusto Bertelli, Fabiano da Silva Marques
A 40-year-old woman presented with Madelung deformity and severe arthritic changes at both the radiocarpal and the distal radioulnar joints. She was treated by using her lunate as an osteochondral graft into the radius allowing reconstruction of the lunate fossa. The scaphoid and triquetrum were removed concomitantly and a Sauve-Kapandji procedure was performed. Complete bone healing was achieved. Ten years later, an excellent functional result was maintained, with a pain-free wrist, an acceptable wrist joint range of motion, as well as a favorable aesthetic appearance...
March 3, 2018: Journal of Hand Surgery
Takafumi Tajima, Yukichi Zenke, Yoshiaki Yamanaka, Kunitaka Menuki, Akinori Sakai
BACKGROUND: The association of scaphoid or other carpal bone fractures with distal radius fractures is frequently reported, whereas few studies have described pisiform malalignment associated with distal radius fractures. The purpose of this study was to investigate the frequency and characteristics of pisiform malalignment associated with distal radius fractures. METHODS: We performed a retrospective study by reviewing the data of 152 consecutive patients with a mean age of 63 years who were treated surgically for distal radius fractures during a five-year period...
March 1, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Jakob Neubauer, Matthias Benndorf, Claudia Ehritt-Braun, Kilian Reising, Tayfun Yilmaz, Christopher Klein, Horst Zajonc, Elmar Kotter, Mathias Langer, Sebastian Moritz Goerke
The aim of this study was to evaluate and compare the diagnostic accuracy, the inter-rater agreement and raters' certainty of cone beam computed tomography (CBCT) and radiography for the detection of scaphoid fractures. Our hypothesis is that the CBCT has a higher diagnostic accuracy for scaphoid fractures than radiography. We retrospectively analysed patients who underwent both radiography and CBCT examinations within 4 days to rule out a scaphoid fracture over a 2-year period in our institution. 4 blinded radiologists and orthopaedic surgeons independently rated the images regarding the presence of a scaphoid fracture...
March 2, 2018: Scientific Reports
Andrew Tomas
A 52-year-old man sustained an injury to the right wrist following a fall into a push-up position. Direct-access outpatient physical therapy evaluation was performed 24 hours after the injury. A scaphoid radiograph series, consistent with American College of Radiology guidelines, was obtained based upon examination findings. The radiographs revealed a scapholunate gap of 4 mm and a scapholunate angle of greater than 60°, suggestive of scapholunate dissociation. J Orthop Sports Phys Ther 2018;48(3):225. doi:10...
March 2018: Journal of Orthopaedic and Sports Physical Therapy
Gernot Schmidle, Hannes Leonhard Ebner, Günter Klima, Kristian Pfaller, Josef Fritz, Romed Hoermann, Markus Gabl
The scaphoid is the most frequently fractured carpal bone and prone to non-union due to mechanical and biological factors. Whereas the importance of stability is well documented, the evaluation of biological activity is mostly limited to the assessment of vascularity. The purpose of this study was to select histological and immunocytochemical parameters that could be used to assess healing potential after scaphoid fractures and to correlate these findings with time intervals after fracture for the three parts of the scaphoid (distal, gap and proximal)...
February 27, 2018: Journal of Anatomy
O Ackermann, A Kaminski
A case of a patient with a combined wrist injury is presented, where a scaphoid fracture was overlooked in the computed tomography scan. The case emphasizes the value of the x‑ray control in ulnar abduction for all wrist lesions which need to be operatively stabilized.
February 20, 2018: Der Unfallchirurg
Berthold Bickert
Complete rupture of the scapholunate (SL) ligament can cause a dissociative carpal instability (CID). These ligamentous lesions are caused by a fall from a limited height of approximately 1 m or a fall, e. g. when playing handball or soccer. For a freshly injured wrist joint, the X‑ray signs of a static instability (after excluding a fracture) are a SL distance ≥3 mm, a SL angle >60°, and a dorsal displacement of the proximal scaphoid pole. Dynamic instabilities are best seen in kinematography of the wrist joint...
February 20, 2018: Der Unfallchirurg
A Marzouki, B Soumare, A S Diarra, K Lahrach, F Boutayeb
The aim of this study was to evaluate the results of percutaneous screw fixation of scaphoid waist fractures in our surgery unit by comparing them with recent data from the literature. This was a retrospective, descriptive study conducted between January 2010 and September 2016. Patients operated due to a recent scaphoid fracture and treated by percutaneous anterograde screw fixation with a Herbert screw were included in this study. Our cohort was a sub-set from a scaphoid fracture group; other fracture sites, other treatment techniques and fractures associated with scapholunate ligament lesions were excluded...
February 17, 2018: Hand Surgery and Rehabilitation
Cory K Mayfield, Daniel J Gould, Marie Dusch, Amir Mostofi
BACKGROUND: Current treatment options for persistent scaphoid nonunion are limited to salvage procedures such as proximal row carpectomy (PRC) or 4-corner fusion (4CF). Several small studies have demonstrated that distal scaphoid excision may provide a simpler alternative with faster recovery. The purpose of this study was to determine the efficacy of distal scaphoid excision as a treatment option for symptomatic scaphoid nonunion. METHODS: The MEDLINE and PubMed databases were searched for the use of distal scaphoid excision in scaphoid nonunions...
February 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Eric Quan Pang, Nathan Douglass, Anthony Behn, Matthew Winterton, Michael J Rainbow, Robin N Kamal
PURPOSE: The ideal material for reconstruction of the scapholunate interosseous ligament (SLIL) should replicate the mechanical properties of the native SLIL to recreate normal kinematics and prevent posttraumatic arthritis. The purpose of our study was to evaluate the cyclic torsional and tensile properties of the native SLIL and load to failure tensile properties of the dorsal SLIL. METHODS: The SLIL bone complex was resected from 10 fresh-frozen cadavers. The scaphoid and lunate were secured in polymethylmethacrylate and mounted on a test machine that incorporated an x-y stage and universal joint, which permitted translations perpendicular to the rotation/pull axis as well as nonaxial angulations...
February 17, 2018: Journal of Hand Surgery
Zirun Xiao, Ge Xiong, Weiguang Zhang
We investigated the intraosseous arteries of six normal cadaveric scaphoids using red lead injection and three-dimensional reconstruction with micro-computed tomography. The arterial entrances were generally located around the dorsal ridge, the insertion of the scaphocapitate ligament and the radial part of the radioscaphocapitate ligament. Two to three trunk arteries entered the scaphoid on dorsal ridge at the level of the waist. The distal part of the scaphoid was mainly supplied by arteries from the waist...
January 1, 2018: Journal of Hand Surgery, European Volume
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