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https://www.readbyqxmd.com/read/29146508/biomechanical-analysis-of-palmar-midcarpal-instability-and-treatment-by-partial-wrist-arthrodesis
#1
Sarah A Shiga, Frederick W Werner, Marc Garcia-Elias, Brian J Harley
PURPOSE: To create a biomechanical model of palmar midcarpal instability by selective ligament sectioning and to analyze treatment by simulated partial wrist arthrodesis. METHODS: Nine fresh-frozen cadaver arms were moved through 3 servohydraulic actuated motions and 2 passive wrist mobilizations. The dorsal radiocarpal, triquetrohamate, scaphocapitate, and scaphotrapeziotrapezoid ligaments were sectioned to replicate palmar midcarpal instability. Kinematic data for the scaphoid, lunate, and triquetrum were recorded before and after ligament sectioning and again after simulated triquetrohamate arthrodesis (TqHA) and radiolunate arthrodesis (RLA)...
November 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29143872/concomitant-hook-of-hamate-fractures-in-patients-with-scaphoid-fracture-more-common-than-you-might-think
#2
Ramin Mandegaran, Sam Gidwani, Ali Zavareh
OBJECTIVE: The scaphoid is the most commonly fractured carpal bone. The presence of a concomitant hook of hamate fracture is of particular relevance given that it is often occult on routine wrist/scaphoid radiographs and that hook of hamate fractures are prone to symptomatic non-union, resulting in chronic ulnar wrist pain. Prompt diagnosis and immobilisation/fixation may minimise such complications. Our study is aimed at assessing the frequency of concomitant hook of hamate fractures in patients with scaphoid fractures...
November 16, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29132789/scaphoid-fracture-fixation-in-a-nonunion-model-a-biomechanical-study-comparing-3-types-of-fixation
#3
Avanthi Mandaleson, Stephen K Tham, Craig Lewis, David C Ackland, Eugene T Ek
PURPOSE: Union of a scaphoid fracture after fixation is influenced by various factors, one of which is fracture stability. This study aims to compare the biomechanical stability of 3 different types of scaphoid fracture fixation in a scaphoid nonunion model. METHODS: Thirty cadaveric scaphoid specimens were assigned to one of 3 different fixation groups: (1) single 3.0-mm compression screw, (2) two 2.2-mm screws, and (3) scaphoid plate. A 3-mm volar wedge osteotomy was created at the scaphoid waist to simulate a nonunion model...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132239/lunate-fractures-and-associated-radiocarpal-and-midcarpal-instabilities-a-systematic-review
#4
Meenalochani Shunmugam, Joideep Phadnis, Amy Watts, Gregory I Bain
The aim of this study was to analyse lunate fractures and any associated osseo-ligamentous injuries. A systematic review identified 34 cases. We identified carpal instabilities at the radiocarpal and midcarpal joints in volar and dorsal directions. Radiocarpal instabilities (10/34) were usually dorsoradial (8/10), with a transverse lunate fracture, best seen on a coronal image. Midcarpal instabilities (24/34) were usually volar (14/18), with a volar lunate shear fracture, best seen on a sagittal image. Instabilities were sub-classified into non-displaced, subluxated and dislocated...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29122424/scaphoid-healing-necessary-for-unrestricted-activity-a-biomechanical-cadaver-model
#5
Michael S Guss, Joshua T Mitgang, Anthony Sapienza
PURPOSE: To determine if scaphoid fractures with bridging bone of 50% of their width treated with a centrally placed screw will restore biomechanical integrity equivalent to that of the intact scaphoid. METHODS: Twenty-four fresh cadaver scaphoids were used. Six were left intact to serve as the control group. Six were osteotomized 50% of their width and made up the osteotomy without screw group. Six were included in the 50% osteotomy plus compression screw group...
November 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29122122/scaphoid-screw-placement-under-minimal-radiation-exposure
#6
Gloria M Hohenberger, Uldis Berzins, Bore Bakota, Patrick Holweg, Bernhard Clement, Stephan Grechenig
BACKGROUND: Percutaneous scaphoid fixation through either a volar or dorsal approach has the advantage of minor soft tissue damage compared with ORIF, and faster fracture union compared with conservative treatment. However, this technique demands highly intraoperative reliance on X-ray control, including increased radiation exposure and all associated side effects. PURPOSE: To test the possibility and efficacy of volar percutaneous scaphoid screw placement under minimalradiation exposure...
November 2017: Injury
https://www.readbyqxmd.com/read/29117821/assessment-of-usefulness-of-anthropometric-data-for-predicting-the-scaphoid-and-the-screw-length-a-new-technique
#7
Darshan Kumar A Jain, Naresh Shetty, L Naveen Kumar, D C Sundaresh
BACKGROUND: Headless screw is frequently used for scaphoid fracture fixation. Aim of the study was to assess the correlation between the axial length of the scaphoid and the axial length of the middle phalanx of index, middle, ring and little finger so as to provide an indirect method to assess the length of the scaphoid and thereby the length of the screw. METHODS: Thirty five fresh frozen cadavers with seventy wrists and hands were dissected. The age, sex and side were recorded...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29116329/digital-tomography-for-detection-of-acute-occult-scaphoid-fractures
#8
Anthony M Barcia, Liang Zhou, Jay B Cook, Kenneth K Lindell, Rey D Gumboc, Aaron D Dykstra, Robert J Lachky, Steven H Shaha, Kenneth F Taylor
Diagnosis of occult scaphoid fractures remains a challenge. Traditional management consisting of 2 weeks of immobilization and repeat radiographs results in unnecessary immobilization of many patients without fracture. Magnetic resonance imaging (MRI) is sensitive but expensive. Digital tomography (DT) is an imaging technique that provides fine-cut visualization with minimal radiation exposure and may be used when there is high clinical suspicion despite negative findings on initial radiographs. The authors compared the ability of DT vs MRI to detect acute occult scaphoid fractures...
November 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/29105591/treatment-of-the-scaphoid-humpback-deformity-is-correction-of-the-dorsal-intercalated-segment-instability-deformity-critical
#9
Christophe L Mathoulin, Margareta Arianni
Treatment of scaphoid fractures has been focused mainly on achieving union, with less attention to restoring normal scaphoid shape and orientation. Malalignment of one carpal bone will disrupt the kinetics of the entire wrist. The dorsal intercalated segment instability deformity associated with scaphoid waist nonunion is a nondissociative form of carpal instability. It has to be reduced in the treatment of scaphoid waist nonunions to avoid kinetic problems that will lead to arthritic changes. Computerized tomography scanning has become indispensable to visualize the humpback deformity clearly...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29105589/the-morphology-of-proximal-pole-scaphoid-fractures-implications-for-optimal-screw-placement
#10
Timothy J Luchetti, Youssef Hedroug, John J Fernandez, Mark S Cohen, Robert W Wysocki
The purpose of this study was to measure the radiographic parameters of proximal pole scaphoid fractures, and calculate the ideal starting points and trajectories for antegrade screw insertion. Computed tomography scans of 19 consecutive patients with proximal pole fractures were studied using open source digital imaging and communications in medicine (DICOM) imaging measurement software. For scaphoid sagittal measurements, fracture inclination was measured with respect to the scaphoid axis. The ideal starting point for a screw in the proximal pole fragment was then identified on the scaphoid sagittal image that demonstrated the largest dimensions of the proximal pole, and hence the greatest screw thread purchase...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29105586/radial-styloidectomy-for-scaphoid-nonunion-advanced-collapse-relevance-of-nonunion-location
#11
Emil S Vutescu, Rishabh Jethanandani, Darryl B Sneag, Scott W Wolfe, Steve K Lee
Radial styloidectomy along with scaphoid nonunion reconstructive surgery is considered an acceptable surgical treatment for stage 1 scaphoid nonunion advanced collapse. The extent of radioscaphoid joint wear that defines scaphoid nonunion advanced collapse stage 1 is unclear. An appropriate radial styloidectomy is limited to 6 mm styloid removal to prevent carpal instability. The aim of this study was to determine whether nonunion fracture location can be a guiding factor in determining whether the scaphoid bone can be retained with scaphoid nonunion reconstructive surgery and radial styloidectomy...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29103356/scaphoid-nonunion-what-is-the-role-of-the-zaidemberg-1-2-intercompartmental-supraretinacular-arterial-flap
#12
Mark Henry
The reported results for the treatment of scaphoid nonunions with non-vascularized grafts are based on observational studies with a high variability in union rates from 38%-100% and time to union from 6-18 weeks, and there is also a lack of a standard classification. Meta-analyses and systematic reviews have been presented to better support conclusions from large pools of data (604 to 5246 cases), but their interpretation remains limited because of lack of uniformity in the studies analysed. Several authors have presented results from the Zaidemburg flap, with highly variable outcomes despite using the same technique; union rates have ranged from 27%-100% achieved between 6...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29102567/clinical-and-radiologic-outcomes-after-scaphoid-fracture-injury-and-treatment-patterns-in-national-football-league-combine-athletes-between-2009-and-2014
#13
Gilbert Moatshe, Jonathan A Godin, Jorge Chahla, Mark E Cinque, Nicholas I Kennedy, George Sanchez, Brendin R Beaulieu-Jones, Robert F LaPrade, Matthew T Provencher
PURPOSE: To report on the clinical and radiologic outcomes and complications after surgical treatment in National Football League (NFL) Combine athletes with a history of a scaphoid fracture. METHODS: The medical records of 2,285 athletes participating in the NFL Combine from 2009 to 2015 were evaluated for a history of scaphoid, hand, or wrist injury. Clinical outcomes, including grip strength, pinch test, range of motion, and presence of pain and stiffness, were recorded...
November 1, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29098903/scaphoid-instability-caused-by-a-giant-cell-tumour-of-the-tendon-sheath-a-case-report
#14
Yanjun Wang, Xiaoxiao Zhu, Genwang Pei, Xianshang Zeng, Deng Chen, Yonggang Zuo, Weiguang Yu, Zhe Ge, Xinchao Zhang
Giant-cell tumour of the tendon sheath (GCTTS) is a soft tissue tumour that may invade bone, causing an intrinsic osseous lesion or instability on radiographs. A case with scaphoid instability caused by a histologically-confirmed neighbouring GCTTS has rarely been described in the literature. No definite and radical method is available for the treatment of GCTTS. This report describes an unusual case of a 22-year-old woman who previously experienced a GCTTS in her right elbow, which was removed 10 years earlier...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29094605/distal-pole-resection-of-the-scaphoid-for-the-treatment-of-scaphotrapeziotrapezoid-osteoarthritis
#15
Merel J-L Berkhout, Yara Bachour, Daan Wessing, Marco J P F Ritt
BACKGROUND: Distal pole resection of the scaphoid is one of the surgical techniques applied for the treatment of painful scaphotrapeziotrapezoid osteoarthritis (STT-OA). METHODS: In this retrospective study, we evaluated midterm outcomes in a consecutive series of patients who underwent distal pole resection of the scaphoid: 13 patients (15 wrists) with a mean follow-up of 4.1 years. We examined objective functional and patient-reported outcome measures. In addition, we assessed the degree of dorsal intercalated segment instability (DISI) and postoperative complications...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29091493/ten-year-minimum-follow-up-of-4-corner-fusion-for-slac-and-snac-wrist
#16
Purnell Traverso, Anselm Wong, Ronit Wollstein, Lois Carlson, Duffield Ashmead, H Kirk Watson
BACKGROUND: Scapholunate advanced collapse (SLAC) of the wrist is the most common degenerative condition of the wrist. Four-corner fusion (4CF) is performed as salvage surgery, though there is limited information on its long-term results. We hypothesized that 4CF is a durable surgery with good clinical long-term function. METHODS: A retrospective chart review of patients undergoing 4CF as well as an interview and recent radiographs were obtained. Patients with a follow-up period of less than 10 years were excluded...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29086094/influence-of-blood-supply-on-fracture-healing-of-vertebral-bodies
#17
L Hajnovic, V Sefranek, L Schütz
INTRODUCTION: The relevance of blood supply for bone fracture healing has been discussed throughout the literature, using scaphoids as the most referred to. But, there is virtually nothing known about the relevance of blood supply for the vertebral fracture healing and even the guidelines of AO do not deal with this issue. MATERIALS AND METHODS: A prospective cohort study of 107 patients was run from January 2016 to December 2016, with 54 male and 53 female patients, who were treated for traumatic vertebral fractures of thoracolumbar spine using posterior stabilization only...
October 30, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29078719/bone-grafting-for-scaphoid-nonunions-is-free-vascularized-bone-grafting-superior-for-scaphoid-nonunion
#18
William R Aibinder, Eric R Wagner, Allen T Bishop, Alexander Y Shin
BACKGROUND: Nonvascularized bone grafting (NVBG) and vascularized bone grafts (VBGs) have been used to treat scaphoid nonunions. A comparison of a single institution' s experience using structural iliac crest bone graft (ICBG), 1,2-intercompartmental supraretinacular artery (1,2-ICSRA), and medial femoral condyle (MFC) grafts to treat scaphoid nonunions was undertaken. METHODS: Thirty-one patients underwent ICBG, 33 patients underwent 1,2-ICSRA, and 45 patients underwent MFC grafting...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29078712/management-modalities-and-outcomes-following-acute-scaphoid-fractures-in-children-a-quantitative-review-and-meta-analysis
#19
Ashkaun Shaterian, Pauline Joy F Santos, Christine J Lee, Gregory R D Evans, Amber Leis
BACKGROUND: Early evaluation and appropriate management of pediatric scaphoid fractures are necessary to avoid complications. To date, current management of pediatric fractures varies among providers. The objective of this study was to compare clinical outcomes following different treatment modalities. METHODS: A PubMed literature search identified studies involving acute scaphoid fractures in children. Studies were evaluated for treatment provided and their respective effects on union rate, wrist range of motion, and wrist pain...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29068934/resurfacing-capitate-pyrocarbon-implant-versus-proximal-row-carpectomy-alone-a-comparative-study-to-evaluate-the-role-of-capitate-prosthetic-resurfacing-in-advanced-carpal-collapse
#20
COMPARATIVE STUDY
Francesco Giacalone, Pietro G di Summa, Alessandro Fenoglio, Arman Sard, Elisa Dutto, Matteo Ferrero, Maddalena Bertolini, Marc Garcia-Elias
BACKGROUND: The Resurfacing Capitate Pyrocarbon Implant associated with proximal row carpectomy has been used to treat symptomatic advanced carpal collapse, widening the indications of proximal row carpectomy to patients with capitate head arthritis. The authors retrospectively compared their case series of implant versus carpectomy alone, analyzing whether prosthetic implant outcomes could be similar to those of proximal row carpectomy even with a higher stage of osteoarthritis. METHODS: Fifty-seven patients who underwent surgery for wrist osteoarthritis (minimum follow-up, 2 years) were selected retrospectively...
November 2017: Plastic and Reconstructive Surgery
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