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Scaphoid bone

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
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
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
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
Eric Quan Pang, Nathan Douglass, Anthony Behn, Matthew Winterton, Michael 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 16, 2018: Journal of Hand Surgery
Tracy L Kivell, Antonio Rosas, Almudena Estalrrich, Rosa Huguet, Antonio García-Tabernero, Luis Ríos, Marco de la Rasilla
Twenty-nine carpal bones of Homo neanderthalensis have been recovered from the site of El Sidrón (Asturias, Spain) during excavations between 1994 and 2009, alongside ∼2500 other Neandertal skeletal elements dated to ∼49,000 years ago. All bones of the wrist are represented, including adult scaphoids (n = 6), lunates (n = 2), triquetra (n = 4), pisiforms (n = 2), trapezia (n = 2), trapezoids (n = 5), capitates (n = 5), and hamates (n = 2), as well as one fragmentary and possibly juvenile scaphoid. Several of these carpals appear to belong to the complete right wrist of a single individual...
January 2018: Journal of Human Evolution
Caley M Orr
In most primates, the os centrale is interposed between the scaphoid, trapezoid, trapezium, and head of the capitate, thus constituting a component of the wrist's midcarpal complex. Scaphoid-centrale fusion is among the clearest morphological synapomorphies of African apes and hominins. Although it might facilitate knuckle-walking by increasing the rigidity and stability of the radial side of the wrist, the exact functional significance of scaphoid-centrale fusion is unclear. If fusion acts to produce a more rigid radial wrist that stabilizes the hand and limits shearing stresses, then in taxa with a free centrale, it should anchor ligaments that check extension and radial deviation, but exhibit motion independent of the scaphoid...
January 2018: Journal of Human Evolution
Hitoshi Hatanaka, Minoru Takasaki, Hiroko Furusho, Yasuhiro Omori
BACKGROUND: Wedge-shaped bone grafts that are internally fixed by a Herbert-type screw are a well-established surgical treatment for scaphoid nonunion. A procedure using cylinder-shaped bone grafts was also reported, but preoperative wrist functions were not assessed. In addition, it was not reported whether the humpback deformity of the scaphoid nonunion was corrected. The purpose of the current study was to compare preoperative wrist functions in cases of scaphoid nonunion with those observed at final follow-up, using cylinder-shaped bone grafts The humpback deformity of the scaphoid nonunion was also evaluated...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Nikolas H Kazmers, Stephanie Thibaudeau, Patrick Gerety, Alex G Lambi, Lawrence Scott Levin
BACKGROUND: The medial femoral condyle (MFC) flap has become a popular choice for treatment of small bony defects. We aim to describe outcomes after MFC flap treatment of upper and lower extremity osseous defects and test the null hypothesis that no factors influence risks for nonunion, increased time to union, and complications. METHODS: A retrospective chart review was performed on all patients undergoing MFC free vascularized bone flaps by the senior author between May 2010 and March 2016...
January 31, 2018: Annals of Plastic Surgery
Fernando Corella, Montserrat Ocampos, Miguel Del Cerro
Background  Patients with scapholunate instability usually have pain in the dorsal wrist. This pain may occur due to the impingement between the scaphoid and the dorsal rim of the radius when the scaphoid is detached from the lunate. This pain appears as the scaphoid is displaced over the dorsal rim of the radius. The arthroscopic scaphoid 3D (dorsal, dynamic, displacement) test is described here to check this pathologic dorsal displacement of the scaphoid. Surgical Technique  The test should be performed both in the radiocarpal and midcarpal joints...
February 2018: Journal of Wrist Surgery
Jill Goodwin, Paulo Castañeda, Patricia Drace, Scott Edwards
Background  Headless screw fixation is the current gold standard of surgical repair for scaphoid fractures. However, maintaining reduction of certain types of scaphoid fractures is challenging with a compression screw. Plate fixation may offer superior fixation in some scaphoid fractures, particularly those with comminution, nonunion, segmental bony defects, and osteopenic or osteoporotic bone. Purpose  This study questions whether method of fixation is a determinant in load to failure in segmental scaphoid fractures, and whether any fixation provides a greater mechanical advantage in simulated normal versus osteoporotic bone...
February 2018: Journal of Wrist Surgery
Morgan M Swanstrom, Kyle W Morse, Joseph D Lipman, Krystle A Hearns, Michelle G Carlson
Background  Ideal internal fixation of the scaphoid relies on adequate bone stock for screw purchase; so, knowledge of regional bone density of the scaphoid is crucial. Questions/Purpose  The purpose of this study was to evaluate regional variations in scaphoid bone density. Materials and Methods  Three-dimensional CT models of fractured scaphoids were created and sectioned into proximal/distal segments and then into quadrants (volar/dorsal/radial/ulnar). Concentric shells in the proximal and distal pole were constructed in 2-mm increments moving from exterior to interior...
February 2018: Journal of Wrist Surgery
Philip M J Schormans, Peter R G Brink, Martijn Poeze, Pascal F W Hannemann
Background  Around 5 to 15% of all scaphoid fractures result in nonunion. Treatment of long-lasting scaphoid nonunion remains a challenge for the treating surgeon. Healing of scaphoid nonunion is essential for prevention of scaphoid nonunion advanced collapse and the subsequent predictable pattern of radiocarpal osteoarthritis. Purpose  The purpose of this study was to investigate the feasibility of fixation of the scaphoid nonunion with a volar angular stable miniplate and cancellous bone grafting. We hypothesized that this technique could be successful, even in patients with previous surgery for nonunion and in patients with a long duration of nonunion...
February 2018: Journal of Wrist Surgery
Tiago Rua, Sanjay Vijayanathan, David Parkin, Vicky Goh, Paul McCrone, Sam Gidwani
Background Wrist injury is a common presentation to the Emergency Department in the United Kingdom. Among these injuries, the scaphoid is the most common fractured carpal bone. However, given the limited ability of conventional radiography to accurately diagnose a suspected scaphoid fracture on presentation, its diagnosis and management remain challenging. Despite the vast clinical evidence supporting the superior accuracy of magnetic resonance imaging, there is little to no evidence around the real-world clinical and economic impact of immediate magnetic resonance imaging in the management of suspected scaphoid fractures...
December 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
Ignacio Esteban-Feliu, Sergi Barrera-Ochoa, Nuria Vidal-Tarrason, Bernat Mir-Simon, Alex Lluch, Xavier Mir-Bullo
PURPOSE: Several options exist for treating scaphoid nonunion. For selected cases, some authors recommend using a volar buttress plate. The aim of the study was to report the clinical and radiological outcomes achieved at a minimum of 3 years' follow-up of treating scaphoid nonunion with a scaphoid volar plate. METHODS: We retrospectively reviewed 15 patients with symptomatic scaphoid nonunion treated with scaphoid plate osteosynthesis and a bone graft from the volar aspect of the distal radius between January 2011 and November 2013...
January 19, 2018: Journal of Hand Surgery
Cary Tanner, Toby Johnson, Alex Majors, Vincent R Hentz, Lisa Husak, Edward Walker Gallego, Brad Christ, Nathan Hoekzema
BACKGROUND: Vascularized periosteal flaps from the distal radius have been previously proposed. The purpose of this study was to investigate the vascularity and osteogenic potential of a vascularized volar distal radial periosteal flap for the treatment of scaphoid nonunion. METHODS: In 5 fresh frozen cadavers, a rectangular periosteal flap was elevated from the distal radius with the pedicle just proximal to the watershed line. Latex dye was injected into the radial artery proximally and the vascularity of the flap characterized by microscopic evaluation...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Paul A Leighton, Stephen D Brealey, Joseph J Dias
OBJECTIVE: To explore stakeholder perspectives upon participant retention in clinical trials, and to generate strategies to support retention in a surgical, clinical trial. STUDY DESIGN AND SETTING: The SWIFFT trial is a multicenter study comparing treatments for the fracture of the waist of the scaphoid bone in adults. Here we report upon a multistage, iterative consultative process with SWIFFT stakeholders, these include workshops with members of the public, with nurses involved in data collection, and with consultant clinicians...
January 22, 2018: Journal of Evidence-based Medicine
Samir Kumta, Sudhir Warrier, Leena Jain, Rani Ummal, Manik Menezes, Shrirang Purohit
Introduction: Scaphoid fractures are not very common and frequently remain undiagnosed, presenting in non-union and persistent wrist pain. Options for scaphoid fracture treatment have been described over several decades, however, none with an optimal solution to achieve union along with good hand function. We describe here, the use of vascularised corticoperiosteal bone grafts from the medial femoral condyle (MFC) as a solution for the difficult problem of scaphoid fracture non-union...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Amit Kumar, B P Sharma, Saurabh
Background: Scaphoid fracture is the most common among carpal bone fractures, frequently imperceptible on initial radiographs. Tendency of scaphoid fracture to undergo in non-union makes it an important challenging injury for all orthopaedic surgeons. Displaced scaphoid fracture has high non-union rate in conservative management asserting the need to explore operative treatment. Materials and method: A prospective study was conducted in our institution in thirty patients in 20 to 50 year age group, for displaced scaphoid fracture (<30 days duration)...
November 2017: Journal of Clinical Orthopaedics and Trauma
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