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Scaphoid bone

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https://www.readbyqxmd.com/read/28027846/pediatric-scaphoid-proximal-pole-nonunion-with-avascular-necrosis
#1
Edward W Jernigan, Brandon S Smetana, J Megan M Patterson
A 13-year-old, right hand-dominant, otherwise healthy boy presented with left wrist pain 19 months after a nonmotorized scooter injury. Radiographs and magnetic resonance imaging at presentation demonstrated proximal pole scaphoid nonunion with avascular necrosis of the proximal fragment. Operative and nonsurgical treatment options were discussed and the family elected for an attempt at nonsurgical management. The patient was placed in a short-arm thumb spica cast, with a window for a bone stimulator, for 14 weeks...
December 24, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28018087/a-unique-case-of-bilateral-trans-scaphoid-perilunate-dislocation-with-dislocation-of-lunate-into-the-forearm
#2
Siddharth R Virani, Sagar Wajekar, Hariharan Mohan, Aditya A Dahapute
INTRODUCTION: Perilunate dislocations are commonly seen after fall on an outstretched hand in extremes of dorsiflexion and ulnar deviation. A greater arc injury is one when there is an associated fracture of one or more bones around the lunate while a lesser arc injury is associated with pure ligamentous disruption around the lunate. CASE REPORT: We report a unique case of bilateral trans-scaphoid perilunate dislocation in a 35-year-old male labourer. This is the first reported case where the lunate dislocated into the forearm on the volar aspect...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28018058/intramedullary-screw-and-kirschner-wire-fixation-for-unstable-scaphoid-nonunion
#3
Raviv Allon, Aviv Kramer, Ronit Wollstein
Surgical treatment of scaphoid nonunion is not always successful, often requiring stabilization and bone grafting to achieve healing. Even after intramedullary screw fixation, residual instability may still hinder union. The purpose of this study was to describe the addition of Kirschner wires (KWs) through the capitate and the lunate to supplement an intramedullary screw for temporary enhanced stability, possibly improving healing of unstable fractures. A case-control study reviewing 25 cases with addition of KWs and 19 controls was performed...
December 2016: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28012704/tomosynthesis-a-new-radiologic-technique-for%C3%A2-rapid-diagnosis-of-scaphoid-fractures
#4
N Compton, L Murphy, F Lyons, J Jones, P MacMahon, J Cashman
Scaphoid fractures constitute 71% of all carpal bone fractures.(1) Early diagnosis and treatment has significant bearing on fracture union rates and better clinical outcomes. While displaced fractures can be readily seen on plain radiograph, undisplaced fractures can require advanced imaging modalities to confirm that diagnosis. Advanced imaging such as Magnetic Resonance Imaging (MRI), Computerised tomography (CT) and bone scintigraphy are routinely used for the diagnosis of scaphoid fractures but require significant radiation exposure, increased cost and can be difficult to access...
December 21, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27999456/investigating-the-effect-of-intra-articular-platelet-rich-plasma-injection-on-union-pain-and-function-improvement-in-patients-with-scaphoid-fracture
#5
Hamid Namazi, Toomaj Kayedi
Introduction Fracture of the scaphoid bone is the most common fracture of the carpus. However, the fracture union occurs late or may not heal. Sometimes, fracture healing requires prolong immobilization. Because of potential for joint stiffness, muscle atrophy, or the inability to use the hand during and after prolonged immobilization, there is great incentive to develop therapies that will accelerate bone healing and allow a quick return to work. To date, the effect of platelet-rich plasma (PRP) on scaphoid fracture has not been studied...
December 2016: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/27939913/non-structural-cancellous-bone-graft-and-headless-compression-screw-fixation-for-treatment-of-scaphoid-waist-non-union
#6
S H Han, H J Lee, I T Hong, U Kim, S J Lee
PURPOSE: Scaphoid fracture commonly occurs around the mid-third of the scaphoid, and non-union of this fracture has several treatment options. The authors performed autologous cancellous bone graft from the iliac crest and headless compression screw fixation for the treatment of Mack-Lichtman type II scaphoid waist non-union. The purpose of this study was to determine whether this procedure was effective in achieving bony union and restoration of alignment. METHODS: Medical records and radiographs of 30 patients who underwent cancellous bone graft and headless compression screw fixation for non-union of scaphoid waist fracture were retrospectively reviewed...
December 7, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27896458/prognostic-factors-in-the-treatment-of-carpal-scaphoid-non-unions
#7
F Schuind, F Moungondo, W El Kazzi
In this literature review, the authors analyse the prognostic factors in the curative treatment of scaphoid non-unions. The main negative prognostic factors are smoking, the time elapsed since the fracture, and avascular necrosis of the proximal fragment. If the latter is present, the revascularization by a pedicle or microsurgical bone autograft is probably the treatment of choice. In non-unions without evidence of osteonecrosis, vascularized bone grafts are probably not superior to conventional bone grafts, which can presently be performed under arthroscopic control, with minimal morbidity...
November 28, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27890247/reproducibility-of-x-rays-and-ct-arthrography-in-slac-snac-scac-wrists
#8
R Belhaouane, N Lebeau, C Maes-Clavier, C Hustin, E Krief, B Bonnaire, M Warin, V Rotari, E David
The purpose of this study was to assess the inter-observer and intra-observer reproducibility of the interpretation of CT arthrography and plain X-rays for scapholunate advanced collapse (SLAC), scaphoid non-union advanced collapse (SNAC) and scaphoid chondrocalcinosis advanced collapse (SCAC) wrist conditions, as well as the clinical relevance of these imaging modalities. The CT and X-rays images were reviewed twice in a blinded and randomized manner by two experienced orthopedic surgeons specialized in hand surgery, two orthopedic surgery residents and two experienced radiologists specialized in bone and joint imaging...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27847665/an-unusual-and-complicated-course-of-a-giant-cell-tumor-of-the-capitate-bone
#9
Ingo Schmidt
A 51-year-old female patient presented with a carpal giant cell tumor (GCT) of the right capitate bone. The lesion was initially misdiagnosed as having an osteomyelitis. First, the diagnosis of a benign GCT was confirmed by histological examination. Second, an intralesional curettage and packing of the cavity with cancellous iliac crest bone grafts combined with a fusion of the third carpometacarpal (CMC III) joint were carried out. Third, due to a secondary midcarpal osteoarthritis and a secondary scaphoid nonunion, the CMC III joint fusion plate was removed and the midcarpal joint completely excised...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27830329/management-of-scaphoid-nonunion-with-iliac-crest-bone-graft-and-k-wire-fixation
#10
Erin Meisel, Alex Seal, Caroline A Yao, Alidad Ghiassi, Milan Stevanovic
PURPOSE: Scaphoid nonunion can occur in both non-operative and operatively treated scaphoid fractures. Without treatment, this can lead to a predictable pattern of carpal collapse and degenerative arthritic change and patients can experience both pain and functional loss in the early and late phases of progression. An operative technique with a high success rate for union is important. This paper describes a technique for treatment of scaphoid nonunion with K-wire fixation and iliac crest cancellous bone graft...
November 9, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27811625/internal-bone-grafting-for-the-treatment-of-scaphoid-nonunions
#11
Utkan Aydin, Sunil M Thirkannad
Scaphoid fracture is the most common carpal fracture of the upper extremity and a significant proportion of these can eventually progress to nonunion. Excision of pseudoarthrosis and fibrous scar tissue at the nonunion site is regarded as one of the important steps in management of scaphoid nonunions. We describe a technique of internal bone grafting, where curettage of the nonunion site was performed through a drill hole in the scaphoid and bone graft was packed through this same hole before fixation with a headless compression screw...
November 2, 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27803379/four-corner-arthrodesis-employing-the-native-scaphoid-as-the-principal-donor-graft-for-advanced-collapse-deformity-of-the-wrist-technique-and-outcomes
#12
S M Koehler, C P Melone
: The purpose of this study was to determine the functional, radiographic, and subjective outcome of the authors' technique of four-corner arthrodesis using the en bloc excised scaphoid as the principal donor bone graft coupled with Kirschner wire fixation. The study comprised 40 consecutive patients with progressive Stage II and III scapholunate advanced collapse or scaphoid nonunion advanced collapse deformities. Preoperative and postoperative range of motion, grip strength, carpal height, and Michigan Hand Outcomes Questionnaire responses were assessed with a mean follow-up of 4...
October 31, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27793864/unilateral-fusion-of-the-scaphoid-and-the-trapezium
#13
Alexander Robert Poublon, Gerald Kraan, Gert-Jan Kleinrensink
Fusion of the carpal bones is a rare anatomical abnormality, caused by a defect in the separation and cavitation during embryonic development. It has a prevalence of about 0.1% and most of the time, patients do not present with symptoms. Symptoms are usually caused by wear and tear of the ligaments attached to the fused carpal fragments. We present a case in which a woman aged 36 years experiences pain caused by a lunato-triquetral instability which in turn is caused by a unilateral complete fusion of the scaphoid and the trapezium...
October 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27785580/management-of-scaphoid-nonunions-with-vascularized-bone-grafts-from-the-distal-radius-mid-to-long-term-follow-up
#14
Konstantinos N Malizos, Zoe Dailiana, Sokratis Varitimidis, Antonios Koutalos
Scaphoid nonunion represents a challenging problem that leads to disability if neglected. Vascularized bone grafts are proposed to augment the local biology and increase the likelihood of union but long-term outcomes are sparse. In this work, we present the mid- to long-term outcome of 140 scaphoid nonunions managed with vascularized bone grafts from the distal radius. Sixteen patients underwent concomitant closed wedge osteotomy of the distal radius because of arthritic changes. There were 130 males and ten females, with mean time from injury to surgery 3...
October 26, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27781988/a-ten-year-prospective-outcome-study-of-pi2%C3%A2-pyrocarbon-spacer-arthroplasty-in-carpometacarpal-joint-osteoarthritis
#15
C Agout, L Ardouin, P Bellemère
Surgical management of carpometacarpal osteoarthritis may use many techniques. Pi2 (pyrocarbon interposition implant) arthroplasty is one possible solution after total trapeziectomy. The present study assessed clinical and radiological results in Pi2 arthroplasty at a minimum 10years' follow-up. Forty-two consecutive cases underwent surgery between March 2003 and April 2005; 29 were followed up for a mean of 125.49months (10.5years). A total of 96.6% of patients were very satisfied or satisfied. Range of motion improved, especially in opposition (mean Kapandji score, 9...
September 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27777822/the-role-of-dynamic-4d-ct-in-the-detection-of-scapholunate-ligament-injury
#16
Sanjeev Kakar, Ryan E Breighner, Shuai Leng, Cynthia H McCollough, Steven L Moran, Richard A Berger, Kristin D Zhao
Background Scapholunate (SL) interosseus ligament injuries detected at an early stage could allow the surgeon to prevent progression through the spectrum of injury that leads to instability, and eventually osteoarthritis. We contend that early instability following injury can be detected by visualizing the relative motions and distances between the involved carpal bones (scaphoid and lunate) during wrist movement in vivo. The purpose of this study is to demonstrate the utility of dynamic CT (i.e., 4DCT) in diagnosing SL interosseus ligament injuries in two patients with clinical suspicion of SL interosseus ligament injury during flexion-extension (FE), radial-ulnar (RU) deviation, and dart thrower's (DT) motions...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777816/stage-iii-advanced-wrist-collapse-treatment-options-a-cadaveric-study
#17
Jorge Chahla, Jason M Schon, Ramiro Olleac, Sebastián Senes, Damián Arroquy, Chase S Dean, Gabriel Clembosky, Alvaro Muratore
Background Scapholunate advanced collapse and scaphoid nonunion advanced collapse result in high morbidity and pose significant challenges for active patients. Multiple treatment options have been proposed to yield satisfactory results; however, restoration of physiological wrist motion remains an issue. Questions/Purposes The objective of this study was to compare wrist mobility after four different treatment methods for grade III wrist collapse: (1) no treatment, (2) scaphoidectomy and lunate-capitate arthrodesis, (3) scaphoidectomy, lunate-capitate arthrodesis, and triquetrum-hamate arthrodesis, and (4) scaphoidectomy, lunate-capitate arthrodesis, and triquetrum excision...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777813/the-etiology-and-pathogenesis-of-kienb%C3%A3-ck-disease
#18
Gregory Ian Bain, Simon Bruce Murdoch MacLean, Chong Jin Yeo, Egon Perilli, David M Lichtman
Kienböck disease is a condition that typically occurs in the "at-risk" patient, in the "at-risk" aspect of the proximal condyle of the "at-risk" lunate. In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. The lunate fracture commences at the point the lunate cantilevers over the edge of the distal radius, and then takes on the shape of the radius. We postulate that the stress fracture violates the parallel veins of the venous subarticular plexus-leading to localized venous hypertension and subsequent ischemia and edema of the fatty marrow...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27766431/ilizarov-fixation-for-the-treatment-of-scaphoid-nonunion-a-novel-approach
#19
Marko Bumbaširević, Tomislav Palibrk, Henry Dushan E Atkinson, Aleksandar Lešić
OBJECTIVES: To evaluate the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft. DESIGN: This is a prospective study of 20 consecutive patients in one center. PATIENTS AND METHODS: This study included 20 patients (19 males) with a mean SNU duration of 14.5 months. Four patients had proximal pole, 15 had waist, and 1 had a distal SNU. Patients with carpal instability, humpback deformities, carpal collapse, avascular necrosis, and marked degenerative change were excluded...
October 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27761662/non-vascularized-bone-grafting-in-scaphoid-nonunion-principles-and-type-of-fixation
#20
Ryoko Uesato, Satoshi Toh, Yoshimitsu Hayashi, Keiichiro Maniwa, Yasuyuki Ishibashi
In scaphoid fractures, delayed diagnosis and nonunion are fairly common as a result of several factors, including the difficulty of radiographic diagnosis of non-displaced fractures and underestimation of the injury by the patient. Main factors to consider when deciding treatment are the type of fracture and fracture stability. In the stable nonunion (Type D1 according to the Filan and Herbert classification, or linear type of Ikeda's classification), percutaneous screw fixation without bone graft is recommended...
October 19, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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