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Scaphoid bone

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
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
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
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
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
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
Kerrin C DePeter, Stephen M Blumberg, Sarah Dienstag Becker, James A Meltzer
BACKGROUND: Despite being an effective analgesic for children with fractures, some clinicians may avoid prescribing ibuprofen due to its potentially harmful effect on bone healing. OBJECTIVE: To determine if exposure to ibuprofen is associated with an increased risk of bone healing complications in children with fractures. METHODS: We performed a retrospective study of children aged 6 months to 17 years who presented to the pediatric emergency department (PED) with a fracture of the tibia, femur, humerus, scaphoid, or fifth metatarsus and who followed up with the orthopedic service...
October 14, 2016: Journal of Emergency Medicine
M Tatebe, H Hirata, K Tanaka, T Oguchi, S Urata
The purpose of this study was to review the clinical results of carpal ligaments injuries with scaphoid nonunion. We hypothesized that scaphoid nonunion with carpal ligament injury is associated with clinical result. We retrospectively reviewed 60 cases of -Herbert screw fixation with bone graft for scaphoid nonunions. Scapholunate (SL) and lunotriquetral (LT) ligaments lesions were confirmed by arthroscopy. Approximately half of the nonunion scaphoid cases had carpal ligaments injuries. At final follow-up evaluation, wrist function as evaluated by the Mayo wrist score was excellent in 34 patients, good in 16 patients, fair in 8 patients, and poor in 2 patients...
August 2016: Acta Orthopaedica Belgica
K Kalb
BACKGROUND: Avascularity of fragments is a common problem in treatment of scaphoid nonunion. Therefore, vascularised bone grafts have gained increasing importance. Especially the free vascularised femoral trochlea flap has become the subject of special interest because of its particular characteristics in the last few years. OBJECTIVES: Indications for and the technique of free vascularised corticocancellous as well as osteocartilagineous femoral trochlea flap are reported according to the author's practice combined with an evaluation of these methods considering current literature...
September 20, 2016: Der Orthopäde
T Kahl, F K Razny, J P Benter, K Mutig, K Hegenscheid, S Mutze, A Eisenschenk
The clinical relevance of scaphoid bone fractures is reflected by their high incidence, accounting for approximately 60 % among carpal fractures and for 2-3 % of all fractures. With adequate therapy most scaphoid bone fractures heal completely without complications. Insufficient immobilization or undiagnosed fractures increase the risk of nonunion and the development of pseudarthrosis.X-ray examination enables initial diagnosis of scaphoid fracture in 70-80 % of cases. Positive clinical symptoms by negative x‑ray results require further diagnostics by multi-slice spiral CT (MSCT) or MRI to exclude or confirm a fracture...
September 16, 2016: Der Orthopäde
A Asmus, M Lautenbach, B Schacher, S Kim, A Eisenschenk
BACKGROUND: Operative treatment of the scaphoid nonunion includes avascular corticocancellous and cancellous bone grafts and increasingly the use of vascular pedicled and free vascular corticocancellous grafts. Especially the latter require a fair amount of operative expertise and experience in microsurgical techniques. OBJECTIVE: Which criteria lead to the decision for or against an avascular graft used for reconstruction of scaphoid nonunion? Is our current classification system of a scaphoid pseudarthrosis able to illustrate our diagnostic potential in a way that makes us refer to operative procedures? METHODS: Evaluation of current literature and expert opinions RESULTS: Avascular bone grafts show a high union rate as long as a sufficient vascularisation of the remaining fragments is present...
September 16, 2016: Der Orthopäde
B Schacher, R Böttcher, A Vogel, A Asmus, S Kim, A Eisenschenk, F Eichenauer
BACKGROUND: Nonunion of the scaphoid as a result of proximal fractures, failed surgical reconstruction, and especially avascular fragment necrosis are possible indications of vascularized bone grafts. Various techniques of vascularized (pedicled and free) grafts have been described. Pedicled grafts from the direct vicinity of the wrist provide several benefits. Harvest-site morbidity is reduced and preserved graft perfusion, without the need for blood vessel anastomosis, may lead to an improved consolidation...
September 15, 2016: Der Orthopäde
Robert Zura, Ze Xiong, Thomas Einhorn, J Tracy Watson, Robert F Ostrum, Michael J Prayson, Gregory J Della Rocca, Samir Mehta, Todd McKinley, Zhe Wang, R Grant Steen
Importance: Failure of bone fracture healing occurs in 5% to 10% of all patients. Nonunion risk is associated with the severity of injury and with the surgical treatment technique, yet progression to nonunion is not fully explained by these risk factors. Objective: To test a hypothesis that fracture characteristics and patient-related risk factors assessable by the clinician at patient presentation can indicate the probability of fracture nonunion. Design, Setting, and Participants: An inception cohort study in a large payer database of patients with fracture in the United States was conducted using patient-level health claims for medical and drug expenses compiled for approximately 90...
September 7, 2016: JAMA Surgery
Souichi Ohta, Ryosuke Ikeguchi, Takashi Noguchi, Yukitoshi Kaizawa, Hiroki Oda, Hirofumi Yurie, Shuichi Matsuda
BACKGROUND: Percutaneous scaphoid screw fixation is a popular treatment for acute scaphoid fractures with no or minimal displacement. For treating scaphoid nonunions, however, open reduction and internal fixation with bone grafting is still the most popular treatment. Percutaneous fixation with bone grafting through the screw insertion hole has received little attention, although it minimizes damage to the surrounding tissues. We report excellent results of six scaphoid nonunions treated by retrograde percutaneous fixation with curettage and bone grafting through the distal insertion hole of a fully threaded headless screw...
October 2016: J Hand Surg Asian Pac Vol
Adam Hart, Edward J Harvey, Reza Rabiei, Francois Barthelat, Paul A Martineau
To promote a quicker return to function, an increasing number of patients are treated with headless screws for acute displaced and even non-displaced scaphoid fractures. Therefore, it is imperative to understand and optimize the biomechanical characteristics of different implants to support the demands of early mobilization. The objective of this study was to evaluate the biomechanical fixation strength of 4 headless compression screws under distracting and bending forces. The Acutrak Standard, Acutrak Mini, Synthes 3...
October 2016: Medical Engineering & Physics
Josef Jurkowitsch, E Dall'Ara, S Quadlbauer, Ch Pezzei, I Jung, D Pahr, M Leixnering
BACKGROUND: The literature describes the treatment of scaphoid fractures comparing the volar and dorsal approaches, the advantages and disadvantages of percutaneous screw fixation, as well as the treatment of scaphoid nonunions using different types of cancellous or corticocancellous bone grafts. Yet, to date no studies are available comparing the outcome of rotational stability in screw-fixed scaphoid fractures to angular stable systems. The purpose of this study is to provide reliable data about rotational stability in stabilised scaphoid fractures and to gain information about the rigidity and the stability of the different types of fixation...
November 2016: Archives of Orthopaedic and Trauma Surgery
A Eisenschenk
No abstract text is available yet for this article.
August 22, 2016: Der Orthopäde
Paul W L Ten Berg, Johannes G G Dobbe, Geert Meermans, Simon D Strackee, Frederik Verstreken, Geert J Streekstra
PURPOSE: In reconstructive surgery of scaphoid nonunions with humpback deformity, some surgeons recommend restoration of the normal scaphoid length whereas others overexpand the normal length to ensure carpal realignment and prevent late collapse. To be able to define overexpansion and investigate which levels of overexpansion yield optimal clinical results, a precise method for estimating the original scaphoid length is required. The purpose of this anatomic study was to investigate the precision of estimating normal scaphoid lengths based on intact adjacent bone dimensions, compared with using the contralateral scaphoid length...
September 2016: Journal of Hand Surgery
Matthew T Houdek, Jane M Matsumoto, Jonathan M Morris, Allen T Bishop, Alexander Y Shin
This study describes a novel technique for the preoperative surgical planning for an osteoarticular medial femoral condyle (MFC) graft to replace the proximal pole of a scaphoid. In cases of proximal pole scaphoid nonunion or in Preiser disease, fragmentation of the articular surface can occur, leading to significant pain and disability. Osteoarticular MFC bone grafting can be used to treat these injuries by providing a vascularized osteoarticular surface. Using 3-dimensional imaging and printing we are able to precisely model the injured scaphoid, and also accurately plan the harvest of MFC osteoarticular graft...
September 2016: Techniques in Hand & Upper Extremity Surgery
Vicente Carratalá, Francisco J Lucas, Eduardo Sánchez Alepuz, Eva Guisasola, Rafael Calero
Scapholunate (SL) ligament injury is among the most common injuries of the intrinsic ligaments of the carpus. Arthroscopic treatment in complete and nonacute injuries has had poor results. These cases have typically been treated using open surgical techniques that require a broad dorsal approach and produce soft tissue impairment, which leads to reduced wrist mobility. The development of wrist arthroscopy techniques has allowed the treatment of complete and nonacute injuries of the SL ligament, without the disadvantages of open surgery, respecting the soft tissues and avoiding injury of the posterior interosseous nerve, in an attempt to preserve the proprioception of the wrist and the secondary dorsal stabilizers...
April 2016: Arthroscopy Techniques
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