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scaphoid nonunion

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https://www.readbyqxmd.com/read/28942683/a-comparison-of-plate-versus-screw-fixation-for-segmental-scaphoid-fractures-a-biomechanical-study
#1
Jill A Goodwin, Paulo Castañeda, Ryan P Shelhamer, Liam C Bosch, Scott G Edwards
BACKGROUND: Volar locking plate fixation may offer several advantages over headless screw fixation for scaphoid nonunion, or segmental or comminuted fractures: (1) increased surface area for bony healing; (2) preserved vascularity; and (3) maintenance of a gap for graft insertion. The purpose of this study is to compare headless screw and locking plate fixation of segmental scaphoid fractures and to determine whether either fixation provides a greater mechanical advantage in osteoporotic versus nonosteoporotic bone...
September 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28921041/stabilization-of-scaphoid-type-b2-fractures-with-one-or-two-headless-compression-screws
#2
S Quadlbauer, T Beer, Ch Pezzei, J Jurkowitsch, A Tichy, T Hausner, M Leixnering
INTRODUCTION: Fractures of the scaphoid account for the most commonly injured carpal bone. Minimally displaced fractures of the waist will heal in 85-90% when using a below elbow cast. However, fractures with displacement have a higher risk for nonunion. Therefore, open reduction and fixation with headless compression screws (HCS) have become the preferred method of treatment. The aim of this study was to compare the radiological and clinical outcome of unstable scaphoid B2 type fractures, stabilized using one or two headless compression screws...
September 18, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28906587/vascularized-thumb-metacarpal-periosteal-pedicled-flap-for-scaphoid-nonunion-an-anatomical-study-and-pediatric-case-report
#3
Sergi Barrera-Ochoa, Gerardo Mendez-Sanchez, Alfonso Rodriguez-Baeza, Jorge Knörr, Jayme Augusto Bertelli, Francisco Soldado
PURPOSE: Through an anatomical review, the primary aim of this study was to delineate the dorsal thumb metacarpal (TM) periosteal branches of the radial artery (RA). In addition, we report here the clinical utility of a vascularized TM periosteal pedicled flap (VTMPF), supplied by the first dorsal metacarpal artery (FDMA), in a complex case of scaphoid nonunion. METHODS: Ten latex-colored upper limbs from fresh human cadavers were used. Branches of the RA were dissected under 3x loupe magnification, noting the periosteal branches arising from the FDMA...
September 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28893145/non-vascularized-iliac-bone-grafting-for-scaphoid-nonunion-with-avascular-necrosis
#4
Jihyeung Kim, Jin Woo Park, Jeehyeok Chung, Kee Jeong Bae, Hyun Sik Gong, Goo Hyun Baek
We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion with avascular necrosis. Although revascularization of the proximal fragment after surgery was not evaluated, bony union was confirmed in nearly all patients...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28888525/clinical-and-radiological-outcomes-following-radioscapholunate-fusion
#5
David Montoya-Faivre, Germain Pomares, Valentin Calafat, François Dap, Gilles Dautel
INTRODUCTION: Radioscapholunate (RSL) fusion is typically performed following wrist trauma. It addresses the pain caused by radiocarpal osteoarthritis but reduces the wrist's mobility. The objective of this study was to determine the long-term clinical and radiological outcomes of this procedure. MATERIALS AND METHODS: This was a retrospective study of all wrists operated for RSL fusion in our surgery unit over a 12-year period. The clinical analysis consisted of joint amplitudes, grip strength, pain (VAS) and functional scores (PRWE, QuickDash, Mayo Wrist Score)...
September 6, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28856357/trans-scaphoid-transcapitate-perilunate-fracture-dislocation
#6
Vasilios A Kontogeorgakos, Andreas F Mavrogenis, Panayiotis Megaloikonomos, Georgios Panagopoulos, Vasilios Mandalos, Leonidas Badras
Trans-scaphoid transcapitate (TSTC) perilunate fracture-dislocation (PLFD) is a rare type of perilunate injury. Because of the rarity and complexity of this entity, initial diagnosis may be delayed and the extent of osseous and ligamentous lesions underestimated. Early surgical treatment by open reduction and fracture stabilization is recommended to avoid complications such as avascular necrosis, nonunion, posttraumatic arthritis, and functional impairment. In this article, we report the case of a 32-year-old man who sustained a TSTC-PLFD...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28852786/-the-scaphoid-fracture-between-pseudoarthrosis-and-possible-anatomical-variance
#7
A H Roushan, D J Tilkorn, C Heyer, J Hauser, H Sorg
The diagnosis of a scaphoid fracture, especially in the differentiation of a fresh fracture, the nonunion or a possible anatomical norm variant, can be difficult. We report on two patients who presented with stress-related, radiocarpal pain in our department. In both cases, radiological abnormalities were observed in the scaphoideal area, with a scaphoideum bipartitum on both sides, as well as an approximately 25-year-old scaphoid pseudarthrosis.
August 29, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28832203/the-fourth-extensor-compartment-artery-vascularized-bone-graft-of-the-distal-radius-for-cmc-fusion-in-the-treatment-of-carpal-boss-a-case-report
#8
Jorge G Boretto, David Fernandez-Fernandez, Gerardo Gallucci, Pablo De Carli
BACKGROUND: Carpometacarpal joints can be affected by traumatic or degenerative pathology. Although different techniques have been described to treat these conditions, most authors agree that arthrodesis is an effective treatment modality. Vascularized bone grafts of the distal radius have been used to treat carpal conditions, such as scaphoid nonunion or Kiënbock disease, and they have been shown to have several advantages over nonvascularized bone grafts. METHODS: We report a case of a carpal boss in a female patient treated with an arthrodesis of the second and third carpometacarpal joints by using the fourth extensor compartment artery vascularized bone graft...
September 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28832197/does-a-comparison-view-improve-the-reliability-of-staging-wrist-osteoarthritis
#9
Paul W L Ten Berg, Tessa Drijkoningen, Thierry G Guitton, David Ring
BACKGROUND: Radiological grading of wrist osteoarthritis associated with scaphoid nonunion advanced collapse (SNAC) can be difficult. A comparison radiograph of the contralateral healthy wrist and an educational training in the various SNAC stages may improve reliability. Our purposes were to evaluate the difference in the reliability: (1) between observers who rate SNAC wrists with and without a comparison radiograph; and (2) between observers who receive training prior to ratings and those who do not...
September 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28791454/-midcarpal-partial-arthrodesis-with-locking-plate-osteosynthesis
#10
REVIEW
J-F Hernekamp, U Kneser, T Kremer, B Bickert
OBJECTIVE: Preservation of residual mobility and pain reduction in the wrist in advanced carpal collapse (scapholunate advanced collapse, SLAC or scaphoid nonunion advanced collapse, SNAC). INDICATIONS: Advanced osteoarthritis of the radiocarpal and intercarpal articulations, SLAC/SNAC stages 2-3. CONTRAINDICATIONS: Arthrotic alterations to the proximal joint surface of the lunate bone or the corresponding joint surface of the radius (lunate fossa)...
August 8, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28765988/scaphoid-nonunion-does-open-reduction-bone-grafting-and-herbert-screw-fixation-justify-the-treatment
#11
K C Kapil Mani, Parimal Acharya
PURPOSE: Conventional bone grafting and Herbert screw fixation give satisfactory results for scaphoid nonunion; however, vascularized bone grafting has superior results, especially in the case of avascular necrosis of proximal fragment. Vascularized bone grafting is technically more demanding with small error of margin, problems of getting the appropriate graft, fixation and incorporation, and requires longer duration for wrist immobilization. METHODS: Forty-five patients of scaphoid nonunion were treated by cancellous bone grafting, cortex containing graft if required and Herbert screw fixation...
August 1, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28746289/management-of-scaphoid-fractures
#12
Jason H Ko, Mitchell A Pet, Joseph S Khouri, Warren C Hammert
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Understand the epidemiology, classification, and anatomy pertinent to the scaphoid. 2. Appropriately evaluate a patient with suspected scaphoid fracture, including appropriate imaging. 3. Understand the indications for operative treatment of scaphoid fractures, and be familiar with the various surgical approaches. 4. Describe the treatment options for scaphoid nonunion and avascular necrosis of the proximal pole...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28733100/long-term-outcomes-after-distal-scaphoid-fractures-a-10-year-follow-up
#13
Martin Clementson, Niels Thomsen, Jack Besjakov, Peter Jørgsholm, Anders Björkman
PURPOSE: The aim of this study was to evaluate the functional, clinical, and radiological outcome 10 years after distal scaphoid fractures. METHODS: From a prospective epidemiological study on posttraumatic radial-sided wrist pain, we evaluated 41 cases of distal scaphoid fractures. All cases had been treated nonsurgically in a thumb spica cast. Patients were examined using radiographs, magnetic resonance imaging and computed tomography at the time of injury and with computed tomography after a median of 10 years (range, 8-11 years)...
July 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28725510/a-critical-appraisal-of-vascularized-bone-grafting-for-scaphoid-nonunion
#14
Ram K Alluri, Christine Yin, Matthew L Iorio, Hyuma Leland, Wendy J Mack, Ketan Patel
Background  Vascularized bone grafting (VBG) has the potential to yield reliable results in scaphoid nonunion; however, results across studies have been highly variable. This study critically evaluates surgical techniques, fracture location, and patient selection in relation to radiographic, clinical, and patient-centered outcomes after VBG for scaphoid nonunion. Methods  We conducted a systematic review of the literature for the use of VBG in scaphoid nonunion. Physical examination, radiographic, and patient-centered outcomes were assessed...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28725498/percutaneous-transtrapezial-fixation-without-bone-graft-leads-to-consolidation-in-selected-cases-of-delayed-union-of-the-scaphoid-waist
#15
Matthias Vanhees, Roger R P van Riet, Annemieke van Haver, Radek Kebrle, Geert Meermans, Frederik Verstreken
Purpose  We evaluated clinical and radiographic outcome of percutaneous transtrapezial fixation of the scaphoid delayed union or nonunion using a headless bone screw without bone grafting. Methods  Sixteen patients with delayed union or nonunion of the scaphoid were included in this retrospective study between 2006 and 2011. All patients had a delayed presentation of scaphoid fracture, and none of them was treated conservatively elsewhere. Patients with bone graft, sclerotic bone debridement, or displacement of the fragment at the nonunion site were excluded...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28676150/volar-radioscapholunate-arthrodesis-and-distal-scaphoidectomy-after-malunited-distal-radius-fractures
#16
Stefan Quadlbauer, Martin Leixnering, Josef Jurkowitsch, Thomas Hausner, Christoph Pezzei
PURPOSE: The purpose of this study was to assess range of motion (ROM), pain, and incidence of radiographic degenerative joint disease (DJD) after volar radioscapholunate (RSL) arthrodesis and distal scaphoidectomy (DSE) following malunited distal radius fractures (DRF). METHODS: Fourteen patients with malunited DRF and DJD limited to the radiocarpal joint underwent RSL arthrodesis and DSE between 2006 and 2014. These were retrospectively analyzed both clinically and radiologically...
September 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28656159/the-prevalence-of-unanticipated-hamate-hook-abnormalities-in-computed-tomography-scans-a-retrospective-study
#17
Silke A Spit, Stéphanie J E Becker, Michiel G J S Hageman, David Ring
BACKGROUND: It is possible that some hamate hook fractures are not diagnosed or treated, thereby affecting the study of their natural history. Study of the prevalence of incidental hamate hook fractures, nonunions, and other abnormalities on computed tomography (CT) ordered for another reason could document a subset of undiagnosed and untreated hamate hook fractures which might change our understanding about the natural history. METHODS: Reports of 2489 hand, wrist, and forearm CT scans for hamate hook abnormalities were searched...
May 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28644943/failure-of-wrist-hemiarthroplasty
#18
Eric G Huish, Zachary Lum, H Brent Bamberger, Marc A Trzeciak
BACKGROUND: Wrist hemiarthroplasty has emerged as a motion-sparing option for severe wrist arthritis. It is technically easy with advantages of limited bone resection and no risk of nonunion. Given the relative infancy of the procedure in clinical practice, there are limited data on patient outcomes. METHODS: Eleven patients were treated with wrist reconstructive hemiarthroplasty. Indications included 1 patient with scaphoid nonunion advanced collapse, 9 patients with scapholunate advanced collapse, and 1 patient with capitolunate arthritis...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644940/percutaneous-treatment-of-unstable-scaphoid-waist-fractures
#19
Andrew P Matson, Ryan M Garcia, Marc J Richard, Fraser J Leversedge, J Mack Aldridge, David S Ruch
BACKGROUND: Percutaneous techniques have been described for the treatment of nondisplaced scaphoid fractures, although less information has been reported about outcomes for unstable, displaced fractures. The aim of this study was to evaluate the union and complication rates following manual closed reduction and percutaneous screw placement for a consecutive series of unstable, displaced scaphoid fractures. METHODS: A total of 28 patients (average age, 27 years; 22 male/6 female) were treated for isolated unstable displaced scaphoid waist fractures...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28629558/is-there-a-trend-in-ct-scanning-scaphoid-nonunions-for-deformity-assessment-a-systematic-review
#20
REVIEW
Paul W L Ten Berg, Marieke G A de Roo, Mario Maas, Simon D Strackee
PURPOSE: The effect of scaphoid nonunion deformity on wrist function is uncertain due to the lack of reliable imaging tools. Advanced three-dimensional (3-D) computed tomography (CT)-based imaging techniques may improve deformity assessment by using a mirrored image of the contralateral intact wrist as anatomic reference. The implementation of such techniques depends on the extent to which conventional CT is currently used in standard practice. The purpose of this systematic review of medical literature was to analyze the trend in CT scanning scaphoid nonunions, either unilaterally or bilaterally...
June 2017: European Journal of Radiology
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