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scaphoid nonunion

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https://www.readbyqxmd.com/read/28629558/is-there-a-trend-in-ct-scanning-scaphoid-nonunions-for-deformity-assessment-a-systematic-review
#1
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
https://www.readbyqxmd.com/read/28552760/denervation-of-the-wrist%C3%A2-with-two-surgical-incisions-is-it-effective-a-review-of-33-patients-with-an-average-of-41months-follow-up
#2
S Delclaux, F Elia, C Bouvet, C Aprédoaei, M Rongières, P Mansat
The goal of wrist denervation is to decrease pain at the wrist, whether caused by an intra- or extra-articular problem or even when the reason for the pain is unknown. It is an alternative to partial or total arthrodesis and proximal row carpectomy. Our hypothesis was that wrist denervation with a two-incision technique was a reliable and efficient way to treat painful degenerative wrists. Thirty-three patients, 48years old on average, were included in this study. Indications were scapholunate advanced collapse (SLAC) in 18 cases, scaphoid nonunion advanced collapse (SNAC) in 10, distal radius fracture sequelae with advanced radiocarpal osteoarthritis in 4, and post-traumatic ulnocarpal impingement in 1 case...
May 25, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28533002/the-radial-aspect-of-the-distal-radial-metaphysis-diaphysis-as-a-source-of-cortical-bone-graft
#3
REVIEW
Steven Regal, Aakash Chauhan, Peter Tang
Cortical bone grafting is commonly required in the finger, hand, and carpus when managing bony trauma. A donor site that can provide a small or large amount of cortical bone graft that is easily accessible and within the same surgical field would be the ideal donor site. In high-energy injuries, a long cortical graft may be needed to reconstruct massive bony defects. In low-energy injuries such as scaphoid nonunions in which a wedge graft is needed, a reliable and easily accessible source of bone grafting would be beneficial...
May 19, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28465197/effect-of-four-corner-fusion-with-locking-plate-without-bone-graft-on-functional-recovery-of-the-wrist-new-treatment-guidelines
#4
A Tielemans, F Van Innis, S Troussel, C Detrembleur, X Libouton, T Lequint
We assessed the effect of four-corner intercarpal fusion with locking plate without bone graft on daily activities and pain in patients with stage II and III scapholunate advanced collapse and scaphoid nonunion. Twenty-one patients who underwent four-corner fusion with scaphoidectomy without bone graft were evaluated with the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Visual Analog Scale (VAS) pain scores before and 16 months after surgery. We also compared postoperative grip strength between the operated and the healthy side...
April 5, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28458971/successful-arthroplasty-using-cadaveric-meniscus-for-osteochondral-defects-in-the-wrist-and-hand-joints
#5
Don Hoang, Vivi W Chen, Daniel J Gould, Myles J Cohen, David A Kulber
BACKGROUND: Osteochondral defects of the radiocarpal, metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints often necessitate joint arthrodesis or mechanical arthroplasty, which has a limited lifespan. In severely arthritic wrist and finger joints, we propose a novel adjunct for joint salvage using cadaveric meniscus for joint resurfacing as an off-the-shelf alternative to address osteochondral defects and restore normal intraarticular contact stress. METHODS: A total of 14 patients with osteochondral defects in 5 radiocapitate, 5 MCP, 3 PIP, and 1 carpometacarpal joints received cadaveric meniscus to facilitate arthroplasty...
March 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28453341/the-scaphoid-staple-a-systematic-review
#6
John Dunn, Nicholas Kusnezov, Austin Fares, Justin Mitchell, Miguel Pirela-Cruz
BACKGROUND: The purpose of this systematic review is to analyze the indications, outcomes, and complications of scaphoid fixation with a staple. METHODS: The literature was reviewed for all cases of the scaphoid staple. Five articles including 188 patients, of 77 primary scaphoid fractures and 111 other indications that included delayed union, nonunion, and avascular necrosis, were reviewed. Demographic data, outcomes, and complications were recorded. RESULTS: The union rate of the scaphoid staple is 94...
May 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28428921/distal-scaphoid-resection-and-prosthetic-semireplacement-arthroplasty-for-a-scaphoid-nonunion-with-degenerative-changes
#7
Paul W L Ten Berg, Miryam C Obdeijn
No abstract text is available yet for this article.
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28428913/comparison-of-magnetic-resonance-imaging-and-radiographs-for-evaluation-of-carpal-osteoarthritis
#8
Angela E Li, Steve K Lee, Schneider K Rancy, Alissa J Burge, Hollis G Potter, Scott W Wolfe
Background We sought to evaluate the interobserver and intraobserver reliability of radiographs and magnetic resonance imaging (MRI) for grading of osteoarthritis in patients with scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC), and to determine whether MRI is more likely than radiographs to detect carpal osteoarthritis. Methods Radiographs and MR studies of 46 patients with SLAC and SNAC arthritis were reviewed by two hand surgeons and two radiologists and were graded according to severity of osteoarthritis at seven carpal joints...
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28391752/low-intensity-pulsed-ultrasound-for-nonoperative-treatment-of-scaphoid-nonunions-a-meta-analysis
#9
Edward W Seger, Julio J Jauregui, Steven A Horton, Gerardo Davalos, Erika Kuehn, Michael A Stracher
BACKGROUND: Scaphoid fractures progress to nonunion rates of up to 15% when non-displaced, and are even more frequent when the fracture is displaced. Standard treatment in these cases is surgery; however, individuals unable to undergo this operation, or for those who wish to try more conservative measures, there may be benefit from nonoperative options. Of these, low-intensity pulsed ultrasound (LIPUS) has been shown to improve fracture nonunion healing. The purpose of this study was to perform a comprehensive meta-analysis of relevant literature to determine success of the use of LIPUS for treatment of scaphoid nonunion...
April 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28383357/radiopaque-element-to-evaluate-adequacy-of-debridement-of-bony-lesions
#10
Nicholas Pulos, Alexander Y Shin
A technique for using an x-ray detectable radiopaque element from a surgical sponge to assess the adequacy of debridement of carpal bone cysts, Kienböck disease (lunate avascular necrosis), enchondroma of the digits, and scaphoid nonunions is described. The technique is simple to perform, inexpensive, and presents minimal additional risk to the patient. The technique has been used over the past 16 years and has enabled adequate debridement of these hand and wrist maladies by radiographically demonstrating the adequacy of the debridement to be bone grafted...
April 21, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28344523/scaphoid-nonunion-with-poor-prognostic-factors-the-role-of-the-free-medial-femoral-condyle-vascularized-bone-graft
#11
Tahseen Chaudhry, Lauren Uppal, Dominic Power, Michael Craigen, Simon Tan
Background: To report on the results of free medial femoral condyle (MFC) vascularized bone graft for scaphoid nonunions with 1 or more poor prognostic factors. Methods: We have used the free MFC vascularized bone graft for scaphoid nonunions that have 1 or more factors associated with a poor prognosis. These were, a delay in presentation of over 5 years, a proximal pole nonunion, the presence of avascular necrosis (AVN), or previous nonunion surgery. We used this technique on 20 patients over a 4.5-year period...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28344522/vascularized-bone-grafting-in-scaphoid-nonunion-a-review-of-patient-centered-outcomes
#12
REVIEW
Ram K Alluri, Christine Yin, Matthew L Iorio, Hyuma Leland, Jason Wong, Ketan Patel
Background: The radiographic and clinical outcomes following vascularized bone grafting (VBG) for scaphoid nonunion have previously been reported in the literature; however, few studies report on patient-derived outcomes. The purpose of this study was to determine the effect of VBG for scaphoid nonunion on patient-derived outcomes. Methods: The MEDLINE and PubMed databases were queried for the use of VBG in scaphoid nonunion. We included studies that reported on patient-derived outcomes. We excluded studies with less than 10 patients or less than 6 months of follow-up...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28340662/vascularized-small-bone-transfers-for-fracture-nonunion-and-bony-defects
#13
REVIEW
Ai Dong Deng, Marco Innocenti, Rohit Arora, Markus Gabl, Jin Bo Tang
Vascularized small-bone grafting is an efficient and often necessary surgical approach for nonunion or necrosis of several bones in particular sites of the body, including scaphoid, lunate, distal ulna, and clavicle. The medial femoral condyle is an excellent graft source that can be used in treating scaphoid, ulna, clavicle, or lower-extremity bone defects, including nonunion. Vascularized bone grafting to the small bones, particularly involving reconstruction of damaged cartilage surfaces, should enhance subchondral vascular supply and help prevent cartilage regeneration...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340661/medial-femoral-trochlea-osteochondral-flap-applications-for-scaphoid-and-lunate-reconstruction
#14
REVIEW
James P Higgins, Heinz K Bürger
Vascularized osteochondral flaps are a new technique described for the reconstruction of challenging articular defects of the carpus. The medial femoral trochlea osteochondral flap is supplied by the descending geniculate artery. This osteochondral flap has shown promise in the treatment of recalcitrant scaphoid proximal pole nonunions and advanced avascular necrosis of the lunate. The anatomy, surgical technique, and results are discussed, with clinical cases provided.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28259113/surgeon-based-3d-printing-for-microvascular-bone-flaps
#15
Erin M Taylor, Matthew L Iorio
Background Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer. Methods Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Open source imaging software was used to convert preoperative computed tomography scans and create 3D models...
July 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28243717/clinical-outcome-after-alternative-treatment-of-scaphoid-fractures-and-nonunions
#16
A L Sander, K Sommer, D Schäf, C Braun, I Marzi, T Pohlemann, J Frank
PURPOSE: Achieving stable fixation of scaphoid fractures and nonunions continues to be a challenge. Compression screw fixation has been the current standard surgical procedure. However, in some cases, bone healing cannot be achieved and requires further revision. Recent series reintroduced volar plating as valid option for stable fixation. The aim of the study was to review clinical outcome of alternative scaphoid treatment. METHODS: From 2011 to 2014, nine patients with scaphoid fracture were treated by Headless Compression Screw (HCS) and seven patients with scaphoid nonunion by HCS or volar mini condylar plate with bone graft...
February 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28149221/proximal-scaphoid-pole-reconstruction-utilizing-ipsilateral-proximal-hamate-autograft
#17
Bassem Elhassan, Mohamed Noureldin, Sanjeev Kakar
Background: Fractures of the proximal pole of the scaphoid can be difficult to heal because of its limited vascular supply. Furthermore, nonunion with avascular necrosis and secondary fragmentation makes surgical reconstruction a challenging procedure. Method: We describe a technique and report the outcome of a proximal hamate autograft to treat a proximal pole scaphoid nonunion with avascular necrosis. Results: At 3.5 years post reconstruction, the patient remains asymptomatic with union of his scaphoid reconstruction without any evidence of scapholunate instability...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28137436/arthroscopic-grafting-of-scaphoid-nonunion%C3%A2-%C3%A2-surgical-technique-and-preliminary-findings-from-23-cases
#18
J-M Cognet, P Louis, X Martinache, F Schernberg
We report our experience with the arthroscopic treatment of 23 cases of scaphoid nonunion. We explain the surgical technique and describe the different steps needed to achieve bone union. We report our initial clinical and radiological results. This was a prospective non-randomized study. Inclusion criteria were a scaphoid nonunion without radiocarpal arthritis, without any time limit and without any selection as to nonunion location. Before the operation, patients underwent an X-Ray and CT scan or MRI. Schernberg's classification was used to evaluate the location of the nonunion...
February 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28027846/pediatric-scaphoid-proximal-pole-nonunion-with-avascular-necrosis
#19
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...
April 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28018058/intramedullary-screw-and-kirschner-wire-fixation-for-unstable-scaphoid-nonunion
#20
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
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