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scaphoid nonunion

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https://www.readbyqxmd.com/read/29258960/corticocancellous-bone-graft-vs-cancellous-bone-graft-for-the-management-of-unstable-scaphoid-nonunion
#1
J K Kim, J O Yoon, H Baek
INTRODUCTION: This study was undertaken to determine whether corticocancellous bone grafting and cancellous bone grafting differ in terms of bone union rate, restoration of scaphoid anatomy, and wrist function when unstable scaphoid nonunions are concomitantly treated by screw fixation. MATERIALS AND METHODS: This is retrospective cohort study. In Group A (17 patients), unstable scaphoid nonunion was treated with corticocancellous graft harvested from the iliac crest and headless compression screw using volar approach...
December 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29249268/treatment-outcomes-of-4-corner-arthrodesis-for-patients-with-advanced-carpal-collapse-an-average-of-4-years-follow-up-comparing-2-different-plate-types
#2
Lisa Reissner, Stefanie Hensler, Sebastian Kluge, Miriam Marks, Daniel B Herren
PURPOSE: The objective was to investigate the clinical and subjective outcomes of patients after 4-corner arthrodesis (FCA) for scapholunate advanced collapse (SLAC) or scaphoid nonunion advanced collapse (SNAC) and to analyze complications. Furthermore, we compared the long-term results of a first-generation nonlocking plate (Spider) and a plate with a locking screw design (Flower plate). METHODS: In a retrospective cohort study, we included 39 patients with stage II or III SLAC or SNAC who underwent FCA...
December 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29241360/interfragmentary-compression-forces-vary-based-on-scaphoid-bone-screw-type-and-fracture-location
#3
Samik Patel, Nathan Tiedeken, Lars Qvick, Richard E Debski, Robert Kaufmann, John R Fowler
BACKGROUND: The objective of this study was to determine the interfragmentary compression forces generated in a foam model as a function of headless compression screw type (fully threaded and central threadless) and fracture location. METHODS: Eighty-eight polyurethane foam models were fixed across a simulated transverse fracture with either a fully threaded screw or a central threadless screw. The location of the transverse fracture varied along the length of the foam model in 2 mm increments for 11 fracture locations...
December 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29234645/bone-graft-in-the-treatment-of-nonunion-of-the-scaphoid-with-necrosis-of-the-proximal-pole-a-literature-review
#4
Antônio Lourenço Severo, Marcelo Barreto Lemos, Osvandré Luiz Canfield Lech, Danilo Barreto Filho, Daniel Paulo Strack, Larissa Knapp Candido
Scaphoid fractures are the most common fractures of the carpal bones, corresponding to 60%. Of these, 10% progress to nonunion; moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized and non-vascularized bone grafts. To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different surgical techniques. The authors conducted a review of the literature using the following databases: PubMed and BIREME/LILACS, where 13 case series were selected (ten with use of vascularized bone grafts and three of non-vascularized bone grafts), according to inclusion and exclusion criteria...
November 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29165015/lessons-learned-from-volar-plate-fixation-of-scaphoid-fracture-nonunions
#5
Seth D Dodds, John B Williams, Max Seiter, Clark Chen
Treating scaphoid nonunions presents difficulties particularly when there is bone loss, significant humpback deformity or avascular necrosis. We describe a new type of fixation with a volar scaphoid plate that adds to the methods of internal fixation that are available for the treatment of recalcitrant scaphoid nonunions. We will also discuss 'lessons learned' from a cases series. The case series includes 20 consecutive patients treated with volar buttress plating and a pedicled vascularized bone graft from the ipsilateral volar distal radius...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29165014/fixation-of-proximal-pole-scaphoid-nonunion-with-non-vascularized-cancellous-autograft
#6
Timothy J Luchetti, Allison J Rao, John J Fernandez, Mark S Cohen, Robert W Wysocki
We present 20 patients with established proximal pole scaphoid nonunions treated with curettage and cancellous autograft from the distal radius and screw fixation. Fractures with significant proximal pole fragmentation were excluded. Patients were treated at a mean of 26 weeks after injury (range 12-72). Union occurred in 18 of 20 patients (90%) based on computed tomographic imaging. The two nonunions that did not heal were treated with repeat curettage and debridement and iliac crest bone grafting without revision of fixation...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29132789/scaphoid-fracture-fixation-in-a-nonunion-model-a-biomechanical-study-comparing-3-types-of-fixation
#7
Avanthi Mandaleson, Stephen K Tham, Craig Lewis, David C Ackland, Eugene T Ek
PURPOSE: Union of a scaphoid fracture after fixation is influenced by various factors, one of which is fracture stability. This study aims to compare the biomechanical stability of 3 different types of scaphoid fracture fixation in a scaphoid nonunion model. METHODS: Thirty cadaveric scaphoid specimens were assigned to one of 3 different fixation groups: (1) single 3.0-mm compression screw, (2) two 2.2-mm screws, and (3) scaphoid plate. A 3-mm volar wedge osteotomy was created at the scaphoid waist to simulate a nonunion model...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29105591/treatment-of-the-scaphoid-humpback-deformity-is-correction-of-the-dorsal-intercalated-segment-instability-deformity-critical
#8
Christophe L Mathoulin, Margareta Arianni
Treatment of scaphoid fractures has been focused mainly on achieving union, with less attention to restoring normal scaphoid shape and orientation. Malalignment of one carpal bone will disrupt the kinetics of the entire wrist. The dorsal intercalated segment instability deformity associated with scaphoid waist nonunion is a nondissociative form of carpal instability. It has to be reduced in the treatment of scaphoid waist nonunions to avoid kinetic problems that will lead to arthritic changes. Computerized tomography scanning has become indispensable to visualize the humpback deformity clearly...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29105586/radial-styloidectomy-for-scaphoid-nonunion-advanced-collapse-relevance-of-nonunion-location
#9
Emil S Vutescu, Rishabh Jethanandani, Darryl B Sneag, Scott W Wolfe, Steve K Lee
Radial styloidectomy along with scaphoid nonunion reconstructive surgery is considered an acceptable surgical treatment for stage 1 scaphoid nonunion advanced collapse. The extent of radioscaphoid joint wear that defines scaphoid nonunion advanced collapse stage 1 is unclear. An appropriate radial styloidectomy is limited to 6 mm styloid removal to prevent carpal instability. The aim of this study was to determine whether nonunion fracture location can be a guiding factor in determining whether the scaphoid bone can be retained with scaphoid nonunion reconstructive surgery and radial styloidectomy...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29103356/scaphoid-nonunion-what-is-the-role-of-the-zaidemberg-1-2-intercompartmental-supraretinacular-arterial-flap
#10
Mark Henry
The reported results for the treatment of scaphoid nonunions with non-vascularized grafts are based on observational studies with a high variability in union rates from 38%-100% and time to union from 6-18 weeks, and there is also a lack of a standard classification. Meta-analyses and systematic reviews have been presented to better support conclusions from large pools of data (604 to 5246 cases), but their interpretation remains limited because of lack of uniformity in the studies analysed. Several authors have presented results from the Zaidemburg flap, with highly variable outcomes despite using the same technique; union rates have ranged from 27%-100% achieved between 6...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29102567/clinical-and-radiologic-outcomes-after-scaphoid-fracture-injury-and-treatment-patterns-in-national-football-league-combine-athletes-between-2009-and-2014
#11
Gilbert Moatshe, Jonathan A Godin, Jorge Chahla, Mark E Cinque, Nicholas I Kennedy, George Sanchez, Brendin R Beaulieu-Jones, Robert F LaPrade, Matthew T Provencher
PURPOSE: To report on the clinical and radiologic outcomes and complications after surgical treatment in National Football League (NFL) Combine athletes with a history of a scaphoid fracture. METHODS: The medical records of 2,285 athletes participating in the NFL Combine from 2009 to 2015 were evaluated for a history of scaphoid, hand, or wrist injury. Clinical outcomes, including grip strength, pinch test, range of motion, and presence of pain and stiffness, were recorded...
November 1, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29091493/ten-year-minimum-follow-up-of-4-corner-fusion-for-slac-and-snac-wrist
#12
Purnell Traverso, Anselm Wong, Ronit Wollstein, Lois Carlson, Duffield Ashmead, H Kirk Watson
BACKGROUND: Scapholunate advanced collapse (SLAC) of the wrist is the most common degenerative condition of the wrist. Four-corner fusion (4CF) is performed as salvage surgery, though there is limited information on its long-term results. We hypothesized that 4CF is a durable surgery with good clinical long-term function. METHODS: A retrospective chart review of patients undergoing 4CF as well as an interview and recent radiographs were obtained. Patients with a follow-up period of less than 10 years were excluded...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29078719/bone-grafting-for-scaphoid-nonunions-is-free-vascularized-bone-grafting-superior-for-scaphoid-nonunion
#13
William R Aibinder, Eric R Wagner, Allen T Bishop, Alexander Y Shin
BACKGROUND: Nonvascularized bone grafting (NVBG) and vascularized bone grafts (VBGs) have been used to treat scaphoid nonunions. A comparison of a single institution' s experience using structural iliac crest bone graft (ICBG), 1,2-intercompartmental supraretinacular artery (1,2-ICSRA), and medial femoral condyle (MFC) grafts to treat scaphoid nonunions was undertaken. METHODS: Thirty-one patients underwent ICBG, 33 patients underwent 1,2-ICSRA, and 45 patients underwent MFC grafting...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29068934/resurfacing-capitate-pyrocarbon-implant-versus-proximal-row-carpectomy-alone-a-comparative-study-to-evaluate-the-role-of-capitate-prosthetic-resurfacing-in-advanced-carpal-collapse
#14
COMPARATIVE STUDY
Francesco Giacalone, Pietro G di Summa, Alessandro Fenoglio, Arman Sard, Elisa Dutto, Matteo Ferrero, Maddalena Bertolini, Marc Garcia-Elias
BACKGROUND: The Resurfacing Capitate Pyrocarbon Implant associated with proximal row carpectomy has been used to treat symptomatic advanced carpal collapse, widening the indications of proximal row carpectomy to patients with capitate head arthritis. The authors retrospectively compared their case series of implant versus carpectomy alone, analyzing whether prosthetic implant outcomes could be similar to those of proximal row carpectomy even with a higher stage of osteoarthritis. METHODS: Fifty-seven patients who underwent surgery for wrist osteoarthritis (minimum follow-up, 2 years) were selected retrospectively...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28991585/arthroscopic-assisted-partial-wrist-arthrodesis
#15
REVIEW
Eva-Maria Baur
Partial wrist arthrodesis (PWA) is a well-known procedure for treating degenerative or posttraumatic wrist conditions. Four-corner fusion (4CF) is mostly used for scapholunate advanced collapse and scaphoid nonunion advanced collapse. The author performed 39 procedures, including 4CFs, 2-corner fusions, 3-corner fusions, scaphoid-capitate/scaphoid-capitate-lunate fusions, scaphoid-trapezium-trapezoid arthrodeses, and radioscapholunate arthroscopic PWAs (A-PWAs). There were 8 revision cases including 4 partial nonunions...
November 2017: Hand Clinics
https://www.readbyqxmd.com/read/28945157/success-of-scaphoid-nonunion-surgery-is-independent-of-proximal-pole-vascularity
#16
Schneider K Rancy, Morgan M Swanstrom, Edward F DiCarlo, Darryl B Sneag, Steve K Lee, Scott W Wolfe
We followed 35 consecutive patients with scaphoid nonunions in a prospective longitudinal registry. All nonunions were treated with curettage, non-vascularized autogenous grafting and headless screw fixation. Preoperative magnetic resonance imaging, intraoperative bleeding points and histopathological analysis of cancellous bone in the proximal pole were recorded as measures of viability. Healing was categorized as ≥50% bony bridging on computed tomographic images in the plane of the scaphoid. Nine of 23 proximal poles demonstrated ischaemia on magnetic resonance imaging but none were interpreted as infarcted...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28942683/a-comparison-of-plate-versus-screw-fixation-for-segmental-scaphoid-fractures-a-biomechanical-study
#17
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
#18
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
#19
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
#20
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
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