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scaphoid nonunion

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https://www.readbyqxmd.com/read/29132789/scaphoid-fracture-fixation-in-a-nonunion-model-a-biomechanical-study-comparing-3-types-of-fixation
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
D Montoya-Faivre, G Pomares, V Calafat, F Dap, G 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
#16
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
#17
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
#18
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
#19
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
#20
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
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