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scaphoid non-union

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https://www.readbyqxmd.com/read/27896458/prognostic-factors-in-the-treatment-of-carpal-scaphoid-non-unions
#1
F Schuind, F Moungondo, W El Kazzi
In this literature review, the authors analyse the prognostic factors in the curative treatment of scaphoid non-unions. The main negative prognostic factors are smoking, the time elapsed since the fracture, and avascular necrosis of the proximal fragment. If the latter is present, the revascularization by a pedicle or microsurgical bone autograft is probably the treatment of choice. In non-unions without evidence of osteonecrosis, vascularized bone grafts are probably not superior to conventional bone grafts, which can presently be performed under arthroscopic control, with minimal morbidity...
November 28, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27890247/reproducibility-of-x-rays-and-ct-arthrography-in-slac-snac-scac-wrists
#2
R Belhaouane, N Lebeau, C Maes-Clavier, C Hustin, E Krief, B Bonnaire, M Warin, V Rotari, E David
The purpose of this study was to assess the inter-observer and intra-observer reproducibility of the interpretation of CT arthrography and plain X-rays for scapholunate advanced collapse (SLAC), scaphoid non-union advanced collapse (SNAC) and scaphoid chondrocalcinosis advanced collapse (SCAC) wrist conditions, as well as the clinical relevance of these imaging modalities. The CT and X-rays images were reviewed twice in a blinded and randomized manner by two experienced orthopedic surgeons specialized in hand surgery, two orthopedic surgery residents and two experienced radiologists specialized in bone and joint imaging...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27830329/management-of-scaphoid-nonunion-with-iliac-crest-bone-graft-and-k-wire-fixation
#3
Erin Meisel, Alex Seal, Caroline A Yao, Alidad Ghiassi, Milan Stevanovic
PURPOSE: Scaphoid nonunion can occur in both non-operative and operatively treated scaphoid fractures. Without treatment, this can lead to a predictable pattern of carpal collapse and degenerative arthritic change and patients can experience both pain and functional loss in the early and late phases of progression. An operative technique with a high success rate for union is important. This paper describes a technique for treatment of scaphoid nonunion with K-wire fixation and iliac crest cancellous bone graft...
November 9, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27785580/management-of-scaphoid-nonunions-with-vascularized-bone-grafts-from-the-distal-radius-mid-to-long-term-follow-up
#4
Konstantinos N Malizos, Zoe Dailiana, Sokratis Varitimidis, Antonios Koutalos
Scaphoid nonunion represents a challenging problem that leads to disability if neglected. Vascularized bone grafts are proposed to augment the local biology and increase the likelihood of union but long-term outcomes are sparse. In this work, we present the mid- to long-term outcome of 140 scaphoid nonunions managed with vascularized bone grafts from the distal radius. Sixteen patients underwent concomitant closed wedge osteotomy of the distal radius because of arthritic changes. There were 130 males and ten females, with mean time from injury to surgery 3...
October 26, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27725994/-acute-scaphoid-fractures-management-under-consideration-of-the-new-s3-level-guideline
#5
M Schädel-Höpfner, B Bickert, C Dumont, P Laier, R Meier, A Nusche, T Pillukat, H Rosenthal, R Schmitt, F Siemers, A Zach, M Jung
BACKGROUND: Scaphoid fractures represent the most common carpal fractures and are often problematic and frequently lead to nonunion with osteoarthritis and collapse of the wrist. The reasons for the nonunion are manifold. Therefore, the main goal of diagnosis and therapy of acute fractures is to achieve bony union and to restore the anatomic shape of the scaphoid. In the long run, only this can preserve the normal function of the wrist. METHODOLOGY: The given recommendations are based on the new S3-level guideline of the AWMF (Association of the Scientific Medical Societies)...
October 10, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27708739/is-casting-for-non-displaced-simple-scaphoid-waist-fracture-effective-a-ct-based-assessment-of-union
#6
Ruby Grewal, Nina Suh, Joy C MacDermid
OBJECTIVE: The purpose of this study is to report the union rate and time to union for acute non-displaced scaphoid waist fractures treated with a short arm thumb spica cast. METHODS: A database was searched (2006-2013) to identify acute undisplaced scaphoid waist fractures. Cases that were not given a trial of casting were excluded (n=33). X-rays, CT scans and health records for each patient were reviewed to extract data. RESULTS: 172 patients met inclusion criteria...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27671798/comparing-radial-styloid-size-between-osteoarthritic-and-healthy-wrists-a-pathoanatomical-three-dimensional-study
#7
P W L Ten Berg, J G G Dobbe, M E Brinkhorst, S D Strackee, G J Streekstra
: Radial styloid pointing due to spur formation is considered an early sign of osteoarthritis, but is sometimes difficult to distinguish from normal anatomic variation. In this pathoanatomical study we used three-dimensional imaging techniques to evaluate quantitatively whether the styloid size is larger in wrists with scaphoid non-union than in healthy wrists. We compared these findings with duration of the non-union and with the scaphoid non-union advanced collapse classification, which was based on radiographic assessment of the general level of wrist osteoarthritis...
September 26, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27622151/four-corner-fusion-using-a-multidirectional-angular-stable-locking-plate
#8
Tahseen Chaudhry, Michelle Spiteri, Dominic Power, Mark Brewster
AIM: To review the results of our experience with the Medartis Aptus plating system for four corner arthrodesis of the wrist, which uses a combination of compression screws and variable angle locking screws. METHODS: We reviewed the results of 17 procedures in 16 patients that underwent scaphoid excision and four corner fusion using the Medartis Aptus system between May 2010 and June 2014. The primary outcome measure was radiographic and clinical union. RESULTS: The mean clinical follow up time was 20...
August 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27571547/the-medial-femoral-trochlea-flap-with-a-monitor-skin-island-report-of-two-cases
#9
M Tremp, A Haumer, R Wettstein, Y X Zhang, P Honigmann, D J Schaefer, D F Kalbermatten
In this report, we present two cases of the bony reconstruction with the medial trochlea (MFT) flap including a skin island that was used to monitor the perfusion of flap in the postoperative period. Between March 2013 and April 2015, we performed surgery on two patients who suffered from scaphoid and talus non-union after trauma and initial treatment by osteosynthesis. A skin island (1 cm × 1 cm and 3 cm × 1 cm, respectively) was included with the osseous flap (1.6 cm × 1 cm × 1 cm and 2 cm × 3 cm × 2 cm, respectively) to assess the perfusion of the flap...
August 29, 2016: Microsurgery
https://www.readbyqxmd.com/read/27458552/evaluation-of-bone-remodeling-in-regard-to-the-age-of-scaphoid-non-unions
#10
Susanne Rein, Uwe Hanisch, Hans-Eberhard Schaller, Hans Zwipp, Stefan Rammelt, Stefan Weindel
AIM: To analyse bone remodeling in regard to the age of scaphoid non-unions (SNU) with immunohistochemistry. METHODS: Thirty-six patients with symptomatic SNU underwent surgery with resection of the pseudarthrosis. The resected material was evaluated histologically after staining with hematoxylin-eosin (HE), tartrate resistant acid phosphatase (TRAP), CD 68, osteocalcin (OC) and osteopontin (OP). Histological examination was performed in a blinded fashion. RESULTS: The number of multinuclear osteoclasts in the TRAP-staining correlated with the age of the SNU and was significantly higher in younger SNU (P = 0...
July 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27323700/treatment-of-scaphoid-fractures-using-a-memory-alloy-nail-feet-fixation-device
#11
Chuan Li, Xiaoshan Xu, Yongyue Su, Tianhua Zhou, Xinyu Fan, Yongqing Xu
BACKGROUND: Scaphoid fracture is a common carpal fracture, and its treatment often requires fixation devices. This study aimed to investigate the efficacy and safety of a memory alloy nail-feet-fixation (MANFF) device in treating scaphoid fractures. METHODS: Sixty-six patients with closed scaphoid fractures were treated using the MANFF device between August 2011 and November 2013. Surgical outcomes were assessed using the Mayo wrist score, including pain intensity, functional status, range of motion and grip strength...
July 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27260639/scaphoid-waist-internal-fixation-for-fractures-trial-swifft-protocol-a-pragmatic-multi-centre-randomised-controlled-trial-of-cast-treatment-versus-surgical-fixation-for-the-treatment-of-bi-cortical-minimally-displaced-fractures-of-the-scaphoid-waist-in-adults
#12
Joseph Dias, Stephen Brealey, Surabhi Choudhary, Liz Cook, Matthew Costa, Caroline Fairhurst, Catherine Hewitt, Stephen Hodgson, Laura Jefferson, Kanagaratnam Jeyapalan, Ada Keding, Paul Leighton, Amar Rangan, Gerry Richardson, Claire Rothery, Nicholas Taub, John Thompson, David Torgerson
BACKGROUND: A scaphoid fracture is the most common type of carpal fracture affecting young active people. The optimal management of this fracture is uncertain. When treated with a cast, 88 to 90 % of these fractures unite; however, for the remaining 10-12 % the non-union almost invariably leads to arthritis. The alternative is surgery to fix the scaphoid with a screw at the outset. METHODS/DESIGN: We will conduct a randomised controlled trial (RCT) of 438 adult patients with a "clear" and "bicortical" scaphoid waist fracture on plain radiographs to evaluate the clinical effectiveness and cost-effectiveness of plaster cast treatment (with fixation of those that fail to unite) versus early surgical fixation...
2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27104332/transcapho-perilunate-dislocation-with-palmar-extrusion-of-the-scaphoid-proximal-pole
#13
Augusto Marcuzzi, Massimiliano Leigheb
Perilunate fracture-dislocations usually combine ligament ruptures, bone avulsions, and fractures in different patterns. Rarely a displaced fracture of the scaphoid can coexist with a scapho-lunate dissociation and can result in enucleation of the proximal pole. We report about a case of trans-scaphoid perilunate dislocation with palmar extrusion/enucleation of the scaphoid proximal pole, treated with scaphoid fracture open reduction and internal fixation with screw, scapho-lunate ligament repair with an anchor and vascularization of the scaphoid proximal pole with the 2nd intermetacarpal artery...
2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/27057144/functional-outcomes-of-proximal-row-carpectomy-2-year-follow-up
#14
Luiz Garcia Mandarano-Filho, Débora Schalge Campioto, Márcio Takey Bezuti, Nilton Mazzer, Cláudio Henrique Barbieri
OBJECTIVE: : To evaluate functional outcomes of patients submit-ted to proximal row carpectomy for the treatment of wrist arthri-tis. METHODS: : This is a retrospective study using wrist motion and grip strenght of patients diagnosed with Kienböck disease and scaphoid non-union surgically treated by this technique. RESULTS: : Eleven patients with 2-year follow-up were evaluated. Wrist motion (flexion, extension and ulnar deviation) and grip strength were significantly better from preoperative values...
November 2015: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/27018317/comparative-meta-analysis-on-the-various-vascularized-bone-flaps-used-for-the-treatment-of-scaphoid-non-union
#15
Konstantinos Ditsios, Ioannis Konstantinidis, Konstantinos Agas, Anastasios Christodoulou
We did a meta-analysis of the literature in order to clarify which of the vascularized bone flaps (VBF) used for scaphoid non-union treatment has the best outcome with regard to various parameters. We analyzed 54 articles that present 9 different types of VBF. The analysis concerned demographical patient information, radiographic parameters, fracture classification, including the presence or non-presence of avascular necrosis of the scaphoid proximal pole (PP AVN), parameters that have to do with the surgery itself and the postoperative protocol, the healing of the non-union and functional scores...
March 28, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/26649260/the-missed-scaphoid-fracture-outcomes-of-delayed-cast-treatment
#16
Ruby Grewal, Nina Suh, Joy C MacDermid
Background The purpose of this study is to evaluate outcomes (report union rates and times based on CT) for subacute scaphoid fractures, defined as those presenting between 6 weeks and 6 months from injury. Questions 1) What are the expected union rates for subacute scaphoid fractures? 2) What are the expected union times for subacute scaphoid fractures? 3) Is it worth trialing a period of cast immobilization for these patients? Methods All isolated sub-acute scaphoid fractures that presented at our institution between 2006 and 2010 were identified...
November 2015: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/26578826/percutaneous-screw-fixation-of-scaphoid-waist-fracture-non-union-without-bone-grafting
#17
Galal Hegazy
The aim of the study was to evaluate results of volar percutaneous headless compression screw fixation without bone grafting in 21 patients with scaphoid waist nonunion fractures. The inclusion criteria in this series were scaphoid waist fracture nonunion with intact cartilaginous envelope, minimal fracture line at nonunion interface, no cyst or sclerosis, no avascular necrosis and normal scapholunate angle without humpback deformity. There were 17 male and 4 female patients with an average age of 23 years (range 16-45 years)...
December 2015: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/26553886/analysis-of-deformity-in-scaphoid-non-unions-using-two-and-three-dimensional-imaging
#18
P W L Ten Berg, J G G Dobbe, S E R Horbach, R M Gerards, S D Strackee, G J Streekstra
UNLABELLED: Pre-operative assessment of the deformity in scaphoid non-unions influences surgical decision-making. To characterize deformity, we used three-dimensional computed tomographic modelling in 28 scaphoid non-unions, and quantified bone loss, dorsal osteophyte volume and flexion deformity. We further related these three-dimensional parameters to the intrascaphoid and capitate-lunate angles, and stage of scaphoid non-union advanced collapse assessed on conventional two-dimensional images and to the chosen surgical procedure...
September 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/26468923/-diagnostically-approach-to-pediatric-carpal-fractures-a-retrospective-analysis
#19
K Eckert, R-B Tröbs, B Schweiger, P Liedgens, E Radeloff, O Ackermann
INTRODUCTION: Carpal fractures in children are rare, but can be missed, as their clinical symptoms are unspecific and discrete. Even X-ray diagnosis is difficult. Timely diagnosis and consistent therapy are especially important for scaphoid fractures, as they can help to avoid complications such as non-union or avascular necrosis. A diagnostic approach to paediatric carpal fractures will be discussed on the basis of the following group of patients. METHODS: Retrospective analysis of children under 14 years treated in our institution between 09/2010 and 02/2012 for clinically suspected carpal fracture...
February 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/26423614/scaphoid-fracture-non-union-a-systematic-review-of-surgical-treatment-using-bone-graft
#20
D O Ferguson, V Shanbhag, H Hedley, I Reichert, S Lipscombe, T R C Davis
UNLABELLED: This systematic review assesses the quality and outcomes of published articles concerning bone graft surgery for scaphoid fracture non-union. Searches of the CENTRAL, MEDLINE, EMBASE, CINAHL and AMED databases captured 2710 articles. Each article was screened and 144 met our inclusion criteria. Data regarding source, study design, population, intervention, comparator and outcomes were extracted. There were 5464 scaphoid non-union outcomes within the 144 studies. Mean reported union rates for vascularized and non-vascularized bone graft were 84% and 80%, respectively...
June 2016: Journal of Hand Surgery, European Volume
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