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scaphoid non-union

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https://www.readbyqxmd.com/read/28401362/carpal-scaphoid-non-union-treatment-a-retrospective-trial-comparing-simple-retrograde-percutaneous-screw-fixation-versus-percutaneous-screw-fixation-plus-pulsed-electromagnetic-fields-physiostim-%C3%A2
#1
Alexis Pereira, Juan José Hidalgo Díaz, Maurise Saur, Santiago Salazar Botero, Sybille Facca, Philippe Liverneaux
BACKGROUND: The purpose of this retrospective comparative study was to assess whether a complementary treatment by pulsed electromagnetic field could increase the bone-healing rate of scaphoid non-union without SNAC (scaphoid non-union advanced collapse) treated by retrograde percutaneous screw fixation. CASE DESCRIPTION: Eighteen patients with scaphoid non-union were included in this retrospective study. The group 1 was made of nine cases (seven stage IIA and two stage IIB) of scaphoid non-union treated by retrograde percutaneous screw fixation and pulsed electromagnetic fields (Physiostim(®))...
April 11, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28391752/low-intensity-pulsed-ultrasound-for-nonoperative-treatment-of-scaphoid-nonunions-a-meta-analysis
#2
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/28365801/a-modified-matti-russe-technique-of-grafting-scaphoid-non-unions
#3
Moritz Dustmann, Ralf Bajinski, Alexander Tripp, Joachim Gülke, Nikolaus Wachter
INTRODUCTION: In treatment of scaphoid non-union bone healing requires beside vital tissue and stability, enduring compression and a good interface between the graft and scaphoid fragments. While fixation techniques show a good primary stability, they reduce sintering and thus compression of fragments in the long term. Therefore, a modified technique optimising the cancellous interface between graft and scaphoid but still providing enough stability without fixating implants should be evaluated...
April 1, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28251560/scaphoid-fractures-in-the-athlete
#4
REVIEW
Mark J Winston, Andrew J Weiland
Scaphoid fractures are a common wrist injury, especially in athletes. Clinicians should have a high index of suspicion for a scaphoid fracture in any patient complaining of radial-sided wrist pain after a fall on an outstretched hand. Advanced imaging, including CT and MRI scans, may be useful in diagnosis and classification of fracture patterns. Treatment varies based on the fracture location, stability of the fracture, and predictability of the fracture to heal. Treatment involves either non-operative management with a thumb spica cast or brace, or operative fixation with a headless compression screw, k-wires, or scaphoid-specific plates...
March 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28205478/scaphotrapeziotrapezoidal-joint-osteoarthritis-a-systematic-review-of-surgical-treatment
#5
Victoria M Deans, Zafar Naqui, Lindsay T S W Muir
BACKGROUND: The management of scaphotrapeziotrapezoidal (STT) joint osteoarthritis (OA) remains controversial. This systematic review aims to review the evidence for surgical interventions specific to STT OA. METHODS: Medline and Embase libraries were searched using a pre-defined search strategy in October 2014. All study designs and languages were included and evaluated by two reviewers (VMD and LM) against the inclusion/exclusion criteria. The study eligibility criteria included papers discussing surgical treatment of STT OA, and the review was conducted using the PRISMA guidelines...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28137436/arthroscopic-grafting-of-scaphoid-nonunion%C3%A2-%C3%A2-surgical-technique-and-preliminary-findings-from-23-cases
#6
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/28125938/vascularized-versus-non-vascularized-bone-grafts-in-the-treatment-of-scaphoid-non-union
#7
Christoph Hirche, Lingyun Xiong, Christian Heffinger, Matthias Münzberg, Sebastian Fischer, Ulrich Kneser, Thomas Kremer
INTRODUCTION: Conventional non-vascularized bone grafts as well as vascularized bone grafts are used to treat scaphoid non-union (SN). Due to limited available studies, the field of application using both grafts for SN still remains controversial. The aim of this study was to evaluate a treatment algorithm for the use of both vascularized versus non-vascularized bone grafts based on clinical outcomes and quality of life (QoL) to improve the level of evidence. MATERIALS AND METHODS: Based on a retrospective cohort study, including 28 patients with vascularized and 45 patients with conventional bone grafts, functional parameters, radiological outcome, Mayo-wrist-score, and QoL by SF-36 were applied to statistically compare the outcome of these two techniques...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/27939913/non-structural-cancellous-bone-graft-and-headless-compression-screw-fixation-for-treatment-of-scaphoid-waist-non-union
#8
S H Han, H J Lee, I T Hong, U Kim, S J Lee
PURPOSE: Scaphoid fracture commonly occurs around the mid-third of the scaphoid, and non-union of this fracture has several treatment options. The authors performed autologous cancellous bone graft from the iliac crest and headless compression screw fixation for the treatment of Mack-Lichtman type II scaphoid waist non-union. The purpose of this study was to determine whether this procedure was effective in achieving bony union and restoration of alignment. METHODS: Medical records and radiographs of 30 patients who underwent cancellous bone graft and headless compression screw fixation for non-union of scaphoid waist fracture were retrospectively reviewed...
December 7, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27896458/prognostic-factors-in-the-treatment-of-carpal-scaphoid-non-unions
#9
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...
January 2017: 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
#10
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
#11
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
#12
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
#13
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)...
November 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
June 4, 2016: BMC Musculoskeletal Disorders
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