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scaphoid non-union

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https://www.readbyqxmd.com/read/29143872/concomitant-hook-of-hamate-fractures-in-patients-with-scaphoid-fracture-more-common-than-you-might-think
#1
Ramin Mandegaran, Sam Gidwani, Ali Zavareh
OBJECTIVE: The scaphoid is the most commonly fractured carpal bone. The presence of a concomitant hook of hamate fracture is of particular relevance given that it is often occult on routine wrist/scaphoid radiographs and that hook of hamate fractures are prone to symptomatic non-union, resulting in chronic ulnar wrist pain. Prompt diagnosis and immobilisation/fixation may minimise such complications. Our study is aimed at assessing the frequency of concomitant hook of hamate fractures in patients with scaphoid fractures...
November 16, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29122122/scaphoid-screw-placement-under-minimal-radiation-exposure
#2
Gloria M Hohenberger, Uldis Berzins, Bore Bakota, Patrick Holweg, Bernhard Clement, Stephan Grechenig
BACKGROUND: Percutaneous scaphoid fixation through either a volar or dorsal approach has the advantage of minor soft tissue damage compared with ORIF, and faster fracture union compared with conservative treatment. However, this technique demands highly intraoperative reliance on X-ray control, including increased radiation exposure and all associated side effects. PURPOSE: To test the possibility and efficacy of volar percutaneous scaphoid screw placement under minimalradiation exposure...
November 2017: Injury
https://www.readbyqxmd.com/read/29105591/treatment-of-the-scaphoid-humpback-deformity-is-correction-of-the-dorsal-intercalated-segment-instability-deformity-critical
#3
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/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/28893145/non-vascularized-iliac-bone-grafting-for-scaphoid-nonunion-with-avascular-necrosis
#5
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/28774245/factors-influencing-outcome-in-the-management-of-scaphoid-non-union-and-comparison-of-matti-russe-and-interpositional-grafting-techniques
#6
Manish Kiran, Ian Persaud, Arpit Jariwala, Carlos Wigderowitz
BACKGROUND: Scaphoid non-union is often caused due to missed fractures, inadequate or inappropriate management. Matti-Russe and interpositional grafting techniques are used in the treatment of non-union. There are very few studies in literature that compare the outcomes of these techniques. The aim of our study was to analyse the factors influencing outcome in the management of scaphoid non-union and to compare the results of the Matti Russe procedure with interpositional grafting techniques...
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28473231/arthroscopic-reconstruction-for-unstable-scaphoid-non-union
#7
P J Delgado-Serrano, I Jiménez-Jiménez, M Nikolaev, F A Figueredo-Ojeda, M Gil de Rozas-López
OBJECTIVE: To evaluate the results of arthroscopic reconstruction for the treatment of unstable scaphoid non-union with cancellous bone autograft. METHODS: 13 patients were treated with a mean age of 26 (18-45) years. The average time from injury until surgery was 14 (6-48) months. Preoperative and postoperative clinical and radiological parameters were evaluated. Mean follow-up was 16.8 (12-36) months. RESULTS: Consolidation was achieved in all cases at 7 (4-10 weeks), no patient had complications or reoperations...
May 1, 2017: Revista Española de Cirugía Ortopédica y Traumatología
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
#8
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(®))...
May 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
#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/28365801/a-modified-matti-russe-technique-of-grafting-scaphoid-non-unions
#10
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...
June 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28251560/scaphoid-fractures-in-the-athlete
#11
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
#12
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
#13
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
#14
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
#15
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...
February 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27896458/prognostic-factors-in-the-treatment-of-carpal-scaphoid-non-unions
#16
REVIEW
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
#17
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
#18
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...
January 2017: 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
#19
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...
January 2017: 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
#20
REVIEW
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
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