Read by QxMD icon Read

scaphoid fracture

Jonathan Porter, Robert Porter, Kevin Joseph Chan
OBJECTIVES: The purpose of this study is to determine the predictive value of clinical suspicion for scaphoid fracture in children aged 4 to 11 years, to look at the efficiency and practicality of current management of children presenting to the emergency department, and to help quantify the burden of the treatment strategy of immobilization for 10 to 14 days on clinical grounds despite negative or equivocal x-rays on presentation. METHODS: We performed a retrospective chart review study of a consecutive sample of all children aged 4 to 11 years old who presented to a tertiary pediatric emergency department from January 1, 2009, to December 31, 2013, within 24 hours of a wrist injury, with a clinical suspicion sufficient to order a scaphoid x-ray...
March 12, 2018: Pediatric Emergency Care
Christopher Klifto, Austin Ramme, Anthony Sapienza, Nader Paksima
Scaphoid nonunions are challenging injuries to manage and the optimal treatment algorithm continues to be debated. Most scaphoid fractures heal when appropriately treated; however, when nonunions occur, they require acute treatment to prevent future complications like scaphoid nonunion advanced collapse. Acute nonunion treatment technique depends on nonunion location, vascular status of the proximal pole, fracture malalignment, and pre-existing evidence of arthrosis. Bone grafting and vascular grafts are common in nonunion management...
March 2018: Bulletin of the Hospital for Joint Diseases
Michel D Crema, Catherine Phan, Anne Miquel, Celine Quach, Lionel Arrivé, Yves Menu
OBJECTIVES: Our primary aim was to evaluate the distribution and severity of cartilage damage in a sample of patients with scaphoid nonunion advanced collapse (SNAC), assessed on MDCT arthrography, with regard to two well-known SNAC staging systems. Secondarily, we wanted to see if the degree of cartilage damage varied with the location of the nonunion. METHODS: We retrospectively included 35 patients with a history of SNAC who had undergone MDCT arthrography. The location of the fracture was defined as the proximal, middle, or distal third of the scaphoid...
March 8, 2018: Skeletal Radiology
M Gurger, M Yilmaz, E Yilmaz, S Altun
Background: Percutaneous screw fixation is widely used in acute fractures of the scaphoid. In this study, we aimed to present our results with volar percutaneous screw fixation in patients with scaphoid nonunions. Methodology: A total of 12 patients with scaphoid nonunion (≥13 weeks) that underwent volar percutaneous screw fixation were evaluated retrospectively. Two of the patients were female, and 10 were male. Mean age was 27 years (range = 19-41). The mean time that elapsed between the fracture and surgical procedure was 7...
March 2018: Nigerian Journal of Clinical Practice
Takafumi Tajima, Yukichi Zenke, Yoshiaki Yamanaka, Kunitaka Menuki, Akinori Sakai
BACKGROUND: The association of scaphoid or other carpal bone fractures with distal radius fractures is frequently reported, whereas few studies have described pisiform malalignment associated with distal radius fractures. The purpose of this study was to investigate the frequency and characteristics of pisiform malalignment associated with distal radius fractures. METHODS: We performed a retrospective study by reviewing the data of 152 consecutive patients with a mean age of 63 years who were treated surgically for distal radius fractures during a five-year period...
March 1, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Jakob Neubauer, Matthias Benndorf, Claudia Ehritt-Braun, Kilian Reising, Tayfun Yilmaz, Christopher Klein, Horst Zajonc, Elmar Kotter, Mathias Langer, Sebastian Moritz Goerke
The aim of this study was to evaluate and compare the diagnostic accuracy, the inter-rater agreement and raters' certainty of cone beam computed tomography (CBCT) and radiography for the detection of scaphoid fractures. Our hypothesis is that the CBCT has a higher diagnostic accuracy for scaphoid fractures than radiography. We retrospectively analysed patients who underwent both radiography and CBCT examinations within 4 days to rule out a scaphoid fracture over a 2-year period in our institution. 4 blinded radiologists and orthopaedic surgeons independently rated the images regarding the presence of a scaphoid fracture...
March 2, 2018: Scientific Reports
Gernot Schmidle, Hannes Leonhard Ebner, Günter Klima, Kristian Pfaller, Josef Fritz, Romed Hoermann, Markus Gabl
The scaphoid is the most frequently fractured carpal bone and prone to non-union due to mechanical and biological factors. Whereas the importance of stability is well documented, the evaluation of biological activity is mostly limited to the assessment of vascularity. The purpose of this study was to select histological and immunocytochemical parameters that could be used to assess healing potential after scaphoid fractures and to correlate these findings with time intervals after fracture for the three parts of the scaphoid (distal, gap and proximal)...
February 27, 2018: Journal of Anatomy
O Ackermann, A Kaminski
A case of a patient with a combined wrist injury is presented, where a scaphoid fracture was overlooked in the computed tomography scan. The case emphasizes the value of the x‑ray control in ulnar abduction for all wrist lesions which need to be operatively stabilized.
February 20, 2018: Der Unfallchirurg
Berthold Bickert
Complete rupture of the scapholunate (SL) ligament can cause a dissociative carpal instability (CID). These ligamentous lesions are caused by a fall from a limited height of approximately 1 m or a fall, e. g. when playing handball or soccer. For a freshly injured wrist joint, the X‑ray signs of a static instability (after excluding a fracture) are a SL distance ≥3 mm, a SL angle >60°, and a dorsal displacement of the proximal scaphoid pole. Dynamic instabilities are best seen in kinematography of the wrist joint...
February 20, 2018: Der Unfallchirurg
A Marzouki, B Soumare, A S Diarra, K Lahrach, F Boutayeb
The aim of this study was to evaluate the results of percutaneous screw fixation of scaphoid waist fractures in our surgery unit by comparing them with recent data from the literature. This was a retrospective, descriptive study conducted between January 2010 and September 2016. Patients operated due to a recent scaphoid fracture and treated by percutaneous anterograde screw fixation with a Herbert screw were included in this study. Our cohort was a sub-set from a scaphoid fracture group; other fracture sites, other treatment techniques and fractures associated with scapholunate ligament lesions were excluded...
February 17, 2018: Hand Surgery and Rehabilitation
Zirun Xiao, Ge Xiong, Weiguang Zhang
We investigated the intraosseous arteries of six normal cadaveric scaphoids using red lead injection and three-dimensional reconstruction with micro-computed tomography. The arterial entrances were generally located around the dorsal ridge, the insertion of the scaphocapitate ligament and the radial part of the radioscaphocapitate ligament. Two to three trunk arteries entered the scaphoid on dorsal ridge at the level of the waist. The distal part of the scaphoid was mainly supplied by arteries from the waist...
January 1, 2018: Journal of Hand Surgery, European Volume
Ronnie L Shammas, Nathan Mela, Scott Wallace, Betty C Tong, Joel Huber, Suhail K Mithani
PURPOSE: We used conjoint analysis to assess the relative importance of factors that influence a patient's decision between surgical or nonsurgical management of a nondisplaced scaphoid fracture. Our hypothesis was that out-of-pocket costs will have a greater influence on decision making than the time spent in a cast or brace, degree of soreness, or the risk of treatment failure. METHODS: Two-hundred and fifty participants were recruited using Amazon Mechanical Turk and asked to assume that they had experienced a nondisplaced scaphoid waist fracture...
February 15, 2018: Journal of Hand Surgery
S Coyle, S Kinsella, B Lenehan, J M Queally
BACKGROUND: As healthcare systems come under ever-increasing pressure to provide more care with fewer resources, emphasis is being placed on value-based systems that maximise quality and minimize cost. The aim of this study was to determine which interventions in fracture care have been demonstrated to be cost effective. METHODS: A systemic review of cost-utility studies on the management of fractures from 1976 to 2015 was carried out using a search of the Cost-Effectiveness Analysis Registry, National Health Service Economic Evaluation Database (NHS EED) and MEDLINE...
January 31, 2018: Injury
Mark S Morris, Andy F Zhu, Kagan Ozer, Jeffrey N Lawton
PURPOSE: To review the incidence of union of patients with proximal pole scaphoid fracture nonunions treated using a 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) vascularized graft and a small compression screw. METHODS: This is a retrospective case series of 12 patients. Calculations of the size of the proximal pole fragment relative to the total scaphoid were performed using posteroanterior view scaphoid radiographs with the wrist in ulnar deviation and flat on the cassette...
February 6, 2018: Journal of Hand Surgery
Anil K Bhat, Ashwath M Acharya, S Manoh, Vinay Kamble
BACKGROUND: To identify acute un-displaced and minimally displaced scaphoid fractures which are unlikely to unite with non-operative treatment at six weeks with CT scan and stabilize them with percutaneous screw fixation with the aim of preventing non-union. METHODS: A scaphoid series radiographs of wrist were obtained for patients with undisplaced or minimally displaced fractures and were immobilized in a thumb spica cast for six weeks. At six weeks, CT scan was done for patients showing doubtful signs of clinical and radiographic union...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Neal Rupani, Nicholas Riley, Ian McNab
Background  Scaphoid fractures in the pediatric population are rare. The majority of nondisplaced fractures tend to unite; however, there is an increased risk of nonunion in proximal pole fractures. Limited evidence exists in their outcomes, owing to the scarcity of the fracture pattern. Case Description  A 13-year-old boy who presented late after developing a traumatic proximal pole scaphoid fracture developed nonunion. He was treated conservatively owing to it being asymptomatic and developed union at 18 months...
February 2018: Journal of Wrist Surgery
Jill Goodwin, Paulo Castañeda, Patricia Drace, Scott Edwards
Background  Headless screw fixation is the current gold standard of surgical repair for scaphoid fractures. However, maintaining reduction of certain types of scaphoid fractures is challenging with a compression screw. Plate fixation may offer superior fixation in some scaphoid fractures, particularly those with comminution, nonunion, segmental bony defects, and osteopenic or osteoporotic bone. Purpose  This study questions whether method of fixation is a determinant in load to failure in segmental scaphoid fractures, and whether any fixation provides a greater mechanical advantage in simulated normal versus osteoporotic bone...
February 2018: Journal of Wrist Surgery
Morgan M Swanstrom, Kyle W Morse, Joseph D Lipman, Krystle A Hearns, Michelle G Carlson
Background  Ideal internal fixation of the scaphoid relies on adequate bone stock for screw purchase; so, knowledge of regional bone density of the scaphoid is crucial. Questions/Purpose  The purpose of this study was to evaluate regional variations in scaphoid bone density. Materials and Methods  Three-dimensional CT models of fractured scaphoids were created and sectioned into proximal/distal segments and then into quadrants (volar/dorsal/radial/ulnar). Concentric shells in the proximal and distal pole were constructed in 2-mm increments moving from exterior to interior...
February 2018: Journal of Wrist Surgery
Emily Gilley, Sameer K Puri, Krystle A Hearns, Andrew J Weiland, Michelle G Carlson
Background  Displaced scaphoid fractures have a relatively high rate of nonunion. Detection of displacement is vital in limiting the risk of nonunion when treating scaphoid fractures. Questions/Purpose  We evaluated the ability to diagnose displacement on radiographs and computed tomography (CT), hypothesizing that displacement is underestimated in assessing scaphoid fracture by radiograph compared with CT. Materials and Methods  Thirty-five preoperative radiographs and CT scans of acute scaphoid fractures were evaluated by two blinded observers...
February 2018: Journal of Wrist Surgery
Philip M J Schormans, Peter R G Brink, Martijn Poeze, Pascal F W Hannemann
Background  Around 5 to 15% of all scaphoid fractures result in nonunion. Treatment of long-lasting scaphoid nonunion remains a challenge for the treating surgeon. Healing of scaphoid nonunion is essential for prevention of scaphoid nonunion advanced collapse and the subsequent predictable pattern of radiocarpal osteoarthritis. Purpose  The purpose of this study was to investigate the feasibility of fixation of the scaphoid nonunion with a volar angular stable miniplate and cancellous bone grafting. We hypothesized that this technique could be successful, even in patients with previous surgery for nonunion and in patients with a long duration of nonunion...
February 2018: Journal of Wrist Surgery
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"