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https://www.readbyqxmd.com/read/29153368/diagnostic-value-of-cone-beam-computed-tomography-cbct-in-occult-scaphoid-and-wrist-fractures
#1
Christophe Borel, Ahmed Larbi, Stephanie Delclaux, Franck Lapegue, Helene Chiavassa-Gandois, Nicolas Sans, Marie Faruch-Bilfeld
OBJECTIVE: Evaluate the diagnostic value of cone beam computed tomography (CBCT) for scaphoid and wrist fractures that are missed on standard radiographs. MATERIALS AND METHODS: Between September 2014 and October 2015, we prospectively enrolled 49 patients with a clinically suspected scaphoid fracture following an acute injury but had normal radiographs. Each patients underwent radiographs, CBCT and (magnetic resonance imaging) MRI within 7days of the initial injury event...
December 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/29143872/concomitant-hook-of-hamate-fractures-in-patients-with-scaphoid-fracture-more-common-than-you-might-think
#2
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/29132789/scaphoid-fracture-fixation-in-a-nonunion-model-a-biomechanical-study-comparing-3-types-of-fixation
#3
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/29132239/lunate-fractures-and-associated-radiocarpal-and-midcarpal-instabilities-a-systematic-review
#4
Meenalochani Shunmugam, Joideep Phadnis, Amy Watts, Gregory I Bain
The aim of this study was to analyse lunate fractures and any associated osseo-ligamentous injuries. A systematic review identified 34 cases. We identified carpal instabilities at the radiocarpal and midcarpal joints in volar and dorsal directions. Radiocarpal instabilities (10/34) were usually dorsoradial (8/10), with a transverse lunate fracture, best seen on a coronal image. Midcarpal instabilities (24/34) were usually volar (14/18), with a volar lunate shear fracture, best seen on a sagittal image. Instabilities were sub-classified into non-displaced, subluxated and dislocated...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29122424/scaphoid-healing-necessary-for-unrestricted-activity-a-biomechanical-cadaver-model
#5
Michael S Guss, Joshua T Mitgang, Anthony Sapienza
PURPOSE: To determine if scaphoid fractures with bridging bone of 50% of their width treated with a centrally placed screw will restore biomechanical integrity equivalent to that of the intact scaphoid. METHODS: Twenty-four fresh cadaver scaphoids were used. Six were left intact to serve as the control group. Six were osteotomized 50% of their width and made up the osteotomy without screw group. Six were included in the 50% osteotomy plus compression screw group...
November 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29122122/scaphoid-screw-placement-under-minimal-radiation-exposure
#6
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/29117821/assessment-of-usefulness-of-anthropometric-data-for-predicting-the-scaphoid-and-the-screw-length-a-new-technique
#7
Darshan Kumar A Jain, Naresh Shetty, L Naveen Kumar, D C Sundaresh
BACKGROUND: Headless screw is frequently used for scaphoid fracture fixation. Aim of the study was to assess the correlation between the axial length of the scaphoid and the axial length of the middle phalanx of index, middle, ring and little finger so as to provide an indirect method to assess the length of the scaphoid and thereby the length of the screw. METHODS: Thirty five fresh frozen cadavers with seventy wrists and hands were dissected. The age, sex and side were recorded...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29116329/digital-tomography-for-detection-of-acute-occult-scaphoid-fractures
#8
Anthony M Barcia, Liang Zhou, Jay B Cook, Kenneth K Lindell, Rey D Gumboc, Aaron D Dykstra, Robert J Lachky, Steven H Shaha, Kenneth F Taylor
Diagnosis of occult scaphoid fractures remains a challenge. Traditional management consisting of 2 weeks of immobilization and repeat radiographs results in unnecessary immobilization of many patients without fracture. Magnetic resonance imaging (MRI) is sensitive but expensive. Digital tomography (DT) is an imaging technique that provides fine-cut visualization with minimal radiation exposure and may be used when there is high clinical suspicion despite negative findings on initial radiographs. The authors compared the ability of DT vs MRI to detect acute occult scaphoid fractures...
November 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/29105591/treatment-of-the-scaphoid-humpback-deformity-is-correction-of-the-dorsal-intercalated-segment-instability-deformity-critical
#9
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/29105589/the-morphology-of-proximal-pole-scaphoid-fractures-implications-for-optimal-screw-placement
#10
Timothy J Luchetti, Youssef Hedroug, John J Fernandez, Mark S Cohen, Robert W Wysocki
The purpose of this study was to measure the radiographic parameters of proximal pole scaphoid fractures, and calculate the ideal starting points and trajectories for antegrade screw insertion. Computed tomography scans of 19 consecutive patients with proximal pole fractures were studied using open source digital imaging and communications in medicine (DICOM) imaging measurement software. For scaphoid sagittal measurements, fracture inclination was measured with respect to the scaphoid axis. The ideal starting point for a screw in the proximal pole fragment was then identified on the scaphoid sagittal image that demonstrated the largest dimensions of the proximal pole, and hence the greatest screw thread purchase...
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
#11
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/29102567/clinical-and-radiologic-outcomes-after-scaphoid-fracture-injury-and-treatment-patterns-in-national-football-league-combine-athletes-between-2009-and-2014
#12
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/29078712/management-modalities-and-outcomes-following-acute-scaphoid-fractures-in-children-a-quantitative-review-and-meta-analysis
#13
Ashkaun Shaterian, Pauline Joy F Santos, Christine J Lee, Gregory R D Evans, Amber Leis
BACKGROUND: Early evaluation and appropriate management of pediatric scaphoid fractures are necessary to avoid complications. To date, current management of pediatric fractures varies among providers. The objective of this study was to compare clinical outcomes following different treatment modalities. METHODS: A PubMed literature search identified studies involving acute scaphoid fractures in children. Studies were evaluated for treatment provided and their respective effects on union rate, wrist range of motion, and wrist pain...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29053096/-scaphoid-fracture-in-a-seven-year-old-girl
#14
Ahmed Halloum, Morten Kjerri Rasmussen, Rikke Thorninger
We report a case of a seven-year-old girl, who had a scaphoid fracture, which occurred when she fell off her bicycle. She was examined in the emergency room. X-ray did not show any sign of fracture of the scaphoid, but the fracture was later verified with a magnetic resonance imaging scan. She wore a shin cast for eight weeks and recovered completely. Very few cases of children aged under eight years and diagnosed with scaphoid fracture have been reported in the literature. Scaphoid fracture should be suspected and examined for in all children with relevant trauma and symptoms, regardless of age...
October 16, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29030782/does-radiography-still-have-a-significant-diagnostic-role-in-evaluation-of-acute-traumatic-wrist-injuries-a-prospective-comparative-study
#15
Mohammad Abd Alkhalik Basha, Ahmad Abdel Azim Ismail, Ahmed Hatem F Imam
AIM: The aim of this study was to evaluate and compare the diagnostic role of radiography and multi-detector computed tomography (MDCT) in acute traumatic wrist injuries. PATIENTS AND METHODS: One hundred sixty-eight patients with acute wrist trauma were enrolled in our study. All patients had submitted to radiography and MDCT within 24 h after wrist trauma. The diagnostic role of radiography and MDCT was evaluated and compared. The effective radiation dose of the two techniques was calculated...
October 13, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29027844/controversies-and-best-practices-for-acute-scaphoid-fracture-management
#16
Nina Suh, Ruby Grewal
Acute scaphoid fractures are common wrist injuries that continue to elicit debate from surgeons regarding the most appropriate diagnostic and management algorithms. This review will examine the current literature and trends, in an attempt to provide the reader with an evidence-based discussion regarding current controversies of interest to clinicians. In addition, an attempt will be made to provide recommendations for the best treatment practices for acute scaphoid fractures.
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28991580/scaphoid-union-the-role-of-wrist-arthroscopy
#17
REVIEW
Jeff Ecker
There are times when clinical examinations, radiographs, and computed tomography scans do not provide sufficient information to know whether a scaphoid fracture or scaphoid bone graft has united, partially united, or not united. When this problem arises, arthroscopic examination of the scaphoid fracture or scaphoid bone graft provides additional information to solve the problem and plan further management in an evidence-based manner. The indications for the use of arthroscopy and surgical technique are described...
November 2017: Hand Clinics
https://www.readbyqxmd.com/read/28942683/a-comparison-of-plate-versus-screw-fixation-for-segmental-scaphoid-fractures-a-biomechanical-study
#18
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
#19
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/28856357/trans-scaphoid-transcapitate-perilunate-fracture-dislocation
#20
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
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