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scaphoid fracture

Ryoko Uesato, Satoshi Toh, Yoshimitsu Hayashi, Keiichiro Maniwa, Yasuyuki Ishibashi
In scaphoid fractures, delayed diagnosis and nonunion are fairly common as a result of several factors, including the difficulty of radiographic diagnosis of non-displaced fractures and underestimation of the injury by the patient. Main factors to consider when deciding treatment are the type of fracture and fracture stability. In the stable nonunion (Type D1 according to the Filan and Herbert classification, or linear type of Ikeda's classification), percutaneous screw fixation without bone graft is recommended...
October 19, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Mark A Tait, John W Bracey, R Glenn Gaston
No abstract text is available yet for this article.
September 20, 2016: JBJS Rev
Kerrin C DePeter, Stephen M Blumberg, Sarah Dienstag Becker, James A Meltzer
BACKGROUND: Despite being an effective analgesic for children with fractures, some clinicians may avoid prescribing ibuprofen due to its potentially harmful effect on bone healing. OBJECTIVE: To determine if exposure to ibuprofen is associated with an increased risk of bone healing complications in children with fractures. METHODS: We performed a retrospective study of children aged 6 months to 17 years who presented to the pediatric emergency department (PED) with a fracture of the tibia, femur, humerus, scaphoid, or fifth metatarsus and who followed up with the orthopedic service...
October 14, 2016: Journal of Emergency Medicine
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
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
Won-Taek Oh, Yun-Rak Choi, Ho-Jung Kang, Il-Hyun Koh, Kyung-Han Lim
PURPOSE: To compare union rates and clinical and radiological outcomes of arthroscopic-assisted reduction and fixation with those of open reduction and fixation in patients with trans-scaphoid perilunate fracture dislocations. METHODS: This retrospective study included consecutive patients with trans-scaphoid PLFDs who underwent arthroscopic-assisted reduction and fixation (group A) or open reduction and fixation (group O), and who were followed up for a minimum of 2 years between May 2005 and March 2013...
October 1, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Hassan Alnaeem, Salah Aldekhayel, Johnathan Kanevsky, Omar Fouda Neel
PURPOSE: The optimal management of undisplaced scaphoid fractures remains controversial. A systematic review was conducted to assess the outcomes of acute, undisplaced scaphoid fractures managed with cast immobilization versus percutaneous or miniopen screw fixation in terms of time to return to work (RTW), time to union, and morbidity. METHODS: PubMed MEDLINE, Ovid MEDLINE, EMBASE, SCOPUS, and Cochrane electronic databases were searched over the period 1974 to 2015...
October 1, 2016: Journal of Hand Surgery
Anil K Bhat, Nishanth A, Ashwath Acharya, Yogesh Kumar
INTRODUCTION: Perilunate and lunate dislocations are uncommon high energy injuries and have extensive soft tissue, cartilaginous and bony damage. The most common pattern is trans-scaphoid perilunate fracture dislocation which constitutes approximately 50% of these injuries. Unusual injury pattern like Scaphocapitate syndrome can occur with fracture through scaphoid waist and capitate that rotates the proximal capitate 180° so that its proximal articular surface points distally. With this case report, we would like to present a novel presentation of an uncommon wrist injury...
April 2016: Journal of Orthopaedic Case Reports
Jessie Janowski, Caitlyn Coady, Louis W Catalano
The treatment of scaphoid nonunion and malunions has undergone a considerable transition since the 1960 modification of Matti's technique by Russe.(1) We present a review of articles with clear data on union rates and functional status to review the current methods of treatment for scaphoid nonunion and malunion.
September 23, 2016: Journal of Hand Surgery
T Kahl, F K Razny, J P Benter, K Mutig, K Hegenscheid, S Mutze, A Eisenschenk
The clinical relevance of scaphoid bone fractures is reflected by their high incidence, accounting for approximately 60 % among carpal fractures and for 2-3 % of all fractures. With adequate therapy most scaphoid bone fractures heal completely without complications. Insufficient immobilization or undiagnosed fractures increase the risk of nonunion and the development of pseudarthrosis.X-ray examination enables initial diagnosis of scaphoid fracture in 70-80 % of cases. Positive clinical symptoms by negative x‑ray results require further diagnostics by multi-slice spiral CT (MSCT) or MRI to exclude or confirm a fracture...
September 16, 2016: Der Orthopäde
A Asmus, M Lautenbach, B Schacher, S Kim, A Eisenschenk
BACKGROUND: Operative treatment of the scaphoid nonunion includes avascular corticocancellous and cancellous bone grafts and increasingly the use of vascular pedicled and free vascular corticocancellous grafts. Especially the latter require a fair amount of operative expertise and experience in microsurgical techniques. OBJECTIVE: Which criteria lead to the decision for or against an avascular graft used for reconstruction of scaphoid nonunion? Is our current classification system of a scaphoid pseudarthrosis able to illustrate our diagnostic potential in a way that makes us refer to operative procedures? METHODS: Evaluation of current literature and expert opinions RESULTS: Avascular bone grafts show a high union rate as long as a sufficient vascularisation of the remaining fragments is present...
September 16, 2016: Der Orthopäde
B Schacher, R Böttcher, A Vogel, A Asmus, S Kim, A Eisenschenk, F Eichenauer
BACKGROUND: Nonunion of the scaphoid as a result of proximal fractures, failed surgical reconstruction, and especially avascular fragment necrosis are possible indications of vascularized bone grafts. Various techniques of vascularized (pedicled and free) grafts have been described. Pedicled grafts from the direct vicinity of the wrist provide several benefits. Harvest-site morbidity is reduced and preserved graft perfusion, without the need for blood vessel anastomosis, may lead to an improved consolidation...
September 15, 2016: Der Orthopäde
Abolfazl Bagherifard, Davod Jafari, Hassan Keihan Shokouh, Ebrahim Motavallian, Farid Najd Mazhar
BACKGROUND: Distal radius radiographic indices may play a role as risk factors in pathogenesis of Kienbock's disease, scaphoid fracture and nonunion. Perilunate fracture dislocations are devastating wrist injuries, and their relationship and distal radius indices have not been addressed in the literature. OBJECTIVES: The aim of this study was to evaluate the possible role of distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt as risk factors in the perilunate fracture dislocation injury of the wrist...
May 2016: Trauma Monthly
Michael P Gaspar, Patrick M Kane, Sidney M Jacoby, Randall W Culp
BACKGROUND: Nonunion of scaphoid proximal pole fractures presents a challenging management dilemma to hand surgeons. This problem is further complicated in the uncommon concurrence of scapholunate (SL) ligament disruption. CASE DESCRIPTION: A 39-year-old male patient presented with new-onset wrist pain following a remote history of a proximal pole scaphoid fracture sustained as a teenager, which was treated nonoperatively. Six months before presentation, the patient sustained a fall while snowboarding...
April 2016: Journal of Hand and Microsurgery
Kyu-Bok Kang, Hyun-Jung Kim, Jae-Hong Park, Young-Soo Shin
The dorsal approach allows better central screw placement along the long axis of the scaphoid compared with the volar approach in managing acute scaphoid fractures. However, it is unclear whether the dorsal approach leads to better clinical outcomes than the volar approach. This meta-analysis compared clinical outcomes, including the incidence of nonunion, postoperative complications, overall functional outcome, postoperative pain, grip strength, and range of wrist motion, between the dorsal and volar percutaneous approaches for the management of acute scaphoid fractures...
2016: PloS One
Robert Zura, Ze Xiong, Thomas Einhorn, J Tracy Watson, Robert F Ostrum, Michael J Prayson, Gregory J Della Rocca, Samir Mehta, Todd McKinley, Zhe Wang, R Grant Steen
Importance: Failure of bone fracture healing occurs in 5% to 10% of all patients. Nonunion risk is associated with the severity of injury and with the surgical treatment technique, yet progression to nonunion is not fully explained by these risk factors. Objective: To test a hypothesis that fracture characteristics and patient-related risk factors assessable by the clinician at patient presentation can indicate the probability of fracture nonunion. Design, Setting, and Participants: An inception cohort study in a large payer database of patients with fracture in the United States was conducted using patient-level health claims for medical and drug expenses compiled for approximately 90...
September 7, 2016: JAMA Surgery
Mujtaba Nassiri, Osama Mohamed, Arvids Berzins, Yasser Aljabi, Talat Mahmood, Shojaeddin Chenouri, Paul O'Grady
BACKGROUND: Patients seeking information and advice on treatment of scaphoid fractures unknowingly confront longstanding medical controversies surrounding the management of this condition. However, there are no studies specifically looking into the quality and reliability of online information on scaphoid fractures. METHODS: We identified 44 unique websites for evaluation using the term "scaphoid fractures". The websites were categorized by type and assessed using the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark criteria and the Health on the net (HON) code...
October 2016: J Hand Surg Asian Pac Vol
Souichi Ohta, Ryosuke Ikeguchi, Takashi Noguchi, Yukitoshi Kaizawa, Hiroki Oda, Hirofumi Yurie, Shuichi Matsuda
BACKGROUND: Percutaneous scaphoid screw fixation is a popular treatment for acute scaphoid fractures with no or minimal displacement. For treating scaphoid nonunions, however, open reduction and internal fixation with bone grafting is still the most popular treatment. Percutaneous fixation with bone grafting through the screw insertion hole has received little attention, although it minimizes damage to the surrounding tissues. We report excellent results of six scaphoid nonunions treated by retrograde percutaneous fixation with curettage and bone grafting through the distal insertion hole of a fully threaded headless screw...
October 2016: J Hand Surg Asian Pac Vol
Adam Hart, Edward J Harvey, Reza Rabiei, Francois Barthelat, Paul A Martineau
To promote a quicker return to function, an increasing number of patients are treated with headless screws for acute displaced and even non-displaced scaphoid fractures. Therefore, it is imperative to understand and optimize the biomechanical characteristics of different implants to support the demands of early mobilization. The objective of this study was to evaluate the biomechanical fixation strength of 4 headless compression screws under distracting and bending forces. The Acutrak Standard, Acutrak Mini, Synthes 3...
October 2016: Medical Engineering & Physics
Keiichiro Oura, Hisao Moritomo, Toshiyuki Kataoka, Kunihiro Oka, Tsuyoshi Murase, Kazuomi Sugamoto, Hideki Yoshikawa
BACKGROUND: The purposes of this study were to quantitatively analyze osteophyte formation of the distal radius following scaphoid nonunion and to investigate how fracture locations relate to osteophyte formation patterns. METHODS: Three-dimensional surface models of the scaphoid and distal radius were constructed from computed tomographic images of both the wrists of 17 patients' with scaphoid nonunion. The scaphoid nonunions were classified into 3 types according to the location of the fracture line: distal extra-articular (n = 6); distal intra-articular (n = 5); and proximal (n = 6)...
August 30, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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