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Eplasty 2022 19;22:e16. Epub 2022 May 19.

Division of Plastic and Reconstructive Surgery, Cook County Health, Chicago, IL 60607, USA.

Scaphoid dislocation with radial carpal disruption constitutes an extremely rare injury, and there are no clear guidelines for treatment. This article reviews a delayed presentation of this injury and its surgical management. Read More

J Hand Surg Am 2022 Jun 3. Epub 2022 Jun 3.

Department of Orthopaedic Surgery, Amsterdam University Medical Centre (UMC), Amsterdam, the Netherlands; Department of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Flinders University, Bedford Park, South Australia, Australia. Electronic address:

Purpose: To identify predictors of a true scaphoid fracture among patients with radial wrist pain following acute trauma, train 5 machine learning (ML) algorithms in predicting scaphoid fracture probability, and design a decision rule to initiate advanced imaging in high-risk patients.

Methods: Two prospective cohorts including 422 patients with radial wrist pain following wrist trauma were combined. There were 117 scaphoid fractures (28%) confirmed on computed tomography, magnetic resonance imaging, or radiographs. Read More

Hand Surg Rehabil 2022 May 31. Epub 2022 May 31.

Unit of Anatomy, Faculty of Medicine of Geneva, Rue Michel Servet 1, 1206 Geneva, Switzerland; Unit of Hand and Peripheral Nerve Surgery, Geneva University Hospital, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.

Anatomical studies on the radial side of the scaphoid mention inter-ligamentous connections, but without detailed description of their relations to one another. The purpose of this study was to provide an anatomical and radiological description of the ligamentous structure on the radial side of the scaphoid. High-field 3-Tesla 3D MRI scans of 7 cadaveric formaldehyde-fixed wrists were performed to assess the presence and location of each ligament. Read More

Bull Hosp Jt Dis (2013) 2022 Jun;80(2):155-159

Avascular necrosis (AVN) and subsequent fragmentation of the proximal pole of the scaphoid following fracture is a challenging problem to treat. Multiple treatment methods have been described, although they have been shown to have varying degrees of success and are associated with donor site morbidities. This case report demonstrates a technique and the excellent radiographic and clinical outcome at 8 months postoperatively for reconstruction of the proximal pole of the scaphoid using an ipsilateral proximal pole of the hamate autograft. Read More

Bone Joint J 2022 Jun;104-B(6):709-714

Queen Margaret Hospital, Dunfermline, UK.

Aims: The aim of this study was to describe the introduction of a virtual pathway for the management of patients with a suspected fracture of the scaphoid, and to report patient-reported outcome measures (PROMs) and satisfaction following treatment using this service.

Methods: All adult patients who presented with a clinically suspected scaphoid fracture that was not visible on radiographs at the time of presentation during a one-year period were eligible for inclusion in the pathway. Demographic details, findings on examination, and routine four-view radiographs at the time of presentation were collected. Read More

Sci Rep 2022 May 19;12(1):8379. Epub 2022 May 19.

Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.

The treatment of scaphoid nonunion can be challenging with increasing defect size. We evaluated the outcome of scaphoid nonunion with a substantial bone defect treated with a multidirectional locking plate combined with cancellous bone grafting only. Thirteen patients with significant osseous defects measuring 6 mm or more suffering from primary nonunion without treatment (n = 6) or recalcitrant nonunion following Herbert screw osteosynthesis (n = 7) were treated and reviewed retrospectively. Read More

J Hand Surg Am 2022 May 6. Epub 2022 May 6.

Institut Kaplan, Barcelona, Spain.

Purpose: We describe a new radiologic test to assess the integrity of the scapholunate ligament in dynamic scapholunate dysfunction.

Methods: A bilateral forearm-holding device was designed to perform a comparative radiographic assessment of the scapholunate joint gap during resisted isometric contraction of the extensor carpi ulnaris muscle with full supination of the forearm. The concept is based on the known scaphoid pronation effect of this muscle. Read More

BMC Sports Sci Med Rehabil 2022 May 1;14(1):79. Epub 2022 May 1.

Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.

Introduction: Summer alpine sports, including mountain biking, hiking and airborne pursuits, have experienced a recent surge in popularity. Accordingly, trauma associated with these activities has increased. There is a scarcity of literature exploring clinical aspects surrounding injuries. Read More

Bone Joint J 2022 May;104-B(5):549-558

Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.

Aims: The purpose of this systematic review was to determine the rates of union for vascularized versus non-vascularized grafting techniques in the operative management of scaphoid nonunion. Secondary aims were to determine the effect of the fixation techniques used, the source of grafting, as well as the influence of fracture location (proximal pole) and avascular necrosis (AVN).

Methods: A search of PubMed, MEDLINE, and Embase was performed in June 2021 using the Preferred Reporting Items for Systematic Review and Meta-Analyses statement and registered using the PROSPERO International prospective register of systematic reviews. Read More

Hand Clin 2022 May;38(2):149-160

Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address:

In patients with radial-sided wrist pain, a myriad of possible etiologies exists and as such, a detailed history, examination, and, where indicated, imaging is obtained to try and aid with its diagnosis. The purpose of this article is to provide an overview of radial-sided wrist pain, diagnostic modalities and discuss current treatment options. More detailed information is out-of-scope for this article and if needed, we would guide the reader to seek out other selected texts, as indicated. Read More

Diagnostics (Basel) 2022 Apr 4;12(4). Epub 2022 Apr 4.

Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan 701, Taiwan.

Scaphoid fractures frequently appear in injury radiograph, but approximately 20% are occult. While there are few studies in the fracture detection of X-ray scaphoid images, their effectiveness is insignificant in detecting the scaphoid fractures. Traditional image processing technology had been applied to segment interesting areas of X-ray images, but it always suffered from the requirements of manual intervention and a large amount of computational time. Read More

Handchir Mikrochir Plast Chir 2022 Apr 20. Epub 2022 Apr 20.

Universitätsspital Basel; Plastische, Rekonstruktive, Ästhetische und Handchirurgie.

Purpose: To evaluate whether a vascularized bone graft from the medial femur condyle (MFC) can successfully be used to reconstruct small bone defects (< 4 cm) on the upper extremity other than the scaphoid.

Patients And Methods: In 7 patients at the age of 28 to 66 years 8 vascularized bone grafts from the MFC were used to reconstruct bone defects on the upper extremity other than the scaphoid. Bone healing, complications, donor side morbidity, and patient´s satisfaction were evaluated. Read More

J Hand Surg Asian Pac Vol 2022 Apr 19;27(2):385-388. Epub 2022 Apr 19.

Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Japan.

We report a dorsal trans-scaphoid perilunate fracture-dislocation associated with dorsal dislocation of the thumb carpometacarpal joint in a 25-year-old man. This is a rare injury and we discuss a possible mechanism for the injury. Level V (Therapeutic). Read More

J Orthop Case Rep 2021 Jun;11(6):63-67

Department of Orthopaedic Surgery, Zucker School of Medicine at Hofstra/Northwell, Plainview, New York, United States.

Introduction: Perilunate dislocations are rare high-energy injuries, and the diagnosis is not infrequently missed at initial presentation. The combination of fractures resulting in a trans-styloid, trans-scaphoid, and trans-triquetral perilunate fracture dislocation is extremely rare. Early recognition and diagnosis of these injuries is prudent to restore patient function and prevent morbidity. Read More

J Hand Surg Eur Vol 2022 Jun 17;47(6):580-589. Epub 2022 Apr 17.

Faculty of Medicine, Hebrew University of Jerusalem, Israel.

The article reviews key considerations and our preferred methods in treating upper extremity palsies, gunshot wounds and scaphoid nonunion. For these three difficult conditions, I highlight the importance of a team approach when treating upper extremity neuromuscular disease, flexibility and creativity when treating gunshot wounds, and my personal protocol for dealing with scaphoid fracture nonunions. V. Read More

J Orthop Case Rep 2021 Nov;11(11):107-111

Serviço de Ortopedia e Traumatologia, Centro Hospitalar Tondela, Viseu, Portugal.

Introduction: Scaphoid dislocations are rare injuries, usually resulting from high-energy trauma and therefore associated to other lesions which may obscure the diagnosis.

Case Presentation: The authors present a case of a 59-year-old man with a partial complex dislocation of the scaphoid, diagnosed 6 days after the initial injury. Closed reduction was unsuccessfully attempted, so the patient was submitted to open reduction and internal fixation. Read More

J Pediatr Orthop B 2022 Apr 11. Epub 2022 Apr 11.

Rady Children's Hospital, San Diego, San Diego, California, USA.

We aimed to assess the risk of conversion to surgical intervention in children initially managed with casting for an isolated scaphoid fracture with a secondary aim of assessing the incidence and management of occult scaphoid fractures without signs of fracture on initial radiographs. A retrospective review was performed. Subsequent evidence of fracture in those with only initial snuffbox tenderness was recorded for the secondary aim. Read More

Hand Surg Rehabil 2022 Jun 10;41(3):334-340. Epub 2022 Mar 10.

Department of Orthopedics and Traumatology, Division of Hand Surgery, Dışkapı Y. Beyazıt Training and Research Hospital, Ö. Halisdemir Blv., No:20, 06110, Ankara, Turkey.

This study aimed to evaluate clinical and radiographic outcomes in a consecutive series of patients who underwent open surgery via a radial approach for reconstruction of scaphoid waist non-union. Over a 2-year period, 16 males with scaphoid waist non-union received surgery using a radial approach; we performed limited styloidectomy, biconcave curettage, ovoid bone grafting from the styloidectomy fragment, and placement of a retrograde radial-entry screw. Mean patient age was 25. Read More

Dermatol Surg 2022 May 2;48(5):581-582. Epub 2022 Mar 2.

Midland Dermatology, Midland, Texas.

EFORT Open Rev 2022 Feb 15;7(2):129-136. Epub 2022 Feb 15.

Department of Clinical Sciences - Orthopedics, Lund University, Lund, Sweden.

Misdiagnosed and maltreated scaphoid fractures filed to the Swedish National Patient Insurance Company (LÖF) 2011-2018 were analyzed in terms of complications and costs for society. All filed claims are database-registered (altogether 200 000 claims since 2000). This database was assessed in June 2019 through injury ICD10-SWE-diagnoses. Read More

Zhonghua Yi Xue Za Zhi 2022 Feb;102(7):513-517

Department of Hand Surgery of Xuzhou Renci Hospital, Xuzhou 221004, China.

To investigate the feasibility and the clinical efficiency of robot navigation combined with wrist arthroscopy in minimally invasive treatment of nondisplaced type Herbert D1 scaphoid fracture. A retrospective analysis was performed on 9 patients who underwent nondisplaced type Herbert D1 scaphoid fracture in Xuzhou Renci Hospital from December 2019 to January 2021. Before the operation and at the last follow-up, grip strength, pinching force, modified wrist Mayo score and visual analogue scale (VAS) of wrist pain were recorded and compared. Read More

Radiography (Lond) 2022 Feb 16. Epub 2022 Feb 16.

Mid Yorkshire Hospitals NHS Trust, Pinderfields Hospital, Aberford Road, Wakefield, WF1 4DG, United Kingdom.

Introduction: Scaphoid radiography has poor sensitivity for acute fracture detection and often requires repeat delayed imaging. Although magnetic resonance (MR) imaging is considered the gold standard, computed tomography (CT) is often used as an alternative due to ease of access. Cone-Beam CT (CBCT) offers equivalent diagnostic efficacy to Multi Slice CT (MSCT) at reduced dose. Read More

BMC Musculoskelet Disord 2022 Feb 17;23(1):158. Epub 2022 Feb 17.

Department of Orthopaedics, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.

Background: Dynamic radiocarpal instability is one of the causes of post-trauma radial-sided wrist pain. It is not easy to diagnose and may possibly be overlooked. The key ligaments responsible for dynamic radiocarpal instability are the radioscaphocapitate (RSC) and long radiolunate (LRL) ligaments. Read More

Handchir Mikrochir Plast Chir 2022 Feb 15;54(1):28-37. Epub 2022 Feb 15.

Berufsgenossenschaftliche Kliniken Bergmannstrost Halle Unfallchirurgie.

Background: Ultrasound has not yet been established in the diagnostic workup of scapholunate ligament lesions. We aimed to develop a standardised examination procedure to visualise and evaluate the SL ligament.

Patients And Methods: Forty patients (70 hands) were examined prospectively with ultrasonography and the results were compared with arthroscopy and MRI findings. Read More

Plast Reconstr Surg 2022 Apr;149(4):901-910

From the Department of Orthopaedic Surgery and Sports Medicine, University of Cincinnati College of Medicine; Department of Orthopaedic Surgery and Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School; and Department of Biostatistics, University of Pittsburgh.

Background: Numerous surgical reconstructive techniques have been described for chronic scapholunate and lunotriquetral interosseous ligament instability.

Methods: The authors retrospectively reviewed 16 consecutive patients who underwent bone-ligament-bone reconstruction for scapholunate or lunotriquetral intraosseous ligament predynamic and dynamic instability at a single tertiary care institution from 2013 to 2019. Clinical and radiographic outcomes, and complications, were recorded. Read More

J Pediatr Orthop 2022 May-Jun 01;42(5):260-264

Department of Orthopaedics, The Ohio State University.

Background: The optimal management of pediatric scaphoid fracture nonunions is controversial. We hypothesize that pediatric patients with scaphoid fracture nonunions will have favorable functional outcomes with the utilization of nonvascularized distal radius cancellous autograft with open reduction and internal fixation (ORIF).

Methods: A review was performed from 2012 to 2017 identifying skeletally immature patients with scaphoid fracture nonunions treated with ORIF and nonvascularized distal radius cancellous autograft, including demographic data, mechanism of injury, length of time from injury to treatment, operative procedure, length of immobilization, time to union, and complications. Read More

Acta Ortop Mex 2021 Jul-Aug;35(4):362-368

Instituto Nacional de Ortopedia y Traumatología (INOT), Montevideo, Uruguay.

Introduction: Carpal dislocations and fracture-dislocations are uncommon injuries and represent approximately 5-7% of all wrist injuries, or about 10% of all carpal injuries. Multiple treatments are proposed to treat these injuries. The aim of our paper is to review the evidence about the treatment of lesser arc perilunate dislocations and to assess the results of the different therapeutic methods. Read More

J Hand Surg Eur Vol 2022 Jun 6;47(6):660-661. Epub 2022 Feb 6.

Department of Orthopedic Surgery, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.

J Orthop Surg Res 2022 Feb 5;17(1):78. Epub 2022 Feb 5.

Department of Hand Surgery, The 3rd Hospital, Hebei Medical University, NO. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.

Purpose: This study aims to introduce the "tripod" technique using cannulated compression screw and two anti-rotational K-wires for treatment of unstable scaphoid waist fracture nonunion, and to compare it with the single cannulated screw fixation technique in term of scaphoid union and surgical outcomes.

Methods: It was a retrospective study. From January 2014 to March 2020, 103 consecutive patients with scaphoid waist fracture nonunion treated with the tripod fixation and bone grafting (n = 45) or with single cannulated compression screw and bone grafting (n = 58) were included. Read More

J Belg Soc Radiol 2021 31;105(1):90. Epub 2021 Dec 31.

Free University of Brussels, BE.

Acute and subacute wrist trauma predominantly consist of fractures of the distal radius in elderly patients and most frequently carpal fractures (scaphoid, followed by triquetrum and hamatum) and avulsion fractures of the ulnar styloid in younger patients, especially in sports-related injuries but also in work activities. The initial radiographs may miss the fractures and result when untreated in complications as nonunion, osteonecrosis, and degenerative osteoarthritis. Fractures of the distal radius and of the scaphoid may be associated with ligament injuries, most frequently the scapholunate complex, which are often overlooked at the emergency department. Read More