456 results match your criteria Wrist Scaphoid Fractures and Complications


Postoperative Immobilization of Scaphoid Fractures: A Comprehensive Review of the Literature.

Hand (N Y) 2022 May 16:15589447221093675. Epub 2022 May 16.

Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

The optimal protocol for postoperative immobilization following operative treatment of scaphoid fractures remains controversial. Reports of successful management with brief postoperative immobilization suggest that earlier restoration of function may be achieved by limiting the duration of immobilization. However, the risk of nonunion and its associated complications suggest that a more conservative approach with extended immobilization could optimize fracture healing. Read More

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Dorsal Trans-Scaphoid Perilunate Fracture-Dislocation in Association with Dorsal Dislocation of the Thumb Carpometacarpal Joint: A Rare Injury Pattern.

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

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Case Study: Trans-styloid, Trans-scaphoid, Trans-triquetral, and Perilunate Dislocation.

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

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An Unusual Occurrence of Scaphoid Fracture Fragment in the Volar Compartment of the Forearm: A Case Report with Review of Literature.

J Orthop Case Rep 2021 Dec;11(12):77-79

Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.

Introduction: Scaphoid fractures are common wrist injuries and are commonly missed. Patients present with radial-sided wrist pain. Computed Tomography and Magnetic Resonance Imaging help in better planning, with analysis of comminution, torn ligaments, timely diagnosis, and intricate fixation prevent avascular necrosis, non-union, and carpal collapse. Read More

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December 2021

Two Parallel Headless Compression Screws for Scaphoid Fractures: Radiographic Analysis and Preliminary Outcome.

Hand (N Y) 2022 Apr 10:15589447221081879. Epub 2022 Apr 10.

Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Despite surgical fixation, the scaphoid nonunion rate remains at 3% to 5%. Recent biomechanical studies have demonstrated increased stability with 2-screw constructs. The objective of our study is to determine the preliminary union rate and anatomic feasibility of 2-screw surgical fixation for scaphoid fractures. Read More

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Non-Displaced Scaphoid Waist Fractures: Percutaneous Screw Fixation Versus Cast Immobilization.

Cureus 2022 Feb 28;14(2):e22684. Epub 2022 Feb 28.

Orthopedics and Traumatology, Samsun Gazi State Hospital, Istanbul, TUR.

Background Scaphoid waist fractures make up 66% of scaphoid fractures and are mostly non-displaced. The purpose of this study was to demonstrate that percutaneous screw fixation is preferable to cast immobilization in the treatment of non-displaced or minimally displaced scaphoid waist fractures. Methodology Between 2017 and 2019, we conducted a retrospective review of patients aged 17-65 years who underwent treatment for acute non-displaced scaphoid waist fractures. Read More

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February 2022

Volar Plating of Scaphoid Fractures: A Retrospective Case Series.

Hand (N Y) 2022 Feb 28:15589447221075674. Epub 2022 Feb 28.

The Alfred Hospital, Melbourne, Victoria, Australia.

Background: The purpose of this study was to evaluate the rate of union of scaphoid fractures managed with volar plating and assess postoperative complications.

Methods: Retrospective consecutive case series of 28 patients with scaphoid fractures, 9 acute and 19 chronic nonunions, undergoing surgical fixation with volar scaphoid plating by a single surgeon between 2013 and 2019. Patients were followed up for a minimum of 3 months with scaphoid bony union being confirmed on radiograph or computed tomography. Read More

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February 2022

Rib osteochondral graft for scaphoid proximal pole reconstruction.

J Plast Surg Hand Surg 2022 Feb 23:1-5. Epub 2022 Feb 23.

Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan.

Background: An irreparable scaphoid proximal pole is challenging to treat because of the fragment size and limited blood supply. Salvage surgery, such as partial wrist fusion or proximal row carpectomy, may be performed but is not ideal for young patients. There are few reports of proximal scaphoid reconstruction using rib osteochondral grafts. Read More

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February 2022

Outcomes of Pediatric Scaphoid Nonunions Treated With Distal Radius Cancellous Autograft.

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

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Wrist Trauma: More Than Bones.

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

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December 2021

Can headless screw used in fixation of the scaphoid proximal pole fracture be broken after wrist trauma? An unreported complication of scaphoid surgery.

Jt Dis Relat Surg 2021 19;32(3):779-785. Epub 2021 Nov 19.

Ankara Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, 06590 Çankaya, Ankara, Türkiye.

The post-traumatic impairment of blood supply of the scaphoid bones' proximal pole is the subject of controversy in the surgical techniques which would heal this fracture. In a surgery performed with a dorsal approach, the main goal is to make a strong fixation with a small incision and a good implant without disturbing the blood supply of the bone. To date, complications related to surgical treatment of scaphoid proximal pole fractures have been reported in detail. Read More

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November 2021

Free vascularized second metatarsophalangeal joint transfer for scaphotrapezial joint reconstruction after distal scaphoid excision and carpal collapse: A case report.

Microsurgery 2022 Mar 11;42(3):282-286. Epub 2021 Nov 11.

Private Practice, Piñal y Asociados, Madrid, Spain.

Treatment of the destroyed scaphotrapezial (ST) joint in young patients is challenging due to the limited available options as they might not tolerate the stiffness, loss of grip strength and long-term complications of partial fusions, bone resections, and interposition implants or arthroplasties. This report presents the results of a free osteocutaneous joint transfer used to reconstruct the ST joint in a young patient suffering from ST destruction and carpal collapse. This 34-year-old patient was previously treated for a right scaphoid nonunion with distal scaphoid excision and interposition implant that evolved to destruction of the ST space, symptomatic carpal collapse associated and a ST height loss of 7 mm. Read More

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Management of acute scaphoid fractures: a pragmatic approach for the non-specialist.

Br J Hosp Med (Lond) 2021 Sep 30;82(9):1-7. Epub 2021 Aug 30.

Department of Surgery, East Lancashire Hospitals NHS Trust, Blackburn, UK.

Scaphoid fractures are common and can cause significant morbidity if treated incorrectly. Thus, a working knowledge of the initial assessment and management of scaphoid fractures by non-specialists is crucial to allow quick diagnosis and avoid potentially catastrophic complications of scaphoid fracture. This article summarises the anatomy of the scaphoid, discusses methods to assess for scaphoid fractures and delineates management plans (conservative or operative) for fractures of the scaphoid based on location of vascular compromise. Read More

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September 2021

Arthroscopic Treatment of Scaphoid Nonunion With Olecranon Bone Graft and Screw Fixation Leads to Union and Improved Outcomes.

Arthroscopy 2022 03 25;38(3):761-772. Epub 2021 Sep 25.

Department of Orthopaedics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.

Purpose: To evaluate the outcomes of arthroscopic treatment of scaphoid nonunion using olecranon bone graft and screw fixation and to analyze the outcomes in accordance with variations in the chronicity, location, and severity of nonunion.

Methods: Between March 2012 and December 2020, patients with diagnoses of scaphoid delayed nonunion and nonunion with substantial bone resorption (Slade and Dodds grade IV-VI) underwent arthroscopic-assisted olecranon bone graft and screw fixation. Preoperative and postoperative measurements included the visual analog scale score for pain; range of motion; grip strength; the Modified Mayo Wrist Score; the Disabilities of the Arm, Shoulder and Hand (DASH) score; and the minimal clinically important difference for the DASH score. Read More

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Use of biomaterials in scaphoid fracture fixation, a systematic review.

Clin Biomech (Bristol, Avon) 2021 10 8;89:105480. Epub 2021 Sep 8.

Department of Orthopaedics, Midlands Regional Hospital Tullamore, Ireland.

Background: Scaphoid fractures account for 60-70% carpal injury. Due to limited vascular supply achieving adequate reduction and healing is important to avoid complications including avascular necrosis. Recent technological advances have led to renewed vigour in bioabsorbable material research to develop devices which could be used without the need for removal and complications including stress shielding and suboptimal imaging. Read More

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October 2021

Delayed diagnosis of carpal scaphoid fracture in a young boy.

Emerg Radiol 2022 Feb 3;29(1):219-223. Epub 2021 Sep 3.

Department of Orthopedic Surgery, Pediatric Orthopedics Section, General Hospital of Ioannina, Ioannina, Greece.

Carpal scaphoid fracture is rare in children and is important to recognize early because of an increased risk for serious complications including non-union, avascular necrosis, and osteoarthritis. In the skeletally immature patient, a scaphoid fracture can easily escape detection due to clinical and diagnostic imaging interpretation errors. We report complete healing of a pediatric scaphoid non-union fracture after a remarkable delay in diagnosis and emphasize the considerable biological potential of the immature skeleton, coupled with proper stabilization, for good clinical outcomes. Read More

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February 2022

Suspected scaphoid injuries managed by MRI direct from the emergency department : a single-centre prospective cohort study.

Bone Jt Open 2021 Jun;2(6):447-453

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Aims: To determine the role of early MRI in the management of suspected scaphoid fractures.

Methods: A total of 337 consecutive patients presenting to an emergency department (ED) following wrist trauma over a 12-month period were prospectively included in this service evaluation project. MRI was not required in 62 patients with clear diagnoses, and 17 patients were not managed as per pathway, leaving a total of 258 patients with normal scaphoid series radiographs who were then referred directly from ED for an acute wrist MRI scan. Read More

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A Rare Presentation of Extensor Pollicis Longus Tendon Rupture After Nondisplaced Scaphoid Fracture.

J Hand Surg Am 2022 May 23;47(5):483.e1-483.e3. Epub 2021 Apr 23.

Rothman Orthopaedic Institute, Philadelphia, PA. Electronic address:

Extensor pollicis longus tendon rupture is a reported complication after nondisplaced distal radius fractures. These are thought to occur secondary to mechanical irritation or compromised blood supply. We present a case of extensor pollicis longus rupture after a healed nondisplaced scaphoid fracture, which may have involved a similar attritional process. Read More

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Percutaneous fixation of acute scaphoid waist fractures: Long-term patient-reported functional outcomes and satisfaction at a mean of 11 years following surgery.

Hand Surg Rehabil 2021 06 27;40(3):293-298. Epub 2021 Feb 27.

Edinburgh Orthopaedics - Trauma, Royal Infirmary of Edinburgh, 51 Little France Cres, Edinburgh EH16 4SA, United Kingdom; Usher Institute, University of Edinburgh, NINE Edinburgh BioQuarter, Edinburgh. Electronic address:

The aim of this study was to report the long-term functional outcomes and complication rates following early percutaneous fixation of acute fractures of the scaphoid. A trauma database was searched to identify all skeletally-mature patients with an undisplaced or minimally-displaced scaphoid waist fracture managed with early percutaneous retrograde screw fixation over a thirteen-year period from 1997-2010. Medical records were retrospectively reviewed, and complications documented. Read More

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Bayesian Statistics to Estimate Diagnostic Probability of Scaphoid Fractures from Clinical Examinations: A Meta-Analysis.

Plast Reconstr Surg 2021 03;147(3):424e-435e

From Oakland University William Beaumont School of Medicine; and the Section of Plastic and Reconstructive Surgery, Department of Surgery, Michigan Medicine.

Background: Management of suspected scaphoid fractures includes repeated evaluation and casting in symptomatic patients with nondiagnostic radiographs. In this systematic review and meta-analysis, the authors compare the diagnostic accuracy of clinical examinations for scaphoid fractures and create a decision guide using Bayesian statistics.

Methods: The MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature databases were queried for studies that evaluated clinical index tests and their diagnostic accuracies for scaphoid fracture. Read More

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A Retrospective Review of Differences in Complication Rates between Dorsal Percutaneous and Mini-Open Surgical Fixation of Scaphoid Fractures.

J Wrist Surg 2021 Feb 14;10(1):42-47. Epub 2020 Sep 14.

Department of Orthopaedics, University of Miami, Miller School of Medicine, Miami, Florida.

 We retrospectively reviewed the complications of 80 cases of scaphoid screw fixation in acute fractures and early nonunions comparing dorsal percutaneous and mini-open approaches.  We performed a chart review of all patients who underwent surgical fixation of a scaphoid fracture or a nascent nonunion using a dorsal percutaneous or dorsal mini-open technique by a single surgeon. We collected data on patient demographics, including age and smoking status, time to surgery, fracture type, union, and the major and minor complications that occurred in each group. Read More

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February 2021

Clinical Outcomes of Double-Screw Fixation with Autologous Bone Grafting for Unstable Scaphoid Delayed or Nonunions with Cavitary Bone Loss.

J Wrist Surg 2021 Feb 30;10(1):9-16. Epub 2020 Jul 30.

Melbourne Orthopaedic Group, Windsor, Melbourne, Victoria, Australia.

 This study reports on the clinical outcomes of double screw fixation with autologous cancellous bone grafting and early active range of motion for delayed and nonunited scaphoid waist fractures with cavitary segmental bone loss.  Twenty-one consecutive patients underwent fixation using two 2.2 mm antegrade headless compression screws with autologous distal radius cancellous bone graft. Read More

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February 2021

Triquetral Fractures Overview.

Curr Rev Musculoskelet Med 2021 Apr 23;14(2):101-106. Epub 2021 Jan 23.

Department of Orthopedic Surgery, Baylor College of Medicine, 7200 Cambridge Street, Houston, TX, 77030, USA.

Purpose Of Review: The triquetrum is the second most commonly fractured carpal bone, comprising 15-18% of all carpal bone fractures. This review summarizes the current knowledge of triquetral fractures, including the anatomy and pathophysiology, evaluation and diagnosis, treatment and management, post-treatment outcomes, and complications.

Recent Findings: Triquetral fractures are frequently caused by impaction of the ulnar wrist after a fall on an outstretched hand or by avulsion of attached ligaments. Read More

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Percutaneous Fixation without Bone Graft for Scaphoid Nonunion.

Rev Bras Ortop (Sao Paulo) 2020 Dec 24;55(6):759-763. Epub 2020 Sep 24.

Serviço de Cirurgia da Mão, Hospital Alvorada, United Health, São Paulo, SP, Brasil.

 To describe the clinical and radiographic outcomes of patients submitted to percutaneous fixation without bone graft for scaphoid nonunion, with a minimum follow-up of six months.  A case series study of a convenience sample of hand surgeons with prospective evaluation. Patients with scaphoid (waist or proximal pole) nonunion and the following features were included: more than six months of history; X-rays showing sclerosis of the edges of the nonunion, with resorption of the nonunion focus measuring less than 4 mm (Slade & Gleissler I, II, III and IV) and no angular deformity; and no proximal pole necrosis on magnetic resonance imaging (MRI). Read More

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December 2020

Scaphoid Fractures below the Age of 10: Case Series and Review of the Literature.

J Wrist Surg 2020 Dec 15;9(6):458-464. Epub 2020 Jul 15.

Hand and Upper Limb Service, Department of Plastic Surgery, Birmingham Women and Children's Hospital, Birmingham, United Kingdom.

 Scaphoid fractures are relatively uncommon in children, especially below the age of 10 due to the ossification of the scaphoid bone, which starts around 4 to 6 years of age and continues until 13 to 15 years of age, where pediatric scaphoid fractures peak. This makes the diagnoses challenging in this age group.  The primary aim of this study was to analyze prospectively collected data in managing scaphoid fractures. Read More

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December 2020

Surgical fixation compared with cast immobilisation for adults with a bicortical fracture of the scaphoid waist: the SWIFFT RCT.

Health Technol Assess 2020 10;24(52):1-234

Alcuin Research Resource Centre Building, Department of Health Sciences, University of York, York, UK.

Background: Scaphoid fractures account for 90% of carpal fractures and occur predominantly in young men. Immediate surgical fixation of this fracture has increased.

Objective: To compare the clinical effectiveness and cost-effectiveness of surgical fixation with cast treatment and early fixation in adults with scaphoid waist fractures that fail to unite. Read More

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October 2020

Four-corner fusion method using a bioabsorbable plate for scapholunate advanced collapse and scaphoid nonunion advanced collapse wrists: a case series study.

BMC Musculoskelet Disord 2020 Oct 15;21(1):683. Epub 2020 Oct 15.

Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 807-8555 Iseigaoka Yahatanisiku, Kitakyusyu City, Fukuoka, Japan.

Background: Scaphoid excision and four-corner arthrodesis is an acceptable salvage procedure for the treatment of scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrists, since first popularized in the 1980s. We investigated the potential application of novel bioabsorbable plates and screws made of un-sintered hydroxyapatite/poly-L-lactide composite for the treatment of metacarpal fractures. We used this material for the fixation of four-corner fusions for SLAC or SNAC wrists commencing from April 2009. Read More

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October 2020

Pedicled vascularized bone grafts compared with xenografts in the treatment of scaphoid nonunion.

Int Orthop 2021 04 30;45(4):1017-1023. Epub 2020 Sep 30.

Clinical Center of Serbia, Orthopedic and Traumatology University Clinic, Belgrade, Serbia.

Introduction: Fractures of the scaphoid account for 60-70% of all wrist bone fractures. The results of treatment in terms of bone healing vary depending on the type and location of the fracture, the time elapsed since the injury, the type of surgical treatment. Nonunion occurs in 5-15% of the cases on average. Read More

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Conservative treatment for fractures of the scaphoid.

Handchir Mikrochir Plast Chir 2020 Sep 29;52(5):399-403. Epub 2020 Sep 29.

University of Western Ontario Roth | McFarlane Hand and Upper Limb Center.

This review article aims to discuss the indications, techniques, outcomes, and complications of non-operative management of scaphoid fractures. Read More

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September 2020

[Scaphoid non-union: Experience from more than 280 reconstructions using a medial femur condyle bone graft].

Handchir Mikrochir Plast Chir 2020 Sep 29;52(5):425-434. Epub 2020 Sep 29.

Rhön-Klinikum AG, Klinik für Handchirurgie.

Background: Since 2008 we have been using many free vascularized medial femoral condyle grafts for reconstruction of difficult scaphoid non-unions. This article aims to report our results and experiences.

Patients And Methods: Until the end of 2019 a total of 287 patients had a microvascular scaphoid reconstruction, 158 with use of a corticocancellous, and 129 using an osseocartilaginous graft. Read More

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September 2020