432 results match your criteria Wrist Scaphoid Fractures and Complications


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 Jun 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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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

Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial.

Lancet 2020 08;396(10248):390-401

Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Oxford, UK.

Background: Scaphoid fractures account for 90% of carpal fractures and occur predominantly in young men. The use of immediate surgical fixation to manage this type of fracture has increased, despite insufficient evidence of improved outcomes over non-surgical management. The SWIFFT trial compared the clinical effectiveness of surgical fixation with cast immobilisation and early fixation of fractures that fail to unite in adults with scaphoid waist fractures displaced by 2 mm or less. Read More

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Robot-assisted double screw fixation of minimally displaced scaphoid waist fracture nonunions or delayed unions without bone graft.

J Hand Surg Eur Vol 2021 Mar 5;46(3):286-291. Epub 2020 Aug 5.

Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing, China.

We retrospectively reviewed 12 minimally displaced fractures of the scaphoid waist in 12 patients who developed delayed or nonunions with or without conservative treatment. Mean time between injury and surgery was 6 months (range 3-12). The fractures were stabilized with double screws, which were percutaneously inserted with robot assistance, and without bone grafting. Read More

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Safety of Releasing the Volar Capsule During Open Treatment of Distal Radius Fractures: An Analysis of the Extrinsic Radiocarpal Ligaments' Contribution to Radiocarpal Stability.

J Hand Surg Am 2020 Nov 31;45(11):1089.e1-1089.e16. Epub 2020 Jul 31.

Department of Orthopedic Surgery, Stanford University, Redwood City, CA. Electronic address:

Purpose: The contribution of the extrinsic radiocarpal ligaments to carpal stability continues to be studied. Clinically, there is a concern for carpal instability from release of the volar extrinsic ligaments during volar plating of distal radius fractures in which the integrity of the dorsal ligaments may be unknown. The primary hypothesis of this study was that serial sectioning of radiocarpal ligaments would lead to progressive ulnar translation of the carpus. Read More

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November 2020

Outcomes of Local Bone Graft and Fixation of Proximal Pole Scaphoid Nascent Nonunions and Nonunions.

J Wrist Surg 2020 Jun 10;9(3):203-208. Epub 2020 Feb 10.

Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

 Fractures of the proximal pole of the scaphoid have an increased risk of nonunion due to its tenuous blood supply. The optimal treatment of proximal pole scaphoid nonunions remains controversial.  To review a single surgeon's experience with proximal pole scaphoid nascent nonunions (delayed unions) and nonunions that underwent surgical fixation with a cannulated headless compression screw and local autologous bone graft from the distal radius. Read More

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Fractures of the scaphoid.

BMJ 2020 May 27;369:m1908. Epub 2020 May 27.

Guy's and St Thomas' NHS Foundation Trust, London, UK.

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[Proximal carpectomy versus four-cornered arthrodesis in patients with lesions SLAC and SNAC].

Acta Ortop Mex 2019 May-Jun;33(3):146-149

Hospital de Traumatología y Ortopedia «Lomas Verdes». Unidad Médica de Alta Especialidad (UMAE), Instituto Mexicano del Seguro Social (IMSS). Estado de México. México.

Advanced scafosemilunar collapse (SLAC) and advanced scaphoid pseudoarthrosis (SNAC) collapse are the result of trauma causing scaphoid fracture and the consequent pseudoarthrosis resulting in abnormal kinematics of the wrist and a scapholunate ligament injury, respectively. Current surgical options for SLAC/SNAC treatment include partial arthrodesis, carpal proximal row resection.

Material And Methods: Retrospective, cross-cutting and descriptive study was carried out in the period from January 2010 to December 2015. Read More

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Pediatric Scaphoid Nonunions: A Case Series, Review of the Literature, and Evidence-Based Guidelines.

J Wrist Surg 2020 Feb 20;9(1):2-12. Epub 2019 Dec 20.

Pulvertaft Hand Centre, Kings Treatment Centre, Royal Derby Hospital, Derby, United Kingdom.

 Scaphoid fractures represent less than 3% of hand and wrist fractures in the pediatric population. Nonunions are very rare. We present a case series (  = 18) of nonunions in skeletally immature children and adolescents. Read More

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February 2020

Scaphoid waist fractures fixation with staple. Retrospective study of a not widespread procedure.

Injury 2020 Aug 28;51 Suppl 3:S2-S8. Epub 2019 Dec 28.

Orthopaedics & Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.

Introduction: In carpal scaphoid fractures, the surgical treatment with screw is considered the gold standard; shape memory staple however presents substantial advantages. The authors report a study on unstable fractures of the scaphoid waist (type B1, B2, B5, according to Herbert classification) treated with shape memory staple on a large sample of patients, with the aim to confirm the usefulness of this method, the quality of reduction and fixation, the functional results, the time of union and the possible complications.

Materials And Methods: A retrospective analysis of 131 patients with scaphoid waist fractures with minimum follow-up 1 year was performed. Read More

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The role of vascularized flaps in the treatment of proximal pole avascular necrosis in scaphoid non-unions.

Acta Biomed 2019 12 5;90(12-S):64-68. Epub 2019 Dec 5.

università la sapienza di roma.

Objectives: The purpose of this study is to evaluate the clinical and radiological outcomes of scaphoid non unions surgically treated with bone graft versus medial condyle corticoperiosteal free flaps.

Materials And Methods: 32 patients were divided in 2 groups. Group A (17 patients 12male, 5 females, mean age 35 years old) treated with bone grafts; Group B (15patients 11 male, 4 females, mean age 33 years old) treated with medial condyle cortico periosteal free flap. Read More

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December 2019

Scaphoid Reconstruction.

Orthop Clin North Am 2020 Jan 17;51(1):65-76. Epub 2019 Oct 17.

Division of the Orthopedics and Traumatology Department, Santa Casa Hospital Complex, Porto Alegre, Brazil; Clinica da Mao ao Cotovelo, 569/601 Soledade Street, Porto Alegre, Rio Grande do Sul 90470-340, Brazil.

Surgical strategies for scaphoid nonunions become more complex based on time from injury to treatment. The decision-making process, however, can follow a logical sequence. Scaphoid nonunions less than 1 year after trauma and no carpal malalignment can be treated with percutaneous screw fixation under fluoroscopic and/or arthroscopic guidance. Read More

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January 2020

Arthroscopic treatment of scaphoid nonunion with humpback deformity and DISI with corticocancellous bone grafting: Technical note.

Hand Surg Rehabil 2019 10 5;38(5):280-285. Epub 2019 Aug 5.

Department of Orthopedics, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.

For two decades, scaphoid nonunion has been treated arthroscopically. However, compressed cancellous bone graft does not have the same mechanical properties as corticocancellous bone graft for reducing the scaphoid humpback deformity and DISI tilt. Here, we describe an arthroscopic technique to treat Alnot stage IIB scaphoid nonunion. Read More

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October 2019

Scaphoid Fracture Repair Does Not Significantly Diminish Short-Term Participation in the National Football League.

HSS J 2019 Jul 5;15(2):137-142. Epub 2018 Nov 5.

1University Hospitals Sports Medicine Institute, Cleveland, OH USA.

Background: Fixation of scaphoid fractures is recommended in elite athletes to hasten healing and return-to-sport times. Complications such as nonunion negatively affect athletic performance.

Questions/purposes: The purpose of this study was to examine the prevalence and impact of scaphoid repair on National Football League (NFL) participation during athletes' first season in the NFL, while identifying significant predictors for development of carpal arthritis and scaphoid nonunion. Read More

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[Acute scaphoid fractures].

Authors:
Jonny Andersson

Lakartidningen 2019 Jun 17;116. Epub 2019 Jun 17.

SportsMed, Carlanderska Sjukhuset, Göteborg - Göteborg, Sweden - SportsMed, Carlanderska Sjukhuset, Göteborg Gothenburg, Sweden.

Early diagnosis and correct treatment of acute scaphoid fractures is mandatory and of great importance in terms of the long-term prognosis for these young patients. Missed acute scaphoid fractures tend to lead to pronounced symptoms later on. A SNAC wrist, with the gradual progression of degenerative osteoarthritis is most often debilitating, with pain, limited and restricted range of motion, and loss of strength. Read More

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Imaging for Acute and Chronic Scaphoid Fractures.

Hand Clin 2019 08 11;35(3):241-257. Epub 2019 May 11.

Department of Radiology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.

The scaphoid is the most commonly fractured bone in the wrist but 20% to 40% of scaphoid fractures are radiographically occult. Delayed or misdiagnosis can have significant consequences with late complications such as nonunion, malunion, or the development of avascular necrosis in the proximal pole. After initial negative radiographs, advanced cross-sectional imaging, including CT and MRI, ultimately may provide more accurate and rapid diagnosis than conventional radiography. Read More

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[Extracorporeal Shockwave Therapy for the treatment of scaphoid delayed union and nonunion: a retrospective analysis examining the rate of consolidation and further outcome variables].

Handchir Mikrochir Plast Chir 2019 Jun 5;51(3):164-170. Epub 2019 Jun 5.

Unfallkrankenhaus Salzburg Unfallchirurgie und Orthopädie.

Background: Operative procedures are considered gold standard in the treatment of scaphoid nonunion, albeit their considerable complexity and the risk of intraoperative complications. High energy extracorporeal shockwave therapy (ESWT) offers a non-invasive treatment option for scaphoid nonunion. The aim of this study was to explore the rate of bony consolidation and further outcome variables in patients with delayed union of scaphoid fractures and scaphoid nonunion treated with ESWT. Read More

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Robot-assisted percutaneous scaphoid fracture fixation: a report of ten patients.

J Hand Surg Eur Vol 2019 Sep 16;44(7):685-691. Epub 2019 May 16.

4 Department of Spine Surgery, Beijing Ji Shui Tan Hospital, Beijing, China.

This study reports the technique, efficacy and safety of robotic-assisted, computer-navigated, percutaneous fixation of scaphoid fractures. Ten males with acute undisplaced waist fractures underwent fixation with this method using a commercially available three-dimensional fluoroscopy unit and robotic navigation system. The mean total operative duration was 40 minutes, which comprised of a set-up time of 18 minutes and planning and surgical time of 22 minutes. Read More

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September 2019

Bilateral Scaphocapitate Fracture Syndrome: A Case Report with Long-Term Follow up.

J Hand Surg Asian Pac Vol 2019 Jun;24(2):243-246

1 Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.

Carpal bone fracture-dislocation is an uncommon wrist injury. Regarding limited prevalence of such injury, most of orthopedic surgeons have low experience in treatment and handling of these fractures and dislocations. A 25-year-old male worker with an uncommon carpal bone fracture-dislocation, namely bilateral scaphocapitate fracture syndrome, was described. Read More

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Proximal Row Carpectomy versus Four-Corner Arthrodesis for the Treatment of Scapholunate Advanced Collapse/Scaphoid Nonunion Advanced Collapse Wrist: A Cost-Utility Analysis.

Plast Reconstr Surg 2019 05;143(5):1432-1445

From the Hansjörg Wyss Department of Plastic Surgery and the Department of Orthopedic Surgery, New York University School of Medicine; All Florida Orthopedics; and the Department of Orthopaedic Surgery, University of Pennsylvania Health System.

Background: Two mainstay surgical options for salvage in scapholunate advanced collapse and scaphoid nonunion advanced collapse are proximal row carpectomy and four-corner arthrodesis. This study evaluates the cost-utility of proximal row carpectomy versus three methods of four-corner arthrodesis for the treatment of scapholunate advanced collapse/scaphoid nonunion advanced collapse wrist.

Methods: A cost-utility analysis was performed in accordance with the Second Panel on Cost-Effectiveness in Health and Medicine. Read More

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Current Fixation Options for Elbow, Forearm, Wrist, and Hand Fractures.

Semin Musculoskelet Radiol 2019 Apr 29;23(2):109-125. Epub 2019 Mar 29.

Weill Cornell Medical College, New York, New York.

The universal goals of upper limb fracture management are to restore anatomic alignment, establish stable fracture fixation (while preserving blood supply), and allow for early mobilization of the elbow, wrist, and digits. However, the indications for operative management and fixation constructs are specific to each fracture type. This article systematically reviews current classifications and treatment options for adult fractures of the distal humerus, radius, ulna, scaphoid, metacarpals, and phalanges. Read More

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