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Scaphoid Bone

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1. Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs. Full Text available with Trip Pro

Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs. In clinically suspected scaphoid fractures, early diagnosis reduces the risk of non-union and minimises loss in productivity resulting from unnecessary cast immobilisation. Since initial radiographs do not exclude the possibility of a fracture, additional imaging is needed. Computed tomography (CT), magnetic resonance imaging (...) (MRI) and bone scintigraphy (BS) are widely used to establish a definitive diagnosis, but there is uncertainty about the most appropriate method.The primary aim of this study is to identify the most suitable diagnostic imaging strategy for identifying clinically suspected fractures of the scaphoid bone in patients with normal radiographs. Therefore we looked at the diagnostic performance characteristics of the most used imaging modalities for this purpose: computed tomography, magnetic resonance

2015 Cochrane

2. Clinical and functional outcomes of vascularized bone graft in the treatment of scaphoid non-union. Full Text available with Trip Pro

Clinical and functional outcomes of vascularized bone graft in the treatment of scaphoid non-union. Scaphoid non-union is a challenging and complex problem. Various methods have been proposed for the management of patients with scaphoid non-union and to reduce the risk of complications. In this study, our aim was to evaluate the clinical and functional outcomes of using a vascularized bone graft in the treatment of scaphoid non-union.Patients with scaphoid non-union who underwent 1,2 (...) to that in patients who did not achieve union. Functional measures, including the Disabilities of Arm and Shoulder score and the Modified Mayo Wrist Score, improved in patients with scaphoid union. The scaphoid length also improved significantly postoperatively in these patients.Surgical treatment of scaphoid non-union using vascularized bone graft led to a high union rate with good clinical and functional outcomes. Smoking is a risk factor for non-union, even with the use of a vascularized bone graft. Avascular

2018 PLoS ONE

3. Wrist arthroscopy for the treatment of scaphoid delayed or nonunions and judging the need for bone grafting. (Abstract)

Wrist arthroscopy for the treatment of scaphoid delayed or nonunions and judging the need for bone grafting. This study reports outcomes of arthroscopy in the treatment of delayed or nonunions of 25 scaphoids (25 patients). The surgery was performed between 8 and 43 weeks after injury. Intraoperatively, 11 fractures were deemed stable to probing and underwent percutaneous screw fixation only; 14 were unstable and received arthroscopic bone grafting with percutaneous screw fixation. All (...) fractures united. At a mean follow-up of 21 months (range 12-48), the mean Mayo wrist score was 96, and patient-rated wrist evaluation was 4, and the flexion-extension arc was 90% of the contralateral wrist. We conclude that arthroscopy is valuable in the treatment of scaphoid delayed or nonunions and in judging the need for bone grafting. Our data indicate that regardless of cystic formation in the scaphoid, bone grafting is not always necessary. Percutaneous fixation alone is sufficient when scaphoid

2019 Journal of Hand Surgery - European

4. The outcome of bone graft surgery for nonunion of fractures of the scaphoid. Full Text available with Trip Pro

The outcome of bone graft surgery for nonunion of fractures of the scaphoid. Data on 806 patients undergoing bone graft surgery for a scaphoid fracture nonunion were retrospectively collected at 19 centres in the United Kingdom. Each centre contributed at least 30 cases. Sufficient data were available in 462 cases to study factors that influenced the outcome of surgery. Overall union occurred in at least 69%, and nonunion in at least 22%, with 9% of cases having 'uncertain union status'. Union (...) appeared to be adversely influenced by smoking and the time between acute scaphoid fracture and nonunion surgery, with adjusted odds ratios of 1.8 and 2.4, respectively, but neither achieved the pre-determined significance level of 0.003. The type of bone graft (vascular vs non-vascular; iliac crest vs distal radius) did not appear to influence outcome. Further large multicentre prospective studies with clear definitions of 'union' and other factors are needed to clarify whether modification

2019 Journal of Hand Surgery - European

5. Retrospective Comparative Outcomes Analysis of Arthroscopic Versus Open Bone Graft and Fixation for Unstable Scaphoid Nonunions. (Abstract)

Retrospective Comparative Outcomes Analysis of Arthroscopic Versus Open Bone Graft and Fixation for Unstable Scaphoid Nonunions. To compare union rates and clinical and radiologic outcomes after arthroscopic and open bone grafting and internal fixation for unstable scaphoid nonunions.Between March 2009 and November 2014, patients with unstable scaphoid nonunion underwent arthroscopic (group A) or open (group O) bone grafting and internal fixation. One senior surgeon alternatively performed (...) ° ± 7.3° vs 49.2°±9.1° [P = .049]; RLA, 9.2° ± 2.0° vs 5.7° ± 3.0° [P = .005]; LISA, 34.8° ± 4.8° vs 25.6° ± 13.0° [P = .028]; HLR, 0.66 ± 0.04 vs 0.54 ± 0.07 [P < .001]).Arthroscopic and open bone grafting and internal fixation in treating unstable scaphoid nonunions, did not show any significant differences in clinical and radiologic outcomes at the minimum of 2 years after operation. In scaphoid nonunions with carpal collapse deformities, open bone grafting restored better carpal alignment than

2018 Arthroscopy

6. Conservative treatment of a pathologic fracture of the scaphoid bone in a child: A case report. Full Text available with Trip Pro

Conservative treatment of a pathologic fracture of the scaphoid bone in a child: A case report. Tumors of the scaphoid are rare, and some can cause pathological fractures. No cases of pathological fractures of the scaphoid have been reported in children. The most common treatment for pathologic fractures of the scaphoid bone associated with a benign lesion in adults is surgical, with intralesional curettage associated with autologous bone grafting and internal fixation.A 10-year-old boy (...) presented with wrist pain after falling from his height.X-ray, CT-scan and MRI showed a pathological undisplaced fracture of the scaphoid on a benign lytic lesion.The arm was immobilized in a below-elbow cast.The fracture healed within 4 months of immobilization. 3 years after the fracture, the functional status was normal, and the lytic lesion could not be seen on radiographs.Retrospectively, the most probable etiology was a ganglion cyst. Our case suggests that some pathological fractures

2018 Medicine

7. Correlation of CT imaging and histology to guide bone graft selection in scaphoid non-union surgery Full Text available with Trip Pro

Correlation of CT imaging and histology to guide bone graft selection in scaphoid non-union surgery For the treatment of scaphoid non-unions (SNU), different surgical techniques, including vascularized and non-vascularized bone grafts, are applied. Besides stability, vascularity, and the biological situation at the non-union site are important for healing and the appropriate choice of treatment. We assessed the healing potential of SNUs by histological parameters and compared it to CT (...) parameters of bone structure and fracture location. Based on the results, we developed a CT classification and a treatment algorithm to impact graft selection in SNU surgery.Preoperative 2D-CT reformations of 29 patients were analyzed for trabecular structure, sclerosis, and fragmentation of the proximal fragment. The fracture location was assessed on 3D-CT reconstructions and grouped in three zones depending on the potential blood supply. Samples were taken during surgery for histological evaluation

2018 Archives of orthopaedic and trauma surgery

8. Time‐dependent changes in bone healing capacity of scaphoid fractures and non‐unions Full Text available with Trip Pro

Time‐dependent changes in bone healing capacity of scaphoid fractures and non‐unions The scaphoid is the most frequently fractured carpal bone and prone to non-union due to mechanical and biological factors. Whereas the importance of stability is well documented, the evaluation of biological activity is mostly limited to the assessment of vascularity. The purpose of this study was to select histological and immunocytochemical parameters that could be used to assess healing potential after (...) scaphoid fractures and to correlate these findings with time intervals after fracture for the three parts of the scaphoid (distal, gap and proximal). Samples were taken during operative intervention in 33 patients with delayed or non-union of the scaphoid. Haematoxylin and Eosin (HE), Azan, Toluidine, von Kossa and Tartrate-resistant acid phosphatase (TRAP) staining were used to characterise the samples histologically. We determined distribution of collagen 1 and 2 by immunocytochemistry, and scanning

2018 Journal of anatomy

9. Primary medial femoral condyle vascularized bone graft for scaphoid nonunions with carpal collapse and proximal pole avascular necrosis. (Abstract)

Primary medial femoral condyle vascularized bone graft for scaphoid nonunions with carpal collapse and proximal pole avascular necrosis. This study aimed to determine the outcome of free vascularized medial femoral condyle bone grafts in the primary treatment of scaphoid nonunions with scaphoid foreshortening or carpal collapse and intraoperatively documented avascular necrosis. Thirty-two patients (28 male, four female) met the inclusion criteria. Median time from injury to surgery was 70 (...) weeks. Thirty of 32 patients healed at a median of 12 weeks. There was significant improvement from preoperative to postoperative lateral intrascaphoid angle, scapholunate angle, and radiolunate angle. Two scaphoids failed to unite; one patient underwent scaphoidectomy and four-corner fusion 15 months postoperatively after suffering a subsequent injury. Another patient underwent 1,2-intercompartmental supraretinacular artery-based vascularized bone grafting at 4 months postoperatively

2018 Journal of Hand Surgery - European

10. The Outcome of Using a Jamshidi Biopsy Trocar Needle in a Novel Technique for Bone Grafting in Percutaneous Internal Fixation of Scaphoid Non-Union Full Text available with Trip Pro

The Outcome of Using a Jamshidi Biopsy Trocar Needle in a Novel Technique for Bone Grafting in Percutaneous Internal Fixation of Scaphoid Non-Union We report the outcome of using a novel technique of minimally invasive internal fixation and distal radius bone grafting using the Jamishidi Trephine needle and biopsy/graft capture device.The technique utilises a 8 mm incision at the distal pole of the scaphoid. The non-union is excavated using the standard Acutrak drill. An 8 gauge Jamshidi (...) trephine needle is used to harvest bone graft from the distal radius which is impacted into the scaphoid and fixed with an Acutrak screw. Fifteen patients were available for retrospective review, 14 male, age mean 29.5 (15-56). Average time from injury to surgery was 167 days (45-72). Fractures classified according to Herbert giving 7 D1 and 8 D2 fractures, 14 waist and 1 proximal pole fractures, all of which had no humpback deformity.Sixty-six percentages of the fractures went onto unite, 4/7 D1 and 6

2018 Open access Macedonian journal of medical sciences

11. Free Vascularized Medial Femoral Condyle Bone Graft After Failed Scaphoid Nonunion Surgery. (Abstract)

Free Vascularized Medial Femoral Condyle Bone Graft After Failed Scaphoid Nonunion Surgery. Outcomes following revision surgery for scaphoid nonunions with osteonecrosis are guarded. We hypothesized that use of free vascularized medial femoral condyle (MFC) bone grafts can lead to healing of the nonunion, increase vascularity of the proximal pole, and restore scaphoid architecture, resulting in acceptable functional outcomes.We performed a retrospective review of 49 patients who were treated (...) with an MFC bone graft, between May 2005 and September 2016, after prior failure of operative treatment for scaphoid nonunion. The mean time from the injury to the revision surgery with the MFC bone graft was 24 months, and the mean time from the prior, failed surgery was 15 months. Thirty-six of the 49 patients had had a prior bone graft procedure and 6 patients had had 2 previous surgical procedures for the nonunion. The initial internal fixation of the scaphoid fracture was with a scaphoid screw in 43

2018 The Journal of Bone and Joint Surgery. American Volume

12. The clinical result of arthroscopic bone grafting and percutaneous K-wires fixation for management of scaphoid nonunions. Full Text available with Trip Pro

The clinical result of arthroscopic bone grafting and percutaneous K-wires fixation for management of scaphoid nonunions. The purpose of this study is to analyze the clinical results of patients with scaphoid nonunion treated with arthroscopic bone grafting and K (Kirschner)-wires fixation.We retrospectively reviewed the records of 27 patients with scaphoid nonunion who had been treated with arthroscopic bone grafting and K-wires fixation method from November 2008 to February 2014. The average (...) decreased from 6.38 (range, 3-10) preoperatively to 1.59 (range, 0-3) at the final follow-up. The average modified Mayo wrist score improved from 60.19 preoperatively to 83.46 at the final follow-up. According to this score, there were 12 excellent, 6 good, and 9 fair results at the final follow-up.Arthroscopic bone grafting and percutaneous K-wires fixation is an effective treatment method for a scaphoid nonunion and has the advantages of allowing thorough assessment, enabling a comprehensive

2018 Medicine

13. Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis. (Abstract)

Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis. We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion

2017 Journal of Hand Surgery - European

14. Bone graft in the treatment of nonunion of the scaphoid with necrosis of the proximal pole: a literature review Full Text available with Trip Pro

Bone graft in the treatment of nonunion of the scaphoid with necrosis of the proximal pole: a literature review Scaphoid fractures are the most common fractures of the carpal bones, corresponding to 60%. Of these, 10% progress to nonunion; moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized and non-vascularized bone grafts. To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different (...) surgical techniques. The authors conducted a review of the literature using the following databases: PubMed and BIREME/LILACS, where 13 case series were selected (ten with use of vascularized bone grafts and three of non-vascularized bone grafts), according to inclusion and exclusion criteria. In most cases VBGs were used, especially those based on the 1,2 intercompartmental supraretinacular artery, due to greater reproducibility in performing the surgical technique.

2017 Revista brasileira de ortopedia

15. Scaphoid fracture: Bone marrow edema detected with dual-energy CT virtual non-calcium images and confirmed with MRI Full Text available with Trip Pro

Scaphoid fracture: Bone marrow edema detected with dual-energy CT virtual non-calcium images and confirmed with MRI We aimed to determine whether bone marrow edema (BME) in acute traumatic scaphoid fracture could be demonstrated with dual-energy CT (DECT) using MRI as the gold standard. In recent years, virtual non-calcium (VNCa) images have been used to demonstrate BME in trauma cases, for example, in vertebral compression fractures, hip trauma to detect occult fractures and knee fractures. We (...) present three cases of acute scaphoid trauma. Two patients had subtle or invisible fractures on x-ray and conventional CT images, while DECT VNCa images clearly visualized the BME, which was confirmed by MRI. One patient had negative findings on both VNCa and MRI images. The DECT VNCa algorithm is a promising technique to demonstrate BME in scaphoid fractures, with potential for increasing the diagnostic value of CT in this type of injury.

2017 Skeletal radiology

16. Pedicled vascularized versus nonvascularized bone graft in treatment of scaphoid nonunion: a meta-analysis of union rate

Pedicled vascularized versus nonvascularized bone graft in treatment of scaphoid nonunion: a meta-analysis of union rate Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

17. Clinical and cost implications of using immediate MRI in the management of patients with a suspected scaphoid fracture and negative radiographs results from the SMaRT trial Full Text available with Trip Pro

both in the diagnosis of a fracture of the scaphoid (100.0% vs 93.8%) and of any other fracture (98.5% vs 84.6%).The use of immediate MRI in the management of participants with a suspected fracture of the scaphoid and negative radiographs led to cost savings while improving the pathway's diagnostic accuracy and patient satisfaction. Cite this article: Bone Joint J 2019;101-B:984-994. (...) Clinical and cost implications of using immediate MRI in the management of patients with a suspected scaphoid fracture and negative radiographs results from the SMaRT trial The aim of the Scaphoid Magnetic Resonance Imaging in Trauma (SMaRT) trial was to evaluate the clinical and cost implications of using immediate MRI in the acute management of patients with a suspected fracture of the scaphoid with negative radiographs.Patients who presented to the emergency department (ED) with a suspected

2019 EvidenceUpdates

18. Scaphoid Bone

Scaphoid Bone Scaphoid Bone Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Scaphoid Bone Scaphoid Bone Aka: Scaphoid Bone , Scaphoid (...) , Carpal Navicular II. Anatomy Lewis (1918) Gray's Anatomy 20th ed (in at or ) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Scaphoid Bone." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Scaphoid bone (C0223724) Definition (NCI) A nut-shaped bone of the wrist located in the radial site of the hand. It is one of the eight carpal bones

2018 FP Notebook

19. Scaphoid Plate Fixation and Volar Carpal Artery Vascularized Bone Graft for Recalcitrant Scaphoid Nonunions. (Abstract)

Scaphoid Plate Fixation and Volar Carpal Artery Vascularized Bone Graft for Recalcitrant Scaphoid Nonunions. We sought to evaluate the clinical and radiographic outcomes after treatment of symptomatic, recalcitrant scaphoid nonunions using a novel combination of volar scaphoid buttress plating with a pedicled vascularized bone graft.We retrospectively followed 9 patients with recalcitrant scaphoid waist nonunions, characterized by failed prior surgery, long duration of nonunion, avascular (...) necrosis of the proximal pole, or considerable bone loss at the nonunion site. We treated these persistent nonunions through a single volar incision with a pedicled vascularized bone graft, based on the volar carpal artery, and a 1.5-mm precontoured, scaphoid-specific, volar buttress plate. Postoperatively, we assessed objective and subjective outcomes as well as radiographs and computed tomography scans.The median duration of nonunion was 15 months, ranging from 6 to 96 months. Postoperative follow-up

2016 Journal of Hand Surgery - American

20. What Physical Examination Findings and Diagnostic Imaging Modalities Are Most Useful in the Diagnosis of Scaphoid Fractures?

,etal.Meta-DiSc: a software for meta-analysis of testaccuracy data.BMCMed Res Methodol. 2006;6:31. 3. DerSimonianR,LairdN.Meta-analysisinclinical trials.ControlClinTrials.1986;7:177-188. 4. Barton NJ. Twenty questions about scaphoid fractures. J Bone Joint Surg Br. 1992;17: 289-310. 5. Harrison W, Newton AW, Cheung G. The litigation cost of negligent scaphoid fracture management. Eur J Emerg Med; 2014 Apr 4. [Epub ahead of print]. 6. Langhoff O, Andersen JL. Consequences of late immobilization (...) What Physical Examination Findings and Diagnostic Imaging Modalities Are Most Useful in the Diagnosis of Scaphoid Fractures? Systematic Review Snapshot TAKE-HOME MESSAGE Whenapatientwithacutewristpainisevaluated,theabsenceofsnuffboxtenderness substantiallydecreasestheprobabilityofascaphoidfracture.Alternatively,to de?nitivelydiagnoseascaphoidfracture,advancedimagingsuchascomputed tomography(CT)ormagneticresonanceimaging(MRI)maybenecessary. What Physical Examination Findings and Diagnostic

2015 Annals of Emergency Medicine Systematic Review Snapshots

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