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At least 271 records · Page 15Linked to original sources
PubMed1978

[Blood supply of the scaphoid bone of the hand].

For investigation of the vascular supply of the os scaphoideum we produced post mortem injection specimens of hands with latex milk. The estraosseous vessels were prepared macroscopically and microscopically. The intraosseous vascular distribution was represented by cleared specimens (Spalteholz technique). A branch of the arteria radialis or of the ramus dorsalis arteriae radialis enters the dorsal face in the middle and distal third by several foramina nutricia. This artery effects the blood supply almost completely. Other vessels entering the navicular bone are small calibrated and only sometimes demonstrable. The proximal third of the scaphoideum shows no artery entrance.

Aged↗
PubMed2004

Bone grafting the scaphoid nonunion: a systematic review of 147 publications including 5,246 cases of scaphoid nonunion.

In order to elucidate the history of scaphoid nonunion and to evaluate whether or not the problem has been solved, we have reviewed the literature from 1928 to 2003 for union rates, postoperative immobilization periods and complications of the different scaphoid bone grafting procedures. The outcomes of 5 246 scaphoid nonunions were evaluated in three treatment groups. In the first group involving nonvascularized bone grafting without internal fixation, we found a union rate of 80% (95% CI: 78-82) after an average immobilization period of 15 weeks. In the second group involving nonvascularized bone grafting with internal fixation, the figures were 84% (CI: 82-85) and 7 weeks, respectively. In the last group involving vascularized bone grafting with or without internal fixation, the figures were 91% (CI: 87-94) and 10 weeks, respectively. We found no prospective randomized studies comparing different operative treatments of scaphoid nonunion. We conclude that there still is a need for improvement in the treatment of scaphoid nonunion.

Bone Transplantation↗
PubMed1984

Bone scanning of fractures of the scaphoid.

The value of isotope scanning in patients with clinical signs of fracture of the carpal scaphoid bone and negative or non-diagnostic initial radiographs was examined. 30 patients were examined using both radiography and isotope scanning. A normal scan excludes a fracture. Increased activity localized to the scaphoid bone indicates a fracture. 9 patients had fracture of the scaphoid evident on bone scans within 2 weeks of the injury. It took 2-6 weeks before these fractures showed up on radiographs.

Adolescent↗
PubMed2002

[Osteotomy of the navicular bone in scaphoid malunion].

In scaphoid malunions corrective osteotomy and filling the gap of scaphoid waist with bone graft was carried out. Corrective osteotomy of malunion was needed in 2 cases among 43 waist reconstructions. The size of the gap was assessed intraoperatively by carpal stretch test. In both 2 cases bone healing, correction of scaphoid angle and pain relief was achieved.

Bone Transplantation↗
PubMed2002

[Personal experience with treatment of pseudoarthrosis of the navicular bone of the carpus].

PURPOSE OF THE STUDY: A displaced fracture of the scaphoid bone of the hand may result, according to some authors, in the development of pseudoarthrosis in 10 to 50% of the patients and aseptic necrosis of the proximal bone fragment may develop in 30 to 50% of them. Them surgical treatment of scaphoid bone pseudoarthrosis has recently made great progress and the results achieved by the authors in this field are reported in this paper. These results are discussed in light of the results and opinions presented at the 8th Congress of the World Federation for Hand Surgery held in Istambul in June 2001 and are compared with the achievements made by other authors and published in the most recent relevant literature. MATERIAL AND METHODS: At our department, two standard surgical procedures are available to treat pseudoarthrosis of the scaphoid bone that is free from deforming changes due to arthritis. One approach involves resection of the pseudoarthrosis and subsequent cancellous bone grafting, using osseous tissue from the styloid process of the radius and osteosynthesis with a navicular screw. The other procedure is a modified arthroplasty according to Dwyer and is applied to cases which show aseptic necrosis of the proximal bone fragment. The follow-up study of the patients treated between 1997 and 2001 included patients in whom the follow-up period was at least six months. The results were evaluated according to Pechlaner's rating system. RESULTS: A total of 26 patients were examined; the average time from the operation was 17 months. Of them, 24 underwent the primary treatment that involved resection of pseudoarthrosis followed by cancellous bone grafting and osteosynthesis with a screw. This primary operation healed the condition in 17 patients, but the rest of them had to undergo one or two more surgical procedures. Evaluation by Pechlaner's scoring system showed 14 excellent, five good, two sufficient and three poor outcomes of the treatment. DISCUSSION: The pseudoarthrosis of the scaphoid bone, its diagnosis, surgical treatment and different operative techniques are discussed. Special attention is paid to the use of either vascularized rotatory grafts or pedicled vascularized grafts. The follow-up results are compared with those of other orthopedic clinics and hospitals. Various aspects of further improvement in the treatment of this disease under current conditions are considered. CONCLUSIONS: The results achieved in the treatment of pseudoarthrosis of the scaphoid bone of the hand are comparable with those of other orthopedic hospitals. Adoption of more recent types of osteosyntheses in considered. For a potential introduction of the vascularized graft technique, the use of a vascularized graft collected from the dorsum of the distal radius is suggested. This method is also regarded as suitable for treatment of certain cases of aseptic necrosis of the lunate bone.

Adolescent↗
PubMed2000

Correction of lunate malalignment when bone grafting scaphoid nonunion with humpback deformity: rationale and results of a technique revisited.

Patients with scaphoid nonunion with humpback deformity and collapse of the wrist were treated with palmar wedge bone grafting combined with reduction of the lunate to correct the dorsal intercalated segment instability deformity. Union was obtained at an average of 3 months, and patient satisfaction with functional outcome and pain relief was high. Palmar wedge bone grafting combined with correction of lunate malalignment successfully achieved scaphoid union, restored scaphoid length, and avoided the potential complication of scaphoid malunion. This report revisits a technique that facilitates accurate correction of lunate malalignment (dorsal intercalated segment instability) by initial reduction and pin fixation to the radius before insertion of scaphoid bone graft and internal fixation.

Adolescent↗