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Results for “Scaphoid Bone”

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At least 487 records · Page 27Linked to original sources
PubMed2005

Extensor pollicis longus tendon rupture as a result of scapholunate dissociation: a case report.

A 39-year-old patient was presented with, to our knowledge, the first ever diagnosed case of extensor pollicis longus (EPL) tendon rupture as a result of scapholunate (S-L) dissociation. Arthroscopic findings showed that the dorsal aspect of the S-L ligament was ruptured and severe synovitis was revealed around the S-L joint. Direct observation revealed synovium at the rupture site of the EPL tendon. After careful resection of this synovium, an aperture in the S-L joint was observed. Thus, it was considered that the synovium in the S-L joint was connected to the rupture site of the EPL tendon, passing through the dorsal capsule of the S-L joint. The ruptured EPL tendon was reconstructed with extensor indicis proprius tendon transfer, and S-L dissociation was treated with a bone-retinaculum-bone autograft taken from the third dorsal compartment region.

Adult↗
PubMed2003

Cast adrift: Gortex cast liners allow greater patient activity.

Extremity fractures are a common injury, with nearly 1.5 million cases reported in the United States in 1998. Treatment often involves lengthy periods of immobilization. This report outlines the use of a Gortex cast liner by a subject who was able to engage in swimming and scuba diving during the healing process. We report that a Gortex cast liner may be considered for an active patient who is keen to return to limited activities during fracture healing. Apparently because of a lack of knowledge of their existence, physicians currently are underutilizing this method of casting in active patients. The use of Gortex liners elsewhere has been reported to have higher patient and physician satisfaction in both use and performance, with no reported detrimental effects on outcome.

Accidents↗
PubMed2001

A vascularized bone graft for repair of scaphoid nonunion.

The majority of scaphoid fractures respond to casting, splinting, or open reduction and internal fixation. In patients who fail to heal a scaphoid fracture, several factors may contribute, including delay in treatment, fracture displacement, proximal third location, avascular necrosis, and associated carpal instability.

Bone Transplantation↗
PubMed1995

Anterior wedge-shaped bone graft for old scaphoid fractures or non-unions. An analysis of relevant carpal alignment.

For appraisal of anterior wedge-shaped grafts for the humpback deformity of the scaphoid, a retrospective study of 27 cases with old scaphoid fractures or non-unions was carried out. 11 cases were treated with Herbert screw fixation and anterior wedge-shaped graft and the other cases with other methods. For the assessment of carpal alignment, radio-lunate and scapho-lunate angles were measured with peri-operative radiographs. For the clinical assessment, the scoring system of Cooney was applied. In 25 cases, primary bone union was obtained with one attempt and in two cases, with the second operation. Union was achieved in a mean of 3.4 months. The post-operative wrist score ranged from 65 to 100 with an average 81.2 points. There was a statistically significant relationship between the wrist score and the post-operative scapho-lunate angulation of the affected wrist. The humpback deformity of scaphoid non-union should be treated precisely with carpal realignment surgery or anterior wedge-shaped bone graft.

Adolescent↗
PubMed1995

Scaphoid nonunion: treatment by open reduction, bone graft, and staple fixation.

Thirty-eight scaphoid nonunions were treated by iliac crest bone grafting and staple fixation. A distractor was inserted through an anterior incision and the scaphoid was distracted to restore its original length. The nonunion was then grafted and held with a staple. Consolidation was achieved in 36 cases despite 6 cases of partial avascular necrosis. Pain at the graft site, which was usually transient, was the only complication. Wrist extension was significantly improved. The main indication for this procedure is pseudarthrosis of the middle third of the scaphoid.

Adolescent↗
PubMed1999

[Proximal scaphoid pseudarthrosis--reconstruction by dorsal bone screw and spongiosa transplantation].

Stable fixation of small proximal pole nonunions of the scaphoid by conventional techniques of bone grafting remains difficult. Because of this, long-lasting immobilisation is necessary. Treatment by retrograde Herbert-screw fixation offers the possibility of stable osteosynthesis resulting in shorter immobilisation. Even in case of avascular proximal fragments, it allows healing of the nonunion. We report on the 29 months follow-up of 23 patients treated in this manner showing bony consolidation in 17 cases (74%). Four patients demonstrated fibrous nonunion with minor symptoms, and in two patients persistent nonunion with slight impairment was seen. Evaluation with the DASH-questionnaire revealed slight disability with an average score of ten points. The availability of the mini-Herbert-screw has improved this treatment concept.

Adult↗
PubMed2002

[Operative treatment of scaphoid nonunions].

43 reconstructive procedures were performed in nonunions and malunions of the scaphoid waist. In 8 cases of proximal pole nonunions the Chacha operation was carried out. Before surgical treatment SL angles and scaphoid length were measure on radiograms, taken with both hands in neutral position. Reconstruction procedures of the scaphoid waist were implemented basing on the carpal stretch test. Five different types of scaphoid nonunions were noted, basing on the localisation of the pathology. Operative procedures were selected in close correlation to nonunion localisation: simple reconstruction, reconstruction and revascularisation on the proximal part of the waist and rerevascularisation of the proximal pole. Additionally 3 revision procedures were performed in cases of nonunion after scaphoid reconstruction. Bone healing was observed in 49 cases, including the revision procedures.

Adolescent↗
PubMed1990

Recalcitrant non-union of the scaphoid treated with a vascularized bone graft based on the ulnar artery.

Eight patients who had a recurrent pseudarthrosis of the carpal scaphoid were treated by a bone graft from the ulna, vascularized by an ulnar-artery pedicle. The graft was taken from the medial aspect of the distal third of the ulna and inserted into the prepared scaphoid. This technique is advocated only for complex recalcitrant non-union. All of our patients had previously had at least two operations, one of which was conventional non-vascularized bone-grafting. In all eight patients, primary osseous union occurred in an average of 4.6 months; all were able to resume their previous occupational or athletic activities.

Adult↗
PubMedDate not supplied

The surgical approach and source of bone graft for symptomatic nonunion of the scaphoid.

In 2 groups of patients treated by bone grafting for scaphoid nonunions, one group had a dorsal or dorsolateral surgical approach with a bone graft from the radius while the other group had a volar approach with an iliac graft. The best results were obtained with an iliac graft. Through the volar approach it is relatively easy to avoid damage to the scaphoid arterial supply. A small proximal vascular pole led to a failure rate of 36%.

Adolescent↗
PubMed1997

Treatment of scaphoid nonunions with a vascularized bone graft based on the first dorsal metacarpal artery.

Four patients with chronic nonunion of the scaphoid were treated by a vascularized bone graft based on first dorsal metacarpal artery. The mean duration of the nonunion was 28.5 months (range 12-48 months). There was avascular necrosis in all patients confirmed by magnetic resonance imaging (MRI). None of the patients had previous attempts at surgical reconstruction. Two fractures were localized at the waist one in the distal part and one at the proximal pole. Osseous union of the scaphoid was confirmed by X-ray in all patients in an average of 2.1 months. We recommend this technique for the treatment of established scaphoid pseudoarthrosis with avascular necrosis since it is associated with minimal morbidity and predictable good results.

Adult↗