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At least 703 records · Page 39Linked to original sources
PubMed2004

Scaphoid views: a need for standardisation.

AIMS: Several views are needed to visualise the scaphoid. These are routinely called 'scaphoid views'. The authors believe that asking for scaphoid views from the radiology department often leads to a wide variety and number of radiographic views being taken. METHODS: 50 radiographers were asked which and how many views of the scaphoid they would take, in the acute setting and then in the out-patient department. RESULTS: We found a wide variation in the descriptive terms used by radiographers for particular views. There was also little agreement on how many and which radiographic views to take when asked for 'scaphoid views'. CONCLUSIONS: Not only is there complete lack of agreement on what 'scaphoid views' should be, it was also discovered that there was little agreement on the nomenclature of the individual views themselves. Loss of information can result from the wrong views being taken and unnecessary radiation exposure. We recommend five particular views, which together visualise all areas of the scaphoid.

Clinical Competence↗
PubMed2006

Distal scaphoid resection arthroplasty for scaphoid nonunion with radioscaphoid arthritis.

The authors compare the functional outcome of 8 patients treated by distal scaphoid resection arthroplasty for scaphoid nonunion with symptomatic wrist arthritis before surgery and after a minimum follow-up of 6 months. There was a significantly better range of radial deviation and grip strength at the time of re-examination. Significantly fewer patients complained of resting pain. By contrast the change of radiolunate angle measured before the surgery and at the time of re-examination was statistically insignificant. Our preliminary results show that distal scaphoid resection arthroplasty seems to be a useful treatment method of scaphoid nonunion with symptomatic wrist arthritis.

Adult↗
PubMed2000

Rotary subluxation of the scaphoid. Revisited.

The SL ligament complex and volar radiocarpal ligaments provide scaphoid stability both at the SL joint and, more importantly, at its distal radius articulation. With disruption or attenuation of these ligaments, rotational displacement of the scaphoid occurs about its longitudinal axis. This results in distal scaphoid flexion and proximal pole subluxation dorsally, toward the distal radius rim. Rotary subluxation of the scaphoid accurately describes this condition, and represents a spectrum of radioscaphoid instability based upon the severity and chronicity of ligamentous disruption. Diagnosis is based upon identification of specific clinical and radiographic features. Recognition of this entity provides for a more rational basis for treatment of ligamentous injuries of the wrist.

Athletic Injuries↗
PubMed2000

Casting acute fractures. Part 4--The scaphoid slab.

BACKGROUND: Injury to the scaphoid carpus and the base of the thumb is extremely common. An initial splint is often required for patient comfort. The scaphoid slab is ideal for patients who require removal for further assessment or repeat imaging at days 7-10. OBJECTIVE: The specific technique for rapid application of a strong and comfortable scaphoid slab is demonstrated. DISCUSSION: Suspected scaphoid fractures should be treated. There is considerable controversy about the degree and position of thumb immobilisation. The demonstrated method combines comfortable immobilisation with good function in the cast.

Casts, Surgical↗
PubMed2000

Rotatory subluxation of the scaphoid.

Rotatory subluxation of the scaphoid remains a challenging problem; a thorough understanding of the basic anatomy, particularly the ligament complexes of the wrist, as well as wrist kinematics are required for the proper diagnosis and treatment. Our understanding of rotatory subluxation of the scaphoid has improved over the years and continues to expand.

Arthrodesis↗
PubMed2001

Modifications to the mechanical behavior of the wrist after fracture of the scaphoid. Modeling by finite element analysis.

Although based on their long-term clinical evolution there appeared to be no doubt that fractures of the scaphoid modify the mechanical behavior of the carpus, the mechanisms of these modifications have not yet been investigated. This study based on finite element analysis provides insight into the sequence behind the onset of arthritis of the wrist, highlighting the existence of pressure peaks at the nonunion and at the midcarpal interface (scaphoid-capitate and lunate-capitate). This evidence explains the clinical evolution of nonunions of the scaphoid. Our study indirectly demonstrates the role played by the scaphoid within the wrist as a force transmission column. The use of finite element analysis for the modeling of simple or complex osteoarticular systems may prove to be a highly useful tool for the understanding of these mechanisms.

Biomechanical Phenomena↗
PubMed2001

Electrophysiologic findings in two patients with digital neuropathy of the thumb.

Repetitive trauma to a finger can result in compressive neuropathy of one or more digital nerves. The thumb is commonly affected in bowlers, hence the term "bowler's thumb". However, this condition can involve other fingers and non-bowlers. To our knowledge, none of the cases reported had undergone neurophysiologic testing. We describe the neurophysiologic findings in two patients who had a history consistent with digital neuropathy of the thumb.

Casts, Surgical↗
PubMed2001

Incidence, mechanism, and natural history of scaphoid fractures.

Scaphoid fractures are fairly common and remain a difficult problem with respect to diagnosis, treatment, and outcome. The initial goal is accurate diagnosis of the fracture using clinical evaluation and available imaging modalities. Union is the subsequent objective, with a trend toward restoration of normal scaphoid anatomy, because nonunion or malunion may lead to unacceptable results and patient dissatisfaction. Despite biomechanical research of simulated fractures and clinical studies on natural history, the exact outcome after scaphoid union, nonunion, and malunion remains variable.

Arthritis↗
PubMed2001

The anatomy of the scaphoid.

The scaphoid is a critical link in the mechanism of the carpus. Its complex shape allows it to participate in the kinematics of both the proximal and distal row. Because of its offset proximal and distal articular surfaces, it has a natural tendency to palmar-flex with longitudinal loading. Because of this, extension of the scaphoid places progressively increasing tension on the palmar cortex of the curved waist of the scaphoid. Excessive extension or ulnar deviation of the wrist, coupled with excessive loading, mechanically predisposes the scaphoid to fracture. This is especially true if the strong ligaments attaching to the scaphoid retain their integrity. When a fracture occurs proximal to the waist of the scaphoid, it is predisposed to displacement because of the opposing forces on the proximal [table: see text] and distal fragments as well as the distribution of ligament attachments. This, in turn, predisposes the proximal fragment to ischemic conditions because of the distal location of nutrient vessels and a retrograde intraosseous blood supply.

Biomechanical Phenomena↗
PubMed2001

Closed cast treatment of scaphoid fractures.

Cast immobilization of the wrist remains the treatment of choice for stable fractures of the waist and distal pole of the scaphoid. Criteria for diagnosis of stability should be stringent; plain radiographs may be misleading. CT may provide more accurate information on displacement. Immobilization of the thumb confers no advantage and restricts function unnecessarily. Evidence to support immobilization of the elbow is weak, but it may be useful for selected fractures. A cast does not protect the carpus from the effects of axial loading, which can produce large angulatory forces at the fracture. A gap or fracture offset of 1 mm or more are indicators of instability with potential for nonunion or malunion; internal fixation should be considered for these fractures. Internal fixation may also be considered routinely for proximal pole fractures, regardless of the degree of displacement, in view of their long healing time and high risk of nonunion after cast treatment.

Casts, Surgical↗
PubMed2001

Open volar repair of acute scaphoid fractures.

Internal fixation of acute scaphoid fractures has significant advantages over conservative treatment, using cast immobilization. Healing rates are improved, functional recovery is accelerated, and morbidity is reduced. Percutaneous fixation has become the treatment of choice for the majority of acute fractures, since it is an out-patient procedure, which produces virtually no scarring and enables an extremely-rapid recovery; however, in those cases where a stable and anatomical reduction cannot be achieved by closed means, open volar repair remains the best method of treatment. With careful attention to technique, and the avoidance of postoperative immobilization, excellent results can be achieved, even in the case of transscaphoid fracture-dislocation of the carpus.

Fracture Fixation, Internal↗
PubMed2001

Arthroscopic evaluation and treatment of scaphoid nonunion.

Scaphoid fractures are one of the most common carpal fractures and heal without complication in a majority of cases. Nonunion of the scaphoid, unfortunately, can occur secondarily to several reasons; namely, delay in treatment, delay in diagnosis, the intra-articular nature of the fracture, the precarious vascular supply of the scaphoid, and significant biomechanical stresses across the fractured scaphoid.

Adult↗
PubMed2001

Electrical and ultrasound stimulation for scaphoid fractures.

The standard treatment for delayed union or nonunion of the scaphoid is operative management. Electrical stimulation has been employed in these clinical situations in patients unable or unwilling to undergo surgical intervention. Recent interest has also focused on the use of low-intensity ultrasound as an adjunct to healing in distal radius and tibial fractures. Results with the use of ultrasound for scaphoid fractures is encouraging. A review of the mechanisms of action, clinical results, and possible indications is presented for these two nonoperative modalities.

Casts, Surgical↗
PubMed2001

Methods of imaging the scaphoid.

Rapid diagnosis of a scaphoid fracture is important so that proper treatment may be initiated. The high frequencies of nonunion of proximal pole, AVN, and scaphoid fractures warrant the use of special imaging to identify an occult fracture that may cause a long-term disability if not diagnosed. The modalities discussed allow the reader to treat patients in an expeditious and accurate manner.

Fractures, Closed↗