Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Scaphoid Bone”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMed2005

Acute coronal plane scaphoid fracture and scapholunate dissociation from an axial load: a case report.

Coronal fractures of the scaphoid are rare and can be difficult to diagnose. Axial load injuries that result in a complete coronal fracture of the scaphoid associated with an acute scapholunate dissociation are exceedingly rare. In our patient the radiographic finding of wide scapholunate dissociation was obvious; however, the coronal scaphoid fracture was not recognized initially nor suspected. During surgery the coronal scaphoid fracture was identified, reduced anatomically, and fixed with a compression screw. The scapholunate ligament also was repaired. A good result was obtained with return to sports with extension of 60 degrees and flexion of 70 degrees , grip strength equal to that of the uninjured wrist, and no radiographic problems (arthrosis, avascular necrosis, nonunion).

Adolescent↗
PubMed1994

Acute compression fracture of the scaphoid.

A previously unreported radiological sign of a sclerotic margin to an acute displaced scaphoid fracture due to bone compression is reported. This should to be recognized because of the implied bone loss and hence risks of both mal-union and non-union, and because of the implication that volar compression fractures of the scaphoid may occur.

Acute Disease↗
PubMed2003

Coronal fractures of the proximal scaphoid: the proximal ring sign.

We present two coronal fractures of the proximal scaphoid which were both missed in the acute stage as interpretation of initial radiographs was difficult. In both cases, recognition of the so-called "Proximal Ring Sign" on the PA ulnar deviation radiographs may have helped diagnosis. CT scans were necessary to fully demonstrate the fractures. Open reduction and internal fixation, performed 2 and 4 months after the injury, resulted in union in both cases.

Adult↗
PubMed1999

Diagnosis of scaphoid fracture and dedicated extremity MRI.

We evaluated the value of dedicated extremity magnetic resonance imaging (E-MRI) in patients with clinical suspicion of a scaphoid fracture and normal initial radiographs. 52 patients underwent E-MRI within a mean of 4 (2-10) days after trauma. Follow-up radiographs were performed at average 11 (8-14) weeks after trauma, and these images were used as the "gold standard". A T1-weighted turbo gradient echo 3D and a tau short inversion recovery STIR were performed, both in coronal planes. The imaging time was less than 10 min. The images were evaluated independently by two radiologists. E-MRI detected occult fractures of the scaphoid in 9 patients, and of the distal radius in a further 6 patients. All these fractures were confirmed at follow-up radiographs. Furthermore, E-MRI revealed a fracture of the capitate bone in 1 patient, and of the triquetrum in 2 patients, and in 8 patients, bone bruise in 1 or more of the carpal bones. However, these fractures and bone lesions could not be confirmed by the follow-up radiographs. The agreement between the two examiners was high (kappa = 0.8) for E-MRI detection of fractures. E-MRI seems to be better than radiographs in the early diagnosis of occult fractures of the scaphoid bone and the wrist.

Adolescent↗
PubMed2006

Arthroscopic reduction-association of the scapholunate.

The reduction-association scapholunate (RASL) procedure for stabilization of the scapholunate joint is an alternative to soft-tissue procedures that do not maintain normal carpal alignment, despite reports of good symptomatic relief. The RASL procedure--indicated for patients with scapholunate instability or scapholunate dissociation without arthritis and, in selected cases, with stage 1 scapholunate advanced collapse of the wrist--can be performed arthroscopically. Radial midcarpal and 3-4 radiocarpal portals are used to excoriate and prepare the scapholunate joint surfaces. By use of 0.62'' K-wire joysticks in the lunate and distal pole of the scaphoid, the scaphoid undergoes dorsiflexion and supination while the lunate undergoes palmarflexion to achieve reduction. A .35'' guidewire is advanced through the scaphoid waist, across the scapholunate joint to the proximomedial corner of the lunate. Supplemental K-wire fixation, from the scaphoid to the capitatum and lunate to the radius, stabilizes the reduction for placement of a cannulated HBS screw (Orthosurgical Implants, Miami, FL) through a 1-2 portal, while reduction and positioning are confirmed arthroscopically. Arthroscopy facilitates anatomic reduction of the joint, as well as the critically important, precise placement of the cannulated HBS screw, by use of 3 portals rather than the traditional 2-incision approach.

Arthroscopy↗
PubMed2007

Collapsed scaphoid non-union with dorsal intercalated segment instability and avascular necrosis treated by vascularised wedge-shaped bone graft and fixation.

Patients with the specific problem of a collapsed Nakamura volar type, scaphoid synovial pseudarthrosis with avascular necrosis on both magnetic resonance imaging and intraoperative inspection were studied to determine the ability of a trapezoidal wedge-shaped structural bone graft vascularised by the 1,2 intercompartmental supraretinacular artery to simultaneously achieve correction of the scaphoid dimension and a high union rate. Fifteen patients with this specific problem were followed for a mean of 32.1 months and achieved union in all cases at a mean of 11.5 weeks. Improvements were seen postoperatively in wrist flexion and extension, grip strength, degree of dorsal intercalated segment instability and degree of scaphoid collapse. Two complications relating to the fixation technique occurred. Although technically difficult, it is possible to achieve a high rate of union for scaphoid pseudarthrosis while correcting substantial collapse deformity by the use of a structural, wedge-shaped, vascularised bone graft.

Adolescent↗
PubMed2003

Management of acute scaphoid fractures.

Scaphoid fractures are a common injury in young, active populations. Non-displaced fractures have a high union rate if promptly treated with cast immobilization. Displaced fractures and proximal pole fractures are best treated with operative fixation. There are a variety of techniques and implants available to the surgeon. The surgical approach and fixation device should be based on fracture characteristics and surgeon experience. Operative fixation of non-displaced fractures is an option in patients who would prefer to avoid prolonged cast immobilization.

Acute Disease↗
PubMed2005

Mechanical strength and optimal site of placement of a threaded bone screw assessed on the basis of the screw breakage for non-union of the scaphoid: a biomechanical study.

We have performed the surgical procedure on the patients with the fracture of the scaphoid using mini-acutrak screws (ACUMED, Inc.). A 25-year-old man was injured in a fall. Surgical treatment for non-union of the scaphoid using a mini-acutrak screw was performed. However, this screw was broken, despite the absence of any obvious trauma mechanism. A structural examination was performed with a metal microscope and a hardness test was performed. A hardness evaluation was conducted on this broken screw and similar screws. Cannulated screws having diameters of 2.7 and 3.5 mm were also evaluated in the strength test as controls for comparison. The breakage of screw occurred due to fatigue. The screw provides the strength equivalent to that of a 3.5 mm cannulated screw but the bending strength of the head end portion in which the breakage occurred was assumed to be the strength of about one-third that of the intermediate portion.

Adult↗
PubMed2003

[Vascularized bone transfers in the wrist and hand].

More and more vascularised bone transfer (VBT) sites, free or pedicled, in the wrist and hand have been described since the 1980s. In the distal forearm, two main VBT: the fibula and the iliac crest, are used for large bone loss (> 6 cm) or for radio-carpal reconstruction. We report our experience of radio-carpal reconstruction using the distal-radio-ulnar joint transfer. At the carpal level, VBT are essentially used for "difficult" scaphoid pseudarthrosis: osteonecrosis, sclerotic bone or failures of conventional grafts and for lunate necrosis. Two pedicled VBT are frequently used for the scaphoid, a graft harvested from the antero-medial part of the distal radius (Kuhlmann) or a graft harvested from the postero-lateral part of the distal radius (Zaidemberg). For the trapezo-metacarpal joint, two new articular pedicle transfers can be used in some cases of trapezo-metacarpal arthritis. At the hand level, VBT are used for distal bone loss, "en bout de chaîne". Bone vascularisation is indispensable to preserve sub-chondral bone and avoid articular destruction. In children VBT are necessary to preserve the growth cartilage.

Bone Transplantation↗
PubMed1991

Magnetic resonance imaging to assess vascularity of scaphoid nonunions.

The unreliability of current methods of assessing of bone vascularity is well documented, precluding any prospective analysis of its influence on bone healing. In hopes of accurately predicting scaphoid vascularity, magnetic resonance imaging was used prospectively in patients with radiographic evidence of nonunion. Magnetic resonance imaging scans were compared to plain radiographs, tomograms, and the operative impressions of the surgeon. The diagnostic accuracy of each test was determined by a pathologist's interpretation of histological sections. Ten of thirteen surgical specimens were available for analysis. The magnetic resonance imaging scan accurately predicted scaphoid viability in all ten cases (three viable, seven avascular). This compared with diagnostic errors in six of ten plain radiographs, one of seven tomographs, and two of ten surgical assessments. Magnetic resonance imaging can accurately predict the vascularity of the ununited scaphoid. With further follow-up of these patients, the capability of the avascular scaphoid to heal will become evident. Definitive preoperative determination of the healing potential of scaphoid nonunions may then be possible, thereby aiding the surgeon's choice of the appropriate surgical procedure.

Adult↗
PubMed1990

Scaphoid fractures and Kienbock's disease of the lunate: MR imaging with histopathologic correlation.

Thirteen patients with scaphoid fractures and four patients with Kienbock's disease of the lunate underwent magnetic resonance imaging (MRI) prior to surgery. A total of 28 specimens had MR-histologic correlation. Biopsy specimens obtained by curettage provided pathologic correlation. MRI proved accurate in prospective evaluation of bone viability for both scaphoid fractures and Kienbock's disease. Normal marrow signal was shown to correlate with the presence of osteoid and osteocytes on light microscopy and a surface layer of fluorescence reflecting tetracycline uptake in viable bone. Decreased marrow signal corresponded to non-viable trabeculae with scant osteoid, without osteocytes and no tetracycline labeling. By virtue of its accurate identification of avascular necrosis, MRI may prove valuable in predicting prognosis for patients with scaphoid fractures and Kienbock's disease of the lunate.

Adult↗
PubMed1995

[Surgical and conservative therapy of scaphoid pseudarthrosis].

Should an asymptomatic scaphoid pseudarthrosis be eliminated by surgery? Two patient populations were followed up in order to be able to answer this central question. The first group comprised 49 unoperated patients and the second group 55 patients in whom Matti Russe reconstructive surgery had led to healing of the bone and in whom the operation had been carried out at least three years previously. The period of observation was up to 25 years. The study yielded the following findings: 1. The spontaneous course automatically terminates in radiocarpal arthrosis. It begins after five to ten years in the radiocarpal joint and also affects the intracarpal joint after a further ten years. Besides an increasing shortening of the scaphoid bone, an exacerbating carpus collapse can also be observed. 2. Neither the position of the fracture, left- or righthandedness nor the patient's occupation affect the course. Only necrosis of the proximal fragment favors the development of arthrosis. 3. The operated patients have much better results both clinically and radiologically. The development of arthrosis is slowed down (but not stopped) by the operation. 4. A DISI deformity left behind after the operation does not affect the development of arthrosis. 5. The earlier the operation is carried out, the more favorable the course. 6. We attribute the relatively high rate of arthrosis in Matti-Russi reconstructive operation (69%) to an excessively long immobilization. For this reason, we prefer internal fixation with a Herbert screw.

Adolescent↗
PubMedDate not supplied

Scaphoid fractures in children.

Fracture of the carpal scaphoid before skeletal maturity represents 0.34% of all fractures in children and 0.45% of children's upper limb fractures. Seventy-seven children, with a mean age of 11 years (range 8-14 years), suffered a scaphoid fracture in Nottingham, England, between 1977 and 1984 inclusive. Sixty-four of them have been personally reviewed. The mechanism of injury was usually a fall onto the outstretched hand and in the majority was an undisplaced fracture of the distal third of the bone. Immobilization in a scaphoid type of forearm-hand cast led to union in virtually all instances. Nonunion is very rare in treated cases of fresh fracture of the carpal scaphoid.

Accidents, Traffic↗