Carpal Scaphoid Fracture Research Articles

Treatment of Carpal Scaphoid Fracture

Fracture of the carpal scaphoid bone is the most common fracture of the carpus. Unfortunately. nonunion are common since the symptoms do not alert patients to seek early medical treatment and the diagnosis is easily missed. Fracture of the scaphoid is a common condition whose management remains controversial. The conservative treatment has many complications, these include inability to work while in plaster, stiffness of the wrist afterwards, muscle wasting, weakness and malunion. So various operative treatments of scaphoid fracture have been developed. Open reduction by use of screws suggested by Maclaughlin first in 1954. In 1984 a new and simple operative technique has been developed to provide rigid internal fixation for all types of fractures of the scaphoid by T.J. Herbert. This involves the use of a double-treaded bone screw which provides good fixation that, after operation, a plaster cast is rarely required and most patients are able to return to work within a few weeks. Authors have experienced 10 cases of scaphoid fracture and accomplished good result in all cases by internal fixation using Herbert screw. The results are as follows : Of these 10 fractures, 2 were fresh fractures and 8 were non unions of scaphoid fracture. In nonunion cases, the time interval between fracture and operation was from 5 months to 5 years. The postoperative immobilization period was average of 4 weeks. Short period of immobilization achieved early functional recovery of the wrist. The bony unions in roentgenogram were seen from 3 months to 9 months after operation. In 2 cases the fracture gap was seen after 9 months. But in these cases the symptoms such as pain and range of motion of wrist were improved.

Simultaneous fracture of the carpal scaphoid and adjacent bones

Simultaneous fracture of the carpal scaphoid and adjacent bones

Carpal scaphoid fracture and non-union in an eight-year-old child. Report of a case.

Carpal scaphoid fracture and non-union in an eight-year-old child. Report of a case.

Radiography and scintigraphy in the diagnosis of carpal scaphoid fractures

Radiography and scintigraphy in the diagnosis of carpal scaphoid fractures

Bone scintigraphy in the evaluation of fracture of the carpal scaphoid bone.

The purpose of the present prospective study was to assess the value of 99m-Tc-MDP wrist scintigraphy performed as a routine examination in excluding or detecting carpal scaphoid bone fracture. The following conclusions are drawn: 99m-Tc-MDP wrist scintigraphy is of high sensitivity, but low specificity in the detection of scaphoid bone fractures. The scintigraphy is expedient to exclude scaphoid bone fracture, if performed after secondary clinical and radiographic assessment, and guided by negative scintigrams a reduction of clinical examinations, radiographies and superfluous casting days is achieved.

Radiography and scintigraphy in the diagnosis of carpal scaphoid fractures.

THIRTY patients with clinically fractured carpel scaphoid bones, but with negative antero posterior (AP), lateral and oblique radiographs, had both modified Stetcher radiographs and bone scintiscans of the wrist performed. A final diagnosis in these patients was made by repeating AP, lateral and oblique x-rays at 2 weekly intervals for 6 weeks. The Stetcher x-ray correctly identified 4 fractures amongst these 30 patients but failed to detect 2 other scaphoid fractures. The results indicate that the specialized radiographs increased the sensitivity of scaphoid fracture detection but still failed to detect some true fractures. Bone scintiscanning on the other hand identified all “true” fractures and accurately identified 19 of the 30 patients as not having a scaphoid fracture. Since bone scintiscanning missed no true fractures, these 19 patients with negative bone scintiscans could have safely been treated without plaster immobilization.

Two cases of non-union of carpal scaphoid fractures in children

Two cases of non-union of fractures of the carpal scaphoid in children are described, which were successfully treated by cancellous bone grafting with Kirschner wire fixation.

FRACTURE OF THE CARPAL SCAPHOID IN CHILDREN

A series of 108 carpal scaphoid fractures in children was analysed with respect to the site, type and treatment of the fracture. The patients were followed until radiological fusion occurred. All fractures united and healed completely with conservative treatment. Ninety-four fractures, 41 of which were avulsions, were located in the distal third of the scaphoid. There were 13 waist fractures, and one avulsion fracture was located in the proximal pole of the scaphoid. The great number of avulsion fractures and the location of the fractures in the distal third of the scaphoid is very typical in children. In three neglected cases marked bone resorption was seen on the fracture surface 3 weeks after the injury. Because non-union is possible especially in neglected cases of waist fractures, control radiographs should be taken 1 or 2 weeks after the injury if the fracture is not visible on the primary radiographs but is suspected clinically. Immobilization with an adequate plaster cast is mandatory in all transverse fractures of the carpal scaphoid in children.

Fracture of the carpal scaphoid in children. A clinical and roentgenological study of 108 cases.

A series of 108 carpal scaphoid fractures in children was analysed with respect to the site, type and treatment of the fracture. The patients were followed until radiological fusion occurred. All fractures united and healed completely with conservative treatment. Ninety-four fractures, 41 of which were avulsions, were located in the distal third of the scaphoid. There were 13 waist fractures, and one avulsion fracture was located in the proximal pole of the scaphoid. The great number of avulsion fractures and the location of the fractures in the distal third of the scaphoid is very typical in children. In three neglected cases marked bone resorption was seen on the fracture surface 3 weeks after the injury. Because non-union is possible especially in neglected cases of waist fractures, control radiographs should be taken 1 or 2 weeks after the injury if the fracture is not visible on the primary radiographs but is suspected clinically. Immobilization with an adequate plaster cast is mandatory in all transverse fractures of the carpal scaphoid in children.

Nonunion of carpal scaphoid fractures in children : R. Southcott and M. A. Rosman. J. Bone Joint Surg. 59B:20–23 (February), 1977

Nonunion of carpal scaphoid fractures in children : R. Southcott and M. A. Rosman. J. Bone Joint Surg. 59B:20–23 (February), 1977

Non-union of carpal scaphoid fractures in children

Fracture of the carpal scaphoid is uncommon in children, but does occur and may fail to unite. Eight patients with established non-union have been reiewed, with an average follow-up of almost four years. All non-unions were grafted with autogenous bone. Excellent clinical and radiological results have been obtained. It is concluded that non-union in children is best managed by bone grafting through the anterior approach. Possible aetiological factors concerned in non-union of scaphoid fractures in this age group are discussed.

Carpal scaphoid fracture associated with fracture of the radial head

Five patients are presented with combined fractures of the carpal scaphoid and the ipsilateral radial head. The mechanism of injury is discussed and the possibility of overlooking the fractured radial head is emphasized. Five patients are presented with combined fractures of the carpal scaphoid and the ipsilateral radial head. The mechanism of injury is discussed and the possibility of overlooking the fractured radial head is emphasized.

The Acrylic Scaphoid Prosthesis in the Treatment of the Ununited Carpal Scaphoid Fracture

(1966). The Acrylic Scaphoid Prosthesis in the Treatment of the Ununited Carpal Scaphoid Fracture. Acta Orthopaedica Scandinavica: Vol. 37, No. 1, pp. 67-76.

Radial Styloidectomy and Styloidectomy Plus Bone Graft in the Treatment of Old Ununited Carpal Scaphoid Fractures

From the Orthopedic Service, U. S. Veterans Hospital and University of California Medical Center, Los Angeles, California

On Fracture of the Carpal Scaphoid

On Fracture of the Carpal Scaphoid

Fracture of Carpal Scaphoid

Fracture of Carpal Scaphoid

Fracture of the (Navicular) Carpal Scaphoid

Fracture of the (Navicular) Carpal Scaphoid