Cases Of Scaphoid Fractures Research Articles

Robot-assisted vs traditional percutaneous freehand for the scaphoid fracture treatment: a retrospective study

PurposeThe purpose of this study was to assess the efficiency, safety, and accuracy of cannulated screw fixation using a robot-assisted method compared with a traditional percutaneous freehand method.MethodsThis retrospective clinical study included 18 patients with scaphoid fracture who underwent cannulated screw fixation by robot-assisted technique or traditional percutaneous freehand technique from June 2018 to June 2020. All patients were divided into the robot-assisted group (9 patients) or the traditional surgery group (9 patients). The operation time, blood loss, number of intra-operative fluoroscopies, fracture healing time, Mayo wrist function score, and screw implantation accuracy were recorded in the two groups.ResultsThe average age of the robot-assisted group was 37.9 ± 10.6 years (with a range of 30 to 52 years), there were eight males and one female, and there were six cases of scaphoid fracture on the right side and three on the left side. The average pre-operative time was 2.8 ± 0.7 days (ranging from 1 to 3 days). The average age of the traditional surgery group was 31.6 ± 6.8 years (with a range of 20 to 45 years), there were eight males and one female, and there were five cases of scaphoid fracture on the right side and four on the left side. The average pre-operative time was 2.1 ± 0.8 days (with a range of 2 to 4 days). The number of intra-operative fluoroscopies was 24.4 ± 3.5 in the traditional surgery group, whereas it was only 10.1 ± 1.9 in the robot-assisted group, which was significantly lower (P < 0.05). The average operation time of the traditional operation group was 48.4 ± 12.2 min, and that of the robot-assisted group was 32.6 ± 4.2 minutes, which was significantly shorter (P < 0.05). The angles between the actual screw position and the central axis of the scaphoid on both the coronal and sagittal post-operative CT images were 8.3° ± 2.3° and 8.8° ± 1.6° for the traditional operation group and 3.8° ± 0.8° and 4.3° ± 1.2° for the robot-assisted group, so the accuracy of the robot-assisted group was significantly higher (P < 0.05). There were no significant differences between the two groups in wrist function recovery or fracture healing time.ConclusionRobot-assisted treatment of scaphoid fracture is more accurate than traditional freehand technology, with shorter operation time and fewer intra-operative fluoroscopies. There is no difference between the two surgical techniques in intra-operative bleeding, post-operative fracture healing, or functional recovery. Robot-assisted surgery is a safe, effective, and accurate method for treating scaphoid fracture.

Tuberculosis presenting as a scaphoid fracture: A rare case report

Tuberculosis of the wrist is an uncommon clinical entity and mostly presents as insidious pain and swelling. Presentation of singular carpal bone involvement is rare as the presenting feature. A case of scaphoid fracture was evaluated in a 20-year-old male patient, and underlying tuberculosis was diagnosed on magnetic resonance imaging and culture of joint fluid. Antitubercular therapy under appropriate supervision resulted in clinical improvement and optimal regain of function. No reactivation of the disease was noted in a follow-up of 2 years. This case highlights a rare presentation of tuberculosis presenting with a fracture of scaphoid.

Clinical application of Acutrak screws in the treatment of fresh scaphoid fractures

Objective To investigate the method and short-term effects of Acutrak screws in the treatment of fresh scaphoid fractures. Methods From January 2011 to January 2015, 11 cases of scaphoid fractures were treated by Acutrak headless compression screws. According to Herbert's classification, one case was type B1, 6 cases were type B2, 2 cases were type B3, and 2 cases were type B4. Volar approach was used in 7 cases, dorsal approach in 3 cases, and combined approach in 1 case. Two cases of type B4 had scapholunate dissociation and were treated by open reduction and fixation with simultaneous repair of scapholunate ligament. After the operation, short arm plaster fixation was used and exercises were gradually carried out after immobilization for 2 to 3 weeks. Results Postoperatively all the patients were follow-up for 12 to 24 months with an average of 16.5 months. The time of fracture healing was 7 to 15 weeks with an average of 11.4 weeks. According to the Mayo scoring system, wrist function at the final follow-up was rated as excellent in 6 cases, good in 3 cases and fair in 2 cases. Conclusion Acutrak headless compression screws can achieve reliable fixation and satisfactory treatment results. Key words: Scaphoid bone; Fractures,bone; Internal fixation; Screw

A comparative study of Herbert screw internal fixation and plaster immobilization for the treatment of stable scaphoid fractures

Objective To compare bone union and clinical results following Herbert screw internal fixation or plaster cast immobilization in the treatment of stable scaphoid fractures. Methods A retrospective analysis was conducted of 48 cases of scaphoid fractures with complete treatment and follow-up data. There were 26 patients whose fractures were treated with closed reduction and internal fixation with Herbert screw (group A), while 22 cases were treated conservatively with long-arm plaster cast immobilization (group B). Results Postoperative follow-up duration ranged from 12 to 36 months with an average of 23.7 months. Evaluation at the last follow-up using Mayo wrist function score revealed excellent results in 15 cases, good in 9 cases, and fair in 2 cases in group A, with an overall 92.3% excellent and good rate. In group B the results were rated as excellent in 9 cases, good in 8 cases, fair in 3 cases, and poor in 2 cases. The overall satisfactory rate was 77.3%. Wrist function was better in group A than in group B, the differences being statistically significant (P=0.018). Conclusion Treatment of stable scaphoid fractures with Herbert screws can achieve reliable fixation that allow early functional exercises. The fracture healing time is shorter and wrist function is better. Key words: Scaphoid bone; Fracture fixation, internal; Plaster external fixation

Dorsal percutaneous retrograde screw fixation of scaphoid fractures

Objective To explore the clinical application and therapeutic results of dorsal percutaneous retrograde screw fixation in the treatment of scaphoid fractures. Methods Twelve cases of scaphoid fractures were treated with 3.0 mm Herbert compression screw ( AO Synthesis) inserted percutaneously via a minimally invasive dorsal approach.The guide wire was inserted at the distal surface of the scaphoid tubercle and penetrated the scaphoid from volar to dorsal.The compression screw was manually threaded along the guide wire from dorsal to volar to fix the fracture.A plaster splint was applied to immobilize the wrist at neutral position with the thumb abducted for 3 weeks after the surgery. Results Twelve cases were follow-up for 6 to 16 months,with an average of 12 months.All the fractures healed.Bone healing time ranged from 4 to 10 months,being 6 months on average.According to Krimmer clinical evaluation system,the outcome was graded as excellent in 5 cases,good in 5 cases and fair in 2 cases. Conclusion Dorsal percutaneous retrograde screw fixation in treating scaphoid fractures can achieve satisfactory interfragmentary compression.The procedure is simple,the fixation is stable,and the results are good.It is an effective way to treat scaphoid fractures. Key words: Scaphoid bone; Fracture fixation,internal; Percutaneous

Scaphoid Fracture Due to Rigid Handcuffs

Rigid handcuffs have been designed to allow ease of application and to allow better control of violent suspects by the police. This paper reports a case of scaphoid fracture sustained during inappropriate use of these handcuffs. The mechanism of injury described has been simulated for demonstration. Law enforcement officers and clinicians need to be aware of the risks of inappropriate use of these handcuffs.

Scaphoid fractures in children

A fracture of the scaphoid in the wrist of a 6-year-old girl and eight new cases of scaphoid fractures in children are reported.