Central screw placement in percutaneous screw scaphoid fixation: a cadaveric comparison of proximal and distal techniques

Chan, Kin‐Sang; McAdams, Timothy R.

doi:10.1016/j.jhsa.2003.09.002

Cited by 93 publications

(71 citation statements)

References 16 publications

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“…However, recent work by some authors [10,17] has shown that the dorsal approach provides better targeting and more precise placement of the screw. Therefore, we felt the need to assess the efficacy of this approach for percutaneous fixation of scaphoid fractures.…”

Section: Discussionmentioning

confidence: 99%

“…The importance of screw position in the scaphoid has been emphasised by various authors [10,11]. The central placement of the screw in the proximal fragment of the scaphoid is associated with excellent clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

“…The near perfect screw positioning in our cases that resulted in excellent functional and radiological outcome emphasises the importance of screw positioning. Chan and McAdams [10] demonstrated that the proximal/dorsal approach to percutaneous screw fixation of scaphoid waist fractures allowed for a more central placement in the distal pole. We also attribute this near accurate screw placement in the scaphoid to the dorsal approach.…”

Section: Discussionmentioning

confidence: 99%

“…However, there has been controversy regarding the best approach for these fractures and many studies have been carried out to find out which one is the best [9][10][11]. We felt that the dorsal approach is very useful in fixation of body and waist fractures of the scaphoid as securing a purchase with the screw in the distal third of the scaphoid in more distal fractures is difficult with this approach.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous fixation of selected scaphoid fractures by dorsal approach

Naranje

Kotwal

Shamshery

et al. 2009

International Orthopaedics (SICOT)

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The aim of our study was to evaluate clinical, radiological and functional outcomes of selected cases of percutaneous fixation of scaphoid fractures via a dorsal approach. Percutaneous fixation by dorsal approach was done in 32 patients (mean age 32.2 years) involving both fresh and late scaphoid fracture presentations (mean 17 days). Fourteen cases of B1 type, ten cases of B2 and eight cases of C type (Herbert's classification) were treated. The patients were prospectively followed up clinically and radiologically for a minimum follow-up of 14 months (mean 16 months), and functional outcome and complications were assessed. All fractures united over an average of nine weeks. There was no avascular necrosis or screw cutout with preservation of wrist movement and grip strength. There were no injuries to any at risk anatomical structures. Percutaneous fixation of scaphoid fractures through dorsal approach gives good clinical and functional outcome in acute and chronic scaphoid fractures of B1, B2 and C types (Herbert's classification).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Percutaneous fixation of selected scaphoid fractures by dorsal approach

Naranje

Kotwal

Shamshery

et al. 2009

International Orthopaedics (SICOT)

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“…Failure to accomplish this goal could lead to fracture nonunion, malunion, or displacement [2,35,36,40]. Numerous studies have made recommendations for better screw placement in the scaphoid [11,26,27,[32][33][34]42].…”

Section: Introductionmentioning

confidence: 99%

Influence of Screw Design, Sex, and Approach in Scaphoid Fracture Fixation

Meermans¹,

Verstreken²

2012

Clinical Orthopaedics &Amp; Related Research

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Background Screw fixation of scaphoid fractures has gained popularity. A long central screw has been shown to be biomechanically advantageous. Questions/purposes We compared the ability of different screw designs to obtain this goal and determined the influence of sex and approach on screw length. Methods We performed all measurements on threedimensional reconstructions of 20 CT scans of normal scaphoids (10 men and 10 women) with the use of software. The three-dimensional computer models were analyzed, the central axis was defined, and the screws were placed along this axis. We compared 15 different available screw designs and volar and dorsal screw placement. Results The length of the scaphoid along its central axis was longer in men (mean, 27.14 mm; standard error of the mean, 0.97 mm) than in women (mean, 23.86 mm; standard error of the mean, 0.37 mm). The screw length that can be used was longer in the volar approach (mean, 23.72 mm; standard error of the mean, 0.19 mm) than in the dorsal approach (mean, 23.31 mm; standard error of the mean, 0.19 mm) regardless of the screw design. Screws with a trailing thread diameter greater than 3.9 mm and leading thread diameter greater than 3.0 mm were shorter. Conclusions Scaphoids in women are smaller than in men. Theoretically, fixation of scaphoid fractures through a volar approach will allow the surgeon to use longer screws. The screw design has a significant influence on the screw length that can be used in scaphoid fracture fixation. We recommend using a differential pitch screw with a thread diameter of 3.9 mm or less.

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Explicit and implicit animation with fuzzy constraints of a versatile multi‐body system for virtual hand surgery

Gourret

Hariri

Liverneaux

2011

Computer Animation & Virtual

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This work is designed to control the movement of hand structural agents under external action, using the implicit animation driven by explicit animation technique (AI-CAE technique). Starting from the configuration of a hand at rest obtained by a 3D scanner and after meshing of the structural agents, we seek the configuration of the rigid agents under orthopaedic surgeon external action and interacting reliance of deformable and rigid agents. We have developed a model and software tools to answer this interactive application with adaptive execution. The first contribution comes from notations and definition of a versatile multi-body system dedicated to the explicit and implicit animation. The second contribution comes from the implicit animation driven by explicit animation itself, and from its ability to mimic the role of cartilages and ligaments. The resulting technique is applied to the bone structure consistency of a specific human hand in the context of virtual hand orthopaedic surgery. The versatile specific multi-body is made up of hierarchical interacting agents conceivable as a construction set of rigid bones with cartilages-ligaments and underlying links. The explicit animation produces a desired configuration from geometric command parameters of torsion, flexion, pivot and axis shifting, given in a scenario subdivided into temporal sequences. The implicit animation controls the movement by implementing a physicsbased model and fuzzy constraints of position and orientation. It gives better configuration than the explicit animation because it takes into account the interactions between agents, and it gives a neat solution without the problems of complexity due to geometric modelling. A methodology based on the AI-CAE technique is discussed, medical expertise and validation tests are presented.

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Central screw placement in percutaneous screw scaphoid fixation: a cadaveric comparison of proximal and distal techniques

Cited by 93 publications

References 16 publications

Percutaneous fixation of selected scaphoid fractures by dorsal approach

Percutaneous fixation of selected scaphoid fractures by dorsal approach

Influence of Screw Design, Sex, and Approach in Scaphoid Fracture Fixation

Explicit and implicit animation with fuzzy constraints of a versatile multi‐body system for virtual hand surgery

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