Operative Management for Pediatric and Adolescent Scaphoid Nonunions: A Meta-analysis

Jauregui, Julio J.; Seger, Edward W.; Hesham, Khalid; Walker, Sarah E.; Abraham, Roby; Abzug, Joshua M.

doi:10.1097/bpo.0000000000000916

Cited by 17 publications

(29 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17 Most commonly, nonunion is defined as the absence of bony union at least 3 months after injury. 5,[17][18][19] However, others take a more adult view and define it as 6 months after the injury. 1,6,18 Furthermore, others believe that the definition of scaphoid nonunion is the presence of cystic changes of the scaphoid or sclerosis of the bone ends around the radiolucent line at the fracture site seen on standard radiographs at least 3 months after injury.…”

Section: Pediatric Scaphoid Nonunionsmentioning

confidence: 99%

“…There is a revision rate of approximately 3% in all surgical techniques. 17 Other complications reported include proximal migration of screws, malunion, pin-site infection, and restriction of wrist movements compared with the contralateral wrist (►Table 6). 17,29,[31][32][33]37 An important technical aspect is that there has been some concern about the use of compression screws in children because of the ossification pattern with the cartilage cap of the scaphoid (►Fig.…”

Section: Surgical Treatment Of Pediatric Scaphoid Nonunionsmentioning

confidence: 99%

“…29,33 In fact, it has been reported that dorsal intercalated segment instability (DISI) deformity was spontaneously corrected due to remodeling in a small case series. 4 The presence of scaphoid humpback deformity and/or DISI deformity may be a stronger indication for surgical intervention in pediatric nonunion cases, 17,32,40 albeit with weak evidence of such management.…”

Section: Surgical Treatment Of Pediatric Scaphoid Nonunionsmentioning

confidence: 99%

See 2 more Smart Citations

Pediatric Scaphoid Nonunions: A Case Series, Review of the Literature, and Evidence-Based Guidelines

et al. 2019

View full text Add to dashboard Cite

Background Scaphoid fractures represent less than 3% of hand and wrist fractures in the pediatric population. Nonunions are very rare. We present a case series (n = 18) of nonunions in skeletally immature children and adolescents. We further present a review of the literature on pediatric scaphoid nonunions. Materials and Methods We reviewed the literature by searching the main databases on pediatric scaphoid nonunions, but to identify factors that lead to nonunion, we also searched for databases on scaphoid fractures. Seventy articles were found for the period between 1961 and 2019, all with level 4/5 evidence. Results The nonunion rate of pediatric scaphoid fractures in the literature is on average 1.5%, occurring mostly as a result of missed or underdiagnosed injuries, similar to our presented case series. Half (n = 9) of the injuries in our case series were missed initial injuries, leading to scaphoid nonunions and half developed nonunions after initial treatment. We found excellent outcomes and with surgical and nonoperative management, with few complications. Not surprisingly, the duration of immobilization is longer with nonoperative management. Conclusions Based on the literature, we recommend a period of nonoperative management before surgery in undisplaced nonunions. In displaced nonunions, open reduction and internal fixation ± bone grafting is necessary. In pediatric scaphoid fractures, similar to adult cases, we identified that suspicious scaphoid fractures should be considered for initial immobilization, and repeat X-rays and early magnetic resonance imaging (MRI) or computed tomography (CT) scans should be considered at follow-up. Immobilization time and type of plaster should be appropriate in relation to the fracture site, similar to the adult scaphoid fracture. Level of Evidence This is a Level IV study.

show abstract

Section: Pediatric Scaphoid Nonunionsmentioning

confidence: 99%

Section: Surgical Treatment Of Pediatric Scaphoid Nonunionsmentioning

confidence: 99%

Section: Surgical Treatment Of Pediatric Scaphoid Nonunionsmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Scaphoid Nonunions: A Case Series, Review of the Literature, and Evidence-Based Guidelines

et al. 2019

View full text Add to dashboard Cite

show abstract

“…However, within the field of pediatric traumatology or orthopedic surgery, strength measurements seem to be predominantly used as outcome parameters to compare two different types of treatment and/or in the setting of a long-term follow-up evaluation. [5][6][7][8][9]] Studies measuring strength shortly after trauma are extremely scarce. [5][6][7][8]10]Furthermore, we could not identify any studies that assessed recovery of strength itself in children after sustainment of reduced fractures.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8][9]] Studies measuring strength shortly after trauma are extremely scarce. [5][6][7][8]10]Furthermore, we could not identify any studies that assessed recovery of strength itself in children after sustainment of reduced fractures. Comparing the affected hands between different treatment groups in itself gives no actual information about recovery of the individual children, as strength could very well still be diminished in the highest scoring group.…”

Section: Introductionmentioning

confidence: 99%

Recovery of strength after reduced pediatric fractures of the forearm, wrist or hand; A prospective study

et al. 2020

View full text Add to dashboard Cite

Introduction The way strength recovers after reduction of pediatric fractures of the upper extremity has not previously been the specific scope of research. This is remarkable, since strength measurements are often used as an outcome measure in studies on trauma of the upper extremity. The aim of this study was to evaluate how strength recovers after sustainment of fractures of the forearm, wrist or hand treated by closed or open reduction in children and adolescents in the first 6 months after trauma. How much strength is lost at 6 weeks, 3 months and 6 months after trauma, and is this loss significant? Are there differences in the pattern of recovery between children who underwent a different treatment? And finally, which of the following factors are associated with an increase in the ratio between affected grip strength and expected strength: type of fracture, cast immobilization, occurrence of complications, and degree of pain? Design Prospective observational study. Participants Children and adolescents aged 4-18 years with a reduced fracture of the forearm, wrist or hand. Methods Grip strength, key grip and three-jaw chuck grip were measured twice in each hand 6 weeks, 3 months and 6 months after trauma. Details on fracture type and location, treatment

show abstract

Frakturen der Handwurzel beim Kind

Singer¹,

Schmidt²,

Weinberg³

et al. 2020

Orthopädie Und Unfallchirurgie

View full text Add to dashboard Cite

Operative Management for Pediatric and Adolescent Scaphoid Nonunions: A Meta-analysis

Abstract: Level III. This study is a meta-analysis of studies containing level of evidence of III or greater.

Cited by 17 publications

References 29 publications

Pediatric Scaphoid Nonunions: A Case Series, Review of the Literature, and Evidence-Based Guidelines

Pediatric Scaphoid Nonunions: A Case Series, Review of the Literature, and Evidence-Based Guidelines

Recovery of strength after reduced pediatric fractures of the forearm, wrist or hand; A prospective study

Frakturen der Handwurzel beim Kind

Contact Info

Product

Resources

About