Percutaneous Screw Fixation for Unstable Scaphoid Fractures

Chen, Alvin Chao‐Yu; Chao, En-Kai; Hung, Shan Ling; Lee, Mel Shiuann-Sheng; Ueng, Steve Wen–Neng

doi:10.1097/01.ta.0000171525.62755.33

Cited by 33 publications

(37 citation statements)

References 13 publications

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“…In addition, the quality of these papers was found to be poor based on the SEQES scores. Only 5 of 59 articles achieved high-quality scores (6)(7)(8) [4,13,14,58,59] and the majority of all reviewed articles were of low quality (32/59, 54%) [5, 6, 9, 10, 12, 16, 17, 21, 22, 24, 28-33, 36, 38, 40, 44, 45, 47-50, 52, 53, 54, 55, 57, 60, 61].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Acute Scaphoid Fractures: A Systematic Review and Meta-Analysis

Suh¹,

Benson

Faber³

et al. 2010

Hand (New York, N,Y.)

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Background/Methods The purpose of this review was to assess the current evidence supporting operative fixation versus casting for acute scaphoid fractures through a systematic review and meta-analysis of the literature. Results Our search yielded 59 articles that met our inclusion criteria with five studies achieving high, 22 moderate, and 32 low Structured Effectiveness Quality Evaluation Scale scores. Pooled results of the four Sackett level 1 evidence studies showed no significant difference between the operative (114/115, 99%) versus non-operative group (106/112, 95%) (p=0.07) when the definition of nonunion was based on more definitive criterion versus plain radiographs that may be insufficient to assess bony union. Similar results were found for the Sackett level 2 and 4 articles.Conclusions This systematic review reveals that significant weaknesses exist in the literature with respect to the level of evidence and quality of published studies on this topic. Currently, there is insufficient evidence to support the most effective treatment for acute scaphoid fractures.

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Section: Discussionmentioning

confidence: 99%

Treatment of Acute Scaphoid Fractures: A Systematic Review and Meta-Analysis

Suh¹,

Benson

Faber³

et al. 2010

Hand (New York, N,Y.)

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“…The indication of percutaneous screw fixation in their report could be considered the equivalent of our linear acute fracture. They achieved bone union in an average of 2.6 months in 11 cases 8 . Since we achieved bone union in an average of 2.3 months in 26 cases including delayed cases, the results are almost the same.…”

Section: Discussionmentioning

confidence: 99%

“…They achieved bone union in all cases in an average 3.5 months 9 . According to these previous papers 8,9 , our strategy for linear fractures without consideration of the length of time between the injury and treatment, using a percutaneous screw fixation without bone graft, was demonstrated to be proper.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous Screw Fixation Without Bone Graft for Cystic-Type Scaphoid Fractures

Ikeda

Osamura

Tomita

2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

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designing a treatment strategy, so we expanded this classification system to acute scaphoid fractures (Fig. 1). The purpose of this study is to explain our treatment strategy based to our new classification system for scaphoid fractures and to demonstrate that bone graft is not necessary for cystic type fractures. PATIENTS AND METHODSWe retrospectively studied the 105 scaphoid fractures (Table 1) of 94 male and 11 female patients ranging in age from 14 to 67 years (average, 26 years). The radiograms were taken of the following views: posteroanterior, lateral wrist, scaphoid (posteroanterior in ulnar deviation), and oblique with 45 degrees to 60 degrees of pronation 5 . Bone union was estimated from all 4 views. There were 12 proximal pole fractures and 93 waist fractures. We omitted tubercle fractures from this study and defined acute fractures as injury happened less than 2 months before surgery, and delayed fractures as more than 2 months. There were 48 acute fractures and 57 delayed fractures. The reason why we had more delayed fractures than acute fractures was that the delayed fracture patients were referred to us in our area. We classified the scaphoid

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“…Depuis, de nombreux modèles de vis canulées coulissant sur broches ont vu le jour, ce type de matériel permettant une insertion percutanée dorsale ou palmaire de la vis. La technique percutanée est plutôt Cependant, des publications récentes font état de procédures de ce type dans les fractures déplacées du corps du scaphoïde avec des manoeuvres de réduction arthroscopique ou fluoroscopique [13][14][15] (Fig. 5).…”

Section: Techniquesunclassified

Treatment of recent fractures of the carpal scaphoid

Martinache¹

2009

Lett Med Phys Readapt

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Les fractures du scaphoïde carpien sont fréquentes, mais leur prise en charge thérapeutique reste difficile du fait de la géométrie particulière de cet os et de la précarité de sa vascularisation. Un retard diagnostique initial et des erreurs de prise en charge peuvent conduire à une pseudarthrose, source de désaxation intracarpienne secondaire menant inexorablement à la dégénérescence arthrosique du poignet. Les progrès dans le dépistage radiologique, le dévelop-pement de techniques chirurgicales mini-invasives et de matériels de synthèse spécifiques ont conduit à une attitude plus résolument chirurgicale, y compris dans les fractures non déplacées relevant classiquement du traitement orthopédique. L'arthroscopie de poignet constitue, dans notre expérience, un apport indéniable dans la prise en charge de ces fractures, non seulement du fait de la possibilité de contrôler la qualité de réduction de ces fractures articulaires, mais également pour ne pas méconnaître les lésions ostéochondrales ou ligamentaires associées.Mots clés Poignet · Carpe · Scaphoïde · Fracture · Traitement Abstract Scaphoid fractures are common but present unique challenges because of the particular geometry of the bone and the tenuous vascular pattern of the scaphoid. Delays in diagnosis and inadequate treatment for acute scaphoid fractures may lead to non-unions that can progress to carpal collapse and degenerative arthritis of the wrist. Improvements in diagnosis, surgical treatment and implant materials have encouraged a trend toward early internal fixation even for non-displaced scaphoid fractures that could potentially be treated non-operatively. In our experience wrist arthroscopy is a useful tool in the management of these fractures not only for assessing the quality of reduction but also for visualizing osteochondral and ligamentous injuries associated with intraarticular fractures.

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Percutaneous Screw Fixation for Unstable Scaphoid Fractures

Cited by 33 publications

References 13 publications

Treatment of Acute Scaphoid Fractures: A Systematic Review and Meta-Analysis

Treatment of Acute Scaphoid Fractures: A Systematic Review and Meta-Analysis

Percutaneous Screw Fixation Without Bone Graft for Cystic-Type Scaphoid Fractures

Treatment of recent fractures of the carpal scaphoid

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