Scaphoid screw placement under minimal radiation exposure

Hohenberger, Gloria; Berzinsh, U.; Bakota, Bore; Holweg, Patrick; Clement, Bernhard; Grechenig, Stephan

doi:10.1016/s0020-1383(17)30739-8

Cited by 1 publication

(5 citation statements)

References 20 publications

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“…Fractures of the scaphoid represent about 50% to 90% of all carpal fractures in young, physically active individuals. 1 , 8 Approximately 345 000 scaphoid injuries occur in the United States every year. 3 With these injuries, the patient will present with wrist pain on the radial side after a traumatic event.…”

Section: Introductionmentioning

confidence: 99%

“…If the injury is deemed minimally displaced, cast or splint immobilization may be employed; however, fracture consolidation via this method ranges from 8 to 12 weeks, which may be too long for a younger, more active patient. 8 , 9 , 16 Once union is achieved, hand therapy may begin. 9 Complications, including muscular atrophy, joint stiffness, and reduced grip strength, may occur and could delay the patient’s return to work and activities.…”

Section: Introductionmentioning

confidence: 99%

“… 9 Complications, including muscular atrophy, joint stiffness, and reduced grip strength, may occur and could delay the patient’s return to work and activities. 8 …”

Section: Introductionmentioning

confidence: 99%

“… 9 , 18 Kirschner wires (k-wires) are helpful for stabilizing the ligamentous forces acting on the area and involve minor soft tissue damage, but can lead to pin tract infection, stiffness, and the need for re-intervention. 1 , 8 Volar plating may be indicated when there is a large degree of comminution or bone loss. 9 , 10 Generally, internal fixation is associated with good union rates, ranging from 85% to 90%, while also providing earlier return to mobilization.…”

Section: Introductionmentioning

confidence: 99%

“… 9 , 10 Generally, internal fixation is associated with good union rates, ranging from 85% to 90%, while also providing earlier return to mobilization. 8 , 18 Not only is vascular compromise an issue, but instability can also be the cause of complications, such as nonunion, post-injury; therefore, a combination of these different treatments may be needed to address all underlying issues in some of these patients. 1 In a biomechanical study, Guss et al 3 found that a 50% intact scaphoid with a headless compression screw provided similar load to failure and stiffness to a fully intact, uninjured scaphoid.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Closed Limb Fractures With Compromised Vascularization: A Narrative Review

Vannabouathong¹,

Schemitsch

Petrisor

et al. 2019

Clin Med�Insights�Arthritis�Musculoskelet Disord

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Vascular compromised fractures typically result in a high rate of healing complications, such as avascular necrosis, nonunion, delayed union, and arthritis, which severely affect a patient’s function and quality of life. The purpose of this review was to identify and describe the epidemiology and available treatment options for the most well-known vascular compromised closed fractures. The injuries discussed in detail in this review were scaphoid, lunate, femoral neck, and talar fractures. Current evidence suggests that optimal treatment for vascular compromised fractures is dependent on the degree of fracture displacement and comminution, and the patient’s post-injury functional demands, age, and bone quality. Conservative efforts generally include casting or splinting with a period of immobilization. Surgery is indicated for substantially displaced fractures, patients who require higher functional demands and an earlier return to activity, or if complications occur following nonoperative treatment; however, operative intervention is typically performed for femoral neck fractures regardless of the amount of displacement. Various surgical techniques exist, though internal fixation with screws is a common procedure among these injuries and can be used in combination with other implants, such as plating or Kirschner wires (k-wires), when needed. Severe fracture comminution, poor bone quality, or arthritis can contraindicate the use of screws and more invasive intervention will be required. Bone grafting is done in some cases to enhance vascularity. Salvage procedures exist for patients who develop severe complications, but these will permanently alter the anatomy of the injured area and should be considered a last resort.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 9 Complications, including muscular atrophy, joint stiffness, and reduced grip strength, may occur and could delay the patient’s return to work and activities. 8 …”

Section: Introductionmentioning

confidence: 99%