Fixation of nondisplaced scaphoid fractures: making treatment cost effective

Arora, Rohit; Gschwentner, Martin; Krappinger, Dietmar; Lutz, M.; Blauth, M.; Gabl, M.

doi:10.1007/s00402-006-0229-z

Cited by 105 publications

(120 citation statements)

References 21 publications

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“…Arora et al randomly allocated forty-seven patients with nondisplaced waist (Herbert type-B2) fractures of the scaphoid to percutaneous scaphoid fixation (twenty-three patients) and cast treatment (twenty-four patients) 31 . The follow-up group consisted of forty-four patients (twelve women and thirty-two men) with a mean age of thirty-three years (range, twenty to fifty-six years).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Four of the eight studies evaluated the primary outcome measure, functional outcome based on validated function scores 13,18,31,32 . Two studies evaluated the DASH score 18,31 , including one study that evaluated the DASH and PRWE scores 18 , one evaluated the PEM score 32 , and one evaluated the modified Green and O'Brien score 13 .…”

Section: Outcome Measure Reportingmentioning

confidence: 99%

“…Two studies evaluated the DASH score 18,31 , including one study that evaluated the DASH and PRWE scores 18 , one evaluated the PEM score 32 , and one evaluated the modified Green and O'Brien score 13 . One study evaluated patient satisfaction 14 , and two studies evaluated pain 31,32 . Seven studies evaluated range of motion and grip strength 13,14,18,[30][31][32][33] .…”

Section: Outcome Measure Reportingmentioning

confidence: 99%

“…Seven studies evaluated range of motion and grip strength 13,14,18,[30][31][32][33] . Three studies evaluated time to union 13,14,31 , seven evaluated infection 13,14,18,[30][31][32][33] , six evaluated the rate of nonunion 14,18,[30][31][32][33] , and seven evaluated the rate of …”

Section: Outcome Measure Reportingmentioning

confidence: 99%

See 3 more Smart Citations

Surgical Compared with Conservative Treatment for Acute Nondisplaced or Minimally Displaced Scaphoid Fractures

Buijze

Doornberg

Ham

et al. 2010

The Journal of Bone and Joint Surgery-American Volume

115

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Section: Description Of Included Studiesmentioning

confidence: 99%

Section: Outcome Measure Reportingmentioning

confidence: 99%

Section: Outcome Measure Reportingmentioning

confidence: 99%

Section: Outcome Measure Reportingmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Compared with Conservative Treatment for Acute Nondisplaced or Minimally Displaced Scaphoid Fractures

Buijze

Doornberg

Ham

et al. 2010

The Journal of Bone and Joint Surgery-American Volume

115

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“…Modern headless compression screws demonstrate high union rates, rapid recovery, and good-to-excellent outcomes in most series. 1,[3][4][5][6][7][8] We were unable to identify reports detailing the potential for secondary proximal pole fracture following scaphoid screw fixation.…”

mentioning

confidence: 99%

Scaphoid Proximal Pole Fracture Following Headless Screw Fixation

et al. 2015

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Nondisplaced scaphoid waist fractures may be managed nonoperatively, but require strict and prolonged immobilization. Fracture nonunion is a troublesome complication that leads to prolonged casting or secondary surgery and, if untreated, to carpal collapse and degenerative arthritis. 1,2 Unstable or displaced fractures, fracture-dislocations, and fractures involving the proximal pole require anatomic reduction with rigid fixation. Modern headless compression screws demonstrate high union rates, rapid recovery, and good-to-excellent outcomes in most series. 1,3-8 We were unable to identify reports detailing the potential for secondary proximal pole fracture following scaphoid screw fixation.In this series we describe three young men with scaphoid fracture nonunion that healed after antegrade headless compression screw fixation (Acumed, Hillsboro, OR, USA). Months later, the men presented with secondary fracture of the proximal pole (►Table 1). A consistently proximal and volar fracture pattern was observed that was contiguous with the screw insertion site. The purpose of this case series is to report our experience and raise awareness of a possible risk of retained hardware following antegrade scaphoid nonunion fixation, offer treatment strategies, and report outcomes. Case 1A 15-year-old right-handed lacrosse player presented to our institution after 3.5 months of sport-related left wrist pain had not abated. A scaphoid fracture had been treated as a AbstractBackground Headless screw fixation of scaphoid fractures and nonunions yields predictably excellent outcomes with a relatively low complication profile. However, intramedullary implants affect the load to failure and stress distribution within bone and may be implicated in subsequent fracture. Case Description We describe a posttraumatic fracture pattern of the scaphoid proximal pole originating at the previous headless screw insertion site in three young male patients with healed scaphoid nonunions. Each fracture was remarkably similar in shape and size, comprised the volar proximal pole, and was contiguous with the screw entry point. Treatment was challenging but successful in all cases. Literature Review Previous reports have posited that stress-raisers secondary to screw orientation may be implicated in subsequent peri-implant fracture of the femoral neck. Repeat scaphoid fracture after screw fixation has also been reported. However, the shape and locality of secondary fracture have not been described, nor has the potential role of screw fixation in the production of distinct fracture patterns. Clinical Relevance Hand surgeons must be aware of this difficult complication that may follow antegrade headless screw fixation of scaphoid fracture nonunion, and of available treatment strategies.

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Acute Scaphoid Fractures

Dias

2021

Evidence‐Based Orthopedics

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Fixation of nondisplaced scaphoid fractures: making treatment cost effective

Abstract: Internal screw fixation of nondisplaced scaphoid fractures had a shorter time to bony union and the patients returned earlier to work compared with cast immobilisation. Although it is assumed that operative treatment is more expensive, in this study the cost was not found to be higher.

Cited by 105 publications

References 21 publications

Surgical Compared with Conservative Treatment for Acute Nondisplaced or Minimally Displaced Scaphoid Fractures

Surgical Compared with Conservative Treatment for Acute Nondisplaced or Minimally Displaced Scaphoid Fractures

Scaphoid Proximal Pole Fracture Following Headless Screw Fixation

Acute Scaphoid Fractures

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