Idiopathic avascular necrosis of the scaphoid. A report of two cases

Allen, Paul

doi:10.1302/0301-620x.65b3.6841406

Cited by 41 publications

(9 citation statements)

References 4 publications

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“…Several surgical techniques have been described: replacement by silicone prosthesis [9], proximal carpectomy [4], partial or total arthrodesis of the carpal [1, 6, 11], arthroscopic drilling [13], osteotomy of the radius [8], conventional graft [11], and vascularized bone graft [5, 12, 14, 17] among others, none of which showed good results.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Preiser Disease with Vascularized Bone Graft from the Distal Radius: A Report of Two Cases

Gama

Rezende

Ribak

2015

Hand (New York, N,Y.)

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The authors report two cases of women with Preiser disease treated with dorsal distal radius vascularized grafts. In the first case, after minor trauma, the patient had pain in the left wrist of insidious onset and evolution with significant worsening. The radiographic examination showed increased density of the proximal pole of the scaphoid, and magnetic resonance imaging (MRI) showed partial necrosis. Intraoperatively, as the integrity of the cartilage of the proximal pole of the scaphoid was observed, dorsal vascularized distal radius graft was performed using the 1,2 intercompartmental supraretinacular artery. In 4 months postoperatively, MRI showed almost total integration of the graft, and 1 year after surgery, the patient was asymptomatic, with normal mobility of the operated wrist and imaging showing a normal scaphoid. The second case had similar history and clinical picture, but the radiographs showed narrowing and diffuse sclerosis and also osteolytic areas in the proximal pole of the scaphoid; MRI showed diffuse necrosis. The same graft technique was used, considering that there was a good cartilaginous coverage of the scaphoid. After 9 years of follow-up, the patients remain free of pain or functional limitations. In such cases, the vascularized graft technique was effective and, therefore, a good therapeutic option, provided that there is no degenerative changes in the carpus and, especially, the cartilage of the proximal pole is viable.

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Section: Discussionmentioning

confidence: 99%

Treatment of Preiser Disease with Vascularized Bone Graft from the Distal Radius: A Report of Two Cases

Gama

Rezende

Ribak

2015

Hand (New York, N,Y.)

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“…However, in a number of cases no obvious cause is identified (Guelpa et al 1980, Ekerot and Eiken 1981, Allen 1983, De Smet et al 1993, Herbert and Lanzetta 1993, Dossing and Boe 1994. In recent years, there has been an increase in the number of reports of idiopathic avascular necrosis of the scaphoid, perhaps reflecting the increased awareness of clinicians regarding the existence of this rather uncommon condition.…”

Section: Discussionmentioning

confidence: 99%

“…Wrist joint fusion (Allen 1983, De Smet et al 1993, proximal row carpectomy (De Smet et al 1993), wrist joint arthroplasty (Ferlic and Morin 1989) and carpal tunnel decompression (Ferlic and Morin 1989) have also been reported to give satisfactory outcomes.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic avascular necrosis of the scaphoid–a case of early diagnosis by MRI

Zadeh

Sakka

MacLellan

1996

Acta Orthopaedica Scandinavica

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“…Because blood flows in a distal to proximal direction, the proximal portion of the scaphoid is vulnerable to inadequate blood supply when fractures occur, which in turn makes it susceptible to avascular necrosis (Ramponi 2011). Between 2 % and 9% of patients with fractured scaphoids develop avascular necrosis (Allen 1983), which can result in reduced grip strength (Walchman, 2014) The scaphoid plays an important part in wrist dynamics, because of its unique Anatomy, it can articulate with all five surrounding bones. For example it articulates with the radius forming the radio carpal joint, and with the trapezium, trapezoid and capitate to aid articulation between the proximal and distal rows of the carpus (McNally et al, 2004).…”

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confidence: 99%