Results of Arthroscopic Reduction and Percutaneous Fixation for Acute Displaced Scaphoid Fractures

Shih, Jui-Tien; Lee, Hung-Maan; Hou, Yao-Tung; Tan, Chuan-Ming

doi:10.1016/j.arthro.2005.02.020

Cited by 66 publications

(52 citation statements)

References 23 publications

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“…In our study, 52% of our patients had coexisting intraarticular disorders, and our results were similar to previous studies, which reported 42% to 83% of the associated ligament injuries in patients with acute scaphoid fractures and nonunions [2,3,18,30,38]. General rules of treatment for coexisting ligament injuries are the following: débridement for partial intrinsic ligament tears and débridement and fixation for complete tears; and débride-ment for Type 1A TFCC tears and repair for Type IB TFCC tears [2,3,18,30,38].…”

Section: Discussionsupporting

confidence: 89%

“…General rules of treatment for coexisting ligament injuries are the following: débridement for partial intrinsic ligament tears and débridement and fixation for complete tears; and débride-ment for Type 1A TFCC tears and repair for Type IB TFCC tears [2,3,18,30,38]. Shih et al [30] and Wong et al [38] reported lower functional scores in patients with coexisting soft tissue injuries; in contrast, in this study, patients with coexisting ligament injuries showed similar outcomes to patients without those injuries. This discrepancy seems to be attributed to the degrees of soft tissue injuries.…”

Section: Discussioncontrasting

confidence: 51%

“…An arthroscopically guided approach comprising nonunion débridement, bone grafting, and rigid internal fixation in patients with minimally displaced scaphoid nonunions with minimal sclerosis has several advantages over the conventional techniques [2,3,18,[30][31][32][33]. Arthroscopy allows direct assessment of scaphoid fractures or nonunions and other associated soft tissue injuries, if present.…”

Section: Discussionmentioning

confidence: 99%

“…Requirements for treatment include nonunion débridement and reduction, bone grafting, and rigid internal fixation while maintaining blood supply [5,22]. As minimally invasive approaches are gaining popularity in the treatment of scaphoid fractures, arthroscopic techniques have been used to treat scaphoid fractures and nonunions [2,3,18,30,31,33]. All these processes could be done under arthroscopic guidance in patients with minimally displaced scaphoid nonunions with minimal sclerosis [3,31,32].…”

Section: Introductionmentioning

confidence: 99%

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Is Arthroscopic Bone Graft and Fixation for Scaphoid Nonunions Effective?

Kang

Chun

Koh

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Arthroscopic management of scaphoid nonunions has been advanced as a less invasive technique that allows evaluation of associated intrinsic and extrinsic ligamentous injuries; however, few studies have documented the effectiveness of arthroscopic treatment of scaphoid nonunions and which intraarticular pathologies coexist with scaphoid nonunions. Questions/purposes (1) What are the outcomes of arthroscopic management of scaphoid nonunions as assessed by the proportion of patients achieving osseous union, visual analog scale (VAS) pain score, grip strength, range of motion, Mayo Wrist Score (MWS), and Disabilities of the Arm, Shoulder and Hand (DASH) score? (2) What complications are associated with arthroscopic scaphoid nonunion management? (3) What forms of intraarticular pathology are associated with scaphoid nonunions? Methods Between 2008 and 2012, we treated 80 patients surgically for scaphoid nonunions. Of those, 45 (56%) had arthroscopic management. During that time, our general indications for using an arthroscopic approach over an open approach were symptomatic scaphoid nonunions without necrosis of the proximal fragment, severe deformities, or arthritis. Of the patients treated arthroscopically, 33 (73%) were available for followup at least 2 years later. There were five distal third, 19 middle third, and nine proximal third fractures. The mean followup was 33 months (range, 24-60 months). Union was determined by CT taken at 8 to 10 weeks after operation with bridging trabecula at nonunion site. VAS pain scores, grip strength, active flexion-extension angle, MWS, and DASH scores were obtained preoperatively and at each followup visit. The coexisting intraarticular pathologies and complications were also recorded. Results Thirty-two (97%) scaphoid nonunions healed successfully. At the last followup, the mean VAS pain score decreased (preoperative: mean 4.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is Arthroscopic Bone Graft and Fixation for Scaphoid Nonunions Effective?

Kang

Chun

Koh

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Nous chiffrons le taux de lésions scapholunaires à environ 10 % sur les données d'une expérience personnelle de 40 fractures non déplacées ayant été traitées par vissage percutané avec assistance arthroscopique. Ce même taux a été retrouvé sur d'autres séries [9,10]. Ce chiffre est à rapprocher du taux de pseudarthrose après traitement orthopédique des fractures non déplacées du scaphoïde carpien (5 à 10 %).…”

Section: Lésions Associéesunclassified

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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Acute Scaphoid Fractures

Dias

2021

Evidence‐Based Orthopedics

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Results of Arthroscopic Reduction and Percutaneous Fixation for Acute Displaced Scaphoid Fractures

Cited by 66 publications

References 23 publications

Is Arthroscopic Bone Graft and Fixation for Scaphoid Nonunions Effective?

Is Arthroscopic Bone Graft and Fixation for Scaphoid Nonunions Effective?

Treatment of recent fractures of the carpal scaphoid

Acute Scaphoid Fractures

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