The presentation of scaphoid non-union

Prosser, Gareth; Isbister, E.S.

doi:10.1016/s0020-1383(02)00162-6

Cited by 47 publications

(22 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is generally accepted that advanced imaging modalities are needed in case of suspected scaphoid fractures and negative radiographs in order to rule out a scaphoid fracture. It is known that missed diagnosis and inadequate treatment of this fracture leads to nonunion and may cause pain and serious disability [7,[10][11][12][13][14]. However, little is known on the clinical consequence of missing those other fractures which are detected in this study.…”

Section: Discussionmentioning

confidence: 82%

“…Patients who visited the Emergency Department with an acute trauma and a suspected scaphoid fracture after physical examination but no evidence of a scaphoid fracture on plain radiographs underwent at our institution bone scintigraphy [5][6][7][8][9][10][11]. We noticed that bone scintigraphy detected many other occult carpal and distal radius fractures in these patients with a suspected scaphoid fracture.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Occult Fractures in the Carpal Region: Incidental Findings on Bone Scintigraphy

Zoakman¹,

Leerdam²,

Beeres³

et al. 2013

OJO

View full text Add to dashboard Cite

The aim of this study was to evaluate the number and distribution of fractures around the wrist found on bone scintigraphy in patients with a clinically suspected scaphoid fracture and negative initial radiographs. We retrospectively included 445 consecutive patients with a suspected scaphoid fracture who underwent routine bone scintigraphy. None of the radiographs showed evidence of a fracture. We analyzed the type and number of other fractures incidentally found on bone scintigraphy. On average, bone scintigraphy was done in 4 days (1 -9). The outcome of bone scintigraphy: 80 (18.0%) a scaphoid fracture, 145 (32.6%) another fracture in the carpal region, 208 (46.7%) normal and the diagnosis of 12 (2.8%) was unclear. In the present study, we demonstrated that in patients with a clinically suspected scaphoid fracture and negative initial radiographs, bone scintigraphy detected in many cases (64.4%) other fractures in the carpal region. This suggests that radiographs not only miss scaphoid but also many other carpal and distal radius fractures. Solutions should be found to solve this problem and probably advanced imaging techniques like CT, MRI or bone scintigraphy should be used in the correct clinical scenario.

show abstract

Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Occult Fractures in the Carpal Region: Incidental Findings on Bone Scintigraphy

Zoakman¹,

Leerdam²,

Beeres³

et al. 2013

OJO

View full text Add to dashboard Cite

show abstract

“…Previous studies have highlighted the difficulty in diagnosing union of scaphoid fractures on radiographs and the lack of reliability in assessing fractures as "clinically united". 1,4) The recommendation of assessment of all patients with scaphoid fractures, at six months, with radiographs or CT scans should be strongly considered. 1,4) In our study, similar union rates were achieved by both the Matti-Russe and interpositional grafting procedures.…”

Section: Discussionmentioning

confidence: 99%

“…1,4) The recommendation of assessment of all patients with scaphoid fractures, at six months, with radiographs or CT scans should be strongly considered. 1,4) In our study, similar union rates were achieved by both the Matti-Russe and interpositional grafting procedures. The Matti-Russe procedure was performed on a significant number of patients with a preoperative DISI deformity.…”

Section: Discussionmentioning

confidence: 99%

“…Non-union can occur due to failure to diagnose a fracture or diagnosing union prematurely, which has medico-legal implications. 4) The natural history of a non-union is a predictable pattern of degenerative changes and collapse, 5) which may necessitate wrist fusion. 6) However, fixation of scaphoid non-unions does not prevent the development of secondary osteoarthritis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Factors Influencing Outcome in the Management of Scaphoid Non-union and Comparison of Matti Russe and Interpositional Grafting Techniques

Kiran

Persaud

Jariwala

et al. 2017

J Hand Surg Asian-Pac Vol

View full text Add to dashboard Cite

Background: Scaphoid non-union is often caused due to missed fractures, inadequate or inappropriate management. Matti-Russe and interpositional grafting techniques are used in the treatment of non-union. There are very few studies in literature that compare the outcomes of these techniques. The aim of our study was to analyse the factors influencing outcome in the management of scaphoid non-union and to compare the results of the Matti Russe procedure with interpositional grafting techniques. Methods: Fifty scaphoid non-unions with a mean follow-up of 39.9 ± 5.5 months were included in this retrospective study. Demographic parameters, treatment, functional and radiological outcomes were recorded. The influence of demographic and treatment factors on union in this cohort was statistically analysed. Results: Union was achieved in 76% of cases. Good to excellent results were achieved in 84% of patients. There was no significant difference in union rates, deformity correction achieved and period of immobilisation between the MR and IG techniques. The occurrence of arthritic changes correlated with the time interval between injury and surgery (p = 0.002). Conclusions: The most important factor that influences the outcome is the time period between the occurrence of the fracture and surgery for non-union. The Matti-Russe procedure can achieve comparable results to interpositional grafting techniques with a shorter period of immobilisation than previously thought to be required. We believe that the presence of a deformity is not a contraindication for the procedure.

show abstract