Patients with wrist pain commonly present with an acute injury or spontaneous onset of pain without a definite traumatic event. A fall onto an outstretched hand can lead to a scaphoid fracture, which is the most commonly fractured carpal bone. Conventional radiography alone can miss up to 30 percent of scaphoid fractures. Specialized views (e.g., posteroanterior in ulnar deviation, pronated obl...

We describe a semi-closed method of Herbert screw fixation for acute fractures of the scaphoid. All 40 patients treated achieved solid union with satisfactory wrist function. This technique gave a significantly shorter time to union and allowed an earlier return to manual labour compared with conservative treatment. There were no complications. Semi-closed insertion requires considerable skill,...

Isolated carpal scaphoid dislocations are rare. Because of this, treatment strategies can be conflicting and vague. The current authors present a case of isolated scaphoid dislocation that was treated initially with closed reduction and percutaneous pinning. Failure of this index treatment necessitated open reduction and internal fixation providing an adequate short-term outcome. Current treatm...

A prospective study of 111 patients thought to have sustained a recent scaphoid fracture on clinical grounds but who were radiologically negative was undertaken over a period of 7 months. All such patients were subjected to ultrasound scanning within a week of their injury under double blind conditions. All patients were re-X-rayed 2-3 weeks after their injury. The authors' results suggest that...

Chondroma is the most common primary bone tumour of the hand, but carpal chondroma has, as far as we know, been reported only twice previously in the English language literature: in one report by Dahlin (1957), no localisation was mentioned: the other, by Takigawa (1971) described a patient with a chondroma in the scaphoid and lunate of the right wrist. We report two patients each with a chondr...

We report on a 74-year-old man with extensor indicis proprius (EIP) tendon rupture secondary to avascular necrosis and collapse of the scaphoid. The collapsed scaphoid was removed, followed by 4-corner fusion and tendon transfer of the extensor digiti minimi to the EIP. At the 3-year follow-up, the patient was painfree and had full extension of his left index finger, with proper alignment of th...

WEBB, B.G. and L.A. RETTIG. Gymnastic wrist injuries. GUTT. Sports Med. Rep.. Vol. 7, No. 5. pp. 289-295, 2008. During gymnastic activities, the wrist is exposed to many different types of stresses, including repetitive motion, higii impact loading, axial compression, torsiorml forces, and distraction in varying degrees of ulnar or radial deviation and hyperextension. Many of these stresses are...

The purpose of this study was to determine the influence of gender, screw design, and the approach on maximal screw length in scaphoid fracture fixation. Measurements were performed on 3D reconstructions of 20 CT scans of normal scaphoids. A comparison was made between 15 different available screw designs and between volar and dorsal screw placement. The length of the scaphoid along its central...

Twenty observers reported independently on the presence or absence of a fracture of the scaphoid on 60 sets of radiographs; these included initial and 2- to 3-week views in patients in whom the outcome was known, normal scaphoids and random copies of these. Analysis of variance of the accuracy of observations revealed that the 2- to 3-week radiographs did not improve diagnostic ability and that...

Functional limitations and pain are end results of scaphoid nonunion with progressive carpal collapse and radiocarpal arthritis. The aim of this study was to assess the functional outcome of four-corner arthrodesis with scaphoidectomy for the treatment of grade IV scaphoid nonunion with Scaphoid Nonunion Advanced Collapse (SNAC) stages II and III. Ten patients with symptomatic grade IV non unio...