PURPOSE To compare the treatment outcome of Acutrak versus Herbert screw fixation for scaphoid non-union and delayed union. METHODS Records of 132 patients who underwent Herbert screw fixation (n=61) or Acutrak screw fixation (n=71) with or without bone grafting for scaphoid non-union and delayed union by a single surgeon were reviewed. The most common fracture site was the waist of the scaph...

A fractured scaphoid is a common disabling injury that is frequently complicated by non-union. The treatment of non-union remains challenging because of the scaphoid's small size and delicate blood supply. Large animal models are the most reliable method to evaluate the efficacy of new treatment modalities before their translation into clinical practice. The goal of this study was to model a hu...

Background. Instability of the wrist, leading to the appearance of a fissure between the scaphoid and lunate bones (SLD), is generally attributed to damage of the scapholunate ligaments (SLIL). However, repair of the SLIL does not give a good outcome. SLD recurs in many cases, despite correct reconstruction. The structures of the joint may be exposed to further overloading and damage, with all ...

BACKGROUND Scaphoid fractures are the most common type of carpal fractures. OBJECTIVES The aim of the study was to compare the diagnostic value of panoramic and conventional radiographs of the wrist in scaphoid fractures. PATIENTS AND METHODS The panoramic and conventional radiographs of 122 patients with acute and chronic wrist trauma were studied. The radiographs were analyzed and examine...

Rowan CH, Downing ND. BMJ Case Rep 2017. doi:10.1136/bcr-2017-221041 Description Perilunate dislocations are uncommon high-energy injuries which are missed in approximately 25% of cases on initial presentation. We present the X-rays of a 25-year-old man who fell from a height of approximately 2 metres onto an extended wrist. Plain radiographs (figure 1) show classical signs of a trans-scaphoid ...

The aim of this study was to better quantify the role of delayed MRI scans in acute wrist injuries, and to assess the prevalence and distribution of multiple occult injuries of the wrist. A retrospective study was made of all patients who had been referred to the orthopaedic trauma clinic for a possible scaphoid fracture and with normal radiographs over a two year period. There were 110 patient...

BACKGROUND Traditionally, acute undisplaced or minimally-displaced scaphoid fractures are treated by casting in short- or long-arm casts. Although reports have shown that operative treatment is safe, effective and produces satisfactory results, outcomes from current studies comparing these two methods are questionable. The aim of this meta-analysis was to evaluate the effects of operative versu...

OBJECTIVE We planned this study to evaluate the role of bone scintigraphy in patients with suspected carpal fracture and normal or suspicious radiographs following carpal injury. METHODS Three-phase bone scintigraphy using Tc-99m-MDP was performed on 32 patients with negative radiographs but clinically suspected fracture at two weeks after the trauma. Focally increased radiopharmaceutical upt...

BACKGROUND AND PURPOSE Fractures of the scaphoid are often not detected on initial plain radiographs. Conventional management of clinically suspected scaphoid fractures is cast immobilization for 2 weeks and then reassessment. Early MRI is a diagnostic alternative. We compared the cost and usefulness of the early MRI diagnostic strategy with that of conventional management. PATIENTS AND METHO...

We have investigated whether assessment of blood flow to the proximal scaphoid can be used to predict nonunion in acute fractures of the scaphoid. We studied 32 fractures of the scaphoid one to two weeks after injury, by dynamic fat-suppressed T1-weighted gradient-echo MRI after the intravenous administration of gadopentetate dimeglumine (0.1 mmol/kg body-weight). Steepest slope values (SSV) an...