Carpal kinematics have been previously limited to in vitro models with cadaveric specimens. Using a newly developed markerless bone registration algorithm, we noninvasively studied the in vivo kinematics of the capitate, scaphoid, and lunate during wrist extension and flexion in both wrists of 5 men and 5 women. Computed tomography volume images were acquired in neutral and in 2 positions in bo...

OBJECTIVES The aim of this study was to assess the cost effectiveness of multiple competing diagnostic strategies for suspected scaphoid fractures. METHODS With published data, the authors created a decision-tree model simulating the diagnosis of suspected scaphoid fractures. Clinical outcomes, costs, and cost effectiveness of immediate computed tomography (CT), day 3 magnetic resonance imagi...

Nonunion can occur relatively frequently after scaphoid fracture and appears to be associated with severity of injury. There have been a number of techniques described for bone grafting with or without screw fixation to facilitate fracture healing. However, even with operative fixation of scaphoid fractures with bone grafting nonunion or malunion rates of 5 to 10 percent are still reported. Thi...

The management of recalcitrant nonunion of the scaphoid can be frustrating. Recent understanding of the vascular anatomy of the distal radius has helped in the management of these problems. Vascularized bone grafting for scaphoid nonunion has improved the union rates. Consequently, familiarity with this procedure is an important tool for any surgeon who treats scaphoid nonunion. Although there ...

The purpose of this article is to present some contemporary views regarding the treatment of scaphoid nonunion using pedicled bone grafts. Based on a review of the literature, the authors discuss surgical technique, including the advantages and disadvantages of various methods and their modifications, as well as outcomes. Among the methods discussed are pronator quadratus pedicled bone grafts, ...

OBJECTIVE The treatment of proximal located scaphoid nonunion is a well-known and common problem. For these patients, we used a vascular pedicled bone graft of the distal radius. METHODS In the last 7 years, 75 patients were treated with the vascular pedicled bone graft. Retrospectively, patients' data, healing rates, and factors influencing scaphoid healing were analyzed. RESULTS The overa...

Enchondroma represents a common bone tumor of the hand. The scaphoid is a rare location. We report the case of a scaphoid enchondroma presenting as chronic wrist pain following a relatively minor trauma. The diagnosis was suggested by radiological study and then confirmed by histological study after biopsy. Enucleation and vascularized bone graft with osteosynthesis provided good results. The c...

We report up-to-date one-year prospective data on the incidence of scaphoid fracture in skeletally immature patients managed in a Fracture Clinic of a Level I Trauma Centre in a University Hospital in the UK. All scaphoid fractures were immobilised until union was achieved. One hundred twenty one skeletally immature patients were referred for a suspected fracture of the scaphoid. Fourteen patie...

The scaphoid is vitally important for the proper mechanics of wrist function. Fracture of the scaphoid bone is the most common carpal fracture. Among all wrist injuries the incidence of scaphoid fracture is second only to fractures of the distal radius. Scaphoid fractures are significant because a delay in diagnosis can lead to a variety of adverse outcomes that include nonunion, delayed union,...