Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
European Journal of Trauma and Emergency Surgery
Erschienen in: European Journal of Trauma and Emergency Surgery 1/2018

27.02.2017 | Original Article

Clinical outcome after alternative treatment of scaphoid fractures and nonunions

verfasst von: A. L. Sander, K. Sommer, D. Schäf, C. Braun, I. Marzi, T. Pohlemann, J. Frank

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Achieving stable fixation of scaphoid fractures and nonunions continues to be a challenge. Compression screw fixation has been the current standard surgical procedure. However, in some cases, bone healing cannot be achieved and requires further revision. Recent series reintroduced volar plating as valid option for stable fixation. The aim of the study was to review clinical outcome of alternative scaphoid treatment.

Methods

From 2011 to 2014, nine patients with scaphoid fracture were treated by Headless Compression Screw (HCS) and seven patients with scaphoid nonunion by HCS or volar mini condylar plate with bone graft. The average age was 34.4 years and the average time to follow-up was 19.3 months. From 1996 to 1998, 38 patients with scaphoid nonunion were treated using compression screw (S-group) or volar mini condylar plate (P-group) with bone graft. The average age was 39.6 years and the average time to follow-up was 26.2 months.

Results

The union rate was 100%. For scaphoid fractures, the mean Modified Mayo Wrist Score (MMWS) was 94.1 and the DASH score 7.4. From 2011 to 2014, the MMWS was 87.9 and the DASH score 7 in scaphoid nonunions. In the period between 1996 and 1998, the MMWS was 67.2 in the P-group and 58.6 in the S-group, and the DASH score 16.8 and 28.2.

Conclusions

Our study demonstrated that appropriate application of the HCS was able to produce very satisfactory results in scaphoid fractures and nonunions. In our opinion, however, the method of scaphoid plate osteosynthesis can achieve a higher degree of stability, particularly rotational stability, in case of multifragmentary avascular scaphoid nonunions.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Adams BD, Blair WF, Reagan DS, Grundberg AB. Technical factors related to Herbert screw fixation. J Hand Surg Am. 1988;13:893–9.CrossRefPubMed
2.
Bunker TD, McNamee PB, Scott TD. The Herbert screw for scaphoid fractures. A multicentre study. J Bone Joint Surg Br. 1987;69:631–4.CrossRefPubMed
3.
Ford DJ, Khoury G, el-Hadidi S, Lunn PG, Burke FD. The Herbert screw for fractures of the scaphoid. A review of results and technical difficulties. J Bone Joint Surg Br. 1987;69:124–7.PubMed
4.
5.
Herbert TJ, Filan SL. Proximal scaphoid nonunion-osteosynthesis. Handchir Mikrochir Plast Chir. 1999;31:169–73.CrossRefPubMed
6.
Herbert TJ, Fisher WE. Management of the fractured scaphoid using a new bone screw. J Bone Jt Surg Br. 1984;66:114–23.
7.
Krimmer H, Kremling E, van Schoonhoven J, Prommersberger KJ, Hahn P. Proximal scaphoid pseudarthrosis—reconstruction by dorsal bone screw and spongiosa transplantation. Handchir Mikrochir Plast Chir. 1999;31:174–7.CrossRefPubMed
8.
Leyshon A, Ireland J, Trickey EL. The treatment of delayed union and non-union of the carpal scaphoid by screw fixation. J Bone Jt Surg Br. 1984;66:124–7.
9.
Manske PR, McCarthy JA, Strecker WB. Use of the Herbert bone screw for scaphoid nonunions. Orthopedics. 1988;11:1653–61.PubMed
10.
Pring DJ, Hartley EB, Williams DJ. Scaphoid osteosynthesis: early experience with the Herbert bone screw. J Hand Surg Br. 1987;12:46–9.CrossRefPubMed
11.
Tu YK, Chen AC, Chou YC, Ueng SW, Ma CH, Yen CY. Treatment for scaphoid fracture and nonunion—the application of 3.0 mm cannulated screws and pedicle vascularised bone grafts. Injury. 2008;39:S96–106.CrossRef
12.
Wozasek GE, Moser KD. Percutaneous screw fixation for fractures of the scaphoid. J Bone Jt Surg Br. 1991;73:138–42.
13.
Leixnering M, Pezzei C, Weninger P, Mayer M, Bogner R, Lederer S, Schauer J, Figl M. First experiences with a new adjustable plate for osteosynthesis of scaphoid nonunions. J Trauma. 2011;71:933–8.CrossRefPubMed
14.
Ghoneim A. The unstable nonunited scaphoid waist fracture: results of treatment by open reduction, anterior wedge grafting, and internal fixation by volar buttress plate. J Hand Surg Am. 2011;36:17–24.CrossRefPubMed
15.
Braun C, Gross G, Bühren V. Osteosynthesis using a buttress plate—a new principle for stabilizing scaphoid pseudarthroses. Unfallchirurg. 1993;96:9–11.PubMed
16.
Ender HG. A new method of treating traumatic cysts and pseudoarthrosis of the scaphoid. Unfallheilkunde. 1977;80:509–13.PubMed
17.
Huene DR, Huene DS. Treatment of nonunions of the scaphoid with the Ender compression blade plate system. J Hand Surg Am. 1991;16:913–22.CrossRefPubMed
18.
Stanković P, Burchhardt H. Experience with the Ender hooked plate in the management of 42 scaphoid pseudarthroses. Handchir Mikrochir Plast Chir. 1993;25:217–22.PubMed
19.
Ahmed U, Malik S, David M, Simpson C, Tan S, Power D. The Headless compression screw—technical challenges in scaphoid fracture fixation. J Orthop. 2015;12:S211–6.CrossRefPubMedPubMedCentral
20.
21.
Singisetti K, Aldlyami E, Middleton A. Early results of a new implant: 3.0 mm headless compression screw for scaphoid fracture fixation. J Hand Surg Eur Vol. 2012;37:690–3.CrossRefPubMed
22.
Braga-Silva J, Peruchi FM, Moschen GM, Gehlen D, Padoin AV. A comparison of the use of distal radius vascularised bone graft and non-vascularised iliac crest bone graft in the treatment of non-union of scaphoid fractures. J Hand Surg Eur Vol. 2008;33:636–40.CrossRef
23.
Dehghani M, Soltanmohamadi M, Tahririan MA, Moezi M, Daneshpajouhnejad P, Zarezadeh A. Management of scaphoid nonunion with avascular necrosis using 1,2 intercompartmental supraretinacular arterial bone graft. Adv Biomed Res. 2014;3:185.CrossRefPubMedPubMedCentral
24.
Eggli S, Fernandez DL, Beck T. Unstable scaphoid fracture nonunion: a medium-term study of anterior wedge grafting procedures. J Hand Surg Br. 2002;27:36–41.CrossRefPubMed
25.
Fernandez DL. Anterior bone grafting and conventional lag screw fixation to treat scaphoid nonunions. J Hand Surg Am. 1990;15:140–7.CrossRefPubMed
26.
Green DP. The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion. J Hand Surg Am. 1985;10:597–605.CrossRefPubMed
27.
Doi K, Oda T, Soo-Heong T, Nanda V. Free vascularized bone graft for nonunion of the scaphoid. J Hand Surg Am. 2000;25:507–19.CrossRefPubMed
28.
Gabl M, Reinhart C, Lutz M, Bodner G, Rudisch A, Hussl H, Pechlaner S. Vascularized bone graft from the iliac crest for the treatment of nonunion of the proximal part of the scaphoid with an avascular fragment. J Bone Jt Surg Am. 1999;81:1414–28.CrossRef
29.
Guimberteau JC, Panconi B. Recalcitrant non-union of the scaphoid treated with a vascularized bone graft based on the ulnar artery. J Bone Jt Surg Am. 1990;72:88–97.CrossRef
30.
Lee JC, Lim J, Chacha PB. The anatomical basis of the vascularized pronator quadratus pedicled bone graft. J Hand Surg Br. 1997;22:644–6.CrossRefPubMed
31.
Zaidemberg C, Siebert JW, Angrigiani C. A new vascularized bone graft for scaphoid nonunion. J Hand Surg Am. 1991;16:474–8.CrossRefPubMed
32.
Boyer MI, von Schroeder HP, Axelrod TS. Scaphoid nonunion with avascular necrosis of the proximal pole. Treatment with a vascularized bone graft from the dorsum of the distal radius. J Hand Surg Br. 1998;23:686–90.CrossRefPubMed
33.
Chang MA, Bishop AT, Moran SL, Shin AY. The outcomes and complications of 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions. J Hand Surg Am. 2006;31:387–96.CrossRefPubMed
34.
Steinmann SP, Bishop AT, Berger RA. Use of the 1,2 intercompartmental supraretinacular artery as a vascularized pedicle bone graft for difficult scaphoid nonunion. J Hand Surg Am. 2002;27:391–401.CrossRefPubMed
35.
Straw RG, Davis TR, Dias JJ. Scaphoid nonunion: treatment with a pedicled vascularized bone graft based on the 1,2 intercompartmental supraretinacular branch of the radial artery. J Hand Surg Br. 2002;27:413.CrossRefPubMed
36.
Ditsios K, Konstantinidis I, Agas K, Christodoulou A. Comparative meta-analysis on the various vascularized bone flaps used for the treatment of scaphoid non-union. J Orthop Res. 2016. doi:10.​1002/​jor.​23242.
Metadaten
Titel
Clinical outcome after alternative treatment of scaphoid fractures and nonunions
verfasst von
A. L. Sander
K. Sommer
D. Schäf
C. Braun
I. Marzi
T. Pohlemann
J. Frank
Publikationsdatum
27.02.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 1/2018
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-017-0773-y

Weitere Artikel der Ausgabe 1/2018

European Journal of Trauma and Emergency Surgery 1/2018 Zur Ausgabe

Original Article

Improved outcomes for hepatic trauma in England and Wales over a decade of trauma and hepatobiliary surgery centralisation

Original Article

Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates advances patients’ own inflammatory cells, platelets and growth factors: the first introduction to the low speed centrifugation concept

Original Article

Basic echocardiography for undergraduate students: a comparison of different peer-teaching approaches

Original Article

The prevalence of incidental findings on computed tomography of the abdomen/pelvis in pediatric trauma patients

Original Article

Two-stage treatment in patients with patients with high-energy femoral fractures does not lead to an increase in deep infectious complications: a propensity score analysis

Review Article

Traumatic inferior shoulder dislocation: a review of management and outcome

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise