Spontaneous consolidation of scaphoid nonunion in a child.
(42/104)
BACKGROUND: Scaphoid nonunion is very rare in childhood. CASE REPORT: A 14 year old boy with scaphoid nonunion confirmed with CT did not past scheduled surgery. In spite of the short period of immobilisation union occurred and two years after the injury he was completely asymptomatic. CONCLUSIONS: We suspect that injury to the scaphoid, in this case may have accelerated the union shortly before the end of ossification. (+info)
Management of clinically suspected scaphoid fractures: a survey of current practice in Israel.
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BACKGROUND: Fracture of the scaphoid is the most common fracture of a carpal bone. Nevertheless, the diagnosis of SF might be challenging. Plain X-rays that fail to demonstrate a fracture line while clinical findings suggest the existence of such a fracture is not uncommon. Currently there is no consensus in the literature as to how a clinically suspected SF should be diagnosed, immobilized and treated. OBJECTIVES: To assess the current status of diagnosis and treatment of clinically suspected scaphoid fractures in Israeli emergency departments. METHODS: We conducted a telephonic survey among orthopedic surgeons working in Israeli EDs as to their approach to the diagnosis and treatment of occult SF. RESULTS: A total of 42 orthopedic surgeons in 6 hospital EDs participated in the survey. They reported performing a mean of 2.45 +/- 0.85 clinical tests, with tenderness over the snuffbox area being the sign most commonly used. A mean of 4.38 +/- 0.76 X-ray views were ordered for patients with a clinically suspected SF. The most common combination included posterior-anterior, lateral, semipronated and semisupinated oblique views. All participating surgeons reported immobilizing the wrists of patients with occult fractures in a thumb spica cast based on their clinical findings. Upon discharge from the ED patients were advised to have another diagnostic examination as follows: 29 (69%) repeated X-rays series, 18 (43%) were referred to bone scintigraphy and 2 (5%) to computed tomography; none were referred to magnetic resonance imaging. CONCLUSIONS: No consensus was found among Israeli orthopedic surgeons working in EDs regarding the right algorithm for assessment of clinically suspected SF. There is a need for better guidelines to uniformly dictate the order and set of tests to be used in the assessment of occult fractures. (+info)
Volar percutaneous screw fixation for scaphoid waist delayed union.
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Is the dorsal percutaneous approach well-founded for osteosynthesis of scaphoid fractures?
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AIMS: To compare complications associated with dorsal percutaneous and limited dorsal approaches in the surgical treatment of fractured scaphoid bone. METHODS: A total of 51 patients with acute type A2, B2 and B3 scaphoid fractures were treated by limited dorsal approach. During follow-up examinations we analysed the functional outcome and per- and post-operative complications, and we compared them with studies using the dorsal percutaneous approach. RESULTS: We found fewer complications using the limited dorsal approach. CONCLUSIONS: We found no advantages of the dorsal percutaneous approach. In addition to a favourable functional outcome, the limited dorsal approach permits visualization of the screw insertion point and of the fracture line course, and prevents insufficient screw sinking underneath the bone cartilage and malunion. (+info)