A 46-year-old woman with a history of metastatic malignant melanoma presented with what appeared to be a scaphoid nonunion. Biopsy and subsequent scaphoid excision confirmed the diagnosis of metastatic melanoma. Her quality of life was improved for her remaining 13 months by scaphoid excision. We assessed our results in relation to the literature.
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Functional outcomes of three-corner fusion without triquetrum excision versus conventional four-corner fusion in scaphoid non-union advanced collapse G II and III in active patients: a prospective randomized control trial.
SICOT J
December 2024
Orthopedic Department, Faculty of Medicine Ain Shams University, 38 Abbassia Square, Cairo 1181, Egypt.
Introduction: Four-corner fusion has long been the preferred treatment for stages II and III of scaphoid nonunion advanced collapse with intact radiolunate articulation. Three corner fusions were then proposed as a more limited procedure with improved ulnar deviation through triquetrum excision. However, we believe triquetrum preservation would decrease the radiolunate contact pressure without affecting the ulnar deviation range.
View Article and Find Full Text PDFResearch Trends in the Management of Scaphoid Non-unions: A Bibliometric Review.
Indian J Orthop
December 2024
Department of Computer Science and Engineering, MCKV Institute of Engineering, Howrah, 711204 West Bengal India.
Background: The scaphoid is the most commonly fractured carpal bone, often going into non-union and secondary complications. Despite this, no explicit guidelines exist for the management of its non-union till date. This study quantitatively analyses the existent research on scaphoid nonunions from 2013 to 2024 using bibliometric methodology.
View Article and Find Full Text PDFEvaluating inter- and intraobserver reliability in radiographic determination of wrist alignment following scaphoid excision and four-corner arthrodesis.
J Hand Microsurg
October 2024
Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA.
Background: Four-corner arthrodesis is commonly performed for advanced collapse patterns of wrist arthritis. Reduction of the capitolunate (CL) angle during four-corner fusion is crucial to allow for the greatest radiocarpal joint arc of motion. Previous studies demonstrate variable inter- and intraobserver reliability of measuring the CL angle.
View Article and Find Full Text PDFDistal Scaphoid Excision and Dermal Allograft Interposition in a Professional Athlete: Long-term Follow-up.
Plast Reconstr Surg Glob Open
August 2024
Cedars-Sinai Medical Center, Division of Orthopaedic Hand Surgery, Los Angeles, Calif.
Scaphoid nonunion occurs in 10%-15% of scaphoid fractures, potentially resulting in scaphoid nonunion advanced collapse. Distal scaphoid excision without allograft interposition is a known treatment, but can result in loss of carpal height and pain. This report describes the application of human acellular dermal matrix as an interposition graft after distal scaphoid excision for stage I scaphoid nonunion advanced collapse.
View Article and Find Full Text PDFProximal row carpectomy or scaphoid excision and four-corner arthrodesis for treatment of scapholunate advanced collapse arthritis.
J Hand Surg Eur Vol
January 2025
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Degenerative wrist conditions, such as scapholunate advanced collapse and scaphoid nonunion advanced collapse, often require salvage procedures to reduce pain and improve function. For early stages of disease, both proximal row carpectomy and scaphoid excision four-corner arthrodesis are viable motion-preserving options. There remains controversy on which technique is superior.
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