Scaphoid fractures are by 80 % the most common fractures of the carpal bones. Detection and treatment can be delayed due to only slight clinical symptoms, which are often shown by acute injuries of the scaphoid. Pseudarthrosis of the scaphoid developing arthrosis of the wrist or even a carpal collapse can be the consequence. An in-depth clinical examination and adequate radiological diagnostics are essential for the detection and the treatment of scaphoid fractures. A primary examination by CT scan is obligatory. The classification of Krimmer/Herbert in the CT is used to subdivide the scaphoid fractures. Depending on the appearance of the fracture a conservative or surgical approach is indicated. All stable fractures of the scaphoid can be treated conservatively. In all forms of unstable scaphoid fractures surgery is recommended. Different ways of surgical approaches and osteosyntheses are described. Pseudarthrosis of the scaphoid should be surgically reconstructed with osteosynthesis in combination with bone graft to prevent a carpal collapse.
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http://dx.doi.org/10.1055/s-0033-1360131 | DOI Listing |
Children (Basel)
January 2025
University Hospital of Lausanne, 1011 Lausanne, Switzerland.
Objectives: The scaphoid fat pad stripe (SFS) is a radiological sign first described in 1975 as a line of relative lucency lying parallel to the lateral border of the scaphoid, with slight convexity toward it, and it is optimally demonstrated on postero-anterior and oblique views with ulnar deviation of the carpus. The obliteration or displacement of this line is commonly present in acute fractures of the scaphoid, radial styloid process, and proximal first metacarpus. The aim of this observational study is to investigate the supportive value of the fat stripe sign (SFS) in the diagnosis of scaphoid fractures in the pediatric population.
View Article and Find Full Text PDFJ Hand Surg Eur Vol
January 2025
Chirurgie de la main, du poignet et du coude, Hôpital Privé Saint Roch, Toulon, France.
We compared the outcomes of two groups of patients with scaphoid nonunion treated with arthroscopic cancellous bone grafting. In group 1, K-wires were introduced beforehand and in group 2 after debridement and packing bone grafts in the nonunion site. Our hypothesis was that the percentage of unions would be higher in group 2.
View Article and Find Full Text PDFJ Hand Surg Eur Vol
January 2025
Clinical Scientific Computing, Guy's and St Thomas' NHS Foundation Trust, London, UK.
This paper discusses the current literature surrounding the potential use of artificial intelligence and machine learning models in the diagnosis of acute obvious and occult scaphoid fractures. Current studies have notable methodological flaws and are at high risk of bias, precluding meaningful comparisons with clinician performance (the current reference standard). Specific areas should be addressed in future studies to help advance the meaningful and clinical use of artificial intelligence for radiograph interpretation.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
BG Klinikum Unfallkrankenhaus Berlin, Department of Hand-, Replantation- and Microsurgery and Chair of Hand-, Replantation- and Microsurgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
Introduction: Rhizarthrosis, or osteoarthritis of the trapeziometacarpal joint, predominantly affects women over 50, with up to 30% experiencing some degree of arthritis in this joint. Traditional surgical approaches, such as trapeziectomy with ligament reconstruction, can result in some patients in persistent pain or limited functionality. TMC ball-in-socket arthroplasty, with a cup placed in the distal scaphoid, offers a promising alternative to traditional arthrodesis or resection-suspension arthroplasty.
View Article and Find Full Text PDFEmerg Radiol
January 2025
Department of Orthopaedics, Institute of Clinical Sciences, Lund University, Lund, Sweden.
Purpose: To evaluate the rate of missed scaphoid fractures on follow-up computed tomography (CT) for suspected occult scaphoid fracture after normal radiography with residual radial-sided wrist pain.
Methods: In a retrospective analysis, wrist CT during a five-year period was analyzed. The CT examinations and radiological reports were re-evaluated.
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