scholarly journals Osteogenic protein-1 (BMP-7) accelerates healing of scaphoid non-union with proximal pole sclerosis

2006 ◽  
Vol 30 (2) ◽  
pp. 128-134 ◽  
Author(s):  
R. Bilic ◽  
P. Simic ◽  
M. Jelic ◽  
R. Stern-Padovan ◽  
D. Dodig ◽  
...  
2018 ◽  
Vol 6 (3) ◽  
pp. 506-510
Author(s):  
Syed Bokhari ◽  
Saifullah Hadi ◽  
Fahad Hossain ◽  
Bernd Ketzer

INTRODUCTION: We report the outcome of using a novel technique of minimally invasive internal fixation and distal radius bone grafting using the Jamishidi Trephine needle and biopsy/graft capture device.METHODS: The technique utilises a 8 mm incision at the distal pole of the scaphoid. The non-union is excavated using the standard Acutrak drill. An 8 gauge Jamshidi trephine needle is used to harvest bone graft from the distal radius which is impacted into the scaphoid and fixed with an Acutrak screw. Fifteen patients were available for retrospective review, 14 male, age mean 29.5 (15-56). Average time from injury to surgery was 167 days (45-72). Fractures classified according to Herbert giving 7 D1 and 8 D2 fractures, 14 waist and 1 proximal pole fractures, all of which had no humpback deformity.RESULTS: Sixty-six percentages of the fractures went onto unite, 4/7 D1 and 6/8 D2 united (p > 0.05). Seventy-five percentages of fracture that had surgery in less than 3 months from time of injury went onto unite, whereas only 63% united in patients who had surgery later than 3 months (p > 0.05). DASH outcome for all patients improved from 86 down to 32 (p < 0.05). With those that united going down from 90 to 6. Those that did not unite went from 81 to 61.CONCLUSION: The Jamshidi bone grafting technique shows comparable results (union rate 66%) to other techniques published in the literature (27-100%) providing the surgeon with an alternative and less demanding procedure than open scaphoid non-union surgery.


1993 ◽  
Vol 18 (6) ◽  
pp. 716-724 ◽  
Author(s):  
J. P. COMPSON ◽  
F. W. HEATLEY

In an audit of 68 scaphoid fractures with delayed and non-union that had been internally fixed using the Herbert bone screw, it was found that 39 had a significant fault in screw position. Poor intra-operatrve imaging was a major contributing factor. An anatomical and radiological study was therefore performed to evaluate which views were necessary in order to be confident about screw position. We recommend a minimum of four views. To display the proximal pole, an ulnar deviated postero-anterior (PA) view and true lateral; and to display the distal pole, a semi-pronated and semi-supinated view.


Injury Extra ◽  
2004 ◽  
Vol 35 (5-6) ◽  
pp. 50-51
Author(s):  
Satish Kutty ◽  
Benny Anto ◽  
David P Mulcahy

2007 ◽  
Vol 7 (5) ◽  
pp. 96S-97S
Author(s):  
Julio C. Furlan ◽  
Raja Rampersaud ◽  
Eric M. Massicotte ◽  
Richard Perrin ◽  
Yuriy Petrenko ◽  
...  

2021 ◽  
Vol 8 (10) ◽  
pp. 3189
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand P. Jayachandiran ◽  
Suresh Rajendran

Avascular necrosis (AVN) of the scaphoid is common following proximal pole fractures due to an arduous retrograde arterial vascular supply and it is a challenge to the hand surgeon. The treatment for scaphoid non-union with avascular necrosis is vascularized or non-vascularized bone grafts. Non vascularised bone grafts (NVBGs) can be categorized as autograft or allograft and cancellous or cortical bone grafts. Vascularised bone grafts promote biological healing and revascularizes ischaemic bone and they are free or pedicled grafts. Pedicled vascularised bone grafts maintain the vascular supply of the donor bone graft and this leads to better bone remodelling, less osteopenia, faster incorporation and better maintenance of bone mass compared to the non-vascularised graft with good clinical and radiological outcomes. In this paper, we have treated avascular necrosis of scaphoid with a pedicled vascularised bone graft based on the 1, 2 intercompartmental supraretinacular artery (1, 2-ICSRA) that resulted in a favourable outcome.


1988 ◽  
Vol 13 (1) ◽  
pp. 80-82
Author(s):  
A. B. CROSS

A case is described in which a patient presented with a rupture of the flexor pollicis longus tendon resulting from an ununited scaphoid fracture. No similar case appears to have been reported in the literature. This was not an attrition rupture and the mechanism is explained. The proximal pole of the scaphoid was removed and the tendon repaired. The patient regained good movement at the interphalangeal joint of the thumb.


2006 ◽  
Vol 31 (3) ◽  
pp. 252-255 ◽  
Author(s):  
C. P. LITTLE ◽  
B. J. BURSTON ◽  
J. HOPKINSON-WOOLLEY ◽  
P. BURGE

Scaphoid fractures predominantly affect young men, in whom the UK smoking prevalence approaches 40%. We examined the association between smoking and failure of non-vascularized bone grafting and screw fixation for scaphoid non-union and delayed union in a retrospective cohort study. Adequate follow-up was obtained in 64 of 87 patients treated (74%). Union was defined as the presence of trabecular continuity on at least two films from a four-view radiographic series. Union was achieved in 47 of 64 cases. Seventeen were smokers. Thirteen of the 17 patients with non-union were smokers (relative risk 3.7; 95% CI: 1.3–10.1, p = 0.005). Proximal pole fractures, long injury-grafting interval and non-compliance were not more frequent in smokers than non-smokers. Smoking is strongly associated with failure of union after screw fixation and non-vascularized bone grafting of the scaphoid. Smokers should be advised to avoid smoking pre-operatively and during the healing period.


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