The Fragmented Proximal Pole Scaphoid Nonunion Treated With Rib Autograft: Case Series and Review of the Literature

2013 ◽  
Vol 38 (11) ◽  
pp. 2188-2192 ◽  
Author(s):  
Jeffrey Yao ◽  
Blake Read ◽  
Vincent R. Hentz
Keyword(s):  
Case Series ◽  
Scaphoid Nonunion ◽  
Review Of The Literature ◽  
Proximal Pole

scholarly journals Treatment of Type II Scaphoid Nonunion Advanced Collapse Lesions by Scaphoid Distal Pole Resection and Proximal Tenodesis of Extensor Brevis Carpi Radialis: Technique Description and Case Series

2019 ◽  
Vol 47 (02) ◽  
pp. 084-090
Author(s):  
Niceas da Silva Gusmão Filho ◽  
Ricardo Kaempf de Oliveira
Keyword(s):  
Scaphoid Fracture ◽  
Case Series ◽  
Good Alternative ◽  
Definitive Treatment ◽  
Type Ii ◽  
Scaphoid Nonunion ◽  
Wrist Flexion ◽  
Proximal Pole ◽  
Included Patient ◽  
The Mean

Abstract Objective To describe a new surgical technique and treatment outcomes of type II scaphoid nonunion advanced collapse (SNAC) lesions by scaphoid distal resection associated to the tenodesis of the remaining proximal pole with the extensor brevis carpi radialis tendon. Material and Methods This is a retrospective, observational study in which six patients were enrolled and submitted to this original technique, from February 2016 to March 2018. Only those patients with a comprehensive assessment and minimum 6 months postoperative evolution were included. Patient data, such as age, gender, and dominance, along with injury characteristics, previous therapies, complaints, and time span between appearance of the lesion and surgery were all analyzed. Results Among the six patients assessed, four were male, with ages ranging from 28 and 46 years (mean, 38.1 years). The elapsed time between nonunion diagnosis or scaphoid fracture and definitive treatment ranged from 34 to 72 months, with an average of 48.0 months. The mean follow-up time between the surgery and final results assessment was 15.3 months, ranging from 8 to 22 months. Preoperative measured mean pain was 8.8, ranging from 8 to 10. At 6 months postoperatively, mean pain assessment was 1.5, ranging from 0 to 5. We added wrist flexion and extension to assess joint range of motion. Preoperatively, the mean measure was 76.6°, ranging from 55° to 90°. Postoperatively, the mean was 127.1°, ranging from 110° to 140°. One patient had proximal scaphoid necrosis at 8 months postoperatively as a complication. The patient was treated with proximal carpectomy, with good clinical outcome; however, he did not return to his original job activities. The other five patients did return to their previous labor activities. Conclusions Treatment of type II SNAC lesions by resection of the distal scaphoid associated to tenodesis of the remaining proximal pole with a portion of the extensor brevis carpi radialis tendon has proved to be a useful, safe technique. Having low morbidity and few complications, the treatment represents a good alternative to previously described techniques.

scholarly journals Medial Femoral Trochlea Graft for Scaphoid Waist Nonunion: A Case Report and Review of the Literature

2019 ◽  
Vol 09 (03) ◽  
pp. 186-189
Author(s):  
Bruno E. Crepaldi ◽  
Cameron Keating ◽  
Eugene T. Ek ◽  
Stephen K. Y. Tham
Keyword(s):  
Articular Surface ◽  
Scaphoid Fracture ◽  
Donor Site ◽  
Degenerative Change ◽  
Salvage Procedure ◽  
Scaphoid Nonunion ◽  
Review Of The Literature ◽  
Proximal Pole ◽  
Femoral Trochlea ◽  
Special Review

AbstractThe medial femoral trochlea (MFT) of the knee is a donor site for convex osteochondral vascularized bone that has been used for the salvage of fractures of the proximal pole of the scaphoid. Chronic nonunited fractures of the scaphoid may lead to a sequence of degenerative change often referred to as scaphoid nonunion advance collapse. The vascularized MFT osteochondral graft has been reported as a salvage procedure for fractures of the proximal pole of the scaphoid, in situations where fixation is not an option. In this “Special review,” we describe the technique of free vascularized MFT graft in a case in which the nonunited scaphoid fracture was associated with segmental loss of the articular surface of the scaphoid waist. Given the likely progression of arthritis, if left untreated, we elected to treat this by replacing the lost articular surface using a vascularized intercalary osteochondral MFT graft between the nonunited scaphoid segments.

Immunosuppression as efficient therapy for Eosinophilic cholangitis: A case series and review of the literature

2018 ◽  
Vol 56 (01) ◽  
pp. E2-E89
Author(s):  
D Reher ◽  
C Schramm ◽  
F Brinkert ◽  
A Lohse ◽  
C Weiler-Normann
Keyword(s):  
Case Series ◽  
Review Of The Literature ◽  
Eosinophilic Cholangitis

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

2021 ◽  
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Functional Outcome ◽  
Grip Strength ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Degenerative Arthritis ◽  
Level Of Evidence ◽  
History Of ◽  
The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

Two Cases of Juvenile Dermatomyositis: Case Series and Review of the Literature

2019 ◽  
Vol 81 (1) ◽  
pp. 14-17
Author(s):  
Yuka KUNIMI ◽  
Yasunori OHGA ◽  
Kotaro ITO ◽  
Shinichi HIROSE ◽  
Shinichi IMAFUKU
Keyword(s):  
Juvenile Dermatomyositis ◽  
Case Series ◽  
Review Of The Literature

Rathke’s cleft cyst infections and pituitary abscesses: case series and review of the literature

Pituitary ◽  
2021 ◽  
Author(s):  
F. Aranda ◽  
R. García ◽  
F. J. Guarda ◽  
F. Nilo ◽  
J. P. Cruz ◽  
...  
Keyword(s):  
Case Series ◽  
Rathke’S Cleft Cyst ◽  
Review Of The Literature ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

scholarly journals Masses of the Sternoclavicular Area: Case Series and Review of the Literature

2021 ◽  
Vol 15 ◽  
pp. 117955652110216
Author(s):  
Parisa Oviedo ◽  
Morgan Bliss
Keyword(s):  
English Language ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Case Series ◽  
Review Of The Literature ◽  
Incision And Drainage ◽  
Surgical Interventions ◽  
Ganglion Cysts ◽  
Icd 10 ◽  
Bronchogenic Cysts

Objective: Masses of the sternoclavicular area are rare, and are not well described in the literature. We aim to present a series of patients with masses in this location and to review all reported English language cases of sternoclavicular masses in pediatric patients. Methods: This is a case series of pediatric patients with masses of the sternoclavicular area presenting to a tertiary care pediatric hospital from 2010 through 2017. Data was collected by using ICD-9 and ICD-10 codes to query the electronic medical record. Chart review included age at presentation, mass characteristics, medical and surgical interventions, and pathology results. A review of the literature was then performed. Results: Ten patients with masses overlying the sternoclavicular area were identified. Four patients presented with abscess and were treated with incision and drainage. Three of these patients were then treated with staged excision once infection cleared. Two additional patients were treated with primary excision. Four patients were treated with observation. The most common histopathologic finding was epidermoid. One patient was found to have a dermoid cyst, and 1 had a congenital cartilaginous rest. Conclusion: Epidermoids and dermoids are the most common masses overlying the sternoclavicular area. Controversy remains regarding the embryologic origin of sternoclavicular masses. The differential for masses in this area also includes branchial remnants, bronchogenic cysts, ganglion cysts, or septic arthritis.

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