Avascular Necrosis of the Proximal Scaphoid after Fracture Union

1995 ◽  
Vol 20 (4) ◽  
pp. 551-556 ◽  
Author(s):  
S. L. FILAN ◽  
T. J. HERBERT
Keyword(s):  
Femoral Neck ◽  
Avascular Necrosis ◽  
Scaphoid Fracture ◽  
Proximal Part ◽  
Femoral Neck Fractures ◽  
The Other ◽  
Fracture Union ◽  
Scaphoid Fractures ◽  
Both Bones ◽  
Plaster Immobilization

We report four cases of late avascular necrosis (AVN) of the proximal part of the scaphoid following apparent healing of acute scaphoid fractures. One patient had been treated conservatively, by plaster immobilization, and the other three had undergone internal fixation of their acute fractures. The onset of symptoms associated with AVN varied, being as late as 2 years in one patient. Late AVN following healing of a scaphoid fracture does not appear to have been previously recognized, perhaps due to the fact that patients are seldom followed up for long enough. We feel that this condition is in many ways analogous to late AVN following femoral neck fractures and as such is a special complication related to the fact that both bones are intracapsular and have a precarious blood supply.

Partial Union of Acute Scaphoid Fractures

2005 ◽  
Vol 30 (5) ◽  
pp. 440-445 ◽  
Author(s):  
H. P. SINGH ◽  
D. FORWARD ◽  
T. R. C. DAVIS ◽  
J. S. DAWSON ◽  
J. A. ONI ◽  
...  
Keyword(s):  
Cross Section ◽  
Longitudinal Axis ◽  
The Other ◽  
Ct Scans ◽  
Fracture Union ◽  
Scaphoid Fractures ◽  
Initial Injury ◽  
Wrist Function ◽  
The Cross ◽  
Plaster Immobilization

Sixty-six patients with acute scaphoid fractures were treated non-operatively in a below elbow plaster for 8 to 12 weeks and underwent CT scans along the longitudinal axis of the scaphoid at 12 to 18 weeks. These scans showed that 14 fractures had not united and that 30 had united throughout the whole cross-section of the scaphoid. The other 22 had partially united with bridging trabeculae in some areas of the cross-section. These 22 partial unions were graded as 0% to 24% union (0 cases), 25% to 49% union (5 cases), 50% to 74% union (7 cases), and 75% to 99% union (10 cases). The 12 patients who had less than 75% fracture union were followed-up further and nine underwent another CT scan at 23 to 40 weeks after the initial injury. These showed union across the whole of the cross-section of the fracture in seven cases and 75% to 99% union in the other two cases, who had full and painless wrist function. We conclude that partial union of the scaphoid is a common occurrence but, in most cases, it progresses to full union without the need for prolonged plaster immobilization.

Displaced femoral neck fractures in patients 60 years of age or younger: results of internal fixation with the dynamic locking blade plate

2018 ◽  
Vol 100-B (4) ◽  
pp. 443-449 ◽  
Author(s):  
J. H. Kalsbeek ◽  
A. D. P. van Walsum ◽  
J. P. A. M. Vroemen ◽  
H. M. J. Janzing ◽  
J. T. Winkelhorst ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Avascular Necrosis ◽  
Young Patients ◽  
Case Series ◽  
Neuromuscular Disorder ◽  
Femoral Neck Fractures ◽  
Blade Plate ◽  
Displaced Femoral Neck Fractures

AimsThe objective of this study was to investigate bone healing after internal fixation of displaced femoral neck fractures (FNFs) with the Dynamic Locking Blade Plate (DLBP) in a young patient population treated by various orthopaedic (trauma) surgeons.Patients and MethodsWe present a multicentre prospective case series with a follow-up of one year. All patients aged ≤ 60 years with a displaced FNF treated with the DLBP between 1st August 2010 and December 2014 were included. Patients with pathological fractures, concomitant fractures of the lower limb, symptomatic arthritis, local infection or inflammation, inadequate local tissue coverage, or any mental or neuromuscular disorder were excluded. Primary outcome measure was failure in fracture healing due to nonunion, avascular necrosis, or implant failure requiring revision surgery.ResultsIn total, 106 consecutive patients (mean age 52 years, range 23 to 60; 46% (49/106) female) were included. The failure rate was 14 of 106 patients (13.2%, 95% confidence interval (CI) 7.1 to 19.9). Avascular necrosis occurred in 11 patients (10.4%), nonunion in six (5.6%), and loss of fixation in two (1.9%).ConclusionThe rate of fracture healing after DLBP fixation of displaced femoral neck fracture in young patients is promising and warrants further investigation by a randomized trial to compare the performance against other contemporary methods of fixation. Cite this article: Bone Joint J 2018;100-B:443–9.

MINIMAL INVASIVE PERCUTANEOUS HERBERT SCREW FIXATION IN ACUTE UNSTABLE SCAPHOID FRACTURE

Hand Surgery ◽  
2003 ◽  
Vol 08 (02) ◽  
pp. 213-218 ◽  
Author(s):  
In-Ho Jeon ◽  
Chang-Wug Oh ◽  
Byung-Chul Park ◽  
Joo-Chul Ihn ◽  
Poong-Taek Kim
Keyword(s):  
Screw Fixation ◽  
Scaphoid Fracture ◽  
Clinical Results ◽  
Minimal Invasive ◽  
Percutaneous Fixation ◽  
Fixation Technique ◽  
Fracture Union ◽  
Herbert Screw ◽  
Scaphoid Fractures ◽  
High Satisfaction

The purpose of this study is to document the percutaneous Herbert screw fixation technique with free-hand method to stabilise acute unstable scaphoid fractures and evaluated the clinical results. Thirteen patients with less than 14 day-old fractures were fixed by percutaneous Herbert screw and reviewed retrospectively for a minimum of 24 months (average, 37 months). All were men with an average age of 22 years. According to Herbert's classification, all fractures were classified as of the acute unstable (B2). Fracture union was achieved in all cases at a mean of 9.2 weeks (eight to 12 weeks). Return to work or school ranged from one day to three weeks according to their occupation. This percutaneous fixation technique using Herbert screw is a reliable and effective alternative for acute scaphoid fractures, which enables the patient to use the hand earlier with high satisfaction and minimum complication.

scholarly journals Femoral osteochondroplasty can be performed effectively without the risk of avascular necrosis or femoral neck fractures in an experimental ovine FAI model

2018 ◽  
Vol 26 (1) ◽  
pp. 128-137 ◽  
Author(s):  
F. Schmaranzer ◽  
L. Arendt ◽  
T.D. Lerch ◽  
S.D. Steppacher ◽  
K. Nuss ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Avascular Necrosis ◽  
Femoral Neck Fractures

Avascular Necrosis of the Capitate and Dorsal Dorsi-Flexion Instability

HAND ◽  
1980 ◽  
Vol os-12 (2) ◽  
pp. 176-178 ◽  
Author(s):  
John H. Newman ◽  
Iain Watt
Keyword(s):  
Avascular Necrosis ◽  
Scaphoid Fracture ◽  
Proximal Part ◽  
Ligamentous Laxity

Avascular necrosis of the proximal part of the capitate is very rare and usually is secondary to a fracture of the waist in association with a scaphoid fracture — the naviculocapitate syndrome. A case is presented in which partial avascular necrosis of the capitate occurred in association with bilateral dorsal dorsi-flexion instability. The authors suggest that this phenomenon represents a form of the naviculocapitate syndrome in which ligamentous laxity altered the line of failure, thus sparing the scaphoid from fracture.

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