Iliac crest bone grafting and herbert screw fixation of nonunions of the scaphoid with avascular proximal poles

1995 ◽  
Vol 20 (5) ◽  
pp. 818-831 ◽  
Author(s):  
Randall R. Robbins ◽  
Peter R. Carter
2017 ◽  
Vol 43 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Timothy J. Luchetti ◽  
Allison J. Rao ◽  
John J. Fernandez ◽  
Mark S. Cohen ◽  
Robert W. Wysocki

We present 20 patients with established proximal pole scaphoid nonunions treated with curettage and cancellous autograft from the distal radius and screw fixation. Fractures with significant proximal pole fragmentation were excluded. Patients were treated at a mean of 26 weeks after injury (range 12–72). Union occurred in 18 of 20 patients (90%) based on computed tomographic imaging. The two nonunions that did not heal were treated with repeat curettage and debridement and iliac crest bone grafting without revision of fixation. Union was achieved in both at a mean of 11 weeks after the revision procedures. Our findings suggest that non-vascularized cancellous autograft and antegrade fixation is a useful option for the treatment of proximal pole scaphoid nonunions. Level of evidence: IV


2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Hoari Krishnan ◽  
Taek Rim Yoon ◽  
Kyung Soon Park ◽  
Je Hyoung Yeo

We present a very rare case of eosinophilic granuloma involving the neck of femur in a 17-year-old male. The patient was treated with curettage and autologous iliac crest bone grafting with prophylactic screw fixation, and the diagnosis was confirmed by histopathological examination. Currently, it has been 14 years since the first surgery and the patient is well with no recurrence or relapse, and the osteolytic lesion has disappeared.


2021 ◽  
Vol 14 (11) ◽  
pp. e243761
Author(s):  
Keval Patel ◽  
Abdullah Khawaja ◽  
Aman Patel ◽  
Michail Kokkinakis

Talonavicular (TN) coalition is a rare pathological union of the talus and navicular bones. We report the case of a 7-year-old girl with a symptomatic TN coalition, who underwent operative management with a lateral column lengthening procedure using autologous iliac crest bone grafting. There are no complications to report and the graft was incorporated at an early stage. At 3 year follow-up the patient has remained pain-free since the operation and maintained alignment. To our knowledge, this is the first reported case of TN coalition treated with reconstructive surgery in a paediatric patient.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Dongxu Feng ◽  
Xiaolong Wang ◽  
Liang Sun ◽  
Xiao Cai ◽  
Kun Zhang ◽  
...  

Abstract Background Although most cases of humeral shaft nonunion respond well to surgical intervention, surgeons still encounter patients with humeral shaft nonunion who have already undergone repeated surgeries for nonunion. This study retrospectively analyzed the efficacy of double locking compression plate (LCP) fixation in combination with autogenous iliac crest bone grafting for recalcitrant humeral shaft nonunion. Methods A consecutive series of patients with aseptic recalcitrant humeral shaft nonunion underwent surgical treatment between May 2010 and August 2017 in our institution. Standardized treatment included thorough debridement, double LCP and screw fixation, and autogenous iliac bone grafting. The injury type and the duration of nonunion were recorded for all patients. The main outcome measurements were the Constant and Murley scale for shoulder function, Mayo elbow performance index (MEPI) for elbow function, and visual analog scale (VAS) for pain. In addition, all complications were documented. Results The study cohort comprised six females and nine males with a mean age of 45.3 ± 13.1 years. Each patient had already undergone at least one failed surgery for humeral shaft nonunion. The average duration of nonunion before the index intervention was 126.8 ± 124.2 months. All patients achieved bone union without implant failure. At final follow-up, the mean Constant and Murley score and mean MEPI were significantly improved, and the mean VAS score was significantly decreased. Each patient was very satisfied with the treatment. Four patients had complications, including one with a superficial wound infection, one with radial nerve palsy, one with ulnar nerve palsy, and one with discomfort at the iliac crest. Conclusion Double plate fixation combined with autogenous iliac crest bone grafting results in successful salvage of humeral shaft nonunion after prior failed surgical interventions.


2013 ◽  
Vol 19 (4) ◽  
pp. 412-419 ◽  
Author(s):  
Feizhou Lu ◽  
Hongli Wang ◽  
Jianyuan Jiang ◽  
Wenjun Chen ◽  
Xin Ma ◽  
...  

Object Monomelic amyotrophy (MMA) is a benign, self-limiting lower motor neuron disease. Optimal surgical strategies—discectomy decompression and fusion (DDF) or corpectomy decompression and fusion (CDF)—for patients with aggravated symptoms (within 6 months of presentation) are controversial, particularly in those who are ineligible for conventional treatment. These 2 methods of anterior cervical decompression and fusion for MMA in patients unwilling or unable to wear a conventional cervical collar long term were evaluated. Methods Anterior cervical decompression and fusion were performed in 48 male patients with MMA between September 2007 and September 2010. Patients were randomly treated with anterior cervical discectomy decompression with autologous iliac crest bone grafting and internal plate fixation (DDF group: 24 patients) or anterior cervical corpectomy, posterior longitudinal ligament resection, autologous iliac crest bone grafting, and internal plate fixation (CDF group: 24 patients). Subjective symptom assessments and electromyography (EMG) examinations were conducted both preoperatively and postoperatively. Results Subjective assessments and EMG studies (mean follow-up duration 25.9 months) indicated improvement in 64.6% and 60% of patients, respectively. No significant correlations between the effectiveness of surgery and age at symptom onset, preoperative symptom duration, or postoperative follow-up time were found. Conclusions The lack of a significant difference in effectiveness between DDF and CDF favors DDF as more clinically applicable because of its lower procedural risks. As a second-line alternative to cervical collar treatment, surgical anterior cervical decompression and fusion via DDF or CDF may prevent further deterioration and produce good short-term therapeutic effects in patients with MMA; however, cervical collar treatment is recommended for eligible patients because of its lower associated risks.


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