Trans-Scaphoid Perilunate Dislocation: Union of an Extruded Scaphoid Proximal Pole Fragment

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 313-315
Author(s):  
PKY Goon ◽  
KR Vaghela ◽  
AJ Chojnowski
Keyword(s):  
Unusual Case ◽  
Scaphoid Fracture ◽  
Extreme Case ◽  
Proximal Pole ◽  
Compression Screw ◽  
Perilunate Dislocation ◽  
Soft Tissue Attachment ◽  
Serious Injury ◽  
Tissue Attachment ◽  
Early Surgical Intervention

We present an unusual case of a closed perilunate dorsal-dislocation of the carpus, with an associated scaphoid fracture. In this extreme case, the proximal scaphoid pole was extruded volarly and proximally. After closed manipulation, the proximal pole of the scaphoid was further dislocated dorsally, a phenomenon not previously described in the literature. At open reduction this fragment was noted to have no soft tissue attachment but after reduction, distal radius bone graft and compression screw fixation the scaphoid went on to unite with a good functional result. This case highlights a rare but serious injury to the wrist with an unusual dislocation pattern not previously described. It demonstrates that early surgical intervention to fix such fractures with an avascular fragment can still achieve fracture union, despite the severity.

Soft Tissue Attachment of a Filamentous Carbon-Absorbable Polymer Tendon and Ligament Replacement

1981 ◽  
Vol &NA; (160) ◽  
pp. 268???278 ◽  
Author(s):  
JAMES ARAGONA ◽  
JOHN R. PARSONS ◽  
HAROLD ALEXANDER ◽  
ANDREW B. WEISS
Keyword(s):  
Soft Tissue ◽  
Filamentous Carbon ◽  
Ligament Replacement ◽  
Soft Tissue Attachment ◽  
Tissue Attachment

scholarly journals An Unusual Case of Penetrating Ocular Trauma with a Pressure Cooker Whistle

2019 ◽  
Vol 1 (2) ◽  
pp. 29-31
Author(s):  
Dinesh Kumar Thapa ◽  
Shyam Vyas ◽  
Rohit Saiju ◽  
Pravash Rajbhandari ◽  
Basant Pant
Keyword(s):  
Developing Countries ◽  
High Pressure ◽  
Unusual Case ◽  
Ocular Trauma ◽  
Common Cause ◽  
Loss Of Vision ◽  
Serious Injury ◽  
Cooking Utensil ◽  
Penetrating Ocular Trauma

Worldwide blindness in 1.6 million people is due to ocular trauma. Trauma is the most common cause of unilateral loss of vision in developing countries and about 5 % of all bilateral blindness is directly due to trauma. In Nepal, ocular trauma is considered a major cause of unilateral blindness and caused 7.9 % of all blindness in Nepal. It is the second leading cause of blindness after cataract. Pressure cooker is a cooking utensil that works with high pressure and heat, consuming less time and fuel but as seemingly easy, the trouble handling with it could be horrible. It may cause serious injury to someone nearby. Here by, we would like to report a case that could rarely happen in kitchen as a worst accident.

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.

SIMULTANEOUS FRACTURE OF THE WAIST OF THE SCAPHOID AND THE HOOK OF THE HAMATE

Hand Surgery ◽  
2010 ◽  
Vol 15 (03) ◽  
pp. 233-234 ◽  
Author(s):  
Shingo Komura ◽  
Yasushi Suzuki ◽  
Tatsuya Ikehata
Keyword(s):  
Scaphoid Fracture ◽  
The Body ◽  
Bone Union ◽  
Compression Screw ◽  
First Report ◽  
Cast Immobilisation ◽  
Headless Compression Screw

A case of simultaneous fracture of the waist of the scaphoid and the hook of the hamate is presented. The scaphoid fracture was treated surgically with a headless compression screw, while the hook fracture was treated conservatively with cast immobilisation for eight weeks. Both fractures achieved bone union and the patient returned to work without any symptoms or complications. Only two cases of fractures of the scaphoid and hamate have been reported previously. However, both of them involved fracture of the body of the hamate. This is the first report of simultaneous fracture of the scaphoid and the hook of the hamate.

Early results of a new implant: 3.0 mm headless compression screw for scaphoid fracture fixation

2012 ◽  
Vol 37 (7) ◽  
pp. 690-693 ◽  
Author(s):  
K. Singisetti ◽  
E. Aldlyami ◽  
A. Middleton
Keyword(s):  
Internal Fixation ◽  
Fracture Fixation ◽  
Scaphoid Fracture ◽  
Compression Screw ◽  
Headless Compression Screw ◽  
Scaphoid Fractures ◽  
Early Results ◽  
Fracture Nonunions ◽  
Radiological Healing ◽  
Vascularized Bone

There has been a considerable evolution of screws used for internal fixation of scaphoid fractures. We discuss here, early results of a recently introduced implant Synthes 3.0 mm headless compression screw used for scaphoid fracture fixation. Twenty eight patients with scaphoid fractures (five acute and 23 nonunions) were treated with internal fixation by this non-variable pitch screw over a period of 18 months. All nonunions had pedicle vascularized bone grafting. All five patients with acute scaphoid fracture fixation had radiological healing at a mean of 8 weeks. Fifteen of 23 scaphoid fracture nonunions showed definite signs and a further seven showed probable signs of radiological healing at a mean of 8 months. One nonunion has failed to unite after surgery.

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