Posterior Percutaneous Screw Fixation to Treat Vertebral Fracture Non-union in Diffuse Idiopathic Skeletal Hyperostosis

Abstract Background Most of the acute scaphoid fractures have been treated nonoperatively in a cast or by open surgery. Percutaneous screw fixation was introduced for acute scaphoid fractures through K-wire-assisted reduction and maintenance, and the effectiveness of the methods was evaluated. Methods From January 2015 to December 2018, a total of 20 patients were recruited to the study and 10 patients were randomly allocated to the open reduction and percutaneous groups respectively. Different groups received open reduction and internal fixation or percutaneous screw fixation. Function outcomes including the range of motion and grip strength were assessed according to the modified Mayo wrist scoring system. Results Final follow-up examination was performed on an average of 12 months after surgery. No immediate postoperative complication occurred. All patients achieved solid union as confirmed by CT scans. A significant increase in the functional recovery of the injured wrist in the percutaneous group than they were in the open reduction group. Conclusions Our novel percutaneous screw fixation method is beneficial to minimise injury to the blood supply of the scaphoid. Primary percutaneous screw fixation for acute scaphoid fractures is a superior method with reduced time to bony union, early return to daily activity or employment and predictably lessened complications of wrist stiffness, diminished grip strength, delayed union, non-union and osteonecrosis.

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Percutaneous screw fixation for painful non-union of lateral malleolus ankle fractures

Injury ◽

10.1016/j.injury.2018.08.010 ◽

2018 ◽

Vol 49 (10) ◽

pp. 1936-1941

Author(s):

Timothy J. Batten ◽

Charlotte Scott-Davies ◽

Michael Butler ◽

Stephen W. Parsons ◽

Richard P. Walter

Keyword(s):

Screw Fixation ◽

Lateral Malleolus ◽

Ankle Fractures ◽

Percutaneous Screw Fixation ◽

Non Union

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A Prospective Study of Acute Undisplaced and Minimally Displaced Scaphoid Fractures Managed by Aggressive Conservative Approach

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835518500029 ◽

2018 ◽

Vol 23 (01) ◽

pp. 18-25 ◽

Cited By ~ 4

Author(s):

Anil K. Bhat ◽

Ashwath M. Acharya ◽

S Manoh ◽

Vinay Kamble

Keyword(s):

Ct Scan ◽

Screw Fixation ◽

Delayed Union ◽

Fracture Site ◽

Percutaneous Fixation ◽

Percutaneous Screw Fixation ◽

Non Union ◽

Scaphoid Fractures ◽

One Year ◽

A Prospective Study

Background: To identify acute un-displaced and minimally displaced scaphoid fractures which are unlikely to unite with non-operative treatment at six weeks with CT scan and stabilize them with percutaneous screw fixation with the aim of preventing non-union. Methods: A scaphoid series radiographs of wrist were obtained for patients with undisplaced or minimally displaced fractures and were immobilized in a thumb spica cast for six weeks. At six weeks, CT scan was done for patients showing doubtful signs of clinical and radiographic union. Patients with a gap less than 2 mm were continued on cast for an additional two to four weeks. Those with gap more than 2 mm underwent percutaneous screw fixation. In both cases the immobilisation was discontinued when the fracture was considered to be united and mobilization was initiated. Results: 21 out of 39 patients managed initially with cast for six weeks showed clinical and radiological evidence of union. 18 patients showed persistent tenderness of which eight showed a clear gap in radiographs and 10 patients had doubtful union. Eight of these 10 patients on CT scan showed fracture gap of more than 2 mm while two patients showed fracture gap of less than 2 mm. Hence, 16 patients underwent percutaneous fixation. Repeat radiographs showed progression to union at an average of 3.8 weeks from surgery. Remaining two eventually united on continuing the cast. All patients showed confirmed union at one year on follow up. Conclusions: An objective measurement of fracture gap by CT scan at six weeks is useful in predicting cases with tendency for delayed union. Early percutaneous fixation of fractures would not further jeopardize the blood supply of fracture site. This aggressive conservative management also avoids unnecessary surgery in all acute scaphoid fractures.

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Retrograde percutaneous screw fixation for scaphoid type II non-union in Schernberg zones 2 to 4: A series of 38 cases

Chirurgie de la Main ◽

10.1016/j.main.2014.10.150 ◽

2015 ◽

Vol 34 (1) ◽

pp. 32-38 ◽

Cited By ~ 2

Author(s):

C. Taleb ◽

F. Bodin ◽

S. Collon ◽

A. Gay ◽

S. Facca ◽

...

Keyword(s):

Screw Fixation ◽

Type Ii ◽

Percutaneous Screw Fixation ◽

Non Union

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Corrigendum to ‘3D - Navigated percutaneous screw fixation of pelvic ring injuries - a pilot study’ [Injury 51S3 (2020) S28 – S33]

Injury ◽

10.1016/j.injury.2021.02.011 ◽

2021 ◽

Author(s):

Michela Florio ◽

Luigi Capasso ◽

Alessandro Olivi ◽

Carla Vitiello ◽

Antonio Leone ◽

...

Keyword(s):

Pilot Study ◽

Screw Fixation ◽

Pelvic Ring ◽

Percutaneous Screw Fixation ◽

Pelvic Ring Injuries

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Thoracic spondylotic myelopathy presumably caused by diffuse idiopathic skeletal hyperostosis in a patient who underwent decompression and percutaneous pedicle screw fixation

SAGE Open Medical Case Reports ◽

10.1177/2050313x20987796 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2098779

Author(s):

Shota Miyoshi ◽

Tadao Morino ◽

Haruhiko Takeda ◽

Hiroshi Nakata ◽

Masayuki Hino ◽

...

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Diffuse Idiopathic Skeletal Hyperostosis ◽

Pedicle Screw Fixation ◽

Vertebral Bone ◽

Bone Bridge ◽

Percutaneous Pedicle Screw ◽

Bilateral Lower Limb ◽

Upper Thoracic ◽

Percutaneous Pedicle Screw Fixation

A 74-year-old man developed bilateral lower limb spastic paresis. He was diagnosed with thoracic spondylotic myelopathy presumably caused by mechanical stress that was generated in the intervertebral space (T1-T2) between a vertebral bone bridge (C5-T1) due to diffuse idiopathic skeletal hyperostosis after anterior fixation of the lower cervical spine and a vertebral bone bridge (T2-T7) due to diffuse idiopathic skeletal hyperostosis in the upper thoracic spine. Treatment included posterior decompression (T1-T2 laminectomy) and percutaneous pedicle screw fixation at the C7-T4 level. Six months after surgery, the patient could walk with a cane, and the vertebral bodies T1-T2 were bridged without bone grafting. For thoracic spondylotic myelopathy associated with diffuse idiopathic skeletal hyperostosis, decompression and percutaneous pedicle screw fixation are effective therapies.

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