Abstract
Purpose
The purpose of this study was to introduce a novel method of percutaneous achievement and maintenance of reduction for acute displaced scaphoid fractures and evaluate the feasibility of this method in treating acute displaced scaphoid fractures as well as explore its indications.
Methods
From February 2012 to March 2014, 15 patients with acute displaced scaphoid fractures were treated with our technique. Two Kirschner wires were used to achieve and maintain the reduction of the scaphoid fractures throughout the entire process of the traditional percutaneous screw fixation process. The following parameters including function scores according to modified Mayo wrist scoring system, range of motion (ROM) of the wrist, grip strength, pinch strength, healing time, time to return to work, and final outcomes were recorded.
Result
All patients were followed up with a mean period of 2.5 years (range, 2–3.5 years). All fractures healed with a mean of 9.3 weeks (range, 7–11.5 weeks). All patients returned to pre-injury level of activity within six weeks. The functional scores averaged 90.3 (range, 80–100). ROM of the wrist was equal to that of the contralateral side at three months postoperatively. Grip strength and pinch strength compared with contralateral were 98% and 92%, respectively. All were satisfied with the final outcomes.
Conclusions
Our technique is successfully performed in acute displaced scaphoid fractures resulting in shortened immobilization and prompt functional recovery. It broadens the indications of the percutaneous method, which means the advantages of the percutaneous method are maximally reserved whilst the drawbacks of open reduction were avoided.
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References
Garcia RM, Ruch DS (2014) Management of scaphoid fractures in the athlete: open and percutaneous fixation. Sports Med Arthrosc 22(1):22–28. https://doi.org/10.1097/JSA.0000000000000008
Bond CD, Shin AY, McBride MT, Dao KD (2001) Percutaneous screw fixation or cast immobilization for nondisplaced scaphoid fractures. J Bone Joint Surg Am 83-A(4):483–488
Grover R (1996) Clinical assessment of scaphoid injuries and the detection of fractures. J Hand Surg (Br) 21(3):341–343
Eddeland A, Eiken O, Hellgren E, Ohlsson NM (1975) Fractures of the scaphoid. Scand J Plast Reconstr Surg 9(3):234–239
Kim WC, Shaffer JW, Idzikowski C (1983) Failure of treatment of ununited fractures of the carpal scaphoid. The role of non-compliance. J Bone Joint Surg Am 65(7):985–991
Herbert TJ, Fisher WE (1984) Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg (Br) 66(1):114–123
Wozasek GE, Moser KD (1991) Percutaneous screw fixation for fractures of the scaphoid. J Bone Joint Surg (Br) 73(1):138–142
Dias JJ, Singh HP (2011) Displaced fracture of the waist of the scaphoid. J Bone Joint Surg (Br) 93(11):1433–1439. https://doi.org/10.1302/0301-620X.93B11.26934
Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney WP 3rd, Linscheid RL (1989) Scaphoid malunion. J Hand Surg [Am] 14(4):679–687
Hove LM (1999) Epidemiology of scaphoid fractures in Bergen, Norway. Scand J Plast Reconstr Surg Hand Surg 33(4):423–426
Arsalan-Werner A, Sauerbier M, Mehling IM (2016) Current concepts for the treatment of acute scaphoid fractures. Eur J Trauma Emerg Surg 42(1):3–10. https://doi.org/10.1007/s00068-015-0587-8
Cooney WP 3rd, Dobyns JH, Linscheid RL (1980) Nonunion of the scaphoid: analysis of the results from bone grafting. J Hand Surg [Am] 5(4):343–354
Dickison J, Shannon J (1944) Fractures of the carpal scaphoid in the Canadian army. Surg Gynecol Obstet 79:225–239
Lozano-Calderon S, Blazar P, Zurakowski D, Lee SG, Ring D (2006) Diagnosis of scaphoid fracture displacement with radiography and computed tomography. J Bone Joint Surg Am 88(12):2695–2703. https://doi.org/10.2106/JBJS.E.01211
Singh HP, Taub N, Dias JJ (2012) Management of displaced fractures of the waist of the scaphoid: meta-analyses of comparative studies. Injury 43(6):933–939. https://doi.org/10.1016/j.injury.2012.02.012
Wallace PF (1963) Fractures of the carpal (wrist) navicular bone. Med Trial Tech Q 10:79–82
Cooney WP, Dobyns JH, Linscheid RL (1980) Fractures of the scaphoid: a rational approach to management. Clin Orthop Relat Res 149:90–97
Clay NR, Dias JJ, Costigan PS, Gregg PJ, Barton NJ (1991) Need the thumb be immobilised in scaphoid fractures? A randomised prospective trial. J Bone Joint Surg (Br) 73(5):828–832
Thomaidis VT (1973) Elbow-wrist-thumb immobilisation in the treatment of fractures of the carpal scaphoid. Acta Orthop Scand 44(6):679–689
Maudsley RH, Chen SC (1972) Screw fixation in the management of the fractured carpal scaphoid. J Bone Joint Surg (Br) 54(3):432–441
Alho A, Kankaanpaa (1975) Management of fractured scaphoid bone. A prospective study of 100 fractures. Acta Orthop Scand 46(5):737–743
Bongers KJ, Ponsen RJ (1980) Operative and nonoperative management of fractures of the carpal scaphoid: five years' experience. Neth J Surg 32(4):142–145
McQueen MM, Gelbke MK, Wakefield A, Will EM, Gaebler C (2008) Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid: a prospective randomised study. J Bone Joint Surg (Br) 90(1):66–71. https://doi.org/10.1302/0301-620X.90B1.19767
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Yu, Y., Cui, H., Yang, X. et al. A novel percutaneous achievement and maintenance of reduction and screw fixation for acute displaced scaphoid fractures: minimum two-year follow-up. International Orthopaedics (SICOT) 42, 1911–1916 (2018). https://doi.org/10.1007/s00264-018-3758-5
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DOI: https://doi.org/10.1007/s00264-018-3758-5