A review of scaphoid fracture, treatment outcomes, and consequences

被引:1
|
作者
Almigdad, Ahmad [1 ]
Al-Zoubi, Ahmad [1 ]
Mustafa, Ayman [1 ]
Al-Qasaimeh, Motaz [1 ]
Azzam, Ehab [1 ]
Mestarihi, Saab [1 ]
Khair, Yousef [1 ]
Almanasier, Ghandi [1 ]
机构
[1] King Hussein Med City, Dept Hand & Upper Limb Surg, Dept Orthoped, King Abdullah II St, Amman 230, Jordan
关键词
Scaphoid; Nonunion; Carpal bone; Fracture; Graft; Jordan; PROXIMAL ROW CARPECTOMY; VASCULARIZED BONE-GRAFT; MEAN FOLLOW-UP; 4-CORNER ARTHRODESIS; CAST IMMOBILIZATION; SCREW FIXATION; NONUNION; WRIST; POLE; UNION;
D O I
10.1007/s00264-023-06014-2
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
PurposeScaphoid fractures are the most common carpal fracture and can lead to severe complications like carpal collapse and osteoarthritis. This study reviewed scaphoid fracture patterns, outcomes, and consequences in conservative and surgical management.MethodsSixty-four patients with scaphoid fracture who attended the hand clinic at King Hussein Medical City from January 2022 to December 2022 were included and reviewed regarding the anatomical fracture site, the associated injury, the treatment modality (conservative versus surgical), the healing time, and fracture sequelae such as nonunion and scaphoid nonunion advanced collapse.ResultsMost patients were males (62 patients, 96.9%), and most (47, 73.4%) fell within 25 to 40 years. Scaphoid waist fracture was the most common location (40, 52.5%). Most patients (47, 73.4%) received conservative treatment and 17 (26.6%) were fixed acutely. However, nonunion complicated 53 fractures (82.8%).Notably, there were no differences in the union rate or time between cases of scaphoid nonunion treated with vascularized or nonvascularized grafts. Furthermore, there were no variations in union rates among genders, extremities, age, fracture locations, or among smokers. However, a higher union rate was noted in office workers and those who received conservative treatment.ResultsMost patients were males (62 patients, 96.9%), and most (47, 73.4%) fell within 25 to 40 years. Scaphoid waist fracture was the most common location (40, 52.5%). Most patients (47, 73.4%) received conservative treatment and 17 (26.6%) were fixed acutely. However, nonunion complicated 53 fractures (82.8%).Notably, there were no differences in the union rate or time between cases of scaphoid nonunion treated with vascularized or nonvascularized grafts. Furthermore, there were no variations in union rates among genders, extremities, age, fracture locations, or among smokers. However, a higher union rate was noted in office workers and those who received conservative treatment.ConclusionNonunions were higher in our study than in the literature, as our department is a referral center for established nonunion cases. For conservative treatment, we recommend aggressive management and follow-up with a clinical and CT scan at three months and early referral of non-united fractures to the hand clinic to avoid the advanced collapse of the scaphoid.
引用
收藏
页码:529 / 536
页数:8
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