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Scaphoid nonunions treated with 2 headless compression screws and bone grafting.
Garcia, Ryan M; Leversedge, Fraser J; Aldridge, J Mack; Richard, Marc J; Ruch, David S.
Afiliación
  • Garcia RM; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; Triangle Orthopedic Associates, Durham, NC.
  • Leversedge FJ; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; Triangle Orthopedic Associates, Durham, NC.
  • Aldridge JM; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; Triangle Orthopedic Associates, Durham, NC.
  • Richard MJ; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; Triangle Orthopedic Associates, Durham, NC.
  • Ruch DS; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; Triangle Orthopedic Associates, Durham, NC. Electronic address: d.ruch@dm.duke.edu.
J Hand Surg Am ; 39(7): 1301-7, 2014 Jul.
Article en En | MEDLINE | ID: mdl-24793227
PURPOSE: To evaluate union and complication rates associated with the use of 2 headless compression screws and bone grafting for the treatment of scaphoid nonunions. METHODS: A total of 19 patients (18 male and 1 female) at an average age of 21 years were treated with open reduction and internal fixation with 2 cannulated, headless, compression screws for scaphoid nonunions. Bone grafting techniques included corticocancellous autograft from the iliac crest in 14 patients, capsular-based vascularized distal radius graft in 3, and medial femoral condyle free vascularized bone graft in 2. Patients were treated an average 19 months after the injury. Fracture nonunions were at the waist (n = 12), proximal third (n = 5), or distal third (n = 2) of the scaphoid. Dorsal (n = 7) and volar (n = 12) surgical approaches were used. RESULTS: All fractures had clinical and radiographic evidence of bone union at an average of 3.6 months. Postoperative computed tomography scans were available in 13 patients and showed union without evidence of screw penetration of the scaphoid cortex. No complications occurred in this series, and no revision procedures have been necessary. CONCLUSIONS: Our results indicate that the use of 2 headless compression screws for the treatment of scaphoid nonunions is safe and effective. A variety of bone grafting techniques can be used with this technique. The use of 2 compression screws may provide superior biomechanical stability and ultimately improve outcomes measured with future long-term comparative studies. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tornillos Óseos / Trasplante Óseo / Hueso Escafoides / Fijación Interna de Fracturas / Fracturas no Consolidadas Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: J Hand Surg Am Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tornillos Óseos / Trasplante Óseo / Hueso Escafoides / Fijación Interna de Fracturas / Fracturas no Consolidadas Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: J Hand Surg Am Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos