Carpal Fractures -Scaphoid and Other Carpal Fractures-Case - Scaphoid and Carpal Fractures Case Vignette

Case - Scaphoid and Carpal Fractures Case Vignette

Pdf Summary

This document discusses the treatment of scaphoid fractures, specifically focusing on a case of a proximal pole scaphoid fracture nonunion. The patient in the case had a history of punching a wall, which caused the initial injury. The document mentions that an MRI scan was performed several months after the injury, which identified a proximal pole nonunion of the scaphoid fracture.<br /><br />The treatment for this type of nonunion involved a vascularized dorsal capsular graft and the use of a scaphoid and scaphocapitate screw. The document states that 10 out of the 13 nonunions achieved solid bone union, with good results. The mean time to union was 13 weeks.<br /><br />The technique for the vascularized dorsal capsular graft involved a dorsal approach and a longitudinal incision. The flap was elevated to provide exposure to the proximal pole of the scaphoid. The document also mentions the importance of adequately debriding the nonunion site and eradicating any sclerotic bone or cystic erosions.<br /><br />The document includes a summary of important points for the treatment of proximal pole scaphoid fracture nonunions. It advises assessing for post-traumatic changes and arthritis before repair, preserving capsular attachments to prevent devascularization, considering additional screws or plates for rigid fixation, and adhering to general principles of nonunion repair such as debridement, reduction, bone grafting, and stabilization.<br /><br />In summary, this document discusses the treatment of proximal pole scaphoid fracture nonunions, emphasizing the use of a vascularized dorsal capsular graft and the importance of proper assessment and surgical technique.

Keywords

scaphoid fractures

proximal pole scaphoid fracture nonunion

punching a wall

MRI scan

vascularized dorsal capsular graft

scaphoid and scaphocapitate screw

solid bone union

mean time to union

dorsal approach

nonunion repair