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Percutaneous Fixation without Bone Graft for Scaphoid Nonunion
Objective To describe the clinical and radiographic outcomes of patients submitted to percutaneous fixation without bone graft for scaphoid nonunion, with a minimum follow-up of six months. Methods A case series study of a convenience sample of hand surgeons with prospective evaluation. Patients w...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Thieme Revinter Publicações Ltda.
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748942/ https://www.ncbi.nlm.nih.gov/pubmed/33364656 http://dx.doi.org/10.1055/s-0040-1712492 |
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author | Belloti, João Carlos Vasconcelos, Klebson Bruno Lopes Raduan Neto, Jorge Okamura, Aldo Fernandes, Marcela de Moraes, Vinícius Ynoe |
author_facet | Belloti, João Carlos Vasconcelos, Klebson Bruno Lopes Raduan Neto, Jorge Okamura, Aldo Fernandes, Marcela de Moraes, Vinícius Ynoe |
author_sort | Belloti, João Carlos |
collection | PubMed |
description | Objective To describe the clinical and radiographic outcomes of patients submitted to percutaneous fixation without bone graft for scaphoid nonunion, with a minimum follow-up of six months. Methods A case series study of a convenience sample of hand surgeons with prospective evaluation. Patients with scaphoid (waist or proximal pole) nonunion and the following features were included: more than six months of history; X-rays showing sclerosis of the edges of the nonunion, with resorption of the nonunion focus measuring less than 4 mm (Slade & Gleissler I, II, III and IV) and no angular deformity; and no proximal pole necrosis on magnetic resonance imaging (MRI). Results After six months of follow-up, all nonunion were consolidated, with no major complications. The functional outcomes revealed good scores on the disabilities of the arm, shoulder and hand (DASH; n = 12; mean: 6.9; standard deviation [SD]: 2.1) and patient-rated wrist evaluation (PRWE; n = 12; mean: 7.97, SD: 1.5) questionnaires. The results of the visual analog scale (VAS) showed little residual pain (n = 12; mean: 0.71; SD: 0.2). Slight decreases in flexion (69 versus 59.1; p = 0.007), extension (62.4 versus 48.7; p = 0.001) and radial deviation (29.6 versus 24.6; p = 0.014) were detected in comparison to the contralateral side. Conclusions All cases in the series presented consolidation and good functional scores at the six-month evaluation. This is a promising option (with lower technical demand and morbidity) for the treatment of scaphoid nonunion. Comparative studies are required to assess the effectiveness of this technique in comparison with other options. |
format | Online Article Text |
id | pubmed-7748942 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Thieme Revinter Publicações Ltda. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77489422020-12-22 Percutaneous Fixation without Bone Graft for Scaphoid Nonunion Belloti, João Carlos Vasconcelos, Klebson Bruno Lopes Raduan Neto, Jorge Okamura, Aldo Fernandes, Marcela de Moraes, Vinícius Ynoe Rev Bras Ortop (Sao Paulo) Objective To describe the clinical and radiographic outcomes of patients submitted to percutaneous fixation without bone graft for scaphoid nonunion, with a minimum follow-up of six months. Methods A case series study of a convenience sample of hand surgeons with prospective evaluation. Patients with scaphoid (waist or proximal pole) nonunion and the following features were included: more than six months of history; X-rays showing sclerosis of the edges of the nonunion, with resorption of the nonunion focus measuring less than 4 mm (Slade & Gleissler I, II, III and IV) and no angular deformity; and no proximal pole necrosis on magnetic resonance imaging (MRI). Results After six months of follow-up, all nonunion were consolidated, with no major complications. The functional outcomes revealed good scores on the disabilities of the arm, shoulder and hand (DASH; n = 12; mean: 6.9; standard deviation [SD]: 2.1) and patient-rated wrist evaluation (PRWE; n = 12; mean: 7.97, SD: 1.5) questionnaires. The results of the visual analog scale (VAS) showed little residual pain (n = 12; mean: 0.71; SD: 0.2). Slight decreases in flexion (69 versus 59.1; p = 0.007), extension (62.4 versus 48.7; p = 0.001) and radial deviation (29.6 versus 24.6; p = 0.014) were detected in comparison to the contralateral side. Conclusions All cases in the series presented consolidation and good functional scores at the six-month evaluation. This is a promising option (with lower technical demand and morbidity) for the treatment of scaphoid nonunion. Comparative studies are required to assess the effectiveness of this technique in comparison with other options. Thieme Revinter Publicações Ltda. 2020-12 2020-09-24 /pmc/articles/PMC7748942/ /pubmed/33364656 http://dx.doi.org/10.1055/s-0040-1712492 Text en Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Belloti, João Carlos Vasconcelos, Klebson Bruno Lopes Raduan Neto, Jorge Okamura, Aldo Fernandes, Marcela de Moraes, Vinícius Ynoe Percutaneous Fixation without Bone Graft for Scaphoid Nonunion |
title |
Percutaneous Fixation without Bone Graft for Scaphoid Nonunion
|
title_full |
Percutaneous Fixation without Bone Graft for Scaphoid Nonunion
|
title_fullStr |
Percutaneous Fixation without Bone Graft for Scaphoid Nonunion
|
title_full_unstemmed |
Percutaneous Fixation without Bone Graft for Scaphoid Nonunion
|
title_short |
Percutaneous Fixation without Bone Graft for Scaphoid Nonunion
|
title_sort | percutaneous fixation without bone graft for scaphoid nonunion |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748942/ https://www.ncbi.nlm.nih.gov/pubmed/33364656 http://dx.doi.org/10.1055/s-0040-1712492 |
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