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Arthroscopic treatment of unstable scaphoid fracture and nonunion with two headless compression screws and distal radius bone graft

BACKGROUND: The treatment of unstable scaphoid fracture and nonunion remains a challenging problem for hand surgeons. Minimally invasive treatment has become the preferred method of treatment. PURPOSE: This study introduces the arthroscopic technique with two headless compression screws (HCS) fixati...

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Autores principales: Cheng, Cong, Jiang, Zongyuan, Sun, Haoran, Hu, Jiaping, Ouyang, Yanggang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9847075/
https://www.ncbi.nlm.nih.gov/pubmed/36653796
http://dx.doi.org/10.1186/s13018-023-03529-7
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author Cheng, Cong
Jiang, Zongyuan
Sun, Haoran
Hu, Jiaping
Ouyang, Yanggang
author_facet Cheng, Cong
Jiang, Zongyuan
Sun, Haoran
Hu, Jiaping
Ouyang, Yanggang
author_sort Cheng, Cong
collection PubMed
description BACKGROUND: The treatment of unstable scaphoid fracture and nonunion remains a challenging problem for hand surgeons. Minimally invasive treatment has become the preferred method of treatment. PURPOSE: This study introduces the arthroscopic technique with two headless compression screws (HCS) fixation and distal radius bone grafting for the treatment of unstable scaphoid fracture and nonunion, aiming to evaluate its clinical and radiological outcomes. METHODS: It was a retrospective study. From January 2019 to February 2021, a total of 23 patients were included in the current study. Among them, 13 patients with unstable scaphoid fracture underwent arthroscopic treatment with two HCS; 10 patients with scaphoid nonunion underwent arthroscopic treatment with two HCS and a distal radius bone graft. The range of motion of the wrist, visual analog scale (VAS), grip strength, the Modified Mayo Wrist Score (MMWS), the Patient-Rated Wrist Evaluation (PRWE) score, and the Disability of the Arm, Shoulder and Hand (DASH) score were collected at preoperatively and the final follow-up. A computed tomography scan of the wrist was performed on each patient to analyze for union and postoperative osteoarthritis during the follow-up period. RESULTS: Significant improvement was only observed in wrist extension. Clinical outcomes including grip strength, VAS pain score, MMWS, PRWE score, and DASH score were significantly improved at the final follow-up. In the subgroup analysis, both patients stabilized with either two HCS or a distal radius bone graft and two HCS have improved clinical outcomes after surgery, respectively. All patients achieved union. No screw fixation failure occurred, and no other postoperative complication was observed in any of the patients. CONCLUSIONS: The arthroscopic technique with two-HCS fixation and distal radius bone grafting is a reliable and effective technique for the treatment of unstable scaphoid fracture and nonunion, providing satisfactory union rates and clinical outcomes.
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spelling pubmed-98470752023-01-19 Arthroscopic treatment of unstable scaphoid fracture and nonunion with two headless compression screws and distal radius bone graft Cheng, Cong Jiang, Zongyuan Sun, Haoran Hu, Jiaping Ouyang, Yanggang J Orthop Surg Res Research Article BACKGROUND: The treatment of unstable scaphoid fracture and nonunion remains a challenging problem for hand surgeons. Minimally invasive treatment has become the preferred method of treatment. PURPOSE: This study introduces the arthroscopic technique with two headless compression screws (HCS) fixation and distal radius bone grafting for the treatment of unstable scaphoid fracture and nonunion, aiming to evaluate its clinical and radiological outcomes. METHODS: It was a retrospective study. From January 2019 to February 2021, a total of 23 patients were included in the current study. Among them, 13 patients with unstable scaphoid fracture underwent arthroscopic treatment with two HCS; 10 patients with scaphoid nonunion underwent arthroscopic treatment with two HCS and a distal radius bone graft. The range of motion of the wrist, visual analog scale (VAS), grip strength, the Modified Mayo Wrist Score (MMWS), the Patient-Rated Wrist Evaluation (PRWE) score, and the Disability of the Arm, Shoulder and Hand (DASH) score were collected at preoperatively and the final follow-up. A computed tomography scan of the wrist was performed on each patient to analyze for union and postoperative osteoarthritis during the follow-up period. RESULTS: Significant improvement was only observed in wrist extension. Clinical outcomes including grip strength, VAS pain score, MMWS, PRWE score, and DASH score were significantly improved at the final follow-up. In the subgroup analysis, both patients stabilized with either two HCS or a distal radius bone graft and two HCS have improved clinical outcomes after surgery, respectively. All patients achieved union. No screw fixation failure occurred, and no other postoperative complication was observed in any of the patients. CONCLUSIONS: The arthroscopic technique with two-HCS fixation and distal radius bone grafting is a reliable and effective technique for the treatment of unstable scaphoid fracture and nonunion, providing satisfactory union rates and clinical outcomes. BioMed Central 2023-01-18 /pmc/articles/PMC9847075/ /pubmed/36653796 http://dx.doi.org/10.1186/s13018-023-03529-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Cheng, Cong
Jiang, Zongyuan
Sun, Haoran
Hu, Jiaping
Ouyang, Yanggang
Arthroscopic treatment of unstable scaphoid fracture and nonunion with two headless compression screws and distal radius bone graft
title Arthroscopic treatment of unstable scaphoid fracture and nonunion with two headless compression screws and distal radius bone graft
title_full Arthroscopic treatment of unstable scaphoid fracture and nonunion with two headless compression screws and distal radius bone graft
title_fullStr Arthroscopic treatment of unstable scaphoid fracture and nonunion with two headless compression screws and distal radius bone graft
title_full_unstemmed Arthroscopic treatment of unstable scaphoid fracture and nonunion with two headless compression screws and distal radius bone graft
title_short Arthroscopic treatment of unstable scaphoid fracture and nonunion with two headless compression screws and distal radius bone graft
title_sort arthroscopic treatment of unstable scaphoid fracture and nonunion with two headless compression screws and distal radius bone graft
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9847075/
https://www.ncbi.nlm.nih.gov/pubmed/36653796
http://dx.doi.org/10.1186/s13018-023-03529-7
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