Nonunion of the scaphoid treated by anterior vascularized bone graft: a review of 26 cases / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the clinical and radiological outcome of anterior vascularized bone graft in the treatment of primitive nonunion of the scaphoid.</p><p><b>METHODS</b>This is a retrospective study of 26 scaphoid nonunion cases treated by this technique between 2004 and 2009. The mean age was 38 years. Nonunion was of types IIA and IIB according to the Alnot's classification and only one case showed a proximal pole necrosis (type IV). The fixation was ensured by K-wire. The mean immobilization period was 9 weeks.</p><p><b>RESULTS</b>At mean 19 months follow-up, the bone union rate was 88.5%. Failure was noted in three cases. No significant complications secondary to this technique were observed. The mobility in extension and flexion had an average recovery of 18 degree Nineteen patients (73%) were free of pain, and the others had occasional pain.</p><p><b>CONCLUSIONS</b>It is a meticulous surgical technique that provides better union rates than those of conventional scaphoid graft. This technique is first adopted in cases of failure of conventional grafts in the treatment of scaphoid nonunion but the encouraging results suggest expanding indications to primitive nonunion.</p>

Upper limb compartment syndrome after an adder bite: a case report / 中华创伤杂志(英文版)

Compartment syndrome after an adder bite is extremely rare, whose effects are only secondary to the cytotoxic and hemorrhagic effects of venom. Here we reported a case of compartment syndrome in the upper limb following an adder bite in the thenar eminence. Elevated compartment pressure was documented and immediate surgical fasciotomy was practiced. The patient achieved complete recovery with a good functional result. We discussed the controversies on fasciotomy and non-invasive measures in such a situation, and recommended intracompartmental pressure monitoring during the management of compartment syndrome following adder bites.

[About a short series of Swanson arthroplasty]

The authors report a series of 12 patients who underwent digital arthroplasty using a Swanson implant. Six patients had the sequellae of an injured hand, and the other six patients had rheumatoid arthritis. The majority of patients were men with an average age of 33 years. The patients were examined again about 4 years later on average. The lateral stability of the operated finger was considered to be satisfactory in 11 cases. The mean movement gain was 40. There was no sign of silicone particle synovitis, because it was fixed arthroplasty