ABSTRACT
Objective: To explore the effectiveness of ultrasound-guided percutaneous Herbert screw for the treatment of fresh nondisplaced carpal scaphoid fracture. Methods: Between May 2013 and August 2015, 15 patients with fresh nondisplaced carpal scaphoid fractures (Krimmer type A2) were treated with ultrasound-guided Herbert screw fixation. There were 12 males and 3 females with an average age of 33.4 years (range, 18-51 years). The causes of injury included 9 cases of falls, 3 cases of training injuries, and 3 cases of machine injuries. The interval from injury to surgery was 2-15 days (mean, 5 days). No other complication was found. The operation time, intraoperative blood loss, intraoperative fluoroscopy times, and the fracture healing time were recorded. The wrist function was assessed by the modified Mayo wrist score standard. Results: The operation time was 28-53 minutes (mean, 33.9 minutes); the intraoperative blood loss was 5-30 mL (mean, 10.5 mL); the intraoperative fluoroscopy was 2-6 times (mean, 2.6 times). All 15 patients were followed up 6-18 months (mean, 10.5 months). One patient developed pain and soreness in the skin of the nail entrance, and gradually relieved after fumigation. No complication such as infection occurred. All fractures healed clinically, and the healing time was 8-16 weeks (mean, 11.6 weeks). At last follow-up, the modified Mayo wrist score was 76-99 (mean, 92.5). Among them, 12 cases were excellent, 2 cases were good, and 1 case was fair, and the excellent and good rate was 93.3%. Conclusion: Ultrasound-guided fixation with Herbert screw is a reliable treatment method for fresh nondisplaced carpal scaphoid fractures with small invasion, less bleeding, and small radiation damage.
ABSTRACT
14 Cases of delayed and nonunion of the carpal scaphoid fractures who were treated at Department of the Orthopedic Surgery, College of medicine, Kyungpook National University, Taegu, Korea during the period of April, 1984. to March, 1986 were analysed. The results were as follows; l. Of the total 14 cases, there were 13 male and 1 female patients. This result showed marked predominence of right hand (10 cases) over the left and most commonly occured between 21 and 40 of age (11 case). 2. The site of fracture were confined to the middle one third in 12 cases (85.7%), the fracture lines were transverse in 6 cases (42.9%). 3. In 14 cases, union was obtained from 13 cases (92.9%) that were treated with Herbert screw,from 2 cases of delyed union after 2.3 months and from 12 cases of nonunion after 4.3 months. 4. Postoperatve cast immobilization was done for 2 weeks in the cases that were treated with Herbert screw and for 4 weeks in the cases that were treated with Herbert screw and bone graft. 5. The results of treatment were excellent in 7 cases (50%), good in 6 cases (42.9%) and fair in 1 case so that all of 14 patient could treturn to their work.
Subject(s)
Female , Humans , Male , Hand , Immobilization , Korea , Orthopedics , TransplantsABSTRACT
Ten cases of fracture of the carpal scaphoid analysed clinically and treated by admission at Department of Orthopedic Surgery, National Police Hospital during the period of 1975 to 1980. The results were summerized as follows: 1. The mode of the injury were consist of 3 in football game, 2 in judo, 2 in army training and 1 in fallen from height, 1 in slipping down, 1 in direct blow and almost falling down by outstretched hand. 2. Of the 10 cases, there were 9 male and 1 female patients. This result showed marked predominence of male over female patients and most commonly occured between 20 and 29 of age. 3. In 8 cases, the fracture was found on the waist of the carpal scaphoid. 4. Nonunion of the carpal scaphoid were noticed in 8 cases. 5. 2 cases of the recent fracture, there were appeared by rechecking X.-ray after 2 weeks. 6. The good results were obtained by bone graft according to method of Russe.