A simple technique for screw fixation of the carpal scaphoid in cases of delayed union and non-union is described. The results obtained in 32 patients treated by this method are reported. The average follow-up was three years ranging from 10 months to 12 years. Union was obtained in 28 patients. The causes of failure to unite are discussed and the advantages of the reported method over other te...

introduction: intramedullary nailing (imn) of high tibia fracture has some mechanical and biological advantages over the other form of fixation. however, valgus, apex anterior malalignment and anterior displacement of proximal fragment commonly occur after isolated imn fixation of proximal high tibia fracture. the purpose of this study is to determine the effectiveness of using 3.5-mm locking c...

An overview about current concepts in treating carpal injuries is presented. These injuries are more commonly seen in young, active individuals after a fall on an outstretched hand. Conventional radiographs and a thorough examination are important. The scaphoid is the most affected bone. Scaphoid fractures can be classified in accordance to OTA, AO, and other classification systems, but mostly ...

We randomly allocated 60 consecutive patients with fractures of the waist of the scaphoid to percutaneous fixation with a cannulated Acutrak screw or immobilisation in a cast. The range of movement, the grip and pinch strength, the modified Green/O'Brien functional score, return to work and sports, and radiological evidence of union were evaluated at each follow-up visit. Patients were followed...

Functional limitations and pain are end results of scaphoid nonunion with progressive carpal collapse and radiocarpal arthritis. The aim of this study was to assess the functional outcome of four-corner arthrodesis with scaphoidectomy for the treatment of grade IV scaphoid nonunion with Scaphoid Nonunion Advanced Collapse (SNAC) stages II and III. Ten patients with symptomatic grade IV non unio...

Acute fractures of the scaphoid were randomly allocated for conservative treatment in a Colles'-type plaster cast with the wrist immobilised in either 20 degrees flexion or 20 degrees extension. The position of the wrist did not influence the rate of union of the fracture (89%) but when reviewed after six months the wrists which had been immobilised in flexion had a greater restriction of exten...

In the past ten to fifteen years, investigators have demonstrated conclusively that some injuries about the wrist have profound long-term consequences relative to function of the wrist. Problem fractures and non-unions of the scaphoid have been associated, in particular~ with major alterations in the kinematics of the wrist8’64. Considering its vulnerable blood supply~-4, irregular shape, pecul...

Non-union of fractures of the scaphoid bone usually results from failure to recognise or adequately to treat a fresh fracture. It is important to differentiate delayed union from established non-union. In the former, even if a year has elapsed since fracture, and even if the radiograph shows a wide cystic fracture line with or without avascular changes in the proximal fragment, union is still p...