جستجوی مقالات مرتبط با کلیدواژه « scaphoid bone » در نشریات گروه « پزشکی »

This study aimed to compare the outcomes of fixing scapholunate with pins and screws in parallel,convergent, and divergent orientations.

In this computer simulation study, the CT scan images of a healthy subject wereused to construct a 3D model of the wrist joint using MIMICS software. The imposed force to scaphoid and3D model lunate bones, as well as the scapholunate angle and distance, were compared in different surgicaltechniques using parallel, divergent, and convergent pins and screws.

In the absence of external force, the imposed stress applied to the scaphoid and lunate bones in casesof parallel pins and screws were 7.5MPa, 5.08MPa (pins), 1.134MPa, and 1.151MPa (screws), and 10.90MPa,10.90MPa (pins), 9.7MPa, and 34.1MPa (screws) for 50N flexion force. The imposed stress in this approach issignificantly lower compared to other interventions. Better outcomes were seen regarding scapholunate angleand scapholunate distance in using parallel pins or screws as well.

In conclusion, implementing parallel pins and screws for scapholunate fixation had better resultsin terms of achieving carpal stability in scapholunate dissociation. However, fixation with pins and screwsshowed a statistically significant difference. Furthermore, a wide range of motion exercises with no additionalforces can be used in the rehabilitation of patients undergoing this surgery.

Scaphoid fracture can cause serious complications and its diagnosis and treatment approaches are still contentious. Tenderness of anatomical snuffbox (ASB), longitudinal compression (LC) of the thumb, and scaphoid tubercle (ST) tenderness are very sensitive tests for clinical diagnosis of scaphoid factures all together. Previous studies recommend taking four standard views of the wrist for non-displaced scaphoid fractures diagnosis. Magnetic resonance imaging (MRI), computed tomography scan (CT scan), bone scintigraphy, and ultrasound are used for triage of suspected scaphoid fractures. MRI has the highest sensitivity and specificity. CT scan images captured in planes by the long axis of the scaphoid guide the diagnosis of nondisplaced scaphoid fracture. Displaced fractures need surgical treatment, but the best way of treating a nondisplaced fracture is controversial. Same results have been determined using a short arm or long arm cast for treatment of nondisplaced scaphoid fractures as well as similar outcomes with or without a thumb-spica component to the cast. Wrist position immobilization did not affect the rate of nonunion, wrist flexion, pain, or grip strength. Percutaneous screw fixation can shorten return to work time. CT scan and MRI both can be applied for assessment of union of fracture during follow-up period. This study aims to review the literature on challenges about clinical and radiologic diagnosis of nondisplaced scaphoid fractures and also present concepts about definite management of nondisplaced and minimally-displaced scaphoid waist fractures.