Journal of Wrist Surgery最新文献_第10页

The Medial Triquetrohamate Portal: A New Portal in Wrist Arthroscopy. Anatomical Study. 腕部关节镜下的一种新门静脉。解剖研究

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-07-28 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1771439

Francisco J Lucas, Vicente Carratalá, Ignacio Miranda, Sergio Pombo Alonso

{"title":"The Medial Triquetrohamate Portal: A New Portal in Wrist Arthroscopy. Anatomical Study.","authors":"Francisco J Lucas, Vicente Carratalá, Ignacio Miranda, Sergio Pombo Alonso","doi":"10.1055/s-0043-1771439","DOIUrl":"10.1055/s-0043-1771439","url":null,"abstract":"Introduction Continuing advances in wrist arthroscopy and better understanding of carpal conditions have created the need to design new wrist access portals that facilitate the implementation of new surgical techniques. The aim of this study was to define and verify the safety of the medial triquetrohamate (MTH) portal. Description of the technique The MTH portal is located about 5-10 mm ulnar and 2-3 mm distal to the midcarpal ulnar portal, ulnar to the extensor digitorum communis (EDC) tendon of the fourth and fifth fingers, and radial to the extensor digiti quinti (minimi) (EDQ) tendon. Methods An anatomical study was performed on 15 upper limb specimens from 15 human cadavers. Iatrogenic injuries to potentially at-risk neurovascular and tendinous structures were assessed, and the distance from the portal to these structures was measured. Results There were no iatrogenic injuries to the structures at risk. Mean distances from the MTH portal to the EDC tendon of the fourth and fifth fingers and to the EDQ tendon were 4.67 ± 0.35 mm and 7.27 ± 0.18 mm, respectively. No differences were observed between the left and right wrists. The distance from the MTH portal to the dorsal sensory branch of the ulnar nerve was 15.07 ± 0.44 mm. The structure with the highest risk of injury was the EDC tendon of the fourth and fifth fingers, with a distance of less than 5 mm. Conclusions The MTH portal is safe, reproducible and facilitates the implementation of various techniques related to midcarpal pathology.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43087287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Hook Test Is Not Pathognomonic for Foveal Detachment of the Triangular Fibrocartilage. 钩试验并非三角纤维软骨窝脱离的先兆。

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-07-24 eCollection Date: 2024-02-01 DOI: 10.1055/s-0043-1770077

Jeff Ecker, Karolina Pavleski, Courtney Andrijich

{"title":"The Hook Test Is Not Pathognomonic for Foveal Detachment of the Triangular Fibrocartilage.","authors":"Jeff Ecker, Karolina Pavleski, Courtney Andrijich","doi":"10.1055/s-0043-1770077","DOIUrl":"10.1055/s-0043-1770077","url":null,"abstract":"Background The integrity of the foveal insertion of the triangular fibrocartilage complex (TFCC) is currently assessed by inference using the hook test. Using dry arthroscopic techniques, the primary author observed that many patients with painful distal radioulnar joint (DRUJ) instability and a positive hook test had an intact foveal insertion. This study was performed to determine whether a positive hook test is a reliable index of a tear of the foveal insertion. Technique The hook test is performed using a probe to elevate the TFCC off the ulna head toward the articular surface of the lunate. In this study, the hook test was considered positive if the TFCC could be elevated to bridge more than 80% of the space between the TFCC and the articular surface of the lunate. Patients and Methods A retrospective study was performed using the medical records and arthroscopic videos of 113 patients who had clinical signs of DRUJ instability and underwent arthroscopic surgery performed by the primary author in 2020. It was documented whether the hook test was positive or negative, whether the foveal insertion was intact, abnormal or absent, and whether there were peripheral (dorsal or volar) tears of the TFCC. Sensitivity and specificity were calculated using arthroscopic findings as the reference standard. Results The sensitivity of the hook test was found to be 100%, and the specificity was 7.0%. The positive predictive value for foveal pathology was found to be 12.3% and the negative predictive value 100%. The diagnostic accuracy of the hook test in determining the presence of foveal tears was found to be 17.7%. The diagnostic accuracy of the hook test in determining the presence of a TFCC abnormality was 99.1%. Conclusions A positive hook test is indicative of a tear of the TFCC, but it is not anatomically specific for a tear of the foveal insertion. To reliably assess the foveal insertion, it must be visualized and probed using dry arthroscopic techniques.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10803151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57981349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trapeziectomy versus Maïa Prosthesis in Trapeziometacarpal Osteoarthritis. 斜方肌切除术与Maïa假体治疗斜方肌掌骨关节炎

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-07-13 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1770793

Christian M Windhofer, Johann Neureiter, Josef Schauer, Georg Zimmermann, Christoph Hirnsperger

{"title":"Trapeziectomy versus Maïa Prosthesis in Trapeziometacarpal Osteoarthritis.","authors":"Christian M Windhofer, Johann Neureiter, Josef Schauer, Georg Zimmermann, Christoph Hirnsperger","doi":"10.1055/s-0043-1770793","DOIUrl":"10.1055/s-0043-1770793","url":null,"abstract":"Background Osteoarthritis at the base of the thumb is the most frequent osteoarthritis of the hand. Trapeziectomy in a broad variety of surgical methods have been proposed to achieve pain reduction and improvement of thumb function. A well-known disadvantage is the long recovery time. Arthroplasty of the thumb carpometacarpal joint is a competing new method for this indication with different revision and complication rates reported. Purposes The aim of this study is to assess whether there are significant differences in outcome during the first 12 months and time return to work after either, implant of a Maïa joint prosthesis, or trapeziectomy with tendon interposition after Weilby. Patients and Methods This clinical follow-up study compares the efficacy of total basal joint replacement using the Maïa prosthesis with tendon interposition arthroplasty in 59 thumbs. Clinical, functional, and radiological results at preoperative, 3-, 6-, and 12-month postoperative are presented. Results We found a significant shorter return to work in the prosthesis group with 4.5 compared with 8.6 weeks. In addition to a significant difference in pain reduction with a better Mayo wrist score in the Maïa group after 3 months. The scores are closer after 6 months and nearly match after 12 months. Measurement of the pinch grip showed a parallel course. A radiological loosening of the cup in two patients was detected after 12 months. Conclusion Implantation of Maïa prosthesis enables a significant shorter recovery but is associated with the risk of loosening and higher costs. Level of Evidence Level IV, case-control study.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48611842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trajectory of Recovery following ORIF for Distal Radius Fractures. 桡骨远端骨折ORIF术后的康复轨迹

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-07-13 eCollection Date: 2024-06-01 DOI: 10.1055/s-0043-1771045

Gabriel Larose, Darren M Roffey, Henry M Broekhuyse, Pierre Guy, Peter O'Brien, Kelly A Lefaivre

{"title":"Trajectory of Recovery following ORIF for Distal Radius Fractures.","authors":"Gabriel Larose, Darren M Roffey, Henry M Broekhuyse, Pierre Guy, Peter O'Brien, Kelly A Lefaivre","doi":"10.1055/s-0043-1771045","DOIUrl":"10.1055/s-0043-1771045","url":null,"abstract":"Background Distal radius fractures are commonly seen among the elderly, though studies examining their long-term outcomes are limited. Purpose The aim of this study was to describe the 5-year trajectory of recovery of distal radius fractures treated with open reduction and internal fixation (ORIF). Methods Patients with distal radius fractures (AO/OTA 23.A-C) treated by ORIF were prospectively studied. Patient-Rated Wrist Evaluation (PRWE) score was measured at baseline (preinjury recall) and postoperatively at 6 months, 1 year, and 5 years. Clinically relevant change in PRWE score was assessed using the minimal clinically important difference (MCID). Results A total of 390 patients were included, of which 75% completed 5-year follow-up. Mean baseline PRWE score was 1.25 (standard deviation, SD: 2.9). At 6 months, mean PRWE score was at its highest up to 20.2 (SD: 18.4; p < 0.01). A significant improvement in mean PRWE score was observed at 1 year down to 15.2 (SD: 17.6; p < 0.01); 44% of patients were still one MCID outside of their baseline PRWE score at 1 year. Further significant improvement in mean PRWE score occurred at 5 years down to 9.4 (SD: 13.4; p < 0.01); 29% of patients remained one MCID outside of their baseline PRWE score at 5 years. Conclusion Recovery after ORIF for distal radius fractures showed significant worsening after surgery, followed by significant improvements up to 1 year and between years 1 and 5, albeit to a lesser extent. Statistically and clinically relevant wrist pain and disability persisted at 5 years. Future research should examine different treatment modalities and include a nonoperative treatment arm for comparison. Level of Evidence Prognostic level II.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41676897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Radially Displaced Perilunate Injuries: A Report of Two Cases. 桡骨移位性月周损伤2例报告

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-07-05 eCollection Date: 2024-02-01 DOI: 10.1055/s-0043-1770952

Sathya Vamsi Krishna, Diego L Fernandez

引用次数: 0

Arthroscopic Resection Arthroplasty for Scapholunate Advanced Collapse Wrist. 关节镜下关节切除术治疗舟月骨晚期塌陷腕关节

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-07-05 eCollection Date: 2023-12-01 DOI: 10.1055/s-0043-1768927

Tyson Cobb, Collin Chase, Jessica Cobb

{"title":"Arthroscopic Resection Arthroplasty for Scapholunate Advanced Collapse Wrist.","authors":"Tyson Cobb, Collin Chase, Jessica Cobb","doi":"10.1055/s-0043-1768927","DOIUrl":"10.1055/s-0043-1768927","url":null,"abstract":"Purpose Scapholunate advanced collapse (SLAC) wrist results from an untreated scapholunate dissociation and is the most common type of degenerative arthritis of the wrist. The most common surgical treatments for SLAC wrist are proximal row carpectomy and four-corner fusion with scaphoid excision. Arthroscopic surgical treatment for SLAC wrist has been reported; however, only limited data on functional outcomes are available. The purpose of this study is to report our 5-year follow-up clinical outcomes for arthroscopic treatment for SLAC wrist. Methods Thirty-one consecutive cases of arthroscopic resection arthroplasty for SLAC wrist were reviewed. Preoperative and postoperative Disabilities of the Arm, Shoulder, and Hand (DASH) scores, range of motion, grip strength, and pain (on 0-10 scale) as well as postoperative satisfaction (0 = not satisfied, 5 = completely satisfied) were recorded. Grip and range of motion were measured by an occupational therapist. Results The preoperative pain score was 7 and 0.18 postoperatively. The mean satisfaction at final follow-up was 4.8. Preoperative and final follow-up scores of the mean DASH was 48 and 3, respectively. The total arc of motion was 114 degrees preoperatively and 126.5 degrees postoperatively. Mean grip strength before surgery was 41 and 49 kg at final follow-up. Conclusion Arthroscopic resection arthroplasty for SLAC wrist results in significant improvement in patient function as measured by DASH and pain scores. Type of Study/Level of Evidence Therapeutic IV.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10781571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46730625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rehabilitation after Distal Radius Fractures: Opportunities for Improvement. 桡骨远端骨折后的康复：改善的机会。

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-07-05 eCollection Date: 2023-10-01 DOI: 10.1055/s-0043-1769925

Henriëtte A W Meijer, Miryam C Obdeijn, Justin van Loon, Stein B M van den Heuvel, Lianne C van den Brink, Marlies P Schijven, J Carel Goslings, Tim Schepers

{"title":"Rehabilitation after Distal Radius Fractures: Opportunities for Improvement.","authors":"Henriëtte A W Meijer, Miryam C Obdeijn, Justin van Loon, Stein B M van den Heuvel, Lianne C van den Brink, Marlies P Schijven, J Carel Goslings, Tim Schepers","doi":"10.1055/s-0043-1769925","DOIUrl":"10.1055/s-0043-1769925","url":null,"abstract":"Background Exercises are frequently prescribed to regain function; yet there is no consensus on a standardized protocol, and adherence is low. Smart technology innovations, such as mobile applications, may be useful to provide home-based patient support in rehabilitation after distal radius fractures. Purposes Our purpose was to establish the potential of digital innovations for support and monitoring of patients and treatment adherence in rehabilitation programs, and additionally, to compare the current practice among physiotherapists to the various wrist exercise regimens and their effectiveness as described in the literature. Methods Standard practice, including the use of support tools for treatment adherence, was evaluated using a nationwide survey. Then, scientific databases were searched using \"distal radius fracture\" and \"physiotherapy\" or \"exercise therapy,\" and related search terms, up until 23 March 2023. Results of the survey and literature review were compared. Results The survey was completed by 92 therapists. Nonstandardized support tools were used by 81.6% of respondents; 53.2% used some form of technology, including taking photos on the patients' smartphone for home reference. In the literature review, 23 studies were included, of which five described an exercise protocol. Treatment adherence was not reported in any of the included studies. Two studies described the use of smart technology or support tools. Conclusions There is no consensus on a standardized exercise protocol for rehabilitation after distal radius fractures, neither from a systematic literature search nor from a nationwide survey. Smart technology may facilitate monitoring of patients and exercise adherence, hereby supporting self-efficacy and improving adherence and outcomes.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metacarpophalangeal Joint Arthroscopy: Indications and Techniques through a Clinical Series. 指骨间关节关节镜检查：临床系列的适应症和技术

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-07-03 eCollection Date: 2024-06-01 DOI: 10.1055/s-0043-1770785

Miguel Tovar-Bazaga, María Pérez-Cuesta Llaneras, Alejandro Badia

{"title":"Metacarpophalangeal Joint Arthroscopy: Indications and Techniques through a Clinical Series.","authors":"Miguel Tovar-Bazaga, María Pérez-Cuesta Llaneras, Alejandro Badia","doi":"10.1055/s-0043-1770785","DOIUrl":"10.1055/s-0043-1770785","url":null,"abstract":"Background Metacarpophalangeal (MCP) joint arthroscopy has been available for many years but sparingly used in typical orthopaedic and hand surgery daily practice. Difficult problems are solved with this technique in a practical and minimally invasive manner. This study describes our diverse experience and broad clinical applications of MCP arthroscopy as well as clinical results. It aims to highlight this technique as one of the tools for a fully trained hand surgeon, avoiding open management and its high complications rates. Methods We present a retrospective clinical series of 79 patients treated with MCP arthroscopy with a mean age of 44 years old. Demographics, surgery, and clinical outcomes were collected in standardized clinical assessments. Results We divided the sample into 20 articular metacarpal or proximal phalanx acute fracture with full functional fist and range of motion at 60 days after surgery. Regarding collateral tears, 12 were classified as acute and 47 as chronic. Two patients were reoperated for further gain range of motion. Conclusions We present an up-to-date publication of our experience in MCP arthroscopy and its applications, with a low complication rate and excellent clinical results. We encourage hand surgeons to incorporate this technique in MCP joint challenging issues. Level of Evidence IV.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43695471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridge Plate Distraction for Complex Distal Radius Fractures: A Cohort Study and Systematic Review of the Literature. 复杂桡骨远端骨折的桥钢板牵引:队列研究和文献系统回顾

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-06-28 eCollection Date: 2024-06-01 DOI: 10.1055/s-0043-1770791

George P Esworthy, Vibha Shaji, Liron Duraku, Feiran Wu, Dominic M Power

{"title":"Bridge Plate Distraction for Complex Distal Radius Fractures: A Cohort Study and Systematic Review of the Literature.","authors":"George P Esworthy, Vibha Shaji, Liron Duraku, Feiran Wu, Dominic M Power","doi":"10.1055/s-0043-1770791","DOIUrl":"10.1055/s-0043-1770791","url":null,"abstract":"Background Dorsal bridge plating (DP) of the distal radius is used as a definitive method of stabilization in complex fracture configurations and polytrauma patients. Questions/Purposes This review aims to summarize the current understanding of DP and evaluate surgical outcomes. Methods Four databases were searched following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and registered with PROSPERO. Papers presenting outcome or complication data for DP were included. These were reviewed using the National Institutes of Health Quality Assessment and Methodological Index for Non-Randomised Studies tools. Results were collated and compared to a local cohort of DP patients. Results Literature review identified 416 patients with a pooled complication rate of 17% requiring additional intervention. The most prevalent complications were infection/wound healing issues, arthrosis, and hardware failure. Average range of motion was flexion 46.5 degrees, extension 50.7 degrees, ulnar deviation 21.4 degrees, radial deviation 17.3 degrees, pronation 75.8 degrees, and supination 72.9 degrees. On average, DP removal occurred at 3.8 months. Quality assessment showed varied results. There were 19 cases in our local cohort. Ten displayed similar results to the systematic review in terms of range of motion and radiographic parameters. Higher QuickDASH scores and complication rates were noted. Local DP showed earlier plate removal at 2.9 months compared to previous studies. Conclusion DP is a valid and useful technique for treating complex distal radius fractures. It displays a lower risk of infection and pain compared to external fixation which is commonly used to treat similar injuries. Patients can recover well following treatment both in function and range of motion. Further high-quality studies are required to fully evaluate the technique.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44319454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Comparison of Rib Osteochondral Graft to Medial Femoral Trochlear Osteocartilaginous Graft for the Salvage of the Fragmented Scaphoid Proximal Pole: A Single-Center Experience with Minimum 2-Year Follow-Up 肋骨骨软骨移植与股骨内侧趾骨骨软骨移植在挽救肩胛骨近端骨折中的比较：随访至少两年的单中心经验

IF 0.7

Journal of Wrist Surgery Pub Date : 2023-06-20 DOI: 10.1055/s-0043-1777734

Stephen Butler, John Galbraith, Eugene T. H. Ek, Anthony C Berger, David McCombe, S. Tham

{"title":"A Comparison of Rib Osteochondral Graft to Medial Femoral Trochlear Osteocartilaginous Graft for the Salvage of the Fragmented Scaphoid Proximal Pole: A Single-Center Experience with Minimum 2-Year Follow-Up","authors":"Stephen Butler, John Galbraith, Eugene T. H. Ek, Anthony C Berger, David McCombe, S. Tham","doi":"10.1055/s-0043-1777734","DOIUrl":"https://doi.org/10.1055/s-0043-1777734","url":null,"abstract":"Abstract Purpose Fragmented fractures of the proximal pole of the scaphoid that cannot be internally fixed may be salvaged by four-corner arthrodesis or proximal row carpectomy. Replacement of the proximal scaphoid with costal-osteochondral graft (COG) or the medial femoral trochlea (MFT) graft are two alternative solutions for this clinical presentation. The purpose of this study was to compare the clinical and radiographic results of the COG and the MFT graft with a minimum 2-year follow-up from a single centre. Methods A retrospective study was performed to investigate the outcome of COG and MFT with a minimum 2 year follow up. Demographic data and clinical assessment including wrist range of motion and grip strength measurements and Oxford Knee score were collected. Patients completed the outcome measures of Disabilities of Arm, Shoulder, and Hand (DASH), the Patient-Rated Wrist Evaluation (PRWE), and a ten-point visual analogue score for pain (VAS). Radiological examination was performed on all wrists at follow-up. Results The visual analogue score, DASH and PRWE were similar between the two groups. There was radiographic evidence of arthritis between the radial styloid and distal scaphoid in all patients that underwent COG but no evidence in those that underwent MFT graft reconstruction. There were different complications in each group. Thirty percent of patients that underwent MFT reconstruction had persistent knee pain at follow up. Conclusion Though there are notable differences in the follow-up period, patients undergoing MFT risk developing knee pain, while those undergoing COG risk radiographic progression of wrist arthritis. Level of Evidence III – Comparative study","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139369264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0