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[Palmarly comminuted scaphoid fractures].

S Löw¹, D Herold

¹Caritas-Krankenhaus, Uhlandstraße 7, 97980, Bad Mergentheim, Deutschland. steffen.loew@ckbm.de

Der Unfallchirurg

|June 19, 2012

Summary

This summary is machine-generated.

Cancellous bone grafting and Herbert screw fixation for acute scaphoid fractures with palmar comminution led to complications. Cortical bone grafting is recommended for palmar defects to improve scaphoid fracture outcomes.

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Area of Science:

Orthopedic Surgery
Traumatology
Hand Surgery

Background:

Acute scaphoid fractures, particularly those with palmar comminution, present treatment challenges.
Herbert screw fixation and cancellous bone grafting are utilized for stabilizing these injuries.

Observation:

Two cases of middle third scaphoid fractures with palmar comminution were treated with cancellous bone graft and Herbert screw fixation.
Despite immobilization, one patient experienced secondary loss of reduction and dislocation.
The second patient developed scaphoid dislocation, dorsiflexed intercalated segment instability, and required hardware removal due to joint irritation.

Findings:

Cancellous bone grafting combined with Herbert screw fixation resulted in suboptimal outcomes in these cases.
Secondary displacement and instability occurred despite initial fixation and immobilization.
Complications included dislocation and the need for hardware removal due to secondary joint irritation.

Implications:

The study suggests limitations of cancellous bone grafting for palmar defects in scaphoid fractures.
Cortical bone grafting from the iliac crest is proposed as a potentially superior alternative for addressing palmar defects.
This recommendation aims to improve stability and reduce complications in scaphoid fracture management.