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Scaphoid implant resection arthroplasty. Long-term results
The Journal of Arthroplasty
|January 1, 1986
Summary
Silicone scaphoid implants effectively treat advanced scaphoid disease, reducing pain and improving hand function. Careful surgical technique and a new classification system minimize complications like cystic changes and implant rotation.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Biomaterials Science
Background:
- Advanced scaphoid disease often leads to arthritic changes, necessitating surgical intervention.
- Simple resection arthroplasty has limitations in managing severe scaphoid pathology.
- Silicone scaphoid implants were introduced in 1967 to enhance treatment outcomes.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of silicone scaphoid implants.
- To develop a classification system for scaphoid disease severity.
- To establish treatment recommendations based on disease stage.
Main Methods:
- Retrospective review of 55 patients undergoing scaphoid implant surgery since 1967.
- Analysis of preoperative/postoperative roentgenograms, clinical charts, and surgical pathology.
- Development of a staging system for scaphoid disease and associated carpal bone changes.
Main Results:
- No implant infections or fractures were reported in the 55 cases.
- Two cases experienced implant rotation; functional use and pain reduction were generally observed.
- Cystic changes in adjacent carpal bones varied, with 37 wrists showing no evidence.
Conclusions:
- Silicone scaphoid implants can be successfully used for scaphoid pathology management.
- Early detection and treatment of carpal instability are crucial.
- Adherence to established treatment protocols, including avoiding oversized implants and Kirschner wire fixation, minimizes complications.