Traumatic and reconstructive problems of the scaphoid.

J. B. Jupiter, A. Y. Shin, T. E. Trumble, D. L. Fernandez

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

The management of acute scaphoid fractures should be oriented on the concept of fracture stability, ease of reduction, associated ligamentous injury, and risk of impaired blood supply, rather than the direction of the fracture line or location of the fracture within the scaphoid. The lack of predictability of successful fracture union and prognostic discrepancies of historic and contemporary classifications may be related to subtle differences of the internal vascular architecture of each scaphoid. Because the possibility of impaired vascularity is greater with fractures located in the proximal third, stable internal fixation is indicated to provide mechanical stability and fracture surface contact to enhance revascularization. Improved healing rates in a shorter time and earlier rehabilitation with percutaneous techniques of internal fixation have produced a clear shift from classic conservative treatment to internal skeletal fixation. Although the rates of union of well-vascularized nonunions have not been dramatically improved with the use of internal fixation as compared with inlay bone grafting, the restoration of scaphoid anatomy and prevention of malunion and associated carpal collapse with interpositional bone grafting techniques will reduce the risk of osteoarthritis.

Original languageEnglish (US)
Pages (from-to)105-122
Number of pages18
JournalInstructional course lectures
Volume50
StatePublished - 2001
Externally publishedYes

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Bone Transplantation
Inlays
Fracture Fixation
Wrist
Osteoarthritis
Blood Vessels
Anatomy
Rehabilitation
Wounds and Injuries
Conservative Treatment
Direction compound

Cite this

Jupiter, J. B., Shin, A. Y., Trumble, T. E., & Fernandez, D. L. (2001). Traumatic and reconstructive problems of the scaphoid. Instructional course lectures, 50, 105-122.

Traumatic and reconstructive problems of the scaphoid. / Jupiter, J. B.; Shin, A. Y.; Trumble, T. E.; Fernandez, D. L.

In: Instructional course lectures, Vol. 50, 2001, p. 105-122.

Research output: Contribution to journalArticle

Jupiter, JB, Shin, AY, Trumble, TE & Fernandez, DL 2001, 'Traumatic and reconstructive problems of the scaphoid.', Instructional course lectures, vol. 50, pp. 105-122.
Jupiter, J. B. ; Shin, A. Y. ; Trumble, T. E. ; Fernandez, D. L. / Traumatic and reconstructive problems of the scaphoid. In: Instructional course lectures. 2001 ; Vol. 50. pp. 105-122.
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