Controversias y buenas prácticas para el manejo de fracturas agudas de escafoides

Controversies and best practices for acute scaphoid fracture management

 
Fuente
Este artículo es originalmente publicado en:
 

https://www.ncbi.nlm.nih.gov/pubmed/29027844

http://journals.sagepub.com/doi/10.1177/1753193417735973

 
De:
 

Suh N1, Grewal R1.

2017 Jan 1:1753193417735973. doi: 10.1177/1753193417735973. [Epub ahead of print]

 
Todos los derechos reservados para:
 

Copyright © 2017 by The British Society for Surgery of the Hand

 
 

Abstract

Acute scaphoid fractures are common wrist injuries that continue to elicit debate from surgeons regarding the most appropriate diagnostic and management algorithms. This review will examine the current literature and trends, in an attempt to provide the reader with an evidence-based discussion regarding current controversies of interest to clinicians. In addition, an attempt will be made to provide recommendations for the best treatment practices for acute scaphoid fractures.

KEYWORDS:

Scaphoid fracture; scaphoid; internal fixation; non-operative treatment; percutaneous fixation

 

Resumen

Las fracturas agudas de escafoides son lesiones comunes en la muñeca que continúan provocando el debate de los cirujanos con respecto a los algoritmos de diagnóstico y manejo más apropiados. Esta revisión examinará la literatura actual y las tendencias, en un intento de proporcionar al lector una discusión basada en la evidencia con respecto a las controversias actuales de interés para los médicos. Además, se intentará proporcionar recomendaciones para las mejores prácticas de tratamiento para las fracturas agudas de escafoides.

PALABRAS CLAVE:

Fractura de escafoides; escafoides; fijación interna; tratamiento no quirúrgico; fijación percutánea
 

PMID:   29027844   DOI:   10.1177/1753193417735973

In vitro investigación experimental de la fuerza y torque que actúa sobre el escafoides durante una compresión ligera

In vitro experimental investigation of the forces and torque acting on the scaphoid during light grasp

Fuente
Este artículo es originalmente publicado en:
http://www.ncbi.nlm.nih.gov/pubmed/26800215
http://onlinelibrary.wiley.com/doi/10.1002/jor.23175/abstract
De:
Erhart J1, Unger E2, Schefzig P1, Krumboeck A3, Hagmann M4, Vecsei V1, Mayr W2.
J Orthop Res. 2016 Jan 22. doi: 10.1002/jor.23175. [Epub ahead of print] Todos los derechos reservados para:
This article is protected by copyright. All rights reserved.
Copyright © 1999-2016 John Wiley & Sons, Inc. All Rights Reserved
 

The aim of this study was to measure the magnitude and direction of forces and torque within osteotomized scaphoids within cadaveric wrists during grasping movement of the hand. The mechanical contributions of clinically relevant individual wrist-crossing tendon groups were investigated. Wrists of 8 forearms were immobilized in the sagittal, transverse and coronal plane on a fixation device with unhindered axial gliding. The scaphoid was osteotomized and the fragments stabilized using an interlocking nail. The nail served as a sensor for measurement of inter-fragmentary forces orthogonal and torque around the sensor axis. Thus, torque and cantilever forces were measured which originated between the fragments through co-contraction through the activity of wrist-crossing tendons. Grasping movement of the hand induced a mean maximum torque of 0.038 ± 0.051Nm and a force of 4.01 ± 1.71N on the scaphoid. The isolated activation of thumb tendons resulted in a torque of 9.9E-3  ± 7.7E-3 Nm and a force of 1.42 ± 0.49N. Despite immobilization of the wrist, grasping movement of the hand caused substantial forces and torque within the osteotomized scaphoid bone in varying directions and severity among different specimens. These factors may contribute to the development of nonunions and malunions in unstable scaphoid fractures through interfragmentary micromotion. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.

KEYWORDS:

biomechanics; grasping movement of the hand; scaphoid; wrist

PMID: 26800215 [PubMed – as supplied by publisher]

 

Polo Proximal de las fracturas de escafoides : Una evaluación de tomografía computarizada de los Resultados

Proximal Pole Scaphoid Fractures: A Computed Tomographic Assessment of Outcomes

 
Fuente
Este artículo es originalmente publicado en:
http://www.ncbi.nlm.nih.gov/pubmed/26710735
http://www.jhandsurg.org/article/S0363-5023(15)01367-2/abstract
De:
Grewal R1, Lutz K2, MacDermid JC3, Suh N2.
J Hand Surg Am. 2016 Jan;41(1):54-8. doi: 10.1016/j.jhsa.2015.10.013.
Todos los derechos reservados para:
Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Abstract

PURPOSE:

To report on union rates and times for a cohort of acute nondisplaced or minimally displaced proximal pole fractures evaluated with serial computed tomography (CT) scans.

CONCLUSIONS:

The reported union incidence and union times in this study compared favorably with the literature. Risk factors that were associated with a significantly greater time to union included fracture comminution, the presence of cysts, and fracture translation. Our sample size was relatively small, and other limitations inherent in the retrospective design must be considered.

 
 
Resumen
PROPÓSITO:
Para informar sobre índices y tiempos de unión para una cohorte de fracturas no desplazadas  o proximales mínimamente desplazadas proximales del polo evaluadas con una serie de tomografías computarizadas(TC).
CONCLUSIONES:
La incidencia de unión y el tiempo de union reportados en este estudio se compararon favorablemente con la literatura. Los factores de riesgo que se asociaron con un tiempo significativamente mayor a la unión incluyen conminución de la fractura, la presencia de quistes, y la traslación de la fractura. Nuestro tamaño de la muestra era relativamente pequeño, y otras limitaciones inherentes al diseño retrospectivo debe ser considerado.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Prognostic IV.
Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Computed tomography; outcomes; proximal pole; scaphoid fracture; union

PMID: 26710735 [PubMed – in process]

 

Las fracturas del escafoides probablemente más prevalentes que se pensaba

Fuente
Este artículo es originalmente publicado en:
http://www.healio.com/orthopedics/hand-wrist/news/online/%7Bba55a6aa-46ca-43de-a4ae-31e08f697b9f%7D/scaphoid-fractures-likely-more-prevalent-than-previously-thought?utm_source=maestro&utm_medium=email&utm_campaign=orthopedics%20news
De:

Reference:

Dy CJ, et al. Paper #8. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 10-12, 2015; Seattle.

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