Non-Union of the Scaphoid. Treatment with Cannulated Screws Compared with Treatment with Herbert Screws* by THOMAS E. TRUMBLE, TODD CLARKE, and HANS J.

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Presentation transcript:

Non-Union of the Scaphoid. Treatment with Cannulated Screws Compared with Treatment with Herbert Screws* by THOMAS E. TRUMBLE, TODD CLARKE, and HANS J. KREDER J Bone Joint Surg Am Volume 78(12): December 1, 1996 ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1 The displacement of the fracture, or the fracture gap, was measured on plain radiographs as the greatest distance between the proximal and distal poles of the scaphoid (arrows). THOMAS E. TRUMBLE et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Figs. 2-A, 2-B, and 2-C: A collapsed scaphoid. THOMAS E. TRUMBLE et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2B: Anteroposterior radiograph demonstrating a decrease in the posteroanterior intrascaphoid angle to 30 degrees. THOMAS E. TRUMBLE et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2C: Lateral radiograph demonstrating non-union of the scaphoid that resulted in a dorsal intercalated segmental instability pattern with a scapholunate angle of 70 degrees. THOMAS E. TRUMBLE et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3-A and 3-B: Radiographs of a wrist that had fixation with a cannulated screw. THOMAS E. TRUMBLE et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-B: Lateral radiograph showing that the cannulated screw was located in the central one- third of the proximal pole of the scaphoid (arrows and dotted lines). THOMAS E. TRUMBLE et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4 Posteroanterior radiograph showing peripheral placement of a Herbert screw, which was associated with a prolonged time to union (eleven months). THOMAS E. TRUMBLE et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 5 Radiograph showing a cannulated screw over the central guide-wire, which is placed first to ensure that the screw can be passed into the optimum axis of the scaphoid (outlined by dotted line). THOMAS E. TRUMBLE et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.