Current concepts for the treatment of acute scaphoid fractures

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• 作者：A. Arsalan-Werner ; M. Sauerbier…
• 关键词：Scaphoid fracture ; Herbert classification ; Minimally invasive screw fixation ; Cannulated screw ; Scaphoid locking plate ; CT scan
• 刊名：European Journal of Trauma and Emergency Surgery
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：42
• 期：1
• 页码：3-10
• 全文大小：1,414 KB
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• 作者单位：A. Arsalan-Werner (1)
  M. Sauerbier (1)
  I. M. Mehling (1)
  
  1. Department for Plastic, Hand and Reconstructive Surgery, Hand Trauma Center, BG Trauma Center Frankfurt am Main, Academic Hospital Goethe University Frankfurt a. Main, Friedberger Landstrasse 430, 60389, Frankfurt am Main, Germany
  
• 刊物主题：Traumatic Surgery; Surgical Orthopedics; Emergency Medicine; Sports Medicine; Intensive / Critical Care Medicine; Surgery;
• 出版者：Springer Berlin Heidelberg
• ISSN：1863-9941

文摘

Fractures of the scaphoid are common injuries, accounting for approximately 80 % of carpal fractures. Differentiation between stable and unstable fractures (Herbert classification) cannot be made with conventional X-rays, so evaluation by computed tomography should additionally be performed. Under most circumstances, minimally invasive surgery with cannulated screws is the treatment of choice. A longer cast immobilization after minimal-invasive surgery is not necessary. Conservative treatment still has a place if the fracture is not dislocated nor unstable, but operative treatment can be offered to reduce the period of cast immobilization. Displaced fractures have a greater risk for nonunion and therefore should be treated operatively. Proximal pole fractures are definitely unstable, requiring treatment with screw fixation. The surgical approach depends on the location of the fracture and the preference of the surgeon. Keywords Scaphoid fracture Herbert classification Minimally invasive screw fixation Cannulated screw Scaphoid locking plate CT scan