Update to Management of Acute Scaphoid Fractures.
J Am Acad Orthop Surg
; 31(15): e550-e560, 2023 Aug 01.
Article
en En
| MEDLINE
| ID: mdl-37332224
ABSTRACT
The scaphoid is the most commonly fractured carpal bone. With high clinical suspicion and negative radiographs, expedient evaluation by CT or MRI has been recommended. When treating nondisplaced or minimally displaced scaphoid waist and distal pole fractures, immobilization below the elbow without inclusion of the thumb is an option. Comparatively, early surgical intervention for nondisplaced or minimally displaced scaphoid waist fractures allows for quicker return of function, but with increased risk of surgical complications and no long-term outcomes differences compared with cast immobilization. For most patients with such fractures, consideration for aggressive conservative treatment involving 6 weeks of immobilization with CT assessment to guide the need for continued casting, surgical intervention, or mobilization is advocated. Determination of union is best done with a CT scan at 6 weeks and at least 50% continuous trabecular bridging across the fracture site deemed sufficient to begin mobilization. Nonsurgical and surgical management of scaphoid fractures requires a thorough understanding of fracture location, fracture characteristics, and patient-specific factors to provide the best healing opportunity of this notoriously difficult fracture and return the patient to full function.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Traumatismos de la Muñeca
/
Hueso Escafoides
/
Fracturas Óseas
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Traumatismos de la Mano
Límite:
Humans
Idioma:
En
Año:
2023
Tipo del documento:
Article