ABSTRACT
We conducted a prospective randomised study comparing the clinical, functional and radiographic results of 46 patients treated for scaphoid nonunion using a vascularised bone graft from the dorsal and distal aspect of the radius (group I), relative to 40 patients treated by means of a conventional non-vascularised bone graft from the distal radius (group II). Surgical findings included 30 sclerotic, poorly-vascularised scaphoids in group I versus 20 in group II. Bone fusion was achieved in 89.1% of group I and 72.5% of group II patients (p=0.024). Functional results were good to excellent in 72.0% of the patients in group I and 57.5% in group II. Considering only patients with sclerotic, poorly-vascularised scaphoids, the mean final outcome scores obtained were 7.5 and 6.0 for groups I and group II, respectively. We conclude that vascularised bone grafting yields superior results and is more efficient when there is a sclerotic, poorly-vascularised proximal pole in patients in scaphoid nonunion.
Subject(s)
Bone Transplantation/methods , Fractures, Ununited/surgery , Scaphoid Bone/surgery , Wrist Injuries/surgery , Activities of Daily Living , Fracture Healing , Fractures, Ununited/physiopathology , Hand Strength/physiology , Humans , Patient Satisfaction , Prostheses and Implants , Radius/blood supply , Radius/surgery , Radius/transplantation , Range of Motion, Articular , Recovery of Function , Scaphoid Bone/injuries , Scaphoid Bone/pathology , Treatment Outcome , Wrist Injuries/pathology , Wrist Injuries/physiopathologyABSTRACT
Relata-se um raro caso de osteomielite aguda do escafóide em punho esquerdo, por Staphylococcus aureus, em homem de 53 anos de idade, paraplégico, sem causa inicial aparente. O tratamento realizado foi baseado em antibioticoterapia venosa específica e drenagem cirúrgica, com bom resultado funcional após seis meses.
The authors report a rare case of acute osteomyelitis of the scaphoid bone in the left wrist, due to Staphylococcus aureus, in a 53 year-old paraplegic man without an apparent initial cause. The treatment used was based in specific venous therapy with antibiotics and surgical draining, with good functional result after six months.
Subject(s)
Humans , Female , Middle Aged , Bone Diseases, Infectious , Osteomyelitis , Scaphoid Bone/pathology , Carpal Bones/pathologyABSTRACT
Se reporta un caso de Osteoma Osteoide del escafoide y del ganchoso en el carpo derecho de un mismo paciente. Se revisa la literatura nacional y extranjera más completa a nuestro alcance, encontrándose que el Osteoma Osteoide ha sido reportada en casi todos los huesos con excepción del cráneo, esternón y clavícula, pero sí constituyen una rareza esta asociación en dos huesos del carpo en un paciente de 54 años de edad.(AU)