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David P Green - One of the best experts on this subject based on the ideXlab platform.

  • Compression Screw fixation without bone grafting for scaphoid fibrous nonunion
    HAND, 2015
    Co-Authors: Jeremy S Somerson, Daniel J Fletcher, Ramesh C Srinivasan, David P Green
    Abstract:

    Purpose Bone graft is often recommended as an adjuvant for treatment of scaphoid nonunions. However, recent literature has suggested that fibrous nonunion may be suited to treatment with rigid fixation without bone grafting. This work reported on outcomes of Compression Screw fixation for established scaphoid fibrous nonunions without bone graft. Methods Fourteen patients underwent surgical Compression Screw fixation without bone grafting of scaphoid fibrous nonunion between January 1, 2000, and December 31, 2012, with minimum follow-up until the time of clinical and radiographic healing. Fibrous nonunion of the scaphoid was defined as a scaphoid fracture with all of the following features: (1) persistent tenderness, (2) incomplete trabecular bridging on three X-ray views, (3) injury that had occurred at a minimum of 6 months prior to surgery, and (4) identification of fibrous union at the time of surgery. Outcomes were assessed with range of motion assessment, Disability of the Arm, Shoulder and Hand (DASH) scores, and plain radiographs. Results Twelve of the 14 patients healed successfully, while two patients required secondary vascularized bone grafting. Both unhealed patients sustained proximal pole fractures and had a duration of ≥1 year from injury to surgery. Average time to healing was 4.4 ± 2.0 months. Average flexion was 73 ± 22° and average extension was 66 ± 22° postoperatively. Average grip strength was 90 ± 25 lbs on the operative side. Mean postoperative pain score was 1.4 (range, 0 to 7). Mean postoperative DASH score was 10.2 (range, 0 to 52). Increasing age and an interval from injury to surgery of >1 year correlated with worse DASH and pain scores. Conclusions Patients with fibrous scaphoid nonunion demonstrated good results with rigid fixation without bone grafting. Increasing age and >1-year interval between injury and surgery resulted in lower self-assessed outcomes. Level of Evidence Therapeutic Level IV, retrospective case series

  • Compression Screw fixation without bone grafting for scaphoid fibrous nonunion
    Hand, 2015
    Co-Authors: Jeremy S Somerson, Daniel J Fletcher, Ramesh C Srinivasan, David P Green
    Abstract:

    Purpose Bone graft is often recommended as an adjuvant for treatment of scaphoid nonunions. However, recent literature has suggested that fibrous nonunion may be suited to treatment with rigid fixation without bone grafting. This work reported on outcomes of Compression Screw fixation for established scaphoid fibrous nonunions without bone graft.

Jeremy S Somerson - One of the best experts on this subject based on the ideXlab platform.

  • Compression Screw fixation without bone grafting for scaphoid fibrous nonunion
    HAND, 2015
    Co-Authors: Jeremy S Somerson, Daniel J Fletcher, Ramesh C Srinivasan, David P Green
    Abstract:

    Purpose Bone graft is often recommended as an adjuvant for treatment of scaphoid nonunions. However, recent literature has suggested that fibrous nonunion may be suited to treatment with rigid fixation without bone grafting. This work reported on outcomes of Compression Screw fixation for established scaphoid fibrous nonunions without bone graft. Methods Fourteen patients underwent surgical Compression Screw fixation without bone grafting of scaphoid fibrous nonunion between January 1, 2000, and December 31, 2012, with minimum follow-up until the time of clinical and radiographic healing. Fibrous nonunion of the scaphoid was defined as a scaphoid fracture with all of the following features: (1) persistent tenderness, (2) incomplete trabecular bridging on three X-ray views, (3) injury that had occurred at a minimum of 6 months prior to surgery, and (4) identification of fibrous union at the time of surgery. Outcomes were assessed with range of motion assessment, Disability of the Arm, Shoulder and Hand (DASH) scores, and plain radiographs. Results Twelve of the 14 patients healed successfully, while two patients required secondary vascularized bone grafting. Both unhealed patients sustained proximal pole fractures and had a duration of ≥1 year from injury to surgery. Average time to healing was 4.4 ± 2.0 months. Average flexion was 73 ± 22° and average extension was 66 ± 22° postoperatively. Average grip strength was 90 ± 25 lbs on the operative side. Mean postoperative pain score was 1.4 (range, 0 to 7). Mean postoperative DASH score was 10.2 (range, 0 to 52). Increasing age and an interval from injury to surgery of >1 year correlated with worse DASH and pain scores. Conclusions Patients with fibrous scaphoid nonunion demonstrated good results with rigid fixation without bone grafting. Increasing age and >1-year interval between injury and surgery resulted in lower self-assessed outcomes. Level of Evidence Therapeutic Level IV, retrospective case series

  • Compression Screw fixation without bone grafting for scaphoid fibrous nonunion
    Hand, 2015
    Co-Authors: Jeremy S Somerson, Daniel J Fletcher, Ramesh C Srinivasan, David P Green
    Abstract:

    Purpose Bone graft is often recommended as an adjuvant for treatment of scaphoid nonunions. However, recent literature has suggested that fibrous nonunion may be suited to treatment with rigid fixation without bone grafting. This work reported on outcomes of Compression Screw fixation for established scaphoid fibrous nonunions without bone graft.

Daniel J Fletcher - One of the best experts on this subject based on the ideXlab platform.

  • Compression Screw fixation without bone grafting for scaphoid fibrous nonunion
    HAND, 2015
    Co-Authors: Jeremy S Somerson, Daniel J Fletcher, Ramesh C Srinivasan, David P Green
    Abstract:

    Purpose Bone graft is often recommended as an adjuvant for treatment of scaphoid nonunions. However, recent literature has suggested that fibrous nonunion may be suited to treatment with rigid fixation without bone grafting. This work reported on outcomes of Compression Screw fixation for established scaphoid fibrous nonunions without bone graft. Methods Fourteen patients underwent surgical Compression Screw fixation without bone grafting of scaphoid fibrous nonunion between January 1, 2000, and December 31, 2012, with minimum follow-up until the time of clinical and radiographic healing. Fibrous nonunion of the scaphoid was defined as a scaphoid fracture with all of the following features: (1) persistent tenderness, (2) incomplete trabecular bridging on three X-ray views, (3) injury that had occurred at a minimum of 6 months prior to surgery, and (4) identification of fibrous union at the time of surgery. Outcomes were assessed with range of motion assessment, Disability of the Arm, Shoulder and Hand (DASH) scores, and plain radiographs. Results Twelve of the 14 patients healed successfully, while two patients required secondary vascularized bone grafting. Both unhealed patients sustained proximal pole fractures and had a duration of ≥1 year from injury to surgery. Average time to healing was 4.4 ± 2.0 months. Average flexion was 73 ± 22° and average extension was 66 ± 22° postoperatively. Average grip strength was 90 ± 25 lbs on the operative side. Mean postoperative pain score was 1.4 (range, 0 to 7). Mean postoperative DASH score was 10.2 (range, 0 to 52). Increasing age and an interval from injury to surgery of >1 year correlated with worse DASH and pain scores. Conclusions Patients with fibrous scaphoid nonunion demonstrated good results with rigid fixation without bone grafting. Increasing age and >1-year interval between injury and surgery resulted in lower self-assessed outcomes. Level of Evidence Therapeutic Level IV, retrospective case series

  • Compression Screw fixation without bone grafting for scaphoid fibrous nonunion
    Hand, 2015
    Co-Authors: Jeremy S Somerson, Daniel J Fletcher, Ramesh C Srinivasan, David P Green
    Abstract:

    Purpose Bone graft is often recommended as an adjuvant for treatment of scaphoid nonunions. However, recent literature has suggested that fibrous nonunion may be suited to treatment with rigid fixation without bone grafting. This work reported on outcomes of Compression Screw fixation for established scaphoid fibrous nonunions without bone graft.

Ramesh C Srinivasan - One of the best experts on this subject based on the ideXlab platform.

  • Compression Screw fixation without bone grafting for scaphoid fibrous nonunion
    HAND, 2015
    Co-Authors: Jeremy S Somerson, Daniel J Fletcher, Ramesh C Srinivasan, David P Green
    Abstract:

    Purpose Bone graft is often recommended as an adjuvant for treatment of scaphoid nonunions. However, recent literature has suggested that fibrous nonunion may be suited to treatment with rigid fixation without bone grafting. This work reported on outcomes of Compression Screw fixation for established scaphoid fibrous nonunions without bone graft. Methods Fourteen patients underwent surgical Compression Screw fixation without bone grafting of scaphoid fibrous nonunion between January 1, 2000, and December 31, 2012, with minimum follow-up until the time of clinical and radiographic healing. Fibrous nonunion of the scaphoid was defined as a scaphoid fracture with all of the following features: (1) persistent tenderness, (2) incomplete trabecular bridging on three X-ray views, (3) injury that had occurred at a minimum of 6 months prior to surgery, and (4) identification of fibrous union at the time of surgery. Outcomes were assessed with range of motion assessment, Disability of the Arm, Shoulder and Hand (DASH) scores, and plain radiographs. Results Twelve of the 14 patients healed successfully, while two patients required secondary vascularized bone grafting. Both unhealed patients sustained proximal pole fractures and had a duration of ≥1 year from injury to surgery. Average time to healing was 4.4 ± 2.0 months. Average flexion was 73 ± 22° and average extension was 66 ± 22° postoperatively. Average grip strength was 90 ± 25 lbs on the operative side. Mean postoperative pain score was 1.4 (range, 0 to 7). Mean postoperative DASH score was 10.2 (range, 0 to 52). Increasing age and an interval from injury to surgery of >1 year correlated with worse DASH and pain scores. Conclusions Patients with fibrous scaphoid nonunion demonstrated good results with rigid fixation without bone grafting. Increasing age and >1-year interval between injury and surgery resulted in lower self-assessed outcomes. Level of Evidence Therapeutic Level IV, retrospective case series

  • Compression Screw fixation without bone grafting for scaphoid fibrous nonunion
    Hand, 2015
    Co-Authors: Jeremy S Somerson, Daniel J Fletcher, Ramesh C Srinivasan, David P Green
    Abstract:

    Purpose Bone graft is often recommended as an adjuvant for treatment of scaphoid nonunions. However, recent literature has suggested that fibrous nonunion may be suited to treatment with rigid fixation without bone grafting. This work reported on outcomes of Compression Screw fixation for established scaphoid fibrous nonunions without bone graft.

Philip E Blazar - One of the best experts on this subject based on the ideXlab platform.

  • arthrodesis of the thumb interphalangeal joint and finger distal interphalangeal joints with a headless Compression Screw
    Journal of Hand Surgery (European Volume), 2014
    Co-Authors: Brandon E Earp, Emerson W Floyd, Philip E Blazar
    Abstract:

    PURPOSE: To study the results of using a small, headless Compression Screw (AcuTwist) for thumb interphalangeal (IP) joint and finger distal interphalangeal (DIP) joint arthrodeses. METHODS: Between November 2007 and January 2012, 48 primary arthrodeses of the thumb IP joint or DIP joint in the other digits were performed in 29 consecutive patients with AcuTwist devices. Indications for arthrodesis included 19 cases of osteoarthritis in 25 fingers, 3 cases of lupus in 9 fingers, 2 cases of post-traumatic osteoarthritis in 2 fingers, and 1 case and finger each of acute trauma, neuromuscular disorder, postinfectious osteoarthritis, boutonniere deformity, and Dupuytren contracture. Charts were reviewed for clinical data, and radiographs were assessed for alignment and healing. RESULTS: Age averaged 59 years and follow-up averaged 12 months (range, 2-50 mo). Union occurred in 43 out of 46 fingers (94%). There were no cases of nail deformity, wound complications, tip hypersensitivity, or clinically notable malalignment. Three arthrodeses failed to fuse, including 2 asymptomatic nonunions and 1 fixation loss requiring revision with autograft. The complication rate was 9%. CONCLUSIONS: Distal digital joint arthrodesis with the AcuTwist resulted in a fusion rate of 94% with a complication rate of 9%. Our rate of fusion compares favorably with prior series using other methods of fixation. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.