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J. Field - One of the best experts on this subject based on the ideXlab platform.
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Scaphoid Bone BRUISE – PROBABLY NOT THE PRECURSOR OF ASYMPTOMATIC NONUNION OF THE Scaphoid.
2008Co-Authors: N. La Hei, I. Mcfadyen, M. Brock, J. FieldAbstract:Magnetic Resonance Imaging (MRI) is gaining popularity for the evaluation of acute wrist injuries, but findings may be confusing with uncertain clinical significance. The presence of Bone marrow oedema but no fracture following trauma has been described in the knee and referred to as a Bone bruise. The clinical implications of similar findings in the Scaphoid have not been described. This study aims to describe the clinical and radiological findings of an acute wrist injury known as the Scaphoid Bone bruise. An MRI classification is proposed, and the outcome described. Between April 2000 and October 2004 all patients who underwent MRI scanning following an acute injury for suspected Scaphoid fracture were considered for this study. The Scaphoid Bone bruise was treated with a degree of caution and the injured limb placed in a below elbow cast for six weeks. Review was arranged at three months when, if symptomatic, a further MRI was performed. A descriptive grading system depending on the extent of the Bone bruise was developed. 41 patients were included in the study. At three months 26 were asymptomatic. Seven defaulted from follow-up. Eight patients were still symptomatic and underwent further MRI scan. The Bone bruise was classified into four grades according to the degree of oedema found on MRI. Seven patients were grade 1, 18 patients were grade 2, 11 grade 3, and the remaining five grade 4. Of the eight patients who underwent repeat MRI scanning all showed improvement of the Bone bruise. At six months only 2 patients remained symptomatic. While healing around the knee is seldom a problem, the possibility that Scaphoid Bone bruise may be a precursor to Scaphoid non-union needs to be excluded. This study suggests that Scaphoid Bone bruise is a benign injury with predictable recovery over time and is unlikely to result in long-term morbidity in the form of non-union. It may be feasible to mobilise these injuries much sooner. However, further study with longer follow-up and repeat MRI scans is necessary to be confident that caution about these injuries is unnecessary.
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Scaphoid Bone bruising - : Probably not the precursor of asymptomatic non-union of the Scaphoid
The Journal of hand surgery European volume, 2007Co-Authors: N. La Hei, I. Mcfadyen, M. Brock, J. FieldAbstract:The MRI finding of Bone marrow oedema, without fracture, following trauma to the Scaphoid has been called a 'Bone bruise'. A similar injury is found in the knee, considered benign and managed conservatively. In the Scaphoid, there is the concern that this lesion may lead to Scaphoid non-union. This study addresses that concern. The clinical and radiological findings of 41 patients with a Scaphoid Bone bruise on MRI are described, an MRI classification system proposed and clinical outcomes investigated. Patients were immobilised for 6 weeks. At 3 months, 8 remained symptomatic and had repeat MRI. Four of these showed complete resolution of the bruise, the others improvement. At 6 months, 2 of the 8 complained of minor, intermittent discomfort but progressed to resolution of symptoms. This study suggests that the Scaphoid Bone bruise is a benign injury with predictable recovery and is unlikely to result in long-term morbidity in the form of non-union.
M.h. Wetherill - One of the best experts on this subject based on the ideXlab platform.
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HOW SHOULD Scaphoid Bone BRUISING BE MANAGED
2012Co-Authors: Dushan Thavarajah, T.a. Syed, M.h. WetherillAbstract:Bone bruising of the Scaphoid is a common term reported, when MRI imaging is carried out for continued pain, within the anatomical snuff box. Is this significant? Our aim was to ascertain if Bone bruising lead to continued symptoms, and resulted in delayed fracture detection- an occult fracture. This was a prospective study looking at 170 patients with Scaphoid injuries. Of the 170 Scaphoid injuries identified there were 120 Scaphoid fractures seen on Scaphoid view radiographs. The remaining 50 had no fracture on radiographs, however were clinically symptomatic and had MRI Scaphoid imaging which demonstrated various grades of Bone bruising. All were treated in a Scaphoid plaster and re-examined at 8 weeks. There 4 were patients that remained symptomatic, MRI scan were performed which revealed 3 with resolving Scaphoid Bone bruising and 1 with a Scaphoid fracture (p-value=0.05). Two further weeks of immobilisation resolved the symptoms of those 4 patients. Therefore occult Scaphoid fractures demonstrating only Bone bruising may take up to 8 weeks to declare itself as a fracture. Immobilisation in a Scaphoid cast should be the mainstay of treatment for a minimum period of 8 weeks.
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Does Scaphoid Bone bruising lead to occult fracture? A prospective study of 50 patients.
Injury, 2011Co-Authors: Dushan Thavarajah, T.a. Syed, Yousef Shah, M.h. WetherillAbstract:Abstract Introduction Bone bruising of the Scaphoid is a term reported when magnetic resonance imaging (MRI) is carried out for Scaphoid injury. The aim of our study was twofold: to see if Bone bruising alone without fracture of the Scaphoid Bone seen on initial MRI, in a clinically symptomatic (tender) patient at 10–14 days, progressed to fracture, and to define how this entity of Bone bruising should be managed. Methods This was a prospective study looking at 170 patients with Scaphoid injuries, of which 50 had Bone bruising without fracture. These were followed up for at least 8 weeks to ascertain whether or not they had developed a fracture. They were assessed for continuity or resolution of their symptoms by way of clinical examination and/or a further MRI and X-ray (Scaphoid views). Results Of the 170 Scaphoid injuries identified, there were 120 Scaphoid fractures seen on Scaphoid view radiographs. The remaining 50 were clinically symptomatic and had MRI Scaphoid imaging, which demonstrated various grades of Bone bruising. All were treated in a Scaphoid plaster, and re-examined at 8 weeks. There were four patients who remained symptomatic, for whom MRI scans were performed, which revealed all four with resolving Scaphoid Bone bruising, and one with a Scaphoid fracture (p value = 0.0386). Incidentally, 2 further weeks of immobilisation resolved the symptoms of those four patients. The one patient with a fracture was offered further treatment for the risk of progressing to a nonunion. Conclusion Bone bruising detected on MRI without fracture is an important entity, and can lead to occult fracture (2%). It can take anywhere up to 8 weeks to declare. Treatment for Bone bruising should be with a Scaphoid cast and follow-up X-ray.
N. La Hei - One of the best experts on this subject based on the ideXlab platform.
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Scaphoid Bone BRUISE – PROBABLY NOT THE PRECURSOR OF ASYMPTOMATIC NONUNION OF THE Scaphoid.
2008Co-Authors: N. La Hei, I. Mcfadyen, M. Brock, J. FieldAbstract:Magnetic Resonance Imaging (MRI) is gaining popularity for the evaluation of acute wrist injuries, but findings may be confusing with uncertain clinical significance. The presence of Bone marrow oedema but no fracture following trauma has been described in the knee and referred to as a Bone bruise. The clinical implications of similar findings in the Scaphoid have not been described. This study aims to describe the clinical and radiological findings of an acute wrist injury known as the Scaphoid Bone bruise. An MRI classification is proposed, and the outcome described. Between April 2000 and October 2004 all patients who underwent MRI scanning following an acute injury for suspected Scaphoid fracture were considered for this study. The Scaphoid Bone bruise was treated with a degree of caution and the injured limb placed in a below elbow cast for six weeks. Review was arranged at three months when, if symptomatic, a further MRI was performed. A descriptive grading system depending on the extent of the Bone bruise was developed. 41 patients were included in the study. At three months 26 were asymptomatic. Seven defaulted from follow-up. Eight patients were still symptomatic and underwent further MRI scan. The Bone bruise was classified into four grades according to the degree of oedema found on MRI. Seven patients were grade 1, 18 patients were grade 2, 11 grade 3, and the remaining five grade 4. Of the eight patients who underwent repeat MRI scanning all showed improvement of the Bone bruise. At six months only 2 patients remained symptomatic. While healing around the knee is seldom a problem, the possibility that Scaphoid Bone bruise may be a precursor to Scaphoid non-union needs to be excluded. This study suggests that Scaphoid Bone bruise is a benign injury with predictable recovery over time and is unlikely to result in long-term morbidity in the form of non-union. It may be feasible to mobilise these injuries much sooner. However, further study with longer follow-up and repeat MRI scans is necessary to be confident that caution about these injuries is unnecessary.
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Scaphoid Bone bruising - : Probably not the precursor of asymptomatic non-union of the Scaphoid
The Journal of hand surgery European volume, 2007Co-Authors: N. La Hei, I. Mcfadyen, M. Brock, J. FieldAbstract:The MRI finding of Bone marrow oedema, without fracture, following trauma to the Scaphoid has been called a 'Bone bruise'. A similar injury is found in the knee, considered benign and managed conservatively. In the Scaphoid, there is the concern that this lesion may lead to Scaphoid non-union. This study addresses that concern. The clinical and radiological findings of 41 patients with a Scaphoid Bone bruise on MRI are described, an MRI classification system proposed and clinical outcomes investigated. Patients were immobilised for 6 weeks. At 3 months, 8 remained symptomatic and had repeat MRI. Four of these showed complete resolution of the bruise, the others improvement. At 6 months, 2 of the 8 complained of minor, intermittent discomfort but progressed to resolution of symptoms. This study suggests that the Scaphoid Bone bruise is a benign injury with predictable recovery and is unlikely to result in long-term morbidity in the form of non-union.
Dushan Thavarajah - One of the best experts on this subject based on the ideXlab platform.
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HOW SHOULD Scaphoid Bone BRUISING BE MANAGED
2012Co-Authors: Dushan Thavarajah, T.a. Syed, M.h. WetherillAbstract:Bone bruising of the Scaphoid is a common term reported, when MRI imaging is carried out for continued pain, within the anatomical snuff box. Is this significant? Our aim was to ascertain if Bone bruising lead to continued symptoms, and resulted in delayed fracture detection- an occult fracture. This was a prospective study looking at 170 patients with Scaphoid injuries. Of the 170 Scaphoid injuries identified there were 120 Scaphoid fractures seen on Scaphoid view radiographs. The remaining 50 had no fracture on radiographs, however were clinically symptomatic and had MRI Scaphoid imaging which demonstrated various grades of Bone bruising. All were treated in a Scaphoid plaster and re-examined at 8 weeks. There 4 were patients that remained symptomatic, MRI scan were performed which revealed 3 with resolving Scaphoid Bone bruising and 1 with a Scaphoid fracture (p-value=0.05). Two further weeks of immobilisation resolved the symptoms of those 4 patients. Therefore occult Scaphoid fractures demonstrating only Bone bruising may take up to 8 weeks to declare itself as a fracture. Immobilisation in a Scaphoid cast should be the mainstay of treatment for a minimum period of 8 weeks.
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Does Scaphoid Bone bruising lead to occult fracture? A prospective study of 50 patients.
Injury, 2011Co-Authors: Dushan Thavarajah, T.a. Syed, Yousef Shah, M.h. WetherillAbstract:Abstract Introduction Bone bruising of the Scaphoid is a term reported when magnetic resonance imaging (MRI) is carried out for Scaphoid injury. The aim of our study was twofold: to see if Bone bruising alone without fracture of the Scaphoid Bone seen on initial MRI, in a clinically symptomatic (tender) patient at 10–14 days, progressed to fracture, and to define how this entity of Bone bruising should be managed. Methods This was a prospective study looking at 170 patients with Scaphoid injuries, of which 50 had Bone bruising without fracture. These were followed up for at least 8 weeks to ascertain whether or not they had developed a fracture. They were assessed for continuity or resolution of their symptoms by way of clinical examination and/or a further MRI and X-ray (Scaphoid views). Results Of the 170 Scaphoid injuries identified, there were 120 Scaphoid fractures seen on Scaphoid view radiographs. The remaining 50 were clinically symptomatic and had MRI Scaphoid imaging, which demonstrated various grades of Bone bruising. All were treated in a Scaphoid plaster, and re-examined at 8 weeks. There were four patients who remained symptomatic, for whom MRI scans were performed, which revealed all four with resolving Scaphoid Bone bruising, and one with a Scaphoid fracture (p value = 0.0386). Incidentally, 2 further weeks of immobilisation resolved the symptoms of those four patients. The one patient with a fracture was offered further treatment for the risk of progressing to a nonunion. Conclusion Bone bruising detected on MRI without fracture is an important entity, and can lead to occult fracture (2%). It can take anywhere up to 8 weeks to declare. Treatment for Bone bruising should be with a Scaphoid cast and follow-up X-ray.
R H Vickers - One of the best experts on this subject based on the ideXlab platform.
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smoking increases failure rate of operation for established non union of the Scaphoid Bone
International Orthopaedics, 2007Co-Authors: A F Dinah, R H VickersAbstract:The aim of the study was to investigate the effect of smoking on the operative treatment of established non-union of the carpal Scaphoid. Case notes and radiographs of patients undergoing Bone grafting and screw fixation of Scaphoid non-unions were reviewed. There were 34 patients that had undergone 37 operations for established non-union of the carpal Scaphoid Bone. There were two female patients, and the average age was 26.8 years (range 13.4 years to 52.9 years). The median delay to operation was 11.9 months. The overall success rate of the operation (internal fixation and autologous Bone grafting) was 59.5% (22/37), but there was a significant association between non-union and smoking (P=0.02 for Fisher’s exact test). In non-smokers (n=17) the success rate was 82.4%, but this dropped to 40.0% among smokers (P<0.01). We concluded that smoking was significantly associated with failure of operative treatment of established non-union of the Scaphoid Bone.
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Smoking increases failure rate of operation for established non-union of the Scaphoid Bone
International orthopaedics, 2006Co-Authors: A F Dinah, R H VickersAbstract:The aim of the study was to investigate the effect of smoking on the operative treatment of established non-union of the carpal Scaphoid. Case notes and radiographs of patients undergoing Bone grafting and screw fixation of Scaphoid non-unions were reviewed. There were 34 patients that had undergone 37 operations for established non-union of the carpal Scaphoid Bone. There were two female patients, and the average age was 26.8 years (range 13.4 years to 52.9 years). The median delay to operation was 11.9 months. The overall success rate of the operation (internal fixation and autologous Bone grafting) was 59.5% (22/37), but there was a significant association between non-union and smoking (P=0.02 for Fisher’s exact test). In non-smokers (n=17) the success rate was 82.4%, but this dropped to 40.0% among smokers (P
