Comments Your initial radiographs look mighty suspicious to me. Articles from Hand New York, N. This is all to illustrate a very common Emergency presentation — the patient with tenderness in their anatomical snuffbox and a non-diagnostic X-ray. Gelberman RH, Menon J. Author information Article notes Copyright and License information Disclaimer. The amount of motion across the fracture site was then quantified and compared within and across groups using one-way ANOVA with repeated measures and Tukey—Kramer multiple comparison test post hoc analysis.

Closed cast treatment of scaphoid fractures. In light of such previous research, we focused on casting below the elbow. Secretly likes admin but is too embarrassed to admit it. Conversely, whereas immobilization of the wrist is necessary to limit motion at the fracture site, casting the thumb is not. Specifically, the axial images were studied for the degree of rotation of the fracture fragments. Acute fractures of the scaphoid. Support Center Support Center.

A CT wrist is 20 uSv vs 3mSv for a bone scan. Each specimen was loaded in extension and flexion by attaching g weights to the EPL and FPL, first with no casting, then with a short arm cast, and finally a short arm thumb spica cast.

Limitations of this study are an inclusion of only waist fractures and the ex vivo nature of the study. This is not in widespread use in either the UK or Australia. Osteonecrosis of the distal pole of the carpal scaphoid following fracture—a rare complication. Materials and Methods Six fresh frozen cadaveric forearm specimens were obtained fracfure the study.

In his prospective study of scaphoid fractures, Clay agreed that, though the wrist needed to be immobilized for fracture healing, the thumb interphalangeal joint did not [ 4 ].

Closed cast treatment of scaphoid fractures. Effects of the adductor pollicis and abductor pollicis brevis on thumb metacarpophalangeal joint laxity before and after ulnar collateral liagament reconstruction. The official report read: This article has been cited by other articles in PMC.


Each specimen was loaded in extension and flexion by attaching g weights to the EPL and FPL, first with no casting, then with a short arm cast, and finally a short arm thumb spica cast. Using six fresh frozen forearm specimens, a transverse waist scaphoid fracture was created through a dorsal approach. The limitations of this ex vivo study may be addressed further by dynamic studies to assess displacement with wrist and thumb motion in multiple planes, as well as assessing the effect of compressive loading during pinch grasp.

Cast follow-up by phone or clinic visit Is cast too tight? The more proximal the fracture, the longer the healing time: Wongworawat1 and Ingrid Kjellin 3.

Wheeless’ Textbook of Orthopaedics

Additionally, a pulley fracturre was arranged to allow the application of weights to the suture attached to the EPL and FPL to simulate normal loading across the thumb interphalangeal joint. This study is an attempt to more clearly define how scaphoid fractures behave in various casts [ 7 ].

The images were reconstructed at 0. In our cadaveric model, wrist immobilization is crucial for nondisplaced scaphoid waist fractures, and short arm casting was just as effective as thumb spica casting in preventing fracture displacement. Bring out the Herbert Czst …. Abstract Immobilization protocols for nondisplaced scaphoid fractures have included the elbow, wrist, and thumb. Leave a Reply Cancel reply Your email address will not be published.

Back Links pages that link to this page. Comments Your initial radiographs look mighty suspicious to me. Early Surgery becoming more commonplace.

These images are a random sampling from a Bing search on the term “Scaphoid Fracture.

Does Thumb Immobilization Contribute to Scaphoid Fracture Stability?

Non-union develops during follow-up. In conclusion, this study demonstrated that, for nondisplaced scaphoid waist fractures, wrist immobilization is crucial to limiting fracture displacement.

This cas always seemed untidy to me. Vijay — I think its a tradition Pete brought over with him from Ulster…. Need the thumb be immobilised in scaphoid fractures? Alho A, Kankaanpaa U.


Numerous studies to date have demonstrated that immobilizing the wrist is necessary to facilitate scaphoid fracture healing [ 246111216 ]. Acute fractures of the scaphoid.

Does thumb immobilization contribute to scaphoid fracture stability?

Our results concur, noting a significant increase in fracture stability when immobilizing the wrist. Biomechanically, we demonstrated that, even in the presence of physiologic loading of the thumb, wrist immobilization alone was sufficient to significantly reduce motion at the fracture site.

Related links to external sites from Bing. Although access to this website is not restricted, the information found here is intended for use by medical providers. Support Center Support Center. Metallic markers were placed on each side of the fracture. Simple removable wrist splint appropriate for low-index-of-suspicion cases.

Scaphoid Fractures – The ED perspective

This study attempts to demonstrate whether foor not immobilization of the thumb makes a difference in preventing motion at the scaphoid fracture site. There was no significant difference in fracture angulation or rotation between spica and short arm casts.

Computed tomography of suspected scaphoid fractures. This sequence was then repeated with the forearm in a short arm fiberglass cast immobilization up to the proximal portion of the thumb metacarpal and second through fifth metacarpal necks, but leaving the thumb metacarpophalangeal and interphalangeal joints free and sfaphoid spica fiberglass cast immobilization including the thumb metacarpophalangeal joint.

Biomechanical implications of scaphoid waist fractures. Injuries occur as a result of axial loading on a dorsiflexed wrist [ 17 ].

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