[Palmar angular stable plate fixation of nonunions and comminuted fractures of the scaphoid].

[Palmar angular stable plate fixation of nonunions and comminuted fractures of the scaphoid]. Oper Orthop Traumatol. 2019 Aug 21;: Authors: Quadlbauer S, Pezzei C, Jurkowitsch J, Krimmer H, Sauerbier M, Hausner T, Leixnering M Abstract OBJECTIVE: Stabilization of comminuted fractures and nonunions of the scaphoid with an angular stable low-profile scaphoid plate. INDICATIONS: Scaphoid nonunions with a large palmar defect, second and third surgical procedure after previous stabilization by headless compression screw (HCS). Comminuted fractures of the scaphoid that cannot be sufficiently stabilized by screws. CONTRAINDICATIONS: Radio- and midcarpal osteoarthritis, small proximal pole fragments, fragmentation of the proximal pole. SURGICAL TECHNIQUE: The scaphoid is accessed by a palmar approach. After correcting the DISI (dorsal intercalated segment instability) deformity of the lunate and humpback deformity of the scaphoid, the reduction is secured by temporary Kirschner wires. The nonunion is debrided and the bone defect filled with cancellous bone graft. Subsequently the scaphoid plate and the angular stable screw are positioned in the order to place three screws in the proximal and distal fragment of the scaphoid. Comminuted fractures of the scaphoid are fixated by temporary Kirschner wires, then the plate is positioned in the same way as nonunions. POSTOPERATIVE MANAGEMENT: Comminuted fractures an...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research