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Four corner fusion, or partial wrist arthrodesis, is a procedure which involves resection/removal of the scaphoid bone and fixation of the remaining wrist bones with a plate or wires. [1] The procedure is usually performed due to wrist arthritis or due to scaphoid collapse.
Manipulation under anesthesia (MUA) or fibrosis release procedures [1] is a noninvasive procedure to treat chronic pain which has been unmanageable by other methods. MUA is designed not only to relieve pain, but also to break up excessive scar tissue.
The injury is typically caused by compression of the scaphoid bone of the hand against the styloid process of the distal radius. It can be caused by falling onto an outstretched hand. Treatment is often open reduction and internal fixation, which is surgical realignment of the bone fragments and fixation with pins, screws, or plates.
A scaphoid fracture is a break of the scaphoid bone in the wrist. [1] Symptoms generally includes pain at the base of the thumb which is worse with use of the hand. [ 2 ] The anatomic snuffbox is generally tender and swelling may occur. [ 2 ]
Scaphoid pseudarthrosis, before and after treatment with Herbert screw. The Herbert screw (invented by Timothy Herbert) is a variable pitch cannulated screw typically made from titanium for its biocompatible properties as the screw is normally intended to remain in the patient indefinitely. It became generally available in 1978.
The scaphoid can be slow to heal because of the limited circulation to the bone. Fractures of the scaphoid must be recognized and treated quickly, as prompt treatment by immobilization or surgical fixation increases the likelihood of the bone healing in anatomic alignment, thus avoiding mal-union or non-union. [6] Delays may compromise healing.
Early detection, on the other hand, enables more effective treatment, a shorter hospitalization period if necessary, and decreased medical costs in the long run. It will also prevent inherent complications such as nonunion, malunion, premature osteoarthritis, and avascular osteonecrosis (as in scaphoid fracture). Of the three types of occult ...
A Smith's fracture, is a fracture of the distal radius. [1]Although it can also be caused by a direct blow to the dorsal forearm [2] or by a fall with the wrist flexed, the most common mechanism of injury for Smith's fracture occurs in a palmar fall with the wrist joint slightly dorsiflexed. [3]