Scaphoid Fracture Surgery - Ian McDermott 20/3/2001

OPERATIVE TREATMENT

Brief	FILAN & HERBERT JBJS-B 1996
Author	Filan S.L. & Herbert T.J.
Title	Herbert Screw Fixation of Scaphoid Fractures
Reference	JBJS 1996; 78-B (4): 519-529
Summary	o 88% union in acute #s. 86% pain free. 91% back to work after mean of 4.7 weeks. o Most type B #s were unstable and 1/3 had soft tissue interposition - poor correlation with pre-op X-rays. o Most common complication = tender hypertrophic scar (in 13%).
Critique	Retrospective review of 304 (out of 431) cases performed by Herbert. 82 acute, # 349 non-unions over a 13 year period. Mean FU 34.2 months. Min FU 6 months.

Brief	RAUDASOJA ANN. CHIR. GYNAECOL 1999
Author	Raudasoja L, Rawlins M, Kallio P & Vasenius J
Title	Conservative Treatment of Scaphoid Fractures: A Follow Up Study
Reference	Annales Chirurgiae et Gynaecologiae 1999; 88: 289-293
Summary	o 89% union o 34% complained of residual symptoms (most were mild) o mean time back to work = 9 weeks o OA in 32%, but not correlated with symptoms
Critique	Retrospective review of 63 (out of 125) patients. Mean FU 54 months. #s with >2mm displacement were treated surgically.

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