Aims. The underlying natural history of suspected
Aims. Occult (clinical) injuries represent 15% of all
Aims. Current National Institute for Health and Clinical Excellence (NICE) guidance advises that MRI direct from the emergency department (ED) should be considered for suspected
Aims. To explore individuals’ experience of a scaphoid waist fracture and its subsequent treatment. Methods. A purposive sample was created, consisting of 49 participants in the Scaphoid Waist Internal Fixation for Fractures Trial of initial surgery compared with plaster cast treatment for fractures of the scaphoid waist. The majority of participants were male (35/49) and more younger participants (28/49 aged under 30 years) were included. Participants were interviewed six weeks or 52 weeks post-recruitment to the trial, or at both timepoints. Interviews were semistructured and analyzed inductively to generate cross-cutting themes that typify experience of the injury and views upon the treatment options. Results. Data show that individual circumstances might exaggerate or mitigate the limitations associated with a
The primary aim of this study was to identify the rate of osteoarthritis in
Background.
Purpose. Knowing the morphology of any fracture, including
Purpose. Knowing the morphology of any fracture, including
Background. In suspected
Introduction. Up to 16% of
The aim of the study was to investigate, firstly, the force distribution between scaphoid/radius and lunate/radius in the normal wrist and in the presence of a
Introduction.
Percutaneous fixation of
We describe a new technique for fixing the proximal pole
Introduction.
The purpose of this study is to introduce our technique of free hand screw insertion for
Objective. To compare the ability of a new composite bio-absorbable screw and two conventional metal screws to maintain fixation of scaphoid waist-fractures under dynamic loading conditions. Methods. Fifteen porcine radial carpi, with morphology comparable to human scaphoids, were osteotomised at the waist. Specimens were randomised in three groups: Group I were fixed with a headed metal screw, group II with a headless tapered metal screw and group III with a bio-absorbable composite screw. Each specimen was oriented at 45° and cyclically loaded using four blocks of 1000 cycles, with peak loads of 40, 60 (normal load), 80 and 100 N (severe load) respectively. Permanent displacement and translation (step-off) at the fracture site was measured after each loading block from a standardised high-magnification photograph using image analysis software (Roman v1.70, Institute of Orthopaedics, Oswestry). Statistical analysis was by ANOVA and tolerance limits. Results. No gross failure or fracture gap displacement occurred. Average translations (step-off) at the fracture site after 4000 cycles up to 100N were 0.05mm±0.02SD (headed metal), 0.14mm±0.14SD (headless metal) and 0.29mm±0.11SD (composite) and differed significantly (p<0.01). Using tolerance limits, the data allowed us to predict that, with 95% certainty, the maximum average translation (step-off) following severe loading in 95% of any sample fixed with a headed metal screw will be below 0.17mm, headless metal screw below 0.74mm, and composite screw below 0.76mm. Conclusion. We observed only small average translations (step-off) for all three screws. Moreover, translations of more than 1mm that would predispose to non-union were highly unlikely for any of the screws, even after severe cyclic loading. We therefore conclude that a new bio-absorbable composite screw can serve as an alternative to conventional screws when fixing
Objective: To compare the ability of a new composite bio-absorbable screw and two conventional metal screws to maintain fixation of scaphoid waist-fractures under dynamic loading conditions. Methods: Fifteen porcine radial carpi, whose morphology is comparable to that of human scaphoids, were osteotomized at the waist. Specimens were randomized in three groups: those in group I were fixed with a headed metal screw, in group II with a headless tapered metal screw, and in group III with a bio-absorbable composite screw. Each specimen was oriented at 45° and cyclically loaded using four blocks of 1000 cycles, with peak loads of 40, 60, 80 and 100 N, respectively. In case of gross failure the number of cycles to failure was determined. Otherwise, permanent displacement at the fracture site was measured after each loading block from a standardized high-magnification photograph using image analysis software (Roman v1.70, Institute of Orthopaedics, Oswestry). Statistical analysis was by ANOVA and tolerance limits. Results: Nogross failure occurred. Average displacements after 4000 cycles up to 100N were 0.05mm±0.03SD (headed metal), 0.15mm±0.16SD (headless metal) and 0.29mm±0.11SD (composite) and differed significantly (p<
0.02). Using tolerance limits, the data allowed us to predict that with 95% certainty, displacement in 95% of any sample fixed with a headed metal screw will be below 0.17mm, headless metal screw below 0.84mm, and composite screw below 0.76mm. Conclusion: Comparing two types of conventional metal screws and a new composite bio-absorbable screw to maintain scaphoid fixation under cyclic loading conditions, we found small average fracture displacements for all three screws. Moreover, even following severe cyclic loading conditions, clinically meaningful displacements of more than 1 mm are highly unlikely for any of the three screws. We therefore conclude that a new bio-absorbable composite screw can serve as an alternative to conventional screws when fixing
Objective: To compare the ability of a new composite bio-absorbable screw and two conventional metal screws to maintain fixation of scaphoid waist-fractures under dynamic loading conditions. Methods: Fifteen porcine radial carpi, whose morphology is comparable to that of human scaphoids, were osteotomized at the waist. Specimens were randomized in three groups: those in group I were fixed with a headed metal screw, in group II with a headless tapered metal screw, and in group III with a bio-absorbable composite screw. Each specimen was oriented at forty-five degrees and cyclically loaded using four blocks of 1000 cycles, with peak loads of 40, 60, 80 and 100 N, respectively. In case of gross failure the number of cycles to failure was determined. Otherwise, permanent displacement at the fracture site was measured after each loading block from a standardized high-magnification photograph using image analysis software (Roman v1.70, Institute of Orthopaedics, Oswestry). Statistical analysis was by ANOVA and tolerance limits. Results: Nogrossfailureoccurred. Averagedisplacements after 4000 cycles up to 100N were 0.05mm±0.03SD (headed metal), 0.15mm±0.16SD (headless metal) and 0.29mm±0.11SD (composite) and differed significantly (p<
0.02). Using tolerance limits, the data allowed us to predict that with 95% certainty, displacement in 95% of any sample fixed with a headed metal screw will be below 0.17mm, headless metal screw below 0.84mm, and composite screw below 0.76mm. Conclusion: Comparing two types of conventional metal screws and a new composite bio-absorbable screw to maintain scaphoid fixation under cyclic loading conditions, we found small average fracture displacements for all three screws. Moreover, even following severe cyclic loading conditions, clinically meaningful displacements of more than 1 mm are highly unlikely for any of the three screws. We therefore conclude that a new bio-absorbable composite screw can serve as an alternative to conventional screws when fixing