Marko Bumbaširević1, Tomislav Palibrk2, Henry Dushan E Atkinson3, Aleksandar Lešić2. 1. School of Medicine, Institute for Orthopaedic Surgery and Traumatology, Clinical Center of Serbia, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia. marko.bumbasirevic@gmail.com. 2. School of Medicine, Institute for Orthopaedic Surgery and Traumatology, Clinical Center of Serbia, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia. 3. Department of Trauma and Orthopaedics, North Middlesex University Hospital, Sterling Way, London, N18 1QX, UK.
Abstract
OBJECTIVES: To evaluate the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft. DESIGN: This is a prospective study of 20 consecutive patients in one center. PATIENTS AND METHODS: This study included 20 patients (19 males) with a mean SNU duration of 14.5 months. Four patients had proximal pole, 15 had waist, and 1 had a distal SNU. Patients with carpal instability, humpback deformities, carpal collapse, avascular necrosis, and marked degenerative change were excluded. Following frame application, the treatment comprises three stages: The frame is distracted by 1 mm per day until the radiographs show a 2-3 mm opening at the SNU site (mean 10 days); the SNU site is compressed for 5 days, at a rate of 1 mm per day, with the wrist in 15 degrees of flexion and 15 degrees of radial deviation; the wrist is then immobilized in the Ilizarov fixator for 8 weeks. RESULTS: Radiographic (radiography and CT scan) and clinical bony union was achieved in all 20 patients after a mean of 90.3 days (70-130 days). All patients returned to their pre-injury occupations. Thirteen patients had excellent results, four good, and three fair, according to the Mayo wrist score. CONCLUSIONS: In these selected patients, this technique safely achieved bony union without the need to open the SNU site and without the requirement of bone graft.
OBJECTIVES: To evaluate the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft. DESIGN: This is a prospective study of 20 consecutive patients in one center. PATIENTS AND METHODS: This study included 20 patients (19 males) with a mean SNU duration of 14.5 months. Four patients had proximal pole, 15 had waist, and 1 had a distal SNU. Patients with carpal instability, humpbackdeformities, carpal collapse, avascular necrosis, and marked degenerative change were excluded. Following frame application, the treatment comprises three stages: The frame is distracted by 1 mm per day until the radiographs show a 2-3 mm opening at the SNU site (mean 10 days); the SNU site is compressed for 5 days, at a rate of 1 mm per day, with the wrist in 15 degrees of flexion and 15 degrees of radial deviation; the wrist is then immobilized in the Ilizarov fixator for 8 weeks. RESULTS: Radiographic (radiography and CT scan) and clinical bony union was achieved in all 20 patients after a mean of 90.3 days (70-130 days). All patients returned to their pre-injury occupations. Thirteen patients had excellent results, four good, and three fair, according to the Mayo wrist score. CONCLUSIONS: In these selected patients, this technique safely achieved bony union without the need to open the SNU site and without the requirement of bone graft.
Entities:
Keywords:
Ilizarov circular frame; Scaphoid nonunion; Without bone graft
Authors: Marko Bumbaširević; Slavko Tomić; Aleksandar Lešić; Vesna Bumbaširević; Zoran Rakočević; Henry D Atkinson Journal: J Orthop Surg Res Date: 2011-11-08 Impact factor: 2.359
Authors: S Matić; Č Vučković; A Lešić; I Glišović Jovanović; D Polojac; S Dučić; M Bumbaširević Journal: Int Orthop Date: 2020-09-30 Impact factor: 3.075