BACKGROUND: Carpal bone lesions are common, even in acute injuries or as sequalae of missed fractures. If not correctly diagnosed and treated, can lead to loss of function, especially in active patients. The surgical management remain difficult particularly in case of small, atypical or non-unions fragments. The treatment of heterogenic shape fractures should require a fragment specific fixation using, traditionally, Kirschner-wire (K-wire). This method of treatment remains the most popular but could be prone to some complication as: not stable fixation, need to long time immobilization and wire mobilization. Methods Nineteen patients presented with carpal bone lesions were treated by the use of HCS 1,5 mm headless compression screws. Patients were evaluated post-operative by Patient-Rated Wrist Evaluation (PRWE), the Visual Analogic Scale (VAS), Quick-DASH Score and the grip strength was measured by Jamar dynamometer. RESULTS: Authors observed improvement of pain control and common activity; fine movements were restored; we observed no post-operative functional instability. CONCLUSIONS: HCS 1,5 mm headless compression screws are suitable and smart technique to treat these uncommon fractures to achieve a stable primary fixation and allow an early mobilization and conciliate the versatility of K-wire and the compression action due to screws also in small bone fragment.
BACKGROUND: Carpal bone lesions are common, even in acute injuries or as sequalae of missed fractures. If not correctly diagnosed and treated, can lead to loss of function, especially in active patients. The surgical management remain difficult particularly in case of small, atypical or non-unions fragments. The treatment of heterogenic shape fractures should require a fragment specific fixation using, traditionally, Kirschner-wire (K-wire). This method of treatment remains the most popular but could be prone to some complication as: not stable fixation, need to long time immobilization and wire mobilization. Methods Nineteen patients presented with carpal bone lesions were treated by the use of HCS 1,5 mm headless compression screws. Patients were evaluated post-operative by Patient-Rated Wrist Evaluation (PRWE), the Visual Analogic Scale (VAS), Quick-DASH Score and the grip strength was measured by Jamar dynamometer. RESULTS: Authors observed improvement of pain control and common activity; fine movements were restored; we observed no post-operative functional instability. CONCLUSIONS: HCS 1,5 mm headless compression screws are suitable and smart technique to treat these uncommon fractures to achieve a stable primary fixation and allow an early mobilization and conciliate the versatility of K-wire and the compression action due to screws also in small bone fragment.
Authors: Kayode O Oduwole; Benedikt Cichy; John P Dillon; Joan Wilson; John O'Beirne Journal: J Orthop Surg (Hong Kong) Date: 2012-04 Impact factor: 1.118
Authors: Andrea Poggetti; Anna Maria Nucci; Thomas Giesen; Maurizio Calcagni; Stefano Marchetti; Michele Lisanti Journal: J Hand Microsurg Date: 2018-03-20
Authors: Josef Jurkowitsch; E Dall'Ara; S Quadlbauer; Ch Pezzei; I Jung; D Pahr; M Leixnering Journal: Arch Orthop Trauma Surg Date: 2016-08-26 Impact factor: 3.067