Imaging evaluation for scaphoid fracture: which surgical approach is more effective and safer?
10.3969/j.issn.2095-4344.2017.31.026
- VernacularTitle:腕舟状骨骨折影像学评价:哪种手术入路对骨折愈合影响最小更安全合适
- Author:
hua Yan FENG
1
;
tie Ying CUI
;
ren Yi TIAN
;
Fang ZHANG
;
bo Shi WANG
;
zhe Ming HE
Author Information
1. 河北省儿童医院骨一科
- From:
Chinese Journal of Tissue Engineering Research
2017;21(31):5072-5077
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Because of scaphoid irregular shape and the wrist joint and adjacent bones overlap, so the diagnosis and treatment of scaphoid fracture and treatment became so difficult. Which imaging methods hold highest diagnosis rate, and which kind of surgical approaches with less impact on fracture healing are still under discussion.OBJECTIVE: To review the imaging examinations of scaphoid fracture and the research advance in surgical approaches.METHODS: The first author retrieved CJFD and PubMed databases for the literature addressing the imaging examinations and surgical approaches of scaphoid fracture published from 2005 to 2015 with the keywords of "scaphodl bone, fracture, iconography, surgical approach" in Chinese and English, respectively. The old and repetitive articles were excluded, totally 3021 articles were retrieved. In accordance with inclusion and exclusion criteria, finally 24 eligible articles were included for result analysis.RESULTS AND CONCLUSION: (1) The wrist joint at positions of pronation 60°, supination 45°, oblique and lateral can reveal the scaphoid from different angles on X-ray, which improves the diagnosis rate. At present, CT is the most reliable method, but there is a lack of quantization parameter for evaluating scaphoid fracture, especially for occult fracture. MRI can completely show the structure of scaphoid, even blood supply. Bone scintigraphy possesses a higher diagnosis rate than X-ray and CT examinations. (2) The surgical approaches of scaphoid fracture include volar, dorsal, radiocarpa approaches, but none is ideal. (3) The ideal surgical approach still needs a in-depth study, which can well reveal the scaphoid, achieve good reduction, reduce the damage to the remaining blood supply, confirm the position of scaphoid benifical for internal fixator implantation, and can be minimally invasive and easy to operate.
