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WRIST INJURIES AND SCAPHOID FRACTURES



Abstract

The major aim of this presentation is to introduce the complex medical procedure concerning wrist fractures, luxations and wrist ligaments injuries based up-to date literature and author’s own experience. In scaphoid fractures the most common one – the diagnostic problems (proper X-ray projection, repete X-ray, CT, bone scan, e.t.c.) are presented as well as the right treatment based on the bone healing pathology (different vascular topography, fracture type e.t.c.). Also the medical procedure algorithm of the fresh scaphoid fractures (Herbert’s screw, Matti-Russe method), prolonged union or pseudoarthroses (bone transplant according to Matti-Russe or Fisk-Fernandes) is suggested.

The treatment ways concerning lunar fractures (blood supply disorders and Kienböck disease), capitatum fractures (unstable fractures - open reposition + bone graft), triquetrum fracture (a mirror Bennet or ridge fracture), trapezoideum fracture, hamatum fracture (most common one – the hook) and posiforme fracture (usually coexists with other fractures) one also discussed based on clinical examples.

Due to the wrist ligaments injuries author presents the most common luxations and instabilities; the treatment of perilunar luxations, either quicke hand reposition or open repositions with simultaneous tunnel decompression is described. The wrist instabilities are presented mainly due to diagnostic problems. According to static instabilities (dissociations) the author compares static X-ray and a healthy wrist X-ray (three arcs estimation, interbone space asymmetry) while dynamic instabilities require forced position X-ray scans. The most common instabilities – VISI and DISI – are also presented from wrist biomechanical point of view.

The abstracts were prepared by Mrs Anna Ligocka. Correspondence should be addressed to IX ICL of EFORT Organizing Committee, Department of Orthopaedics, ul. Kopernika 19, 31–501 Krakow, Poland