gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Management of Scaphoid Fractures at a Tertiary Center in the UK: The University Hospital North Midlands Experience

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  • presenting/speaker Yasser Al Omran - University Hospital North Midlands NHS Foundation Trust, Stoke-on-Trent, United Kingdom
  • Zamira Keeling - University Hospital North Midlands NHS Foundation Trust, Stoke-on-Trent, United Kingdom
  • Manikandar Srinivas Cheruvu - University Hospital North Midlands NHS Foundation Trust, Stoke-on-Trent, United Kingdom
  • Karam Ahmad - University Hospital North Midlands NHS Foundation Trust, Stoke-on-Trent, United Kingdom
  • Ashley Brown - University Hospital North Midlands NHS Foundation Trust, Stoke-on-Trent, United Kingdom
  • Kevin Smith - University Hospital North Midlands NHS Foundation Trust, Stoke-on-Trent, United Kingdom

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1083

doi: 10.3205/19ifssh0113, urn:nbn:de:0183-19ifssh01133

Veröffentlicht: 6. Februar 2020

© 2020 Al Omran et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: Carpel bone fractures encompass approximately 18% of all hand fractures; with scaphoid fractures being the most common of these fractures. Up to 40% of scaphoid fractures are missed at initial presentation as plain radiographs lack adequate sensitivity to detect a fracture immediately after injury and so many cases are managed non-operatively initially. In the United Kingdom, The National Institute of Clinical Excellence (NICE) issued guidance on non-complex fractures in February 2016 and have recommended that MRI should be considered as first-line imaging for suspected scaphoid fractures. We report on a select group of patients in which operative management of scaphoid fractures was necessary before and after introduction of this guideline.

Methods: A retrospective chart review of patients with scaphoid fractures who required operative fixation was undertaken between January 2015 and August 2018 was undertaken. We evaluated many aspects including implementation of the nice guideline in these cases, time to presentation to the orthopedic team, time to decision to operate and complications.

Results and Conclusions: 31 cases were reviewed and tabulated. Operative cases ranged from percutaneous screw fixation, headless compression screws and open reduction internal fixation +/- bone graft We report on the outcomes of these patients and identify key trends and lessons that we have learnt over this time period.