Our Summary

This research paper discusses a new method for treating common wrist fractures, specifically those of the scaphoid bone. The usual method involves inserting a guide wire to fix the fracture, a process that often requires multiple tries and adjustments using a type of medical imaging called intraoperative fluoroscopy. In this paper, the researchers present a new approach: using a custom-made guide, created with the help of computer imaging and 3D printing, that can help perform the procedure in one shot. This new method could potentially make the treatment process quicker and more efficient.

FAQs

  1. What is a scaphoid fracture and how common is it?
  2. How is percutaneous fixation used to treat nondisplaced or minimally displaced scaphoid fractures?
  3. What is the 1-shot procedure for acute scaphoid fracture described in the article, and how do patient-specific guiding templates play a role in it?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scaphoid fracture surgery is to follow post-operative care instructions carefully, including keeping the surgical site clean and dry, following up with any prescribed physical therapy or rehabilitation exercises, and avoiding putting weight or strain on the affected hand until cleared by the surgeon. It is important to attend all follow-up appointments to ensure proper healing and avoid any complications.

Suitable For

Patients who are typically recommended scaphoid fracture surgery are those with acute scaphoid fractures that are either displaced or minimally displaced. Percutaneous fixation is a popular treatment option for these types of fractures, as it allows for a minimally invasive approach to stabilize the fracture. Additionally, patients who have difficulty with non-operative management or have failed non-operative treatment may also be recommended for scaphoid fracture surgery. Overall, the decision to undergo surgery for a scaphoid fracture is based on the specific characteristics of the fracture and the individual patient’s needs and goals for recovery.

Timeline

  • Patient experiences a fall or trauma resulting in a scaphoid fracture
  • Patient seeks medical attention and undergoes physical examination, X-rays, and possibly an MRI to diagnose the fracture
  • Patient discusses treatment options with their orthopedic surgeon, including the possibility of surgery
  • Surgery is scheduled and the patient undergoes pre-operative assessments and preparations
  • On the day of surgery, the patient is taken to the operating room and given anesthesia
  • The surgeon performs the percutaneous fixation procedure using patient-specific guiding templates made by computer reconstructions and 3D printing
  • The guidewire is placed accurately on the first attempt with the help of intraoperative fluoroscopy
  • The fracture is stabilized and the incisions are closed
  • The patient is monitored in the recovery room before being discharged home or to a hospital room
  • The patient begins the post-operative recovery process, which may include physical therapy, follow-up appointments, and gradually returning to normal activities.

What to Ask Your Doctor

  1. What is the success rate of percutaneous fixation for scaphoid fractures?
  2. What are the potential risks and complications associated with scaphoid fracture surgery?
  3. How long is the recovery time after scaphoid fracture surgery?
  4. Will physical therapy be necessary after the surgery, and if so, for how long?
  5. What type of anesthesia will be used during the surgery?
  6. How soon after the surgery can I return to normal activities, such as driving or working?
  7. Will I need to wear a cast or splint after the surgery, and for how long?
  8. What is the likelihood of needing additional surgeries or treatments in the future for the scaphoid fracture?
  9. How will the surgery affect my range of motion and strength in my wrist and hand?
  10. Are there any specific precautions or limitations I should be aware of following the surgery?

Reference

Authors: Yin HW, Xu J, Xu WD. Journal: J Hand Surg Am. 2017 Apr;42(4):301.e1-301.e5. doi: 10.1016/j.jhsa.2017.01.017. Epub 2017 Mar 1. PMID: 28259565