Our Summary

This study looked at a new, less invasive method of treating a specific type of rare but serious wrist injury called perilunate fracture dislocations. The new technique uses a combination of minimally invasive surgery and robotic assistance.

The researchers reviewed the cases of two male patients who had this type of wrist injury. The doctors used a small camera to guide the surgery (arthroscopic-assisted precise reduction) and a robot to help place the screw that holds the bones together (robot-assisted headless screw fixation).

They kept track of how many times they had to place the guide wire during the surgery, and then followed up with the patients regularly until their wrist fractures healed. They also checked the range of motion, strength, and pain in the patients’ wrists, as well as any signs of osteoarthritis.

The results showed that the fractures had healed by 8 to 12 weeks, and that the patients’ wrist movements were similar to their uninjured wrists, except for one patient who had slightly less flexion in his injured wrist. The patients reported minimal pain and had good grip strength, and there were no signs of osteoarthritis.

In conclusion, this new technique of using minimally invasive surgery with robotic assistance seems to be a good option for treating this type of wrist injury. It allows for precise placement of the screws into the wrist bones, which could help with healing and recovery.

FAQs

  1. What is the new method of treating perilunate fracture dislocations?
  2. What were the results of the cases that used the new minimally invasive surgery with robotic assistance?
  3. How does the new technique of using minimally invasive surgery with robotic assistance impact the healing and recovery of the wrist injury?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about scaphoid fracture surgery is to follow post-operative instructions carefully, including keeping the wrist immobilized as directed, attending follow-up appointments, and participating in physical therapy to regain strength and range of motion in the wrist. It is also important to avoid putting too much stress on the wrist during the healing process to ensure proper healing and prevent complications.

Suitable For

Patients who are typically recommended scaphoid fracture surgery are those with displaced fractures, fractures that are not healing properly with conservative treatment, fractures that are at risk of nonunion or avascular necrosis, and fractures in which there is a risk of long-term wrist dysfunction if not treated surgically. Additionally, patients with multiple fractures in the wrist or those with associated ligament injuries may also be candidates for scaphoid fracture surgery.

Timeline

Before scaphoid fracture surgery:

  1. Patient experiences wrist pain, swelling, and tenderness after a fall or injury.
  2. Patient visits a doctor who orders imaging tests such as X-rays or MRI to diagnose the scaphoid fracture.
  3. Patient may wear a cast or splint to stabilize the wrist while waiting for surgery.
  4. Patient may undergo pre-operative tests and consultations to prepare for surgery.

After scaphoid fracture surgery:

  1. Patient undergoes minimally invasive surgery with robotic assistance to fix the scaphoid fracture.
  2. Patient is monitored in the hospital for a short period of time before being discharged.
  3. Patient may wear a cast or splint post-surgery to immobilize the wrist and allow for proper healing.
  4. Patient attends follow-up appointments with the doctor to monitor healing progress and remove the cast.
  5. Patient undergoes physical therapy to regain wrist strength and range of motion.
  6. Patient gradually resumes normal activities as instructed by the doctor.
  7. Patient continues to follow-up with the doctor for long-term monitoring of the wrist and to address any potential complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scaphoid fracture surgery include:

  1. What are the risks and benefits of the surgery?
  2. What is the success rate of this type of surgery for scaphoid fractures?
  3. What is the recovery time and rehabilitation process like after surgery?
  4. Will I need physical therapy after the surgery?
  5. What type of anesthesia will be used during the surgery?
  6. How long will I need to stay in the hospital after the surgery?
  7. What are the potential complications of the surgery?
  8. How soon after the surgery can I return to my normal activities?
  9. Will I need any additional follow-up appointments after the surgery?
  10. Are there any alternative treatment options for scaphoid fractures that I should consider?

Reference

Authors: Yi Z, Qi W, Chen S, Zhang Y, Liu B. Journal: Orthop Surg. 2023 Apr;15(4):1203-1209. doi: 10.1111/os.13677. Epub 2023 Mar 2. PMID: 36864552