ArticleArchives of orthopaedic and trauma surgery2023
Double screw versus angular stable plate fixation of scaphoid waist nonunions in combination with intraoperative extracorporeal shockwave therapy (ESWT).
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- Systematic mapping review of applications of extracorporeal shockwave therapy (ESWT) in hand surgery.JPRAS open · 2026Review
- Evaluation of the Effect of Ununion Percentage of Scaphoid on Stress and Displacement of Fragment Part of Scaphoid in Various Degrees of Wrist Extension with and without External Force.Journal of wrist surgery · 2026Article
- Palmar Plate Fixation in Scaphoid Nonunions-Surgical Technique and Review of the Literature.Journal of wrist surgery · 2026Article
- Arthroscopic treatment of scaphoid nonunion, a new algorithm after six years practice.Archives of orthopaedic and trauma surgery · 2025Article
- The vascular anatomy and harvesting of the medial femoral condyle flap in pigs.Archives of orthopaedic and trauma surgery · 2024Article
- Patient-specific scaphoid prosthesis: surgical technique.Archives of orthopaedic and trauma surgery · 2024Article
- Volar locking and angular stability plate for treatment of comminuted scaphoid fractures: a case series of 44 cases.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Bilateral ST-coalition with thumb hypoplasia and scaphoid synchondrosis.Archives of orthopaedic and trauma surgery · 2024Article
- Comparative analysis of cancellous graft and cortico-cancellous graft in osteosynthesis of scaphoid pseudoarthrosis with plate.Archives of orthopaedic and trauma surgery · 2023Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOver the past years, different fixation techniques focused on rotational stability in order to increase stability and stimulate union rates. Additionally, extracorporeal shockwave therapy (ESWT) has gained importance in the treatment of delayed and nonunions. Purpose of this study was to compare the radiological and clinical outcome of two headless compression screws (HCS) and plate fixation in scaphoid nonunions, in combination with intraoperative high energy ESWT. MATERIALS AND
methodsThirty-eight patients with scaphoid nonunions were treated by using a nonvascularized bone graft from the iliac crest and stabilization with either two HCS or a volar angular stable scaphoid plate. All patients received one ESWT session with 3000 impulses and energy flux per pulse of 0.41 mJ/mm
resultsThirty-two patients returned for clinical and radiological examination. Out of these, 29 (91%) showed bony union. All patients treated with two HCS compared to 16 out of 19 (84%) patients treated by plate showed bony union on the CT scans. The difference was not statistically significant. However, at a mean follow-up interval of 34 months, no significant differences could be found in ROM, pain, grip strength and patient-reported outcome measurements between the two HCS and plate group. Height-to-length ratio and capitolunate angle improved significantly in both groups compared to preoperative.
conclusionsScaphoid nonunion stabilization by using two HCS or angular stable volar plate fixation and intraoperative ESWT results in comparable high union rates and good functional outcome. Due to the higher rate for a secondary intervention (plate removal), HCS might be preferable as first choice, whereas the scaphoid plate fixation should be reserved for recalcitrant (substantial bone loss, humpback deformity or failed prior surgical intervention) scaphoid nonunions.
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