scaphoid non-union

Kahnbein-Pseudarthrose
und Versorgung mit Herbert-Schraube.
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Geteiltes
Kahnbein. In einigen Fällen, vor allem, wenn keine Verletzung erinnerlich ist, kann zwischen einer Pseudarthrose und einer zweigeteilten Anlage (Os scaphoideum bipartitum) nicht sicher unterschieden werden. In diesem Fall handelt es sich wegen der harmonischen Kontaktflächen eher um eine geteilte Anlagevariante.
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Scaphoid-Pseudarthrose
in der Computertomographie (coronar rekonstruiert).
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Alte
Pseudarthrose des Scaphoids mit erneuter Fraktur des proximalen Fragments (im CT gesehen).
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Scaphoid
non-union advanced collapse
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Scaphoid
non-union advanced collapse
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Scaphoidpseudarthrose
mit SL-Band Verletzung
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Scaphoid
non-union advanced collapse • Scaphoid non union advanced collapse - Ganzer Fall bei Radiopaedia
Greif E, Scaphoid non union advanced collapse. Case study, Radiopaedia.org (Accessed on 23 Jan 2023) https://doi.org/10.53347/rID-29656 • CC by-nc-sa 3.0 (modified)
Scaphoid
non-union advanced collapse • Scaphoid non-union advanced collapse (SNAC wrist) - Ganzer Fall bei Radiopaedia
Knipe H, Scaphoid non-union advanced collapse (SNAC wrist). Case study, Radiopaedia.org (Accessed on 23 Jan 2023) https://doi.org/10.53347/rID-47303 • CC by-nc-sa 3.0 (modified)
Humpback
deformity of the scaphoid • Scaphoid fracture with non-union, AVN, DISI, and SNAC - Ganzer Fall bei Radiopaedia
Saber M, Scaphoid fracture with non-union, AVN, DISI, and SNAC. Case study, Radiopaedia.org (Accessed on 21 Jan 2023) https://doi.org/10.53347/rID-86682 • CC by-nc-sa 3.0 (modified)
Radiopaedia • CC-by-nc-sa 3.0 • de

Scaphoid non-union is one of the complications of scaphoid fracture because of the unique anatomy of the scaphoid and its vascular supply.

Epidemiology

Scaphoid fractures have one of the highest rates non-union of all fractures at ~10% (range 5-15%) .

Pathology

Scaphoid non-union occurs most commonly through the middle or proximal thirds .

Classification

Six grades of non-union have been described by Slade and Dodds :

  • grade 1: delayed presentation - 4-8 weeks
  • grade 2: fibrous non-union - minimal fracture line; no cyst or sclerosis
  • grade 3: minimal sclerosis - <1 mm bone resorption with minimal sclerosis
  • grade 4: cyst formation and sclerosis - <5 mm bone resorption with cyst formation; normal scaphoid alignment
  • grade 5: cyst formation and sclerosis - 5-10 mm bone resorption with cyst formation; normal scaphoid alignment
  • grade 6: separate bone fragments with profound bone resorption; fragment motion and scaphoid deformity common

The following subtypes can also be applied:

  • a: proximal pole non-union 
  • b: avascular necrosis (AVN)
  • c: ligamentous injury
  • d: deformity

Complications

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Scaphoidpseudarthrose:
scaphoid
non-union advanced collapse
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Os
scaphoideum bipartitum
Wikipedia • CC BY-SA 3.0
scaphoid bone
 
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