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Bone Morphogenetic Protein for Scaphoid Nonunion
Behavior of the distal and proximal fragment of the scaphoid after its nonunion has been discussed both biomechanically and clinically. Too many factors can affect the motion of the either proximal or distal fragment of the scaphoid. Once the scaphoid is fractured, gradually the distal fragment flexes, due to the force from the flexor carpi radialis, and the proximal fragment extends, on account of the extension force passing through the scapholunate ligament from the triquetrum. This motion inside the proximal row indicates the dorsal intercalated segment instability (DISI) deformity after scaphoid fracture/nonunion. However, in daily clinical practice, we sometimes observed normal alignment of the proximal carpal row after scaphoid fracture/nonunion. We still need good bony fixation device, such as the headless screw and the device or agent which accelerates healing of nonunion of the scaphoid.
This issue includes the “special reviews” of “bone morphogenetic protein (BMP) in scaphoid non-union: a systematic review” described by Polmear et al. They have made a systematic review of effectiveness of the BMP for scaphoid nonunion in four studies from 2002 to 2019 and found that the efficacy of BMP in scaphoid nonunion is unfortunately unclear. Interesting wrist papers such as motion range changes after the salvage procedure of the wrist, carpal tunnel syndrome, biomechanics of the distal radioulnar joint (DRUJ), palmar midcarpal instability, 4-DCT analysis, triangular fibrocartilage complex (TFCC) repair technique, and interesting case reports are also included.
Article published online:
01 June 2021
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