Hand clinics
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Scaphoid fractures carry significant long-term morbidity and short-term socioeconomic difficulty in the young and active patient population in which they most commonly occur. While cast immobilization results in high rates of radiographic union in nondisplaced scaphoid fractures, internal fixation with headless compression screws has been recommended in cases of displaced fractures. ⋯ Multiple manufacturers are now offering "second generation" headless compression screws for the internal fixation of scaphoid fractures. The few biomechanical studies that exist demonstrate improved compression forces and load to failure for the newer generation of headless compression screws when compared with the first generation headless compression screw, although it is unclear if these differences are clinically significant.
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Surgical treatment options for distal radius fractures are many and commonly involve volar locked plating. More recently, newer volar locking plates have been introduced to the market that allow the placement of independent distal subchondral variable-angle locking screws to better achieve targeted fracture fixation. This article reviews this new technology and presents the authors' experience with the Aptus (Medartis, Kennett Square, Pennsylvania) variable-angle volar locking plates.
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Radial head arthroplasty remains an encouraging treatment option for comminuted radial head fractures in an unstable elbow or forearm. This article discusses the surgical considerations related to radial head arthroplasty, including anatomy, indications, and surgical technique. Radial head arthroplasty outcomes literature and a review of current implant options are also discussed.