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• W4239780756 abstract "We would like to thank Dr. Meek and Dr. Heras-Palou for reading our article and for their comments. We agree with their observation that insertion of a screw that is too long can damage articular surfaces on either side of the scaphoid.Dr. Meek and Dr. Heras-Palou have stated that insertion of the longest screw possible is not necessary; however, a recent biomechanical study suggests that a longer screw provides significantly greater stability (p < .01).1Dodds S.D. Panjabi M.M. Slade III, J.F. Screw fixation of scaphoid fractures: a biomechanical assessment of screw length and screw augmentation.J Hand Surg. 2006; 31A: 405-413Google Scholar Additionally, a microarchitectural study of the scaphoid in our laboratory suggests that the most dense cancellous bone for screw purchase is located at the proximal and distal poles of the bone (Bindra et al, presented at the Meeting of the International Federation of Societies for Surgery of the Hand, 2004). Although it is possible that different screw designs may achieve compression with shorter screws, we do believe that a screw that engages the dense bone at the two poles of the scaphoid may offer maximum stability.The cadaveric measurements we have provided in our paper are to be used as a guide only—it remains critical for the surgeon to accurately measure the length of the screw track prior to screw insertion. We would like to thank Dr. Meek and Dr. Heras-Palou for reading our article and for their comments. We agree with their observation that insertion of a screw that is too long can damage articular surfaces on either side of the scaphoid. Dr. Meek and Dr. Heras-Palou have stated that insertion of the longest screw possible is not necessary; however, a recent biomechanical study suggests that a longer screw provides significantly greater stability (p < .01).1Dodds S.D. Panjabi M.M. Slade III, J.F. Screw fixation of scaphoid fractures: a biomechanical assessment of screw length and screw augmentation.J Hand Surg. 2006; 31A: 405-413Google Scholar Additionally, a microarchitectural study of the scaphoid in our laboratory suggests that the most dense cancellous bone for screw purchase is located at the proximal and distal poles of the bone (Bindra et al, presented at the Meeting of the International Federation of Societies for Surgery of the Hand, 2004). Although it is possible that different screw designs may achieve compression with shorter screws, we do believe that a screw that engages the dense bone at the two poles of the scaphoid may offer maximum stability. The cadaveric measurements we have provided in our paper are to be used as a guide only—it remains critical for the surgeon to accurately measure the length of the screw track prior to screw insertion. Anthropometry of the Human ScaphoidJournal of Hand SurgeryVol. 33Issue 2PreviewWe read with great interest the paper by Heinzelmann, Archer, and Bindra on their analysis of morphometric data of the human scaphoid.1 We would like to congratulate the authors on their work. However, it is our view that their conclusion must be interpreted with caution. Full-Text PDF" @default.
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• W4239780756 date "2008-02-01" @default.
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• W4239780756 title "In Reply" @default.
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• W4239780756 doi "https://doi.org/10.1016/j.jhsa.2007.11.015" @default.
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