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Journal of Wrist Surgery

Alexander Zolotov
The article presents handmade traction wrist tower, made from improvised means, which can be an alternative for expensive branded traction devices. The proposed device can be used successfully for wrist joint arthroscopy, as well as for performing various surgical procedures on the wrist and forearm, when traction is needed. This a Level IV study.
November 2018: Journal of Wrist Surgery
Onur Berber, Lorenzo Garagnani, Sam Gidwani
Background  End-stage wrist arthritis has traditionally been treated with a total wrist fusion. There is a recent trend toward motion preserving surgery in the form of total wrist replacement. Questions  Is there a functional benefit to performing a total wrist replacement instead of a total wrist fusion in patients with end-stage wrist arthritis? Is there any difference in secondary outcome measures including pain, grip strength, and range of motion? Does the risk of adverse events and treatment failure differ between the two techniques? Methods  A systematic literature search was performed to identify studies reporting either total wrist arthrodesis or arthroplasty for end-stage wrist arthritis...
November 2018: Journal of Wrist Surgery
Rishabh G Jethanandani, Schneider K Rancy, Keith T Corpus, Jeffrey Yao, Scott W Wolfe
Background  Isolated capitate nonunion is rare. No consensus on the appropriate treatment for this condition exists. Case Description  We reported two cases of capitate fracture nonunion presenting several months after untreated high-impact wrist trauma. Treatment was delayed as both patients' nonunions were missed on conventional radiographs. Both were ultimately diagnosed with advanced imaging and successfully treated with internal fixation and autogenous bone grafting. The relevant literature pertaining to capitate nonunion was reviewed...
November 2018: Journal of Wrist Surgery
Nathan T Rietberg, Matthew S Brown, Steven C Haase
Background  Pisiform excision and pisotriquetral arthrodesis are two surgical options for the treatment of pisotriquetral joint pain when conservative methods fail. However, it is unclear which option is best for patients who experience substantial, repetitive loading on their wrists and wish to preserve wrist flexibility and function. Case Description  We present a case of bilateral ulnar-sided wrist pain related to the pisotriquetral joint in a 19-year-old collegiate diver. The pain was exacerbated by activities specific to this sport that requires wrist hyperextension, namely full weight-bearing on the hands (handstands), and has an impact on the hands and wrists upon water entry during dives due to direct palmar pressure...
November 2018: Journal of Wrist Surgery
J Ryan Hill, Paul D Navo, Gabriel Bouz, Ali Azad, William Pannell, R Kiran Alluri, Alidad Ghiassi
Background  No consensus exists regarding postoperative splinting position following volar plate fixation of distal radius fractures. Purpose  The purpose of this study was to determine whether immobilization in supination would result in superior outcomes compared with no restriction of forearm range of motion. Patients and Methods  All patients >18 years of age with distal radius fractures indicated for volar plate fixation were eligible. Exclusion criteria were open fracture and concomitant injury to, or functional deficit of, either upper extremity...
November 2018: Journal of Wrist Surgery
Andy F Zhu, Geoffrey Burns, Breana Siljander, Jennifer F Waljee, Kagan Ozer
Background  The triangular fibrocartilage complex (TFCC) provides stability to the wrist and disruption of this complex can result in axial instability which can lead to ulnocarpal abutment. Purpose  This article determines the individual contributions of the volar radioulnar ligament (VRUL), dorsal radioulnar ligament (DRUL), and foveal attachment of the TFCC to longitudinal stability of the forearm under axial load. Materials and Methods  Eighteen cadaveric specimens were randomly assigned into three groups representing the component of the TFCC to be initially transected: VRUL, DRUL, and foveal attachment...
November 2018: Journal of Wrist Surgery
Adam C Brekke, Mark C Snoddy, Donald H Lee, Marc J Richard, Mihir J Desai
Background  It remains unknown how much force a partially united scaphoid can sustain without refracturing. This is critical in determining when to discontinue immobilization in active individuals. Purpose  The purpose of this study was to test the biomechanical strength of simulated partially united scaphoids. We hypothesized that no difference would exist in load-to-failure or failure mechanism in scaphoids with 50% or more bone at the waist versus intact scaphoids. Materials and Methods  Forty-one cadaver scaphoids were divided into four groups, three experimental osteotomy groups (25, 50, and 75% of the scaphoid waist) and one control group...
November 2018: Journal of Wrist Surgery
Kjell Van Royen, Bart Kestens, Sven Van Laere, Jean Goubau, Chul Ki Goorens
Background  Proximal migration of the first metacarpal can be seen after total trapeziectomy and various techniques have been described to prevent this subsidence. Purpose  We hypothesized the insertion of a poly-L/D-lactide spacer to prevent proximal migration of the first metacarpal without the need of an additional ligament reconstruction, allowing early mobilization and less demanding rehabilitation. Patients and Methods  Ten thumbs were treated with a total trapeziectomy and insertion of a poly-L/D-lactide scaffold...
November 2018: Journal of Wrist Surgery
Hirofusa Ichinose, Ryogo Nakamura, Etsuhiro Nakao, Takaaki Shinohara, Masahiro Tatebe, Harumoto Yamada
Background and Purpose  Wrist swelling is a frequent clinical manifestation of Kienböck's disease, but no study has reported the site and pathology of wrist swelling in this disease. The aim of this study is to elucidate the site and pathology of wrist swelling in Kienböck's disease. Materials and Methods  Dorsal and palmar soft tissue thicknesses of the wrist were measured on standard lateral radiographs of the wrist in 26 patients with Kienböck's disease and 30 subjects without intra-articular lesion...
November 2018: Journal of Wrist Surgery
N O B Thomsen, J Besjakov, A Björkman
Background  Magnetic resonance (MR) is the most important imaging technique to assess intra-articular pathology of the wrist. Among various MR imaging protocols, the diagnostic performance of indirect MR arthrography needs further investigation. Purpose  The purpose of this study was to assess the diagnostic performance of pre- and postcontrast, 3 T indirect MR arthrography in the diagnosis of scapholunate intrinsic ligament (SLIL) and triangular fibrocartilage complex (TFCC) injuries, using wrist arthroscopy as reference standard...
November 2018: Journal of Wrist Surgery
Taiichi Matsumoto, Peter Tang, Keiji Fujio, Robert J Strauch, Melvin P Rosenwasser
Background  Transosseous repair of foveal detachment of the triangular fibrocartilage complex (TFCC) is effective for distal radioulnar joint stabilization. However, studies of the optimal foveal and TFCC suture positions are scant. Purpose  The purpose of this study was to clarify the optimal TFCC suture position and bone tunnels for transosseous foveal repair. Materials and Methods  Seven cadavers were utilized. The TFCC was incised at the foveal insertion and sutured at six locations (TFCCs 1-6) using inelastic sutures...
November 2018: Journal of Wrist Surgery
Aviv Kramer, Raviv Allon, Frederick Werner, Idit Lavi, Alon Wolf, Ronit Wollstein
Background  In joints, structure dictates function and consequently pathology. Interpreting wrist structure is complicated by the existence of multiple joints and variability in bone shapes and anatomical patterns in the wrist. Previous studies evaluated lunate and capitate shape in the midcarpal joint, and two distinct patterns have been identified. Purpose  Our purpose was to further characterize the two wrist patterns in normal wrist radiographs using measurements of joint contact and position. Our hypothesis was that we will find significant differences between the two distinct anatomical patterns...
November 2018: Journal of Wrist Surgery
Schneider K Rancy, Stephanie D Malliaris, Eric A Bogner, Scott W Wolfe
Purpose  CAGE-DR implant is a novel Food and Drug Administration approved intramedullary fracture fixation device used for distal radius fractures. We examine a series of 22 patients and report the outcomes with this device. Materials and Methods  A total of 24 patients with distal radius fractures (8 articular AO type C1/C2; 16 extra-articular AO type A2/A3) underwent open reduction and internal fixation (ORIF) using CAGE-DR implant by a single surgeon. Data including fracture type, angle of displacement, radiographic consolidation, grip strength, wrist range of motion (ROM), patient-rated wrist evaluation (PRWE), and Visual Analog Scale (VAS) pain scores were recorded at time of surgery and at standard follow-up...
November 2018: Journal of Wrist Surgery
Toshiyasu Nakamura
No abstract text is available yet for this article.
November 2018: Journal of Wrist Surgery
Bo J W Notermans, Wiesje Maarse, Arnold H Schuurman
Aim  This study aims to evaluate the long-term complications, results, and patient satisfaction rates of a dorsally approached ulnar shortening osteotomy for ulnar impaction syndrome. Methods  A retrospective chart review of 20 patients was performed. Primary outcomes of interest were subjective, measured using the Patient-Rated Wrist Evaluation (PRWE) score, Disability of the Arm, Shoulder, and Hand (DASH) score, and the third questionnaire about patient satisfaction, composed by the authors. Secondary outcomes included hardware removal due to irritation and other complications...
September 2018: Journal of Wrist Surgery
Toshiyasu Nakamura, Koji Abe, Nobuki Terada
Purpose  Changes in the shape of the triangular fibrocartilage complex (TFCC) during radial-ulnar deviation were studied using "cine-mode" magnetic resonance imaging (MRI) in 10 right wrists of healthy volunteers, 5 wrists of TFCC tear, and 5 wrists of ulnar styloid nonunion. Subjects and Methods  The wrist was fixed in a custom acrylic device, which only allows radial and ulnar deviation. Coronal MR images of nine radial-ulnar deviated positions (every 5 degree from 15 degrees radial deviation to 25 degrees ulnar deviation) were obtained in volunteers and patients...
September 2018: Journal of Wrist Surgery
Zaid Ali, Laura Hamilton, Jonathan Compson
No abstract text is available yet for this article.
September 2018: Journal of Wrist Surgery
Reinier B Beks, Tessa Drijkoningen, Femke Claessen, Thierry G Guitton, David Ring
Purpose  Fractures of the proximal pole of the scaphoid are prone to adverse outcomes such as nonunion and avascular necrosis. Distinction of scaphoid proximal pole fractures from waist fractures is important for management but it is unclear if the distinction is reliable. Methods  A consecutive series of 29 scaphoid fractures from one tertiary hospital was collected consisting of 5 scaphoid proximal pole and 24 scaphoid waist fractures. Fifty-seven members of the Science of Variation Group (SOVG) were randomized to diagnose fracture location and displacement by using radiographs alone or radiographs and a computed tomography (CT) scan...
September 2018: Journal of Wrist Surgery
Ahmed Elgammal, Bernhard Rozée
Background  The purpose of this study is to evaluate the results of patients with ulnar impaction syndrome treated with diaphyseal osteotomy using freehand technique and fixation with ulnar osteotomy compression plate placed on the ulnar surface of the ulna. Materials and Methods  A retrospective chart review of patients with ulnar impaction syndrome between 2010 and 2014 identified 38 patients. The following clinical data were observed: patient age, sex, range of motion, grip strength, visual analog scale (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiological assessment, and complications...
September 2018: Journal of Wrist Surgery
Thomas Apard, Benoit Mariotte, Gilles Candelier
Symptomatic lunotriquetral coalition is very rare and need open surgery after failure of conservative treatment. We report a case of a symptomatic congenital lunotriquetral coalition type 1 according to the Minaar classification, at the left wrist of a 14-year-old boy. We performed an arthroscopic treatment with two compression screws and without cancellous bone grafting. Healing was obtained at 2 months postoperatively.
September 2018: Journal of Wrist Surgery
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