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Journal of Wrist Surgery

Matthew D Treiser, Kayva Crawford, Matthew L Iorio
Background  Imaging of the triangular fibrocartilaginous complex (TFCC) remains difficult, as no single imaging modality demonstrates perfect sensitivity and specificity. Purpose  This study performs a meta-analysis of multiple previous publications to guide noninvasive imaging selection for the diagnosis of TFCC injuries. Methods  A literature search was performed and conducted. Studies were included that compared the diagnostic accuracy of magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and computed tomography (CT)/computed tomographic arthrography (CTA) for the evaluation of TFCC injuries...
July 2018: Journal of Wrist Surgery
Ahmed Elgammal, Claus J Deglmann, Vanja Celigoj, Bernhard Lukas
Purpose  The purpose of this prospective study was to evaluate the results of four-corner fusion using dorsal circular plate. Methods  We operated on 20 patients between 2009 and 2011. Results  At a mean follow-up period of 30 months (range: 14-62, SD: 16), the mean VAS improved from 8 (range: 4-10, SD: 2) preoperatively to 4 (range: 0-8, SD: 2). Function measured with the DASH score improved from 37 (range: 10-75, SD: 18) to 26 (range: 2.5-64, SD: 19). Eighteen patients in our series showed full consolidation and two patients showed persistent nonunion...
July 2018: Journal of Wrist Surgery
Venus Vakhshori, Ram K Alluri, Anuj Mahajan, Alidad Ghiassi
Background  Arteriovenous malformations (AVMs) are commonly treated using endovascular techniques. Previous nerve palsies after embolization have been reported as isolated case reports, none of which affected the forearm. Case Description  A case of acute, transient neuropathy of the radial nerve following embolization of a forearm AVM is described. The patient, an otherwise healthy 27-year-old man, began having symptoms of superficial radial nerve (SRN) and posterior interosseous nerve (PIN) palsies immediately following endovascular embolization...
July 2018: Journal of Wrist Surgery
R E López-Cervantes, M García-Elias, I Bermúdez Soto
Background  Axial carpal dislocations and fracture dislocations are 1.4 to 2.08% of all the fractures and dislocations of the wrist. These injuries are caused by high-energy blast or compression mechanisms. Only 11 cases of axial-radial-ulnar (ARU) fracture dislocations have been described in the literature. Case Description  We describe a case with a traumatic transtrapezoid, peritrapezium, transhamate, peripisiform ARU in a patient with acute compartment syndrome, traumatic transverse flexor retinaculum (TFR) rupture, and radial nerve palsy...
July 2018: Journal of Wrist Surgery
Kagan Ozer, Andy F Zhu, Breana Siljander, Jeffrey N Lawton, Jennifer F Waljee
Background  Forearm rotation results in change in ulnar variance. Axial loading of the wrist is required to maintain daily activities. Change in ulnar variance during axial loading has not been investigated previously. Purpose  To measure the change in ulnar variance on axially loaded wrists. Patients and Methods  We examined 21 asymptomatic individuals and 24 patients with unilateral ulnar-sided wrist pain. All patients underwent standard neutral posteroanterior wrist radiographs without load and under axial loading on bilateral wrists...
July 2018: Journal of Wrist Surgery
Thomas J M Kootstra, Wouter F van Leeuwen, Neal Chen, David Ring
Background  There is controversy regarding the value of repair of the triangular fibrocartilage complex (TFCC). Given that an acute tear of the TFCC associated with a displaced distal radius fracture uncommonly benefits from repair, the role of repair in other settings is uncertain. Our impression is that TFCC repair is highly variable from surgeon-to-surgeon. Purpose  The purpose of this study is to determine the rate of TFCC repair in patients who had a magnetic resonance imaging (MRI) scan of the wrist obtained for ulnar-sided wrist pain, and that showed signal changes in the TFCC...
July 2018: Journal of Wrist Surgery
André Duprat, Juan José Hidalgo Diaz, Paul Vernet, Stéphanie Gouzou, Sybille Facca, Yuka Igeta, Philippe Liverneaux
Background  The goal of this study was to demonstrate that the use of a splint after performing an osteosynthesis of the distal radius with a volar locking plate is unnecessary. The main hypothesis was that postoperative flexion of the wrist was greater without a splint. Secondary hypothesis was that patients who were allowed immediate mobilization got better results in terms of pain, Quick Disabilities of the Arm, Shoulder and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), strength, extension, pronation, and supination...
July 2018: Journal of Wrist Surgery
William J Warrender, Jeffrey Henstenburg, Mitchell Maltenfort, Kevin Lutsky, Pedro K Beredjiklian
Introduction  Seasonal variation in disease processes and injuries have been reported, but it is unclear if this variation exists in upper extremity disorders. The goal of this study is to characterize seasonal and weather variations in common upper extremity orthopaedic conditions. Methods  This cross-sectional study reviewed 68,943 consecutive, new patient visits from January 2010 to September 2015 for carpal tunnel syndrome (CTS), trigger finger (TF), DeQuervain's tenosynovitis (DeQ), lateral epicondylitis (LE), hand arthritis (OA), and distal radius fractures (DRF)...
July 2018: Journal of Wrist Surgery
Sebastian Farr, Thierry G Guitton, David Ring
Background  Patients with Madelung deformity exhibit a spectrum of mild to severe deformity and distortion of wrist geometry. It may be difficult to reliably distinguish mild Madelung deformity from normal. Purpose  This study thus tested the reliability of the diagnosis of mild Madelung deformity on a single posteroanterior (PA) radiograph. Materials and Methods  An online survey was sent to hand and wrist surgeons of the Science of Variation Study Group for evaluation of 25 PA wrist radiographs comprising five adults with suspected mild Madelung deformity and 20 radiographs without any evident wrist pathology...
July 2018: Journal of Wrist Surgery
G Medlock, M Smith, A J Johnstone
Purpose  Multifragmentary intra-articular fractures displaced in multiple planes are a challenge. We use a reproducible technique of fracture and articular reduction using an initial volar approach targeting reduction in the volar lunate facet first with plate and unicortical locking screws. This creates a template for reduction in dorsal fragments through a dorsal approach. Our study investigated the radiological, clinical, and functional outcomes of patients treated with this technique. Materials and Methods  We reviewed the postoperative radiographs and notes of 18 patients that had this method of fixation between the years 2008 and 2015, the mean age being 43...
July 2018: Journal of Wrist Surgery
M A M Mulders, G S I Sulkers, A J Videler, S D Strackee, M J C Smeulders
Background  Patients with palmar midcarpal instability have symptoms of pain, combined with clinical signs of abnormal mobility on stressing the joint, an unpredictable blockade feeling, and a noticeable clunk, in the absence of an underlying trauma. No data are available on the effect of conservative treatment for these patients. Purpose  The purpose of this study was to evaluate the effect and the long-term functional outcomes of a wrist exercise program in patients with palmar midcarpal instability. Patients and Methods  All patients diagnosed with palmar midcarpal instability between 2005 and 2011 were included...
July 2018: Journal of Wrist Surgery
Takaaki Kanazawa, Kazunari Tomita, Keikichi Kawasaki, Toshio Yagi, Yuji Tanabe, Katsunori Inagaki
Background  The Frag-Loc (FL) compression screw system was designed to stabilize dorsally displaced intra-articular dorsoulnar (die-punch) fragments in distal radius fractures. Purpose  Comparison of the biomechanical properties of fixation of the die-punch fragment (stiffness, ultimate strength, and displacement ratio of the fragment), using the FL and traditional locking screw (LS), and using simulated distal radial fractures in cadaveric specimens under axial compressive loading. Both screws were used with a volar locking plate (VLP)...
July 2018: Journal of Wrist Surgery
João Torrinha Jorge, Ana Ferrão, Sandra Alves, Ruben Caetano, Frederico Teixeira
Background  The treatment of chronic scapholunate instability is yet a controversial topic. Arthroscopic reduction-association scapholunate technique is a minimally invasive option in which a stable pseudoarthrosis at the scapholunate joint is obtained, allowing some degree of movement while maintaining the normal alignment of the wrist. The purpose of this study was to review the results of arthroscopic reduction-association scapholunate with an absorbable screw. Methods  We retrospectively evaluated patients with dynamic or static, but reducible, chronic scapholunate instability who underwent arthroscopic reduction-association scapholunate between 2012 and 2015...
July 2018: Journal of Wrist Surgery
Karthikeyan P Iyengar, Hosam E Matar, William Y C Loh
Background  Injuries to thumb carpometacarpal joint ligaments lead to instability. Eaton-Littler's ligament reconstruction traditionally uses a strip of flexor carpi radialis to stabilize the CMC joint. Study Description  We have modified this technique to reproduce the direction of active action of the anterior oblique ligament by reconstructing both the volar and dorsoradial ligaments. In this prospective study, we evaluated patients with confirmed traumatic thumb CMC joint instability who underwent modified Eaton-Littler's reconstruction...
July 2018: Journal of Wrist Surgery
P V Vermaak, T R Southwood, T R Lindau, A Jester, K Oestreich
Introduction  Juvenile Idiopathic Arthritis (JIA) is the most common rheumatological condition in children and frequently affects the wrist. The roles for wrist arthroscopy and arthroscopic synovectomy (AS) in JIA are unclear. Our aim was to find the current evidence supporting its use. Methods  Systematic literature review of relevant publications from 1990 to present in the Cochrane Library, Clinical Knowledge Summaries, DynaMed, PEMSoft, NICE Guidance, MEDLINE, EMBASE, and PubMed. Results  We found no publications detailing the use of arthroscopy or AS specifically in patients with JIA involving the wrist...
July 2018: Journal of Wrist Surgery
Toshiyasu Nakamura
No abstract text is available yet for this article.
July 2018: Journal of Wrist Surgery
YongSeok Nam, SeungHwan Hwang, SuRak Eo
No abstract text is available yet for this article.
April 2018: Journal of Wrist Surgery
Riccardo Luchetti, Luca Padua, Daniele Coraci, Ilaria Paolasso, Valter Santilli
No abstract text is available yet for this article.
April 2018: Journal of Wrist Surgery
Sami Almedghio, Mohammed Shoaib Arshad, Fayez Almari, Indranil Chakrabarti
Purpose  In this literature review, functional outcomes such as Disability of Arm, Shoulder and Hand (DASH) score and the visual analog scale (VAS) of pain along with clinical outcomes such as range of movement and grip strength of treated distal radius fractures (DRF) accompanied with ulnar styloid fractures (USF) will be compared with those with isolated DRF. Materials and Methods  We analyzed articles from MEDLINE, Embase, and CINAHL that met our predetermined inclusion and exclusion criteria as per the Preferred Reporting Items for Systematic Reviews and Meta-analysis statements...
April 2018: Journal of Wrist Surgery
Robert Kemper, Johanna Wirth, Eva-Maria Baur
Background  Minimal invasive treatments such as arthroscopic techniques may be adequate to restore the anatomy and functional integrity of the thumb CMC (carpometacarpal) joint. In this paper, we reported the interposition of autologous fat tissue in combination with arthroscopic synovectomy/debridement for early stage of the thumb CMC joint osteoarthritis. Patients and Methods  Twelve patients with a mean age of 46 years with early radiological stages of thumb CMC joint osteoarthritis were included. Evaluation of outcome was measured prior and 3, 12, and 24 months after surgery including, Visual Analog Scale (VAS), QuickDASH, grip and pinch strength, range of motion (ROM), and patient satisfaction...
April 2018: Journal of Wrist Surgery
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