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Wrist arthrodesis

Daniel Tordjman, Mohamed K Barry, Richard M Hinds, S Steven Yang
Lunotriquetral (LT) synchondrosis is an uncommon variant of congenital LT coalition. Unlike complete LT fusions, this incomplete pseudoarthrosis-like coalition can become symptomatic. Surgical LT arthrodesis is a described treatment for this variant of LT coalition (Minnaar type I). We report 4 patients who underwent LT fusion with a second-generation headless compression screw and distal radius cancellous autograft. Fusion was achieved in all cases at an average of 2.5 months postoperatively. All the patients were satisfied with complete pain relief in 2 patients and minimal pain in 2 patients, and all improved their range of motion...
October 12, 2016: Techniques in Hand & Upper Extremity Surgery
B Bickert, T Kremer, U Kneser
Closed tendon ruptures of the thumb that require secondary reconstruction can affect the extensor pollicis longus (EPL), extensor pollicis brevis (EPB) and flexor pollicis longus (FPL) tendons. Treatment of rupture of the EPB tendon consists of refixation to the bone and temporary transfixation of the joint. In the case of preexisting or posttraumatic arthrosis, definitive arthrodesis of the thumb is the best procedure. Closed ruptures of the EPL and FPL tendons at the wrist joint cannot be treated by direct tendon suture...
September 30, 2016: Der Unfallchirurg
S D Iordache, D Nam, J Paylan, T Axelord
We present the outcome of four-corner wrist arthrodesis using two headless compression screws for fixation. The study group consisted of 27 patients who underwent arthrodesis from 1998 through 2007. Data on demographic parameters, diagnosis, range of motion, pain and complications were collected from the medical files. A total of 77 series of anteroposterior, oblique, and lateral x-rays were reviewed by three independent interpreters ; consensus of at least two was required for the bones to be considered fused...
August 2016: Acta Orthopaedica Belgica
Tahseen Chaudhry, Michelle Spiteri, Dominic Power, Mark Brewster
AIM: To review the results of our experience with the Medartis Aptus plating system for four corner arthrodesis of the wrist, which uses a combination of compression screws and variable angle locking screws. METHODS: We reviewed the results of 17 procedures in 16 patients that underwent scaphoid excision and four corner fusion using the Medartis Aptus system between May 2010 and June 2014. The primary outcome measure was radiographic and clinical union. RESULTS: The mean clinical follow up time was 20...
August 18, 2016: World Journal of Orthopedics
Kevin D Han, Jaehon M Kim, Michael V DeFazio, Ricardo J Bello, Ryan D Katz, Brent G Parks, Kenneth R Means
PURPOSE: A high incidence of nonunion and relatively poor outcomes with prior fixation techniques has precluded scapholunate (SL) arthrodesis as a standard treatment for SL instability. Our purpose was to determine the impact on range of motion (ROM) of simulated SL arthrodesis via headless screw fixation. METHODS: We performed baseline wrist ROM for 10 cadaveric wrists using a standardized mounting-and-weights system. Extension, flexion, radial deviation, ulnar deviation, dart-thrower's extension, and dart-thrower's flexion were assessed...
September 2016: Journal of Hand Surgery
Julia-Ann Lee, Sreedharan Sechachalam
PURPOSE: Studies on grip endurance are scant even though it is an important topic with practical implications. This study compares the effect of wrist position, in the flexion-extension plane, on grip endurance and grip strength. METHODS: Grip strength and grip endurance were quantified bilaterally at 6 different wrist positions (unrestrained, 45°, 30°, and 15° extension, 0° and 30° flexion) in 38 healthy right-handed individuals. RESULTS: Our results show that wrist orthosis significantly reduced grip strength across all positions and the maximum grip strength in the position with an orthosis occurred at 15° and 30° extension for the dominant hand and 15°, 30°, and 45° extension for the nondominant hand...
October 2016: Journal of Hand Surgery
W Zhang, J Zhong, D Li, C Sun, H Zhao, Y Gao
: Giant cell tumour of the distal radius is a locally aggressive lesion. In this study, we performed a wrist arthrodesis reconstruction with an ipsilateral double barrel segmental ulnar bone graft combined with a modified Sauve-Kapandji procedure for a giant cell tumour of the distal radius. From January 2007 to September 2013, we followed eight patients for a mean duration of 36 months. One patient developed a recurrence and was treated by amputation; the other seven patients achieved radiological union in about 8 months...
August 25, 2016: Journal of Hand Surgery, European Volume
Alexia Hernandez-Soria, Soumen Das De, Zina Model, Steve K Lee, Scott W Wolfe
PURPOSE: The objective of this study was to examine the effect of altering the capitolunate relationship on coronal-plane wrist motion after scaphoidectomy and simulated 4-corner arthrodesis. Two positions of different capitolunate alignments were compared: "anatomic" (unchanged from pre-fusion) and "lunate-covered" (capitate translated to cover the lunate). We hypothesized that wrist resting posture would be altered and radial-ulnar motion would diminish after 4-corner arthrodesis in the lunate-covered position when compared with normal wrists...
August 11, 2016: Journal of Hand Surgery
Ricardo Horta, Ricardo Nascimento, Alvaro Silva, Rui Pinto, Pedro Negrão, Ricardo São-Simão, Jorge Carvalho, Marta Santos Silva, Jose Amarante
Radial club hand may be congenital or acquired; radial deviation of the hand is usually found, associated with palmar flexion-pronation and treatment of severe forms of radial club hand is often difficult. Here we present a case of reconstruction of a severe postraumatic radial club hand with a free fibular osteoseptocutaneous flap and Sauve-Kapandji procedure in a 28-year-old man. The patient had a radial deviation of the wrist and right upper limb shortening as a result of an infected pseudarthrosis of the radius...
October 2016: Microsurgery
Kosuke Shintani, Kenichi Kazuki, Kiyohito Takamatsu, Masahiro Yoneda, Takuya Uemura
BACKGROUND: Limited wrist arthrodesis with scaphoid excision is a useful treatment for scapholunate advanced collapse (SLAC) of the wrist. Multiple Kirschner wires were originally used for internal fixation of the four carpal bones, however long-term cast immobilization, pin tract infection, and hardware removal are still problematic. We introduce and evaluate the clinical outcomes of an internal fixation technique; triangle fixation for four-corner fusion, using three headless screws, as an alternative to conventional multiple Kirschner wires for the treatment of SLAC wrist...
June 2016: J Hand Surg Asian Pac Vol
Shardul Madhav Soman, Bhavik Nandubhai Patel, Pratik Dineshbhai Shah
INTRODUCTION: It is uncommon for hand surgeons to diagnose and treat persistent post-traumatic radius fracture on the lines of tuberculosis infection even in developing countries especially when the clinical picture resembles more of a complex regional pain syndrome (CRPS). Although it works for many patients, some conditions that affect the wrist don't fall in this category and worsen with this treatment practice. We present a patient who had an extra articular distal radius fracture treated initially with percutaneous pinning and was treated as CRPS for the next ten months by local physician...
October 2015: Journal of Orthopaedic Case Reports
Nicolas de l'Escalopier, Philippe Anract, David Biau
There are two main surgical treatments for osteoarthritis: conservative treatments, where the damaged cartilage is left in place, and radical treatments, where the cartilage is replaced by an artificial endoprosthesis; this latter procedure is termed joint arthroplasty. These treatments are only offered to symptomatic patients. Arthrodesis is yet another surgical intervention in cases of osteoarthritis. It will sacrifice the joint's articular function and is performed on small osteoarthritic joints, such as wrists and ankles, for instance...
June 2016: Annals of Physical and Rehabilitation Medicine
D H Owen, P A Agius, A Nair, D M Perriman, P N Smith, C J Roberts
AIMS: Total wrist arthrodesis (TWA) produces a spectrum of outcomes. We investigated this by reviewing 77 consecutive TWA performed for inflammatory and post-traumatic arthropathies, wrist instability and as a salvage procedure. PATIENTS AND METHODS: All operations were performed by a single surgeon using a specifically designed pre-contoured dorsally applied non-locking wrist arthrodesis plate at a single centre. RESULTS: Median post-operative Buck-Gramcko Lohman (BGL), Disabilities of the Arm, Shoulder and Hand and Patient Rated Wrist Evaluation scores at six years (interquartile range (IQR) 3 to 11) were 9 (IQR = 6 to 10), 19 (IQR = 7 to 45) and 13 (IQR = 1 to 31) respectively...
May 2016: Bone & Joint Journal
E Jardin, C Pechin, P-B Rey, N Gasse, L Obert
The authors present the case of a patient with a rare combination of open volar radiocarpal dislocation and complete destruction of the dorsal capsule-ligament complex and tendons. The treatment consisted of open reduction and arthrorisis (temporary arthrodesis during 45 days) with four K-wires (radiocarpal and radioulnar). The capsule-ligament complex was fixed with anchors and the extensor tendons were repaired by suturing. A long-arm cast was applied for six weeks. After an 18-month follow-up, the Cooney-modified Green and O'Brien score was 70 and the wrist range of motion was 85°...
April 2016: Hand Surgery and Rehabilitation
Pascale Laronde, Nicolas Christiaens, Aurélien Aumar, Christophe Chantelot, Christian Fontaine
Proximal row carpectomy (PRC) and four-corner arthrodesis (4CA) are the two most commonly performed surgical procedures to treat wrist arthritis. Postoperative strength is one of the criteria for choosing between the two techniques. Some authors believe that strength is correlated with residual carpal height. The goal of this study was to determine if postoperative carpal height was predictive of postoperative strength. This study consisted of two parts: a clinical evaluation of grip strength after 4CA or PRC; anatomical and radiological measurements of carpal height before and after 4CA or PRC...
April 2016: Hand Surgery and Rehabilitation
Grzegorz Guzik
The most common neoplasms of the distal radius are primary tumors, of which aneurysmal bone cysts and giant cell tumors are seen almost exclusively. Chondrosarcomas are most commonly located in the pelvis, ribs and proximal segments of the extremities; they rarely occur in forearm bones. Bone defects after distal radial resection can be replaced with bone grafts, both autogenous and allogenic. There is always a risk of failure of the bones to mend or slower synostosis, which necessitates the search for new treatments...
January 2016: Ortopedia, Traumatologia, Rehabilitacja
Arlindo Gomes Pardini, Rodolfo Fonseca Pádua Gonçalves, Afrânio Donato Freitas, Antonio Barbosa Chaves
OBJECTIVE: Wrist arthrodesis is a surgical procedure that should always be considered in cases of pathological conditions in which anatomical and functional structures are altered. In general, the results are very satisfactory, particularly for pain relief, and in the majority of cases, there is considerable functional improvement. Various techniques have been described, with different methods of internal fixation, most of which include the carpometacarpal joints in the fusion. The objective of this study was to evaluate the results from wrist arthrodesis using a technique that is simpler, more biological, less expensive, and does not involve the carpometacarpal joints...
January 2010: Revista Brasileira de Ortopedia
Brian D Adams, Ben P Kleinhenz, Justin J Guan
PURPOSE: Treatment options for failed total wrist arthroplasty include implant revision, resection arthroplasty, and arthrodesis. Variable results associated with different techniques have been reported for arthrodesis and the procedure has substantial technical challenges, including restoration of wrist height, obtaining stable fixation, and achieving bony fusion. This study evaluates the radiographic results of a surgical technique for conversion of a failed arthroplasty to an arthrodesis...
June 2016: Journal of Hand Surgery
Jérémie Chevrollier, Clotilde Strugarek-Lecoanet, François Dap, Gilles Dautel
Our retrospective study aimed to evaluate functional and radiological results of a unicentric series of 17 total wrist prostheses implanted between 2001 and 2011. Nine women and seven men, mean age 59, underwent wrist joint arthroplasty, bilateral in one case. Universal Total Wrist and Remotion prostheses were used and followed-up at a mean of 5.2 years (1.1-10). Fifteen patients were reviewed. Four patients had postoperative complications, three of whom required arthrodesis. The rest obtained satisfactory pain relief...
March 2016: Acta Orthopaedica Belgica
Dragosloveanu Serban, Christiana Celea, Cristian Celea
CASE REPORT: A young healthy patient, health-care worker in a state hospital, presented in the eye department complaining of pain and blurred vision in the left eye for approx. 2 weeks. Examination revealed a VA of 12/20 in the left eye, an interstitial keratitis, some signs of vitreal inflammation and two chorioretinal mass lesions (at echography appearing cystic) in the affected eye. She also mentioned a chronic pain in the right wrist. No systemic association was found. Based on the orthopaedic examination, biopsy, and surgical intervention, a strong suspicion of ocular tuberculosis was made and the patient was advised to start tuberculostatic treatment for 12 months and ocular steroidian treatment for 4 months...
April 2015: Romanian Journal of Ophthalmology
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