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Carpal Instability

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https://www.readbyqxmd.com/read/28325425/treatment-of-scaphotrapeziotrapezoid-osteoarthritis-with-the-pyrocardan-%C3%A2-implant-results-with-a-minimum-follow-up-of-2-years
#1
E Gauthier, M-V Truffandier, E Gaisne, P Bellemère
The aim of this study was to report the results of arthroplasty using a mobile pyrocarbon implant (Pyrocardan(®)) for isolated scaphotrapeziotrapezoid (STT) osteoarthritis. The hypothesis was that this arthroplasty leads to functional improvement without carpal instability. Twenty patients (22 implants) were included with a minimum follow-up of 2 years and an average age of 59.6 years. Outcome criteria were pain (VAS scale), QuickDASH and PRWE scores, strength (grip and pinch), wrist mobility, the Kapandji index, carpal height and the capitolunar angle measured on X-rays...
April 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28325424/surgical-treatment-of-carpal-boss-by-simple-resection-results-in-25%C3%A2-cases-at-a-mean-of-8%C3%A2-years-follow-up
#2
S Roulet, G Bacle, E Marteau, J Laulan
Carpal boss is a symptomatic bony protrusion on the dorsal surface of the wrist at the base of the 2nd and/or 3rd metacarpal. The goal of this study was to assess the reliability and safety of simply resecting the exostosis. From 1994 to 2014, 29 cases of carpal boss were treated by simple resection. Twenty-five of these patients were subsequently assessed by telephone questionnaire at a mean of 8 years' follow-up (range 1.1 to 20 years). There were no cases of recurrence; however, 1 patient reported carpometacarpal instability requiring fusion, 5 years after surgery...
April 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28236565/novel-isometric-exercises-for-the-dynamic-stability-programs-for-thumb-carpal-metacarpal-joint-instability
#3
Lori DeMott
No abstract text is available yet for this article.
February 21, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28229185/hamate-and-pisiform-coalition-a-case-report-and-introduction-to-the-carpal-c-sign-on-lateral-radiograph
#4
Jonathan Cortese, Marc Soubeyrand, Leo Razakamanantsoa, Marie-France Bellin, Maud Creze
Hamate-pisiform coalition is an exceptional form of carpal coalition. Case reports are essential to gain a better understanding of this variant. We report a case of congenital bilateral hamate-pisiform coalition in a 20-year-old male discovered in the context of a right wrist trauma. Radiographs also revealed a bilateral scapholunate diastasis. Clinical examination and radiological findings suggested that the right wrist scapholunate diastasis was related to scapholunate instability. Left wrist scapholunate diastasis could be related to (1) a pathological feature or (2) a normal variant associated with hamate-pisiform coalition...
February 22, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28191366/radiological-and-functional-outcome-of-displaced-colles-fracture-managed-with-closed-reduction-and-percutaneous-pinning-a-prospective-study
#5
Sagar Panthi, Kishor Khatri, Krishna Kharel, Subin Byanjankar, Jay R Sharma, Rahul Shrestha, Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay
BACKGROUND: Displaced Colles' fractures are treated by manipulation and below elbow cast application. Malunion is a common complication, resulting in pain, mid-carpal instability, and post-traumatic arthritis. Fracture stabilization by percutaneous pinning is a simple, minimally invasive technique that helps prevent displacement of the fracture, thereby minimizing complications. This study aims to assess the amount of collapse after closed manipulation and percutaneous pinning with Kirschner wires (K-wires) and its correlation with the functional outcome of the wrist after union...
January 6, 2017: Curēus
https://www.readbyqxmd.com/read/28143515/modified-minimally-invasive-extensor-carpi-radialis-longus-tenodesis-for-scapholunate-dissociation-a-prospective-observational-study
#6
Alexander Kaltenborn, Sebastian Hoffmann, Andreas Settje, Peter M Vogt, André Gutcke, Mike Rüttermann
BACKGROUND: Scapholunate dissociation is the most common form of carpal instability. However, there is no gold standard for operative treatment. In this prospective observational study on 54 patients, a modified minimally invasive dynamic extensor carpi radialis longus tenodesis is described, which is characterized by a smaller approach and application of a cannulated screw and washer for tendon fixation. METHODS: Quick-Disabilities of Arm, Shoulder and Hand (DASH)-questionnaire results, post-operative satisfaction, range of motion and grip strength are analyzed...
January 31, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28132592/classification-of-ulnar-triangular-fibrocartilage-complex-tears-a-treatment-algorithm-for-palmer-type-ib-tears
#7
A Atzei, R Luchetti, L Garagnani
The classical definition of 'Palmer Type IB' triangular fibrocartilage complex tear, includes a spectrum of clinical conditions. This review highlights the clinical and arthroscopic criteria that enable us to categorize five classes on a treatment-oriented classification system of triangular fibrocartilage complex peripheral tears. Class 1 lesions represent isolated tears of the distal triangular fibrocartilage complex without distal radio-ulnar joint instability and are amenable to arthroscopic suture. Class 2 tears include rupture of both the distal triangular fibrocartilage complex and proximal attachments of the triangular fibrocartilage complex to the fovea...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28065372/dynamic-high-resolution-ultrasound-of-intrinsic-and-extrinsic-ligaments-of-the-wrist-how-to-make-it-simple
#8
REVIEW
Salvatore Gitto, Carmelo Messina, Giovanni Mauri, Alberto Aliprandi, Francesco Sardanelli, Luca Maria Sconfienza
Wrist ligaments are crucial structures for the maintenance of carpal stability. They are classified into extrinsic ligaments, connecting the carpus with the forearm bones or distal radioulnar ligaments, and intrinsic ligaments, entirely situated within the carpus. Lesions of intrinsic and extrinsic ligaments of the wrist have been demonstrated to occur largely, mostly in patients with history of trauma and carpal instability, or rheumatoid arthritis. Ultrasound allows for rapid, cost-effective, non-invasive and dynamic evaluation of the wrist, and may represent a valuable diagnostic tool...
February 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28012551/strain-shielding-in-distal-radius-after-wrist-arthroplasty-with-a-current-generation-implant-an-in-vitro-analysis
#9
A Completo, J Pereira, A Nascimento, F Almeida
A systematic review of peer reviewed articles has shown that the main cause for wrist arthroplasty revision is carpal and radial prosthetic loosening and instability. To improve arthroplasty outcomes, successive generations of implants have been developed over time. The problem with the current generation of implants is the lack of long-term outcomes data. The aim of the present work was to test the hypothesis that the current generation Maestro WRS implant has a stress, strain and stability behaviour which may be associated with a reduced risk of long-term radial component loosening...
December 16, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27920391/dorsal-intercalated-segmental-instability-associated-with-malunion-of-a-reconstructed-scaphoid
#10
J-H Kim, K-H Lee, B G Lee, C-H Lee, S-J Kim, W-S Choi
We analysed scaphoid deformity as a result of surgical treatment of scaphoid fracture nonunion and assessed the deformity associated with a dorsal intercalated segmental instability pattern of carpal malalignment. A total of 45 patients who were treated for scaphoid fracture nonunion were included in the study. The height-to-length ratio of the scaphoid was measured on computed tomographic images and used to assess scaphoid deformity. Carpal malalignment was quantified based on the radio-lunate angle. A correlation analysis between the height-to-length ratio and the radio-lunate angle was performed...
December 5, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27909756/-ligament-injuries-of-the-wrist
#11
R Schmitt
The distal radioulnar joint, the triangular fibrocartilage complex (TFCC) and the wrist are stabilized by many ligaments allowing not only a wide range of motion but also providing sufficient stability. The complex arrangement of carpal ligaments and prosupination around the forearm joint enables multiaxial motion patterns. In the wrist, intra-articular ligaments can be differentiated from extra-articular capsular ligaments as well as intrinsic and extrinsic ligament courses. Imaging is essential for classification of dynamic and static instability patterns...
December 2016: Der Radiologe
https://www.readbyqxmd.com/read/27855045/-four-corner-fusion-in-patients-with-wrist-arthritis
#12
María Francisca Vázquez-Alonso, Alberto Viñas-Silva
Scapholunate advance collapse (SLAC) and Scaphoid nonunion advance collapse (SNAC), are the two most common patterns of postraumatic wrist arthritis. SLAC wrist develops after attenuation, either traumatically or atraumatically, of the scapholunate ligament. Atraumatic causes of SLAC wrist include calcium pyrophosphate dehydrate deposition disease, reumathoid arthritis, neuropathic diseases, and b2-microglobulin asociated amyloid deposition diseases. On the other hand, SNAC wrist develops following a scahpoid fracture that has progressed to a nonunion...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27793864/unilateral-fusion-of-the-scaphoid-and-the-trapezium
#13
Alexander Robert Poublon, Gerald Kraan, Gert-Jan Kleinrensink
Fusion of the carpal bones is a rare anatomical abnormality, caused by a defect in the separation and cavitation during embryonic development. It has a prevalence of about 0.1% and most of the time, patients do not present with symptoms. Symptoms are usually caused by wear and tear of the ligaments attached to the fused carpal fragments. We present a case in which a woman aged 36 years experiences pain caused by a lunato-triquetral instability which in turn is caused by a unilateral complete fusion of the scaphoid and the trapezium...
October 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27781979/scapholunate-interosseous-ligament-injury-in-professional-volleyball-players
#14
R Mugnai, N Della Rosa, L Tarallo
Injuries to the scapholunate interosseous ligament (SLIL) are the most common cause of carpal instability. A SLIL injury typically follows a fall on an outstretched hand, with the wrist in hyperextension, ulnar deviation and intercarpal supination. We hypothesize that repetitive axial loading on the wrist in hyperextension, during the reception and digging motions of volleyball, can lead to functional overloading of the SLIL. To identify patients and to determine the clinical history and surgical treatment performed, we analyzed hospital records, X-rays, electronic databases containing all the operations performed, and image files (including before and after surgery and follow-up)...
October 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27777822/the-role-of-dynamic-4d-ct-in-the-detection-of-scapholunate-ligament-injury
#15
Sanjeev Kakar, Ryan E Breighner, Shuai Leng, Cynthia H McCollough, Steven L Moran, Richard A Berger, Kristin D Zhao
Background Scapholunate (SL) interosseus ligament injuries detected at an early stage could allow the surgeon to prevent progression through the spectrum of injury that leads to instability, and eventually osteoarthritis. We contend that early instability following injury can be detected by visualizing the relative motions and distances between the involved carpal bones (scaphoid and lunate) during wrist movement in vivo. The purpose of this study is to demonstrate the utility of dynamic CT (i.e., 4DCT) in diagnosing SL interosseus ligament injuries in two patients with clinical suspicion of SL interosseus ligament injury during flexion-extension (FE), radial-ulnar (RU) deviation, and dart thrower's (DT) motions...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777814/kienb%C3%A3-ck-disease-and-arthroscopy-assessment-classification-and-treatment
#16
Gregory I Bain, Simon B M MacLean, Wing-Lim Tse, Pak-Cheong Ho, David M Lichtman
The assessment and management of Kienböck Disease (KD) has always been a conundrum. The Lichtman classification has traditionally been used to guide treatment based on imaging. Arthroscopy provides a direct visualization of the articular surface, allows probing of the surfaces, and enables minimally invasive techniques to be performed. The Lichtman-Bain classification is a new classification that takes into account the osseous, vascular, and cartilage aspects of the lunate and the secondary effects on the wrist...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777813/the-etiology-and-pathogenesis-of-kienb%C3%A3-ck-disease
#17
Gregory Ian Bain, Simon Bruce Murdoch MacLean, Chong Jin Yeo, Egon Perilli, David M Lichtman
Kienböck disease is a condition that typically occurs in the "at-risk" patient, in the "at-risk" aspect of the proximal condyle of the "at-risk" lunate. In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. The lunate fracture commences at the point the lunate cantilevers over the edge of the distal radius, and then takes on the shape of the radius. We postulate that the stress fracture violates the parallel veins of the venous subarticular plexus-leading to localized venous hypertension and subsequent ischemia and edema of the fatty marrow...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27766431/ilizarov-fixation-for-the-treatment-of-scaphoid-nonunion-a-novel-approach
#18
Marko Bumbaširević, Tomislav Palibrk, Henry Dushan E Atkinson, Aleksandar Lešić
OBJECTIVES: To evaluate the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft. DESIGN: This is a prospective study of 20 consecutive patients in one center. PATIENTS AND METHODS: This study included 20 patients (19 males) with a mean SNU duration of 14.5 months. Four patients had proximal pole, 15 had waist, and 1 had a distal SNU. Patients with carpal instability, humpback deformities, carpal collapse, avascular necrosis, and marked degenerative change were excluded...
October 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27725994/-acute-scaphoid-fractures-management-under-consideration-of-the-new-s3-level-guideline
#19
M Schädel-Höpfner, B Bickert, C Dumont, P Laier, R Meier, A Nusche, T Pillukat, H Rosenthal, R Schmitt, F Siemers, A Zach, M Jung
BACKGROUND: Scaphoid fractures represent the most common carpal fractures and are often problematic and frequently lead to nonunion with osteoarthritis and collapse of the wrist. The reasons for the nonunion are manifold. Therefore, the main goal of diagnosis and therapy of acute fractures is to achieve bony union and to restore the anatomic shape of the scaphoid. In the long run, only this can preserve the normal function of the wrist. METHODOLOGY: The given recommendations are based on the new S3-level guideline of the AWMF (Association of the Scientific Medical Societies)...
November 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27569785/carpal-kinematics-and-kinetics
#20
REVIEW
Robin N Kamal, Adam Starr, Edward Akelman
The complex interaction of the carpal bones, their intrinsic and extrinsic ligaments, and the forces in the normal wrist continue to be studied. Factors that influence kinematics, such as carpal bone morphology and clinical laxity, continue to be identified. As imaging technology improves, so does our ability to better understand and identify these factors. In this review, we describe advances in our understanding of carpal kinematics and kinetics. We use scapholunate ligament tears as an example of the disconnect that exists between our knowledge of carpal instability and limitations in current reconstruction techniques...
October 2016: Journal of Hand Surgery
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