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Carpal Instability

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https://www.readbyqxmd.com/read/29619121/intra-articular-fracture-of-the-distal-part-of-the-triquetrum-within-the-pisotriquetral-joint-case-report-and-review-of-literature
#1
V Athanasiou, A Panagopoulos, I D Iliopoulos, I Vrahnis, G Diamantakis, P Kraniotis, M Tyllianakis
Background: Intra-articular fractures of the distal part of the triquetrum within the pisotriquetral joint are uncommon, and can be associated with tears of the dorsal carpal ligaments, pisiform subluxation and/or FCU dislocation. Their diagnosis is difficult and requires a high clinical suspicion and a proper radiological examination including oblique wrist x-rays, computed tomography and MRI scan. These fractures can be delayed diagnosed due to late presentation thus leading to painful nonunion, persistent instability and late pisotriquetral arthritis...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29576913/current-management-of-scaphoid-nonunion-based-on-the-biomechanical-study
#2
Kunihiro Oka, Hisao Moritomo
Scaphoid nonunion causes abnormal wrist kinematics and typically leads to carpal collapse and subsequent degenerative arthritis of the wrist. However, the natural history, including carpal collapse and degenerative arthritis of scaphoid nonunion, may vary at different fracture locations. This article reviews recent biomechanical studies related to the natural history of scaphoid nonunion. In the distal-type fractures (type B2 in Herbert classification), where the fracture located distal to the scaphoid apex, the proximal scaphoid fragment and lunate, which are connected through the dorsal scapholunate interosseous ligament (DSLIL) and dorsal intercarpal ligament (DIC), extend together, and the distal fragment of the scaphoid flexes individually...
April 2018: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/29536137/-mediocarpal-instability-of-the-wrist
#3
REVIEW
A L Sander, K Sommer, K Eichler, I Marzi, J Frank
Typical lesions of the carpal ligaments are mostly found after a fall on the wrist in hyperextension or as complex injuries after severe trauma, e. g. after a fall from a significant height, motorcycle accident or as accompanying lesions in multiple trauma. The typical mechanisms, patterns and diagnostic algorithms are well known for the common ligamentous injuries (e.g. scapholunate, lunotriquetral and perilunate); therefore, consistent diagnostic procedures and adequate therapy are increasingly performed after such lesions, e...
May 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29464291/-rupture-of-the-scapholunate-intercarpal-ligament
#4
REVIEW
Berthold Bickert
Complete rupture of the scapholunate (SL) ligament can cause a dissociative carpal instability (CID). These ligamentous lesions are caused by a fall from a limited height of approximately 1 m or a fall, e. g. when playing handball or soccer. For a freshly injured wrist joint, the X‑ray signs of a static instability (after excluding a fracture) are a SL distance ≥3 mm, a SL angle >60°, and a dorsal displacement of the proximal scaphoid pole. Dynamic instabilities are best seen in kinematography of the wrist joint...
May 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29310416/medium-term-outcome-of-closed-radial-wedge-osteotomy-of-the-distal-radius-for-preiser-disease-with-concomitant-kienb%C3%A3-ck-disease-two-case-reports-and-a-literature-review
#5
REVIEW
Yuji Tomori, Takuya Sawaizumi, Nanno Mitsuhiko, Shinro Takai
RATIONALE: Idiopathic avascular necrosis of the scaphoid or lunate bone are known as Preiser disease and Kienböck disease, respectively. Although there are reports of avascular necrosis involving more than one carpal bone, concurrent idiopathic avascular necrosis of the scaphoid and lunate bones is rare, with only five cases reported in the English literature (including the two herein). Although the optimum treatment for Preiser disease with concomitant Kienböck disease has not been established, our cases underwent closed radial wedge osteotomy based on the evidence of satisfactory outcomes for treating Kienböck disease...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29282524/perilunate-fracture-dislocations-clinical-and-radiological-results-of-21-cases
#6
Thomas Meszaros, Esther Vögelin, Lukas Mathys, Franck Marie Leclère
BACKGROUND: Perilunate dislocations and fracture-dislocations are a subcategory of the carpal instability complex. Herein, we report our university hospital experience with this complex injury. The goal of our study was to find predictive factors and quantify the development of arthritis and lunate necrosis. We tried to measure the impact of arthritis on hand function. METHODS: Between January 2000 and December 2014, 21 patients underwent surgery for perilunate dislocations and perilunate fracture-dislocations of the wrist in our tertiary university center...
February 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29242793/open-anterior-peri-lunardislocation-of-the-carp-a-case-report
#7
Hassini Lassaad, Nawar Nader, Youcef Othmen, Mtaoumi Mourad, Mohamed Laziz Ben Ayeche
Introduction: The anterior perilunate dislocations of the carp (PDC)are exceptional and poorly known lesions, which may go unnoticed in an emergency. They derive their importance from the severity of sequelae, which are dominated by chronic wrist instability and long-term osteoarthritis. Case Report: We report the case of an open anterior PDC with no carpal fracture in a young patient. The injury occurred in a road accident and was treated at once with satisfactory results 1year after...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29199895/radiological-evaluation-of-scapholunate-intercarpal-ligamentoplasty-for-chronic-scapholunate-dissociation-in-cadavers
#8
Lionel Athlani, Nicolas Pauchard, Gilles Dautel
We performed a cadaveric study to evaluate radiological performance of a technique for scapholunate intercarpal ligamentoplasty designed for treating reducible scapholunate dissociation. We created scapholunate instability in 12 fresh adult cadaveric forearms by sectioning the dorsal scapholunate interosseous ligament and the dorsal intercarpal ligament. All wrists showed scapholunate diastasis, dorsal intercalated segmental instability and posterior scaphoid subluxation. We performed scapholunate intercarpal ligamentoplasty in six wrists and Garcia-Elias three-ligament tenodesis in another six...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29132239/lunate-fractures-and-associated-radiocarpal-and-midcarpal-instabilities-a-systematic-review
#9
Meenalochani Shunmugam, Joideep Phadnis, Amy Watts, Gregory I Bain
The aim of this study was to analyse lunate fractures and any associated osseo-ligamentous injuries. A systematic review identified 34 cases. We identified carpal instabilities at the radiocarpal and midcarpal joints in volar and dorsal directions. Radiocarpal instabilities (10/34) were usually dorsoradial (8/10), with a transverse lunate fracture, best seen on a coronal image. Midcarpal instabilities (24/34) were usually volar (14/18), with a volar lunate shear fracture, best seen on a sagittal image. Instabilities were sub-classified into non-displaced, subluxated and dislocated...
January 2018: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29105591/treatment-of-the-scaphoid-humpback-deformity-is-correction-of-the-dorsal-intercalated-segment-instability-deformity-critical
#10
Christophe L Mathoulin, Margareta Arianni
Treatment of scaphoid fractures has been focused mainly on achieving union, with less attention to restoring normal scaphoid shape and orientation. Malalignment of one carpal bone will disrupt the kinetics of the entire wrist. The dorsal intercalated segment instability deformity associated with scaphoid waist nonunion is a nondissociative form of carpal instability. It has to be reduced in the treatment of scaphoid waist nonunions to avoid kinetic problems that will lead to arthritic changes. Computerized tomography scanning has become indispensable to visualize the humpback deformity clearly...
January 2018: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29105586/radial-styloidectomy-for-scaphoid-nonunion-advanced-collapse-relevance-of-nonunion-location
#11
Emil S Vutescu, Rishabh Jethanandani, Darryl B Sneag, Scott W Wolfe, Steve K Lee
Radial styloidectomy along with scaphoid nonunion reconstructive surgery is considered an acceptable surgical treatment for stage 1 scaphoid nonunion advanced collapse. The extent of radioscaphoid joint wear that defines scaphoid nonunion advanced collapse stage 1 is unclear. An appropriate radial styloidectomy is limited to 6 mm styloid removal to prevent carpal instability. The aim of this study was to determine whether nonunion fracture location can be a guiding factor in determining whether the scaphoid bone can be retained with scaphoid nonunion reconstructive surgery and radial styloidectomy...
January 2018: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29098903/scaphoid-instability-caused-by-a-giant-cell-tumour-of-the-tendon-sheath-a-case-report
#12
Yanjun Wang, Xiaoxiao Zhu, Genwang Pei, Xianshang Zeng, Deng Chen, Yonggang Zuo, Weiguang Yu, Zhe Ge, Xinchao Zhang
Giant-cell tumour of the tendon sheath (GCTTS) is a soft tissue tumour that may invade bone, causing an intrinsic osseous lesion or instability on radiographs. A case with scaphoid instability caused by a histologically-confirmed neighbouring GCTTS has rarely been described in the literature. No definite and radical method is available for the treatment of GCTTS. This report describes an unusual case of a 22-year-old woman who previously experienced a GCTTS in her right elbow, which was removed 10 years earlier...
March 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29071123/treatment-of-scapholunate-ligament-injury-current-concepts
#13
Jonny K Andersson
Injuries to the scapholunate joint are the most common cause of carpal instability.An isolated injury to the scapholunate ligament may progress to abnormal joint mechanics and degenerative cartilage changes.Treatment for scapholunate instability is aimed at arresting the degenerative process by restoring ligament continuity and normalising carpal kinematics.Early arthroscopic diagnosis of scapholunate injury is mandatory for establishing the prognosis of the injury, as a proper ligament repair is recommended within four to six weeks after trauma...
September 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/28988679/cumulative-incidence-of-carpal-instability-12-24-months-after-fall-onto-outstretched-hand
#14
Lisa O'Brien, Luke Robinson, Eugene Lim, Hayley O'Sullivan, Helen Kavnoudias
STUDY DESIGN: Descriptive Epidemiological Study. INTRODUCTION: Ligament tears between carpal bones are easily missed on initial presentation, but can have potentially debilitating effects on the patient if they progress to an instability. They are usually the result of a fall onto an outstretched hand with the wrist in hyperextension. Current incidence of carpal instability after these falls is unknown. PURPOSE OF THE STUDY: Using established clinical and radiological measures, we sought to establish the cumulative incidence of carpal instability in people who have fallen onto an outstretched hand in the second year after injury...
October 5, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28940545/effect-of-distal-ulnar-ostectomy-on-carpal-joint-stability-during-weight-bearing-in-the-dog
#15
Pierre M Amsellem, Aisha N Young, Tammy L Muirhead, LeeAnn Pack, Peter Moak, Andrea R Matthews, Denis J Marcellin-Little
OBJECTIVE: To assess the influence of a 50% distal ulnectomy on mediolateral carpal stability in the dog. STUDY DESIGN: Canine cadaveric study. SAMPLE POPULATION: Seven canine thoracic limbs METHODS: Thoracic limbs were placed in a jig to mimic weight bearing with a load representing 30% of body weight. Carpal extension angle was standardized at 190° ± 5°. Frontal plane carpal angles were measured with the limb loaded on craniocaudal radiographs before and after ulnectomy...
September 22, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28921041/stabilization-of-scaphoid-type-b2-fractures-with-one-or-two-headless-compression-screws
#16
S Quadlbauer, T Beer, Ch Pezzei, J Jurkowitsch, A Tichy, T Hausner, M Leixnering
INTRODUCTION: Fractures of the scaphoid account for the most commonly injured carpal bone. Minimally displaced fractures of the waist will heal in 85-90% when using a below elbow cast. However, fractures with displacement have a higher risk for nonunion. Therefore, open reduction and fixation with headless compression screws (HCS) have become the preferred method of treatment. The aim of this study was to compare the radiological and clinical outcome of unstable scaphoid B2 type fractures, stabilized using one or two headless compression screws...
September 18, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28917548/volar-capsular-release-after-distal-radius-fractures
#17
Robin N Kamal, David S Ruch
PURPOSE: Loss of full wrist range of motion is common after treatment of distal radius fractures. Loss of wrist extension limiting functional activities, although uncommon, can occur after volar plating of distal radius fractures. Unlike other joints in which capsular release is a common form of treatment for stiffness, this has been approached with caution in the wrist owing to concerns for carpal instability. We tested the null hypothesis that hardware removal and open volar capsular release would not lead to improved upper extremity-specific patient-reported outcome (Disabilities of the Arm, Shoulder, and Hand [DASH] questionnaire)...
December 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28877592/the-optimal-location-to-measure-scapholunate-diastasis-on-screening-radiographs
#18
Joseph Said, Kevin Baker, Laviel Fernandez, David E Komatsu, Elaine Gould, Lawrence C Hurst
BACKGROUND: Lack of a universally accepted location and normal value limits the utility of measuring scapholunate diastasis. The primary purpose of this study was to define the optimal location to measure the scapholunate gap throughout sequential ligament transections. Secondary purposes were to compare plain radiographs with fluoroscopy and to evaluate interrater reliability in measuring scapholunate diastasis. METHODS: Five cadaver forearms were imaged with intact carpal ligaments and after sequentially transecting the scapholunate, radioscaphocapitate, and scaphotrapezium-trapezoid ligaments...
September 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28828602/association-of-lunate-morphology-sex-and-lunotriquetral-interosseous-ligament-injury-with-radiologic-measurement-of-the-capitate-triquetrum-joint
#19
Marissa Borgese, Robert D Boutin, Christopher O Bayne, Robert M Szabo, Abhijit J Chaudhari
OBJECTIVE: Radiologic presentation of carpal instability at the radial side of the carpus, e.g. scapholunate diastasis following scapholunate interosseous ligament injury, has been studied extensively. By comparison, presentation at the ulnar-sided carpus has not. The purpose of this study was to assess the effects of lunate morphology, sex, and lunotriquetral interosseous ligament (LTIL) status on the radiologic measurement of the capitate-triquetrum joint (C-T distance). Further, we sought to evaluate the diagnostic accuracy of C-T distance for assessing LTIL injuries...
December 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28673627/carpal-ligaments-a-functional-classification
#20
REVIEW
Marc Garcia-Elias, Inma Puig de la Bellacasa, Corinne Schouten
Recent laboratory research has disclosed that carpal ligaments exhibit different kinetic behaviors depending on the direction and point of application of the forces being applied to the wrist. The so-called helical antipronation ligaments are mostly active when the wrist is axially loaded, whereas the helical antisupination ligaments constrain supination torques to the distal row. This novel way of interpreting the function of the carpal ligaments may help in developing better strategies to treat carpal instabilities...
August 2017: Hand Clinics
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