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Carpal Instability

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https://www.readbyqxmd.com/read/28673627/carpal-ligaments-a-functional-classification
#1
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
https://www.readbyqxmd.com/read/28628801/evaluation-of-midcarpal-capitate-contact-mechanics-in-normal-injured-and-post-operative-wrists
#2
Saman Modaresi, Madhan S Kallem, Phil Lee, Terence E McIff, E Bruce Toby, Kenneth J Fischer
BACKGROUND: Scapholunate ligament injury is a commonly occurring carpal ligament injury. Pathology associated with scapholunate ligament injury depends on several factors such as the time after injury, type of injury (instability) and the development of osteoarthritis. The aim of this study was to investigate and compare contact mechanics in the lunocapitate and scaphocapitate joints in the normal, injured (scapholunate dissociation) and repaired (postoperative) wrist. METHODS: Four human subjects with scapholunate ligament dissociation participated in this study...
June 13, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28624019/scapholunate-dissociation-diagnostics-made-easy
#3
K C A L Cheriex, G S I Sulkers, M P Terra, N W L Schep, B J P L van Aard, S D Strackee
Scapholunate dissociation (SLD) is a form of carpal instability, caused by rupture of the scapholunate ligament (SLL) the secondary stabiliser of the scapholunate (SL) compartment. SLD can cause osteoarthritis of the wrist. Recently a study was published that shows cineradiography to be an excellent radiological imaging technique for diagnosing SLD at a tertiary centre for hand and wrist surgery [1]. As the quality of these results can be influenced by the expertise of the operator and observer of the cineradiographic studies, the aim of this study was to determine if these results were reproducible at a secondary centre for hand and wrist surgery with less expertise in wrist cineradiography...
July 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28578528/update-on-operative-treatment-of-scapholunate-sl-instability-for-radiologists-part-1-sl-ligament-repair-dorsal-capsulodesis-and-sl-ligament-reconstruction
#4
REVIEW
Kimia Khalatbari Kani, Hyojeong Mulcahy, Jack Porrino, Aaron Daluiski, Felix S Chew
Scapholunate instability is the most common form of carpal instability. Imaging (especially radiography) plays an important role in the staging, management and post-operative follow-up of scapholunate (SL) instability. The goals of this article are to review the pre-operative staging of SL instability, the surgical options for repair and reconstruction of the SL ligament, along with the normal postoperative imaging findings as well as complications associated with these surgical options.
June 3, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28547205/update-on-the-operative-treatment-of-scapholunate-instability-for-radiologists-ii-salvage-procedures-total-wrist-arthrodesis-and-total-wrist-arthroplasty
#5
REVIEW
Kimia Khalatbari Kani, Hyojeong Mulcahy, Jack Porrino, Daluiski Aaron, Felix S Chew
Scapholunate (SL) instability is the most common form of carpal instability. Imaging (especially radiography) plays an important role in the staging, management, and postoperative follow-up of SL instability. In the final stage of SL instability, known as scapholunate advanced collapse, progressive degenerative changes occur at the carpal level. The goals of this article are to review the surgical options available for addressing the different stages of scapholunate advanced collapse, along with an emphasis on normal postoperative imaging and complications associated with each surgical option...
August 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28525962/association-of-lunate-morphology-with-carpal-instability-in-scapholunate-ligament-injury
#6
Eric Quan Pang, Nathan Douglass, Robin N Kamal
BACKGROUND: We examined the relationship between lunate morphology (type 1 without a medial facet; type II with a medial facet) and dorsal intercalated segmental instability (DISI) in patients with scapholunate ligament injuries. We tested the primary null hypothesis that there is no relationship between lunate morphology and development of DISI. Secondary analysis compared the agreement of classifying lunate morphology based on the presence of a medial lunate facet, capitate-to-triquetrum (CT) distance, and magnetic resonance imaging (MRI)...
May 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28507968/posttraumatic-static-volar-intercalated-segment-instability-iatrogenic-or-missed-injury
#7
Vishnu Senthil, Imthias V Kottamttavide, Hitesh Shah
INTRODUCTION: Carpal instability is broad category consisting of various patterns of injury, with dissociative type more common. CASE REPORT: A 13 -year -old boy presented at 6 months following a fall with restriction of wrist movements. Patient had sustained a closed distal one -third both bones fracture forearm fixed with K -wire, and volar lunate instability was found during sequential follow -up. CONCLUSION: Posttraumatic carpal instability should be identified at the earliest to avoid poor hand function and morbidity associated with it...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28494943/kinematic-analysis-of-the-scaphoid-using-gated-four-dimensional-ct
#8
I S Mat Jais, S C Tay
AIM: To investigate the kinematics of the scaphoid while the wrist was in radioulnar motion using gated four-dimensional computed tomography (4DCT) imaging. MATERIALS AND METHODS: Six cadaveric wrist specimens were scanned in the following order of capsulotomy and ligament sectioning: (1) ligaments intact, (2) capsulotomy, (3) scapholunate ligament division, and lastly, (4) lunotriquetral ligament division. A three-dimensional model was then reconstructed to analyse the translation and angular displacements of the scaphoid...
May 7, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28488457/wrist-cineradiography-a-protocol-for-diagnosing-carpal-instability
#9
G S I Sulkers, S D Strackee, N W L Schep, M Maas
Carpal instability is often related to ruptured or lax carpal ligaments. Wrist cineradiography has been shown to be a good modality for diagnosing carpal instability. To create uniformity in obtaining and assessing wrist cineradiography, a wrist cineradiography protocol is desirable. This protocol will focus on wrist cineradiography for diagnosing carpal instabilities. It describes the pathologic motions of the carpus and correlates these with a clinical diagnosis. LEVEL OF EVIDENCE: III...
March 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28488448/indications-techniques-and-outcomes-of-arthroscopic-repair-of-scapholunate-ligament-and-triangular-fibrocartilage-complex
#10
C L Mathoulin
This review includes updated understanding of the roles of intrinsic and extrinsic carpal ligaments in scapholunate instability and details the author's experience of indications, arthroscopic repair methods, and outcomes of treating the instability. A classification on triangular fibrocartilage complex injuries is reviewed, followed by author's indications, methods, and outcomes of arthroscopic repair of triangular fibrocartilage complex injuries.
July 2017: Journal of Hand Surgery, European Volume
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
May 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
#18
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
#19
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
#20
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
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