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Carpal Instability

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https://www.readbyqxmd.com/read/28921041/stabilization-of-scaphoid-type-b2-fractures-with-one-or-two-headless-compression-screws
#1
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%C3%A2-fractures
#2
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)...
September 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28877592/the-optimal-location-to-measure-scapholunate-diastasis-on-screening-radiographs
#3
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
#4
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...
August 21, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28673627/carpal-ligaments-a-functional-classification
#5
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
#6
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...
August 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28624019/scapholunate-dissociation-diagnostics-made-easy
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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...
September 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28488457/wrist-cineradiography-a-protocol-for-diagnosing-carpal-instability
#13
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
#14
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
#15
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
#16
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
#17
Lori DeMott
No abstract text is available yet for this article.
July 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
#18
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
#19
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
#20
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
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