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Carpal Instability

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https://www.readbyqxmd.com/read/29132239/lunate-fractures-and-associated-radiocarpal-and-midcarpal-instabilities-a-systematic-review
#1
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 1, 2017: 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
#2
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 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29105586/radial-styloidectomy-for-scaphoid-nonunion-advanced-collapse-relevance-of-nonunion-location
#3
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 1, 2017: 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
#4
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...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29071123/treatment-of-scapholunate-ligament-injury-current-concepts
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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.
December 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
#16
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
#17
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
#18
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
#19
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
#20
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
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