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Distal radioulnar joint

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https://www.readbyqxmd.com/read/28991575/arthroscopic-assisted-triangular-fibrocartilage-complex-reconstruction
#1
REVIEW
Michael Chu-Kay Mak, Pak-Cheong Ho
Injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. Volar and dorsal radioulnar ligaments and their foveal insertion are the most important stabilizing components of the TFCC. In irreparable tears, anatomic reconstruction of the TFCC aims to restore normal biomechanics and stability of the distal radioulnar joint. We proposed a novel arthroscopic-assisted technique using a palmaris longus tendon graft. Arthroscopic-assisted TFCC reconstruction is a safe and effective approach with outcomes comparable to conventional open reconstruction and may result in a better range of motion from minimizing soft tissue dissection and subsequent scarring...
November 2017: Hand Clinics
https://www.readbyqxmd.com/read/28991574/arthroscopic-management-of-triangular-fibrocartilage-complex-foveal-injury
#2
REVIEW
Keiji Fujio
The deep component of triangular fibrocartilage complex (TFCC) inserts onto the fovea of the ulnar head. This component is critical to provide distal radioulnar joint stability. The surgical techniques and results of transosseous inside-out TFCC foveal repair are discussed. The rewarding results encouraged the repair of TFCC to the fovea arthroscopically. Although the results are good, the factors of age (traumatic or degenerative) and quality of stump and TFCC proper, which relate to the results should be considered in the future...
November 2017: Hand Clinics
https://www.readbyqxmd.com/read/28991573/arthroscopic-management-of-triangular-fibrocartilage-complex-peripheral-injury
#3
REVIEW
Jan Ragnar Haugstvedt, Endre Søreide
Patients suffering from ulnar-sided wrist pain after trauma may develop tenderness, clicking, a positive fovea sign, or instability of the distal radioulnar joint. If the pain is persistent, conservative treatment does not help, and the patient agrees to surgery, arthroscopy may reveal a triangular fibrocartilage complex (TFCC) injury with capsular detachment, foveal avulsion, or a combination thereof. Capsular reattachment is possible using an arthroscopic assisted technique. The reattachment can be performed with an inside-out, outside-in, or all-inside technique, providing good to excellent results, which tend to persist over time, in 60% to 90% of cases...
November 2017: Hand Clinics
https://www.readbyqxmd.com/read/28991572/chronologic-and-geographic-trends-of-triangular-fibrocartilage-complex-repair
#4
REVIEW
Taichi Saito, Jennifer M Sterbenz, Kevin C Chung
This article shows trends in triangular fibrocartilage complex (TFCC) repair since 1990 by geographic area and year. The repair methods presented in the literature were inside-out, outside-in, all-inside, and open repair. The outside-in technique was reported most often for ulnar-side tears, whereas the inside-out technique was reported most frequently for radial-side tears. Recently, a foveal reattachment technique for ulnar-side tears has garnered attention and has been reported with increasing frequency, especially in Asia, because the deepest portion of TFCC, attached to fovea, plays a key role in stabilizing the distal radioulnar joint...
November 2017: Hand Clinics
https://www.readbyqxmd.com/read/28979859/hernia-mesh-prevent-dislocation-after-wide-excision-and-reconstruction-of-giant-cell-tumor-distal-radius
#5
I Gede E Wiratnaya, I Gusti Bagus Arie M Budiartha, I Gusti Ngurah Y Setiawan, Dwijo A Sindhughosa, I Ketut S Kawiyana, Putu Astawa
Giant cell tumor (GCT) remains as major health problem. GCT which located at the lower end of the radius tends to be more aggressive. Wide excision and reconstruction of the wrist in stage 3 of distal radius GCT lesion is an optimal modality to prevent tumor recurrence. However, dislocation often occurs as its complication. We are reporting patient with GCT of distal radius treated with wide excision and reconstruction using nonvascularized fibular graft and the addition of hernia mesh. Circumferential non-absorbable polypropylene hernia mesh was applied, covered radioulnar joint and volar aspect of radius, and served as additional support to prevent dislocation...
September 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28951793/volar-distal-radioulnar-joint-dislocation-associated-with-acute-median-nerve-neuropathy-and-a-distal-radius-fracture
#6
Naser Alnusif, Sultan Aldebeyan, Rudolf Reindl
Volar distal radioulnar (DRUJ) dislocations are uncommon and can easily be missed. We present a rare case of an irreducible volar DRUJ dislocation associated with a distal radius fracture and acute median nerve neuropathy at the wrist. An attempt to reduce the DRUJ dislocation in the emergency department had failed. The patient was then taken to the operating room requiring a carpal tunnel release, as well as an open reduction and internal fixation of the distal radius fracture and repair of the volar distal radioulnar ligament...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28951101/arthrokinematics-of-the-distal-radioulnar-joint-measured-using-intercartilage-distance-in-an-in%C3%A2-vitro-model
#7
Braden Gammon, Emily Lalone, Masao Nishiwaki, Ryan Willing, James Johnson, Graham J W King
PURPOSE: Current techniques used to measure joint contact rely on invasive procedures and are limited to statically loaded positions. We sought to examine native distal radioulnar joint (DRUJ) contact mechanics using nondestructive imaging methods during simulated active and passive forearm rotation. METHODS: Testing was performed using 8 fresh-frozen cadaveric specimens that were surgically prepared by isolating muscles involved in forearm rotation. A wrist simulator allowed for the evaluation of differences between active and passive forearm rotation...
September 23, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28932701/mr-imaging-of-the-traumatic-triangular-fibrocartilaginous-complex-tear
#8
REVIEW
Alex W H Ng, James F Griffith, Cindy S Y Fung, Ryan K L Lee, Cina S L Tong, Clara W Y Wong, Wing Lim Tse, Pak Cheong Ho
Triangular fibrocartilage complex is a major stabilizer of the distal radioulnar joint (DRUJ). However, triangular fibrocartilage complex (TFCC) tear is difficult to be diagnosed on MRI for its intrinsic small and thin structure with complex anatomy. The purpose of this article is to review the anatomy of TFCC, state of art MRI imaging technique, normal appearance and features of tear on MRI according to the Palmar's classification. Atypical tear and limitations of MRI in diagnosis of TFCC tear are also discussed...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28888571/accuracy-and-early-clinical-outcome-of-3-dimensional-planned-and-guided-single-cut-osteotomies-of-malunited-forearm-bones
#9
Simon Roner, Lazaros Vlachopoulos, Ladislav Nagy, Andreas Schweizer, Philipp Fürnstahl
PURPOSE: To investigate the reduction accuracy of 3-dimensional planned single-cut osteotomies (SCOTs) of the forearm that were performed using patient-specific guides. METHODS: A retrospective analysis of SCOTs performed between 2012 and 2014 was performed. Ten patients (age, 15-59 years) with 6 malunions of the ulna and 6 malunions of the radius were identified. The reduction accuracy was assessed by comparing the 3-dimensional preoperative plan of each osteotomy with the superimposed bone model extracted from postoperative computed tomography data...
September 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28888525/clinical-and-radiological-outcomes-following-radioscapholunate-fusion
#10
David Montoya-Faivre, Germain Pomares, Valentin Calafat, François Dap, Gilles Dautel
INTRODUCTION: Radioscapholunate (RSL) fusion is typically performed following wrist trauma. It addresses the pain caused by radiocarpal osteoarthritis but reduces the wrist's mobility. The objective of this study was to determine the long-term clinical and radiological outcomes of this procedure. MATERIALS AND METHODS: This was a retrospective study of all wrists operated for RSL fusion in our surgery unit over a 12-year period. The clinical analysis consisted of joint amplitudes, grip strength, pain (VAS) and functional scores (PRWE, QuickDash, Mayo Wrist Score)...
September 6, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28865983/distal-radioulnar-joint-instability
#11
O Marès
Distal radioulnar joint (DRUJ) instability is a rare but disabling problem. Surgical treatment remains a challenge. The advent of arthroscopic techniques has helped to rebuild the triangular fibrocartilaginous complex (TFCC), especially its deep part. However, isolated TFCC damage is not responsible for instability. Its repair is sometimes not sufficient to restore DRUJ stability, or the chronicity of the injury prevents its direct repair. Open surgical procedures still have a role in these cases. They require a detailed knowledge of the various stabilizers of the DRUJ...
October 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28844582/outcomes-of-isolated-radial-osteotomy-for-volar-distal-radioulnar-joint-instability-following-radial-malunion-in-children
#12
Ashley Miller, Nina Lightdale-Miric, Emily Eismann, Preston Carr, Kevin James Little
PURPOSE: The radius bone has a slight dorsoradial bow that allows for full forearm pronosupination around the ulna. However, radial malunion can lead to reversal of the radial bow and subsequent volar instability of the distal radioulnar joint (DRUJ), predominantly in supination. This study assessed the outcomes of corrective radial osteotomy for volar DRUJ instability after radial malunion in children. METHODS: The charts of 7 children (2 boys and 5 girls) treated with corrective radial osteotomy for volar DRUJ instability after a radius fracture or deformity were reviewed...
August 23, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28836879/outcome-of-the-sauv%C3%A3-kapandji-procedure-for-distal-radioulnar-joint-disorder-with-rheumatoid-arthritis-or-osteoarthritis-results-of-one-year-follow-up
#13
Mikinori Ikeda, Akira Kawabata, Keisuke Suzuki, Masahiko Toyama, Takeshi Egi
OBJECTIVES: We performed the Sauvé-Kapandji procedure for treating disorders of the distal radioulnar joint (DRUJ) in patients with rheumatoid arthritis (RA) or osteoarthritis (OA). This study aimed to compare and clarify the results of the SK procedure between RA and OA patients. We report the one-year follow-up results of patients who underwent the SK procedure to correct the DRUJ disorder caused by RA or OA. METHODS: The study included 22 wrists of 19 patients with RA and 10 wrists of nine patients with OA...
August 24, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28832196/salvage-of-failed-achilles-tendon-interposition-arthroplasty-for-druj-instability-after-ulnar-head-resection-with-aptis-prosthesis
#14
Sunishka M Wimalawansa, Rocio Rodriguez Lopez, Fernando Garcia de Lucas, Luc De Smet, Michael A Boin, Matthew Dorweiler, Ilse Degreef
BACKGROUND: Historically, failed conservative treatment for irreparably damaged distal radioulnar joints (DRUJs) is treated via distal ulnar resection or DRUJ fusion; complications include disabling painful convergence of the radius and ulnar stump during lifting Various treatments for radioulnar impingement include distal radioulnar Achilles tendon allograft interpositional arthroplasty. This technique does not adequately prevent radioulnar impingement and we explore an alternative treatment...
September 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28809637/-comparison-of-short-therm-results-of-conservative-versus-operative-treatment-of-distal-ulna-fractures-associated-with-distal-radius-fracture-treated-by-plate-osteosynthesis
#15
P Meluzinová, L Kopp, P Dráč, K Edelmann, P Obruba
PURPOSE OF THE STUDY The study aims to evaluate and compare the results of conservative and operative treatment of individual types of distal ulna fractures associated with distal radius fracture treated by plate osteosynthesis and to verify the conclusions of the other authors regarding the recommended therapeutic procedures in these fractures. MATERIAL AND METHODS In the period from 08/2013 to 09/2015, a total of 81 patients participated in the prospective randomised study, with the mean follow-up period of 24 months (6-36)...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28751170/rehabilitation-of-distal-radioulnar-joint-instability
#16
G Mesplié, V Grelet, O Léger, S Lemoine, D Ricarrère, C Geoffroy
Distal radioulnar joint (DRUJ) instabilities are common and often combined with other injuries of the interosseous membrane and/or the proximal radioulnar joint. Once they are diagnosed and the treatment is chosen, physiotherapists have limited choices due to the lack of validated protocols. The benefits of proprioception and neuromuscular rehabilitation have been brought to light for the shoulder, knee and ankle joints, among others. However, no program has been described for the DRUJ. The purpose of this article is to study the muscular elements responsible for active DRUJ stability, and to propose a proprioceptive rehabilitation program suited to this condition...
October 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28718329/assessment-of-forearm-rotational-control-using-4-upper-extremity-immobilization-constructs
#17
Ayesha M Rahman, Nicole Montero-Lopez, Richard M Hinds, Michael Gottschalk, Eitan Melamed, John T Capo
BACKGROUND: Forearm immobilization techniques are commonly used to manage distal radius, scaphoid, and metacarpal fractures. The purpose of our study was to compare the degree of rotational immobilization provided by a sugar-tong splint (STS), short arm cast (SAC), Munster cast (MC), and long arm cast (LAC) at the level of the distal radioulnar joint (DRUJ), carpus, and metacarpals. METHODS: Seven cadaveric upper extremity specimens were mounted to a custom jig with the ulnohumeral joint fixated in 90° of flexion...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28718315/ulnar-styloid-base-fractures-cause-distal-radioulnar-joint-instability-in-a-cadaveric-model
#18
Tyler S Pidgeon, Joseph J Crisco, Gregory R Waryasz, Douglas C Moore, Manuel F DaSilva
BACKGROUND: The deep portion of the distal radioulnar ligaments (DRUL) inserts on the ulnar fovea and is the most important stabilizer of the distal radioulnar joint (DRUJ). Ulnar styloid base fractures that include the ulnar fovea may cause DRUJ instability. METHODS: DRUJ stability in pronosupination was evaluated in 12 fresh-frozen upper extremities (4 female) aged 52 to 68 years (mean: 58.8 years) using a custom fixture, which allowed free rotation of the radius around the fixed ulna...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28709834/radiological-degenerative-changes-in-the-distal-radioulnar-joint-after-ulnar-shortening-osteotomy-in-patients-with-idiopathic-ulnar-impaction-syndrome-analysis-of-factors-affecting-degenerative-lesions
#19
Soo Min Cha, Byong San Choi, Hyun Dae Shin
PURPOSE: To identify factors influencing overall radiologic changes in the distal radioulnar joint after ulnar shortening osteotomy (USO) in patients with idiopathic ulnar impaction syndrome. MATERIALS AND METHODS: A total of 310 patients who had undergone USO between May 2007 and December 2013 were included in this retrospective case-control study. The patients were classified into two groups (with or without radiologic findings of new arthritic changes), after which the following factors were analyzed: 1) demographic factors; 2) radiologic aspects, including ulnar variance (UV), morphological DRUJ type (classified according to Tolat et al...
July 11, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28708756/anatomic-reconstruction-of-distal-radioulnar-ligaments-with-tendon-graft-for-treating-distal-radioulnar-joint-instability-surgical-technique-and-outcome
#20
Daniela Meyer, Andreas Schweizer, Ladislav Nagy
Among the various reasons for chronic posttraumatic ulnar-sided wrist pain, instability of the distal radioulnar joint (DRUJ) has recently received major attention and finally achieved fundamental progress in understanding thanks to anatomic and biomechanical studies. This has resulted in more physiological and successful treatment methods compared with the historic options. One and the most dramatic surgical technique consists in the replacement of the main ligamentous stabilizer of the DRUJ, the so-called triangular fibrocartilage, with a tendon graft...
September 2017: Techniques in Hand & Upper Extremity Surgery
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