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Midcarpal instability

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https://www.readbyqxmd.com/read/29428553/radiocarpal-dislocations-and-fracture-dislocations-injury-types-and-long-term-outcomes
#1
C Spiry, G Bacle, E Marteau, B Charruau, J Laulan
INTRODUCTION: . Radiocarpal dislocation (RCD) and fracture-dislocations (RCFD) are severe but rare injuries for which the treatment and outcomes are not well defined. The aim of this retrospective study was to describe the prevalence of the various injury types and their long-term outcomes. PATIENTS AND METHODS: Between 1992 and 2014, 41 patients with RCFD were seen at our institution. According to the Dumontier classification, there were 4 cases of type 1 and 37 cases of type 2...
February 8, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29383283/arthroscopic-scaphoid-3d-test-for-scapholunate-instability
#2
Fernando Corella, Montserrat Ocampos, Miguel Del Cerro
Background  Patients with scapholunate instability usually have pain in the dorsal wrist. This pain may occur due to the impingement between the scaphoid and the dorsal rim of the radius when the scaphoid is detached from the lunate. This pain appears as the scaphoid is displaced over the dorsal rim of the radius. The arthroscopic scaphoid 3D (dorsal, dynamic, displacement) test is described here to check this pathologic dorsal displacement of the scaphoid. Surgical Technique  The test should be performed both in the radiocarpal and midcarpal joints...
February 2018: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/29241841/dorsal-wrist-plication-for-midcarpal-instability
#3
Herbert P von Schroeder
PURPOSE: Midcarpal instability (MCI) is a cause of chronic wrist pain for which treatment remains controversial. This study's purpose was to determine the outcome of a treatment algorithm for MCI that included immobilization and surgical interventions. METHODS: We prospectively enrolled 23 consecutive patients (12 males, average age 27 years) with 27 symptomatic wrists. All had generalized wrist pain with an average duration of 22 months. All had MCI and a catch-up clunk that reproduced the symptoms...
December 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29146508/biomechanical-analysis-of-palmar-midcarpal-instability-and-treatment-by-partial-wrist-arthrodesis
#4
Sarah A Shiga, Frederick W Werner, Marc Garcia-Elias, Brian J Harley
PURPOSE: To create a biomechanical model of palmar midcarpal instability by selective ligament sectioning and to analyze treatment by simulated partial wrist arthrodesis. METHODS: Nine fresh-frozen cadaver arms were moved through 3 servohydraulic actuated motions and 2 passive wrist mobilizations. The dorsal radiocarpal, triquetrohamate, scaphocapitate, and scaphotrapeziotrapezoid ligaments were sectioned to replicate palmar midcarpal instability. Kinematic data for the scaphoid, lunate, and triquetrum were recorded before and after ligament sectioning and again after simulated triquetrohamate arthrodesis (TqHA) and radiolunate arthrodesis (RLA)...
November 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132239/lunate-fractures-and-associated-radiocarpal-and-midcarpal-instabilities-a-systematic-review
#5
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/29117846/lunotriquetral-ligament-reconstruction-utilizing-a-palmaris-longus-autograft
#6
Carl M Harper, Matthew L Iorio
Injury to the lunotriquetral ligament can result in midcarpal instability, with resultant alterations in normal wrist kinematics and subsequent arthrosis. We performed a previously undescribed technique of lunotriquetral ligament reconstruction in two patients utilizing a palmaris longus tendon autograft. Average age at presentation was 24 years old with a mean follow up of 10 months. Average range of motion was 62.5° of flexion and 57.5° of extension. Total arc of motion was 83% of the contralateral uninvolved extremity...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28991583/midcarpal-instability-the-role-of-wrist-arthroscopy
#7
REVIEW
Ryan P C Higgin, David G Hargreaves
The evidence behind management options for midcarpal instability (MCI) is scarce, relying solely on case series. Established treatments cause significant loss of wrist motion. As understanding of the condition has progressed, surgeons have been trying soft tissue techniques. The treatment option should be chosen for the appropriate type and grade of MCI. The Hargreaves grading system for palmar MCI aids treatment decision-making. A possible role for arthroscopy in treatment of MCI has been developed using arthroscopic thermal capsular shrinkage, appropriate for cases with dynamic instabilities...
November 2017: Hand Clinics
https://www.readbyqxmd.com/read/28628801/evaluation-of-midcarpal-capitate-contact-mechanics-in-normal-injured-and-post-operative-wrists
#8
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/28205478/scaphotrapeziotrapezoidal-joint-osteoarthritis-a-systematic-review-of-surgical-treatment
#9
Victoria M Deans, Zafar Naqui, Lindsay T S W Muir
BACKGROUND: The management of scaphotrapeziotrapezoidal (STT) joint osteoarthritis (OA) remains controversial. This systematic review aims to review the evidence for surgical interventions specific to STT OA. METHODS: Medline and Embase libraries were searched using a pre-defined search strategy in October 2014. All study designs and languages were included and evaluated by two reviewers (VMD and LM) against the inclusion/exclusion criteria. The study eligibility criteria included papers discussing surgical treatment of STT OA, and the review was conducted using the PRISMA guidelines...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/27855045/-four-corner-fusion-in-patients-with-wrist-arthritis
#10
María Francisca Vázquez-Alonso, Alberto Viñas-Silva
Scapholunate advance collapse (SLAC) and Scaphoid nonunion advance collapse (SNAC), are the two most common patterns of postraumatic wrist arthritis. SLAC wrist develops after attenuation, either traumatically or atraumatically, of the scapholunate ligament. Atraumatic causes of SLAC wrist include calcium pyrophosphate dehydrate deposition disease, reumathoid arthritis, neuropathic diseases, and b2-microglobulin asociated amyloid deposition diseases. On the other hand, SNAC wrist develops following a scahpoid fracture that has progressed to a nonunion...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27777814/kienb%C3%A3-ck-disease-and-arthroscopy-assessment-classification-and-treatment
#11
Gregory I Bain, Simon B M MacLean, Wing-Lim Tse, Pak-Cheong Ho, David M Lichtman
The assessment and management of Kienböck Disease (KD) has always been a conundrum. The Lichtman classification has traditionally been used to guide treatment based on imaging. Arthroscopy provides a direct visualization of the articular surface, allows probing of the surfaces, and enables minimally invasive techniques to be performed. The Lichtman-Bain classification is a new classification that takes into account the osseous, vascular, and cartilage aspects of the lunate and the secondary effects on the wrist...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27570228/changes-in-wrist-motion-after-simulated-scapholunate-arthrodesis-a-cadaveric-study
#12
Kevin D Han, Jaehon M Kim, Michael V DeFazio, Ricardo J Bello, Ryan D Katz, Brent G Parks, Kenneth R Means
PURPOSE: A high incidence of nonunion and relatively poor outcomes with prior fixation techniques has precluded scapholunate (SL) arthrodesis as a standard treatment for SL instability. Our purpose was to determine the impact on range of motion (ROM) of simulated SL arthrodesis via headless screw fixation. METHODS: We performed baseline wrist ROM for 10 cadaveric wrists using a standardized mounting-and-weights system. Extension, flexion, radial deviation, ulnar deviation, dart-thrower's extension, and dart-thrower's flexion were assessed...
September 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27264901/role-of-muscles-in-the-stabilization-of-ligament-deficient-wrists
#13
REVIEW
Mireia Esplugas, Marc Garcia-Elias, Alex Lluch, Manuel Llusá Pérez
This article reviews the results of a series of cadaver investigations aimed at clarifying the role of muscles in the stabilization of ligament-deficient wrists. According to these studies, isometric contraction of some forearm muscles induces midcarpal (MC) supination (ie, the abductor pollicis longus, extensor carpi radialis longus, and flexor carpi ulnaris), whereas other muscles induce MC pronation (ie, the extensor carpi ulnaris). Because MC supination implies tightening of the volar scaphoid-distal row ligaments, the MC supination muscles are likely to prevent scaphoid collapse of wrists with scapholunate ligament insufficiency...
April 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/27247752/fixed-lunate-flexion-deformity-in-distal-radius-fractures
#14
Sanglim Lee, Jae-Ha Yu, Suk Ha Jeon
Carpal malalignments in malunion of distal radius fracture are considered as an adaptive response of the carpus to loss of normal architecture of the distal radius. This condition leads to mechanical overload, ligament attenuation and progressive dynamic instability around the wrist joint. Radial corrective osteotomy is suggested as a treatment option of carpal malalignment after distal radius malunion. In radiocarpal malalignment, the lunate is usually observed in flexion in contrast to its extension posture in the more common midcarpal malalignment...
June 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27117017/isolated-or-predominant-capitolunate-osteoarthritis-is-the-consequence-of-lunotriquetral-dissociation-x-ray-analysis-of-22-consecutive-cases
#15
J Brunet, G Bacle, E Marteau, F Gadea, J Laulan
Secondary osteoarthritis due to a scapholunate malalignment is well known, but is debatable in cases of lunotriquetral malalignment. It has been shown that lunotriquetral malalignment can lead to midcarpal osteoarthritis. The hypothesis of this retrospective study was that a relationship exists between the presence of midcarpal osteoarthritis and the presence of lunotriquetral malalignment. All patients with midcarpal osteoarthritis, isolated or predominant, treated between 1981 and 2013 were reviewed. Intracarpal angles were measured and the relative position of the carpal bones was analyzed by two examiners...
February 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/26598109/midcarpal-instability
#16
REVIEW
D G Hargreaves
Midcarpal instability is a collective term for a number of conditions where the instability of the wrist is predominantly between the proximal and distal carpal rows. It has been regarded as relatively rare and infrequently requires surgical treatment. Palmar midcarpal instability is the most commonly found type of midcarpal instability and can be responsible for causing a clunking and painful wrist. The diagnosis is made on clinical grounds using the midcarpal instability provocative tests. Standard imaging and arthroscopic inspection do not usually confirm a definite diagnosis, but are important in excluding other pathologies...
January 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/26581604/the-role-of-arthroscopy-in-carpal-instability
#17
REVIEW
T R Lindau
Carpal instability is predominantly caused by trauma and presents as a painful wrist with signs and symptoms of weakness, clicking, clunking and a sense of giving way. Wrist arthroscopy is widely regarded as the 'gold standard' in diagnosing and understanding carpal instability. This article is based on an extensive literature search to evaluate the evidence behind the use of wrist arthroscopy in the assessment and management of these patients. There is convincing evidence supporting the role of arthroscopy in diagnosis and assessment of factors involved in the development of carpal instability, but weak evidence for the effectiveness of arthroscopic techniques in the actual treatment of this condition...
January 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/26543034/conservative-management-of-midcarpal-instability
#18
REVIEW
C Harwood, L Turner
Midcarpal instability is a complex condition that can present in various forms, from mild pain to debilitating subluxation. Once diagnosed, treatment guidelines for hand therapy are limited by the scarcity of high-level evidence. Evidence does exist for use of proprioceptive awareness and neuromuscular rehabilitation for instability of the knee, shoulder and ankle joint, but studies of similar programmes for the wrist joint have not been published. The purpose of this review is to examine the evidence supporting current concepts in the non-operative management of midcarpal instability, and to provide recommendations for the management of this condition with hand therapy...
January 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/26539325/outcomes-of-capitohamate-bone-ligament-bone-grafts-for-scapholunate-injury
#19
Robert J van Kampen, Christopher O Bayne, Steven L Moran, Richard A Berger
Purpose In an attempt to restore natural carpal kinematics more closely, bone-ligament-bone (BLB) grafts have been described for treating scapholunate (SL) injury. In this article we report the long-term results of capitohamate BLB autograft for the treatment of SL dissociation. Methods The medical records of patients treated with capitohamate BLB grafts for SL dissociation were retrospectively reviewed. Twenty-three patients were available for evaluation. Patients were sent a Disabilities of the Arm, Shoulder, and Hand (DASH) and a Patient-Rated Wrist Evaluation (PRWE) questionnaire and returned for exam...
November 2015: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/26448803/radiocarpal-and-midcarpal-instability-in-rheumatoid-patients-a-systematic-review
#20
Eric E J Raven, Michel P J van den Bekerom, Annechien Beumer, C Niek van Dijk
BACKGROUND: This study was aimed at identifying the criteria for the diagnosis of Radiocarpal instability in rheumatoid arthritis RA). METHODS: The main databases were searched to identify studies describing the pathophysiology of Radiocarpal instability in patients with RA. We focussed on the epidemiology, radiographic parameters, criteria for instability and on treatment options. Results. In the search 108 articles were found, of these 12 studies were included for this review...
2015: Open Orthopaedics Journal
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