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scapholunate instability

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https://www.readbyqxmd.com/read/28181465/the-effect-of-ulnar-variance-on-scapholunate-and-capitolunate-angles
#1
Ozgur Tosun, Atilla Hikmet Çilengir, Berna Dirim Mete, Muhsin Engin Uluc, Orhan Oyar, Aliye Tosun
Background Ulnar variance (UV), which is measured using anteroposterior (AP) X-rays, is associated with the development of multiple wrist pathologies. The scapholunate angle (SLA) and capitolunate angle (CLA) are measured using lateral X-rays, and these can be used in the diagnosis of intercalated segmental instability. Purpose To determine the effect of UV on SLA and CLA. Material and Methods A total of 140 patients (73 women, 67 men; mean age, 37.8 ± 14.6 years; 95% confidence interval [CI], 35.4-40...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28149221/proximal-scaphoid-pole-reconstruction-utilizing-ipsilateral-proximal-hamate-autograft
#2
Bassem Elhassan, Mohamed Noureldin, Sanjeev Kakar
Background: Fractures of the proximal pole of the scaphoid can be difficult to heal because of its limited vascular supply. Furthermore, nonunion with avascular necrosis and secondary fragmentation makes surgical reconstruction a challenging procedure. Method: We describe a technique and report the outcome of a proximal hamate autograft to treat a proximal pole scaphoid nonunion with avascular necrosis. Results: At 3.5 years post reconstruction, the patient remains asymptomatic with union of his scaphoid reconstruction without any evidence of scapholunate instability...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28143515/modified-minimally-invasive-extensor-carpi-radialis-longus-tenodesis-for-scapholunate-dissociation-a-prospective-observational-study
#3
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/28119791/combined-tenodesis-capsulodesis-for-scapholunate-instability-minimum-2-year-follow-up
#4
Pablo De Carli, Agustin G Donndorff, Miguel Tovar Torres, Jorge G Boretto, Gerardo L Gallucci
Background The aim of this study is to evaluate the clinical and radiological midterm results of a combined dorsal tenodesis-capsulodesis for static and reducible scapholunate dissociation (SLD). Patients and Methods We evaluated 20 of 22 consecutive patients with static SLD minimum with follow-up of 2 years operated between 2003 and 2012. The mean age was 40 years (range: 23-65 years). Seventeen were men. Final evaluation included comparative wrist range of motion (ROM) and grip strength, pre- and postoperative pain and function by visual analog scale, and QuickDASH and Wrightington scores...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28018058/intramedullary-screw-and-kirschner-wire-fixation-for-unstable-scaphoid-nonunion
#5
Raviv Allon, Aviv Kramer, Ronit Wollstein
Surgical treatment of scaphoid nonunion is not always successful, often requiring stabilization and bone grafting to achieve healing. Even after intramedullary screw fixation, residual instability may still hinder union. The purpose of this study was to describe the addition of Kirschner wires (KWs) through the capitate and the lunate to supplement an intramedullary screw for temporary enhanced stability, possibly improving healing of unstable fractures. A case-control study reviewing 25 cases with addition of KWs and 19 controls was performed...
December 2016: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/27904216/scapholunate-ligament-reconstruction-using-the-palmaris-longus-tendon-and-suture-anchor-fixation-in-chronic-scapholunate-instability
#6
Maulik Jagdish Gandhi, Timothy Paul Knight, Peter John Ratcliffe
BACKGROUND: Multiple reconstruction techniques have been described in the management of chronic scapholunate (SL) instability, either based on the capsulodesis or tenodesis principle. It is uncertain which surgical method produces the best patient outcomes. We describe results of a technique using palmaris longus (PL) tendon for surgical reconstruction of the SL ligament and provide functional outcomes scores. MATERIALS AND METHODS: We surgically reconstructed the SL ligament using a PL tendon graft secured with Mitek(®) bone anchors...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27890246/treatment-of-dynamic-scapholunate-instability-dissociation-contribution-of-arthroscopy
#7
C Mathoulin
Scapholunate (SL) ligament injuries generally result from trauma to an extended, supinated wrist, leading to chronic instability that progresses toward osteoarthritis. They can occur together with distal radius fracture. These injuries can be difficult to diagnose, especially early on. Treating chronic SL ligament injuries before the onset of osteoarthritis is still a challenge for surgeons. Until recently, the recommended treatments consisted of open SL ligament reconstruction or repair procedures that reduce pain and improve pinch strength but also lead to wrist stiffness...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27855045/-four-corner-fusion-in-patients-with-wrist-arthritis
#8
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/27781979/scapholunate-interosseous-ligament-injury-in-professional-volleyball-players
#9
R Mugnai, N Della Rosa, L Tarallo
Injuries to the scapholunate interosseous ligament (SLIL) are the most common cause of carpal instability. A SLIL injury typically follows a fall on an outstretched hand, with the wrist in hyperextension, ulnar deviation and intercarpal supination. We hypothesize that repetitive axial loading on the wrist in hyperextension, during the reception and digging motions of volleyball, can lead to functional overloading of the SLIL. To identify patients and to determine the clinical history and surgical treatment performed, we analyzed hospital records, X-rays, electronic databases containing all the operations performed, and image files (including before and after surgery and follow-up)...
October 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27777822/the-role-of-dynamic-4d-ct-in-the-detection-of-scapholunate-ligament-injury
#10
Sanjeev Kakar, Ryan E Breighner, Shuai Leng, Cynthia H McCollough, Steven L Moran, Richard A Berger, Kristin D Zhao
Background Scapholunate (SL) interosseus ligament injuries detected at an early stage could allow the surgeon to prevent progression through the spectrum of injury that leads to instability, and eventually osteoarthritis. We contend that early instability following injury can be detected by visualizing the relative motions and distances between the involved carpal bones (scaphoid and lunate) during wrist movement in vivo. The purpose of this study is to demonstrate the utility of dynamic CT (i.e., 4DCT) in diagnosing SL interosseus ligament injuries in two patients with clinical suspicion of SL interosseus ligament injury during flexion-extension (FE), radial-ulnar (RU) deviation, and dart thrower's (DT) motions...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777813/the-etiology-and-pathogenesis-of-kienb%C3%A3-ck-disease
#11
Gregory Ian Bain, Simon Bruce Murdoch MacLean, Chong Jin Yeo, Egon Perilli, David M Lichtman
Kienböck disease is a condition that typically occurs in the "at-risk" patient, in the "at-risk" aspect of the proximal condyle of the "at-risk" lunate. In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. The lunate fracture commences at the point the lunate cantilevers over the edge of the distal radius, and then takes on the shape of the radius. We postulate that the stress fracture violates the parallel veins of the venous subarticular plexus-leading to localized venous hypertension and subsequent ischemia and edema of the fatty marrow...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27601698/how-do-scapholunate-instabilities-and-distal-radial-fractures-affect-wrist-kinematics
#12
Jorge E Licano
No abstract text is available yet for this article.
September 2016: Radiologic Technology
https://www.readbyqxmd.com/read/27570228/changes-in-wrist-motion-after-simulated-scapholunate-arthrodesis-a-cadaveric-study
#13
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/27569785/carpal-kinematics-and-kinetics
#14
REVIEW
Robin N Kamal, Adam Starr, Edward Akelman
The complex interaction of the carpal bones, their intrinsic and extrinsic ligaments, and the forces in the normal wrist continue to be studied. Factors that influence kinematics, such as carpal bone morphology and clinical laxity, continue to be identified. As imaging technology improves, so does our ability to better understand and identify these factors. In this review, we describe advances in our understanding of carpal kinematics and kinetics. We use scapholunate ligament tears as an example of the disconnect that exists between our knowledge of carpal instability and limitations in current reconstruction techniques...
October 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27415161/arthroscopic-classification-of-the-lesions-of-the-dorsal-capsulo-scapholunate-septum-dcss-of-the-wrist
#15
Luc Van Overstraeten, Emmanuel J Camus
The dorsal capsulo-scapholunate septum (DCSS) is an anatomic structure linking the scapholunate ligament and the dorsal capsule of the wrist. It should be a predynamic scapholunate stabilizer. The authors, using their experience for the extrinsic ligaments testing, suggest an arthroscopic testing of the DCSS. The status could be graded in 4 stages according to the trampoline aspect and to the fiber attachment. They report a preliminary study on a series of 53 arthroscopies made between January 2014 and December 2015 with evaluation of scapholunate ligament instability and DCSS laxity...
September 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27264903/proprioception-retraining-for-a-patient-with-chronic-wrist-pain-secondary-to-ligament-injury-with-no-structural-instability
#16
Olga L Hincapie, Jeananne S Elkins, Laura Vasquez-Welsh
STUDY DESIGN: Case report. INTRODUCTION: Previously published studies demonstrate the importance of the sensory innervation of the carpal ligaments and the implication for the sensorimotor control of the wrist. In addition, this case considers key rehabilitation concepts to include the dart-throwing motion and the stabilizing effect of the forearm muscles. PURPOSE OF THE STUDY: To describe the rehabilitation program for a patient with chronic wrist pain, diagnosed with a partial tear of the dorsal intercarpal ligament and a sprain of the scapholunate ligament of the right wrist...
April 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/27264901/role-of-muscles-in-the-stabilization-of-ligament-deficient-wrists
#17
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/27247743/the-role-of-lunate-morphology-on-scapholunate-instability-and-fracture-location-in-patients-treated-for-scaphoid-nonunion
#18
Byoung-Jin Kim, David Kovacevic, Young-Min Lee, Jong-Hwan Seol, Myung-Sun Kim
BACKGROUND: To determine the association between lunate morphology and the scapholunate instability using radiographic images, and investigate the association between lunate morphology and scaphoid fracture location. METHODS: Between January 2003 and December 2011, we retrospectively evaluated the plain radiographs and computed tomography (CT) images of 70 patients who underwent surgical intervention for a scaphoid nonunion, in order to determine the association between lunate type (I or II) and scapholunate instability or scaphoid fracture location...
June 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27117018/the-role-of-extrinsic-ligaments-in-maintaining-carpal-stability%C3%A2-%C3%A2-a-prospective-statistical-analysis-of-85-arthroscopic-cases
#19
Luc Van Overstraeten, Emmanuel J Camus
Several biomechanical studies have shown that the scapholunate (SL) and lunotriquetral (LT) ligaments are not the only stabilizers of the proximal carpal row. However, no study has yet analyzed the range of ligament lesions leading to instability in vivo. Arthroscopy has been used to assess the condition of the wrist's extrinsic ligaments by palpating and tensioning the various ligament and capsule structures. In this prospective study, this arthroscopic method was used in 85 cases of wrist sprain without static instability to evaluate the correlation between lesions of the intrinsic and extrinsic carpal ligaments and carpal instability...
February 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27117017/isolated-or-predominant-capitolunate-osteoarthritis-is-the-consequence-of-lunotriquetral-dissociation-x-ray-analysis-of-22-consecutive-cases
#20
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
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