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triangular fibrocartilage complex

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https://www.readbyqxmd.com/read/28419031/prognostic-factors-affecting-union-after-ulnar-shortening-osteotomy-in-ulnar-impaction-syndrome-a-retrospective-case-control-study
#1
Soo Min Cha, Hyun Dae Shin, Ki Jun Ahn
BACKGROUND: Ulnar shortening osteotomy (USO) is a widely adopted procedure with excellent outcomes. However, delayed union or nonunion has occasionally been observed. The purpose of this retrospective case-control study was to identify variables affecting osseous consolidation after USO in patients with ulnar impaction syndrome. METHODS: The study included 325 patients who had undergone USO between March 2008 and March 2014. We evaluated the association between union and basic demographic factors as well as preoperative pain (assessed on a visual analog scale [VAS]), range of wrist motion, grip strength, and modified Mayo wrist score...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28399788/distal-radioulnar-joint-functional-anatomy-including-pathomechanics
#2
J R Haugstvedt, M F Langer, R A Berger
The distal radioulnar joint allows the human to rotate the forearm to place the hand in a desired position to perform different tasks, without interfering with the grasping function of the hand. The ulna is the stable part of the forearm around which the radius rotates; the stability of the distal radioulnar joint is provided by the interaction between ligaments, muscles and bones. The stabilizing structures are the triangular fibrocartilage complex, the ulnocarpal ligament complex, the extensor carpi ulnaris tendon and tendon sheath, the pronator quadratus, the interosseous membrane and ligament, the bone itself and the joint capsule...
May 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28373941/arthroscopically-assisted-transosseous-foveal-repair-of-triangular-fibrocartilage-complex
#3
Wei-Jen Chen
The radioulnar ligament of the triangular fibrocartilage complex (TFCC), especially the deep fibers inserted at the ulnar fovea, is the key component for the distal radioulnar joint (DRUJ) stability. Traumatic injuries to the TFCC foveal insertion would cause DRUJ instability. Traditionally, arthroscopic techniques of the TFCC repair are suturing the ulnar-sided disruption peripherally to the dorsal or ulnar capsule instead of suturing the TFCC to the fovea and thus fail to restore the DRUJ stability if the TFCC is detached from the fovea...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28345546/high-resolution-3t-magnetic-resonance-imaging-of-the-triangular-fibrocartilage-complex-in-chinese-wrists-correlation-with-cross-sectional-anatomy
#4
Hui-Li Zhan, Wen-Ting Li, Rong-Jie Bai, Nai-Li Wang, Zhan-Hua Qian, Wei Ye, Yu-Ming Yin
BACKGROUND: The injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) could demonstrate the detailed complex anatomy of TFCC in Chinese. METHODS: Fourteen Chinese cadaveric wrists (from four men and three women; age range at death from 30 to 60 years; mean age at 46 years) and forty healthy Chinese wrists (from 20 healthy volunteers, male/female: 10/10; age range from 21 to 53 years with a mean age of 32 years) in Beijing Jishuitan Hospital from March 2014 to March 2016 were included in this study...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28344533/diagnostic-wrist-arthroscopy-for-nonspecific-wrist-pain
#5
Amin Mohamadi, Femke M A P Claessen, Sezai Ozkan, Gregory P Kolovich, David Ring, Neal C Chen
Background: This study addresses the prevalence of discrete pathophysiology accounting for patients' symptoms during diagnostic wrist arthroscopy in individuals with wrist pain without a specific preoperative diagnosis. Secondarily, we determined the number and type of surgeries subsequent to diagnostic wrist arthroscopy. Methods: Between January 2000 and January 2015, 135 diagnostic wrist arthroscopies were performed by 12 surgeons in 3 urban academic hospitals. We recorded the diagnostic findings of diagnostic wrist arthroscopy and any subsequent surgeries...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28339356/diagnostic-accuracy-of-musculoskeletal-ultrasound-and-conventional-radiography-in-the-assessment-of-the-wrist-triangular-fibrocartilage-complex-in-patients-with-definite-diagnosis-of-calcium-pyrophosphate-dihydrate-deposition-disease
#6
Andrea Di Matteo, Emilio Filippucci, Fausto Salaffi, Marina Carotti, Davide Carboni, Eleonora Di Donato, Walter Grassi
OBJECTIVES: To compare the diagnostic accuracy of musculoskeletal ultrasound (MSUS) and x-ray in evaluating wrist triangular fibrocartilage complex (TFCC) in patients with calcium pyrophosphate dihydrate deposition disease (CPPD) and to investigate the agreement between the extent of the calcium pyrophosphate dihydrate (CPP) crystal deposits assessed by MSUS and the radiographic findings. METHODS: We enrolled 84 patients: 36 patients with "definite" CPPD and 48 controls...
March 23, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28259283/impact-of-distal-ulnar-fracture-malunion-on-distal-radioulnar-joint-instability-a-biomechanical-study-of-the-distal-interosseous-membrane-using-a-cadaver-model
#7
Satoshi Miyamura, Atsuo Shigi, Jirachart Kraisarin, Shohei Omokawa, Tsuyoshi Murase, Hideki Yoshikawa, Hisao Moritomo
PURPOSE: Certain distal ulna fractures may contribute to distal radioulnar joint (DRUJ) instability. We hypothesized that residual distal ulna translation could affect DRUJ stability by slackening the distal interosseous membrane (DIOM). We aimed to test this hypothesis in a cadaver model. METHODS: We created an ulnar translated distal ulna fracture model in 6 cadavers. Dorsal and palmar displacements of the ulna relative to the radius were measured and DRUJ instability was staged under the following conditions: (1) 0-, 2-, and 4-mm ulnar translation of the distal ulna with an intact triangular fibrocartilage complex (TFCC) and DIOM; (2) 0-, 2-, and 4-mm translations with TFCC divided and an intact DIOM; and (3) a 0-mm translation with TFCC and DIOM divided...
March 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28246600/can-the-diagnostics-of-triangular-fibrocartilage-complex-lesions-be-improved-by-mri-based-soft-tissue-reconstruction-an-imaging-based-workup-and-case-presentation
#8
Niels Hammer, Ulrich Hirschfeld, Hendrik Strunz, Michael Werner, Thomas Wolfskämpf, Sabine Löffler
Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT), 3 T magnetic resonance imaging (MRI), and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28211292/clinical-and-functional-outcome-of-open-primary-repair-of-triangular-fibrocartilage-complex-tears-associated-with-distal-radius-fractures
#9
Faisal Johandi, Sreedharan Sechachalam
PURPOSE: We evaluate the clinical and functional outcome of open primary repair of acute TFCC tears in distal radius fracture, when there is gross intraoperative distal radioulnar joint (DRUJ) instability after fixation of the distal radius, in the absence of an ulnar styloid fracture or when the ulnar fracture fragment is too small to be fixed. METHODS: A retrospective review of our institution's distal radius fracture database over a 4-year period (January 2010 to December 2013)...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28185125/ulnar-sided-wrist-pain-in-the-athlete-tfcc-druj-ecu
#10
REVIEW
Eric Quan Pang, Jeffrey Yao
PURPOSE OF REVIEW: The goal of this manuscript is to review key historic and recent literature regarding extensor carpi ulnaris (ECU), triangular fibrocartilage complex (TFCC) and distal radioulnar joint (DRUJ) injuries, particularly in athletes. RECENT FINDINGS: Many recent studies examining the ECU focus on clinical and radiographic diagnosis. Several physical exam findings are described in addition to the use of MRI and US. Imaging studies must be clinically correlated due to high incidence of findings in asymptomatic patients...
March 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28183230/arthroscopic-assisted-tendon-reconstruction-for-triangular-fibrocartilage-complex-irreparable-tears
#11
R Luchetti, A Atzei
We report our 11-year experience of performing arthroscopically assisted triangular fibrocartilage complex reconstruction in the treatment of chronic distal radio-ulnar joint instability resulting from irreparable triangular fibrocartilage complex injuries. Eleven patients were treated. Three skin incisions were made in order to create radial and ulna tunnels for passage of the tendon graft, which is used to reconstruct the dorsal and palmar radio-ulnar ligaments, under fluoroscopic and arthroscopic guidance...
February 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28132592/classification-of-ulnar-triangular-fibrocartilage-complex-tears-a-treatment-algorithm-for-palmer-type-ib-tears
#12
A Atzei, R Luchetti, L Garagnani
The classical definition of 'Palmer Type IB' triangular fibrocartilage complex tear, includes a spectrum of clinical conditions. This review highlights the clinical and arthroscopic criteria that enable us to categorize five classes on a treatment-oriented classification system of triangular fibrocartilage complex peripheral tears. Class 1 lesions represent isolated tears of the distal triangular fibrocartilage complex without distal radio-ulnar joint instability and are amenable to arthroscopic suture. Class 2 tears include rupture of both the distal triangular fibrocartilage complex and proximal attachments of the triangular fibrocartilage complex to the fovea...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28119801/the-parc-lesion-a-proximal-avulsion-of-the-radiocarpal-capsule
#13
Francis Bonte, Christophe L Mathoulin
Purpose A proximal avulsion of the radiocarpal capsule (PARC) is a cause of persisting posttraumatic wrist pain. This lesion is often overlooked and left untreated during wrist arthroscopy. Materials and Methods A record review was performed on 13 patients with this lesion who underwent diagnostic wrist arthroscopy after failed conservative treatment. We retrospectively reviewed the results of an arthroscopic repair method in 13 patients. Results In 11 of the 13 consecutive cases the lesion was sutured using an arthroscopic dorsal capsule-ligamentous repair technique...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28119800/ulna-rotation-osteotomy-in-complete-dislocation-of-the-distal-radioulnar-joint
#14
Markus Gabl, Rohit Arora, Eva Maria Gassner, Gernot Schmidle
Background Complete dislocation of the distal radioulnar joint (DRUJ) is a rare injury. Dislocation can present as uni- or multidirectional, acute or chronic, reducible or irreducible. It can occur due to isolated loss of ligamentous restraints or more frequent in Galeazzi - or Essex-Lopresti-type fractures. Case Description A 28-year-old man sustained a distal radius fracture and presented after conservative treatment with blocked supination. Examination revealed a malunion of the distal radius in combination with an irreducible dorsal dislocation of the DRUJ...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28119797/microfracture-for-ulnar-impaction-syndrome-surgical-technique-and-outcomes-with-minimum-2-year-follow-up
#15
David Kaufman, Jennifer Etcheson, Jeffrey Yao
Purpose The purpose of this study is to assess functional and patient-reported outcomes after lunate microfracture for management of lunate chondral lesions in the setting of ulnar impaction syndrome. Methods This was a retrospective review of all patients undergoing wrist arthroscopy for triangular fibrocartilage complex pathology by one surgeon from 2007 until 2010. Disabilities of the arm, shoulder, and hand (DASH) scores were assessed preoperatively and at minimum 2-year follow-up. Patient-rated wrist evaluation and bilateral wrist range of motion, grip strength, and key pinch strength were assessed at final follow-up...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28119793/preventable-repeat-wrist-arthroscopies-analysis-of-the-indications-for-133-cases
#16
Steffen Löw, Christian K Spies, Frank Unglaub, Jörg van Schoonhoven, Karl-Josef Prommersberger, Marion Mühldorfer-Fodor
Background Frequently, patients undergo repeated wrist arthroscopies for single wrist problems. Purpose The purposes of this study were to assess the indications for repeat wrist arthroscopies and to identify potentially preventable procedures. Methods For this retrospective, two-center study, the electronic patient records were examined for patients, who underwent repeat wrist arthroscopy in a 5-year period. The cases were sorted by the underlying pathologies and the causes that necessitated repeat arthroscopies...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28080158/diagnosing-central-lesions-of-the-triangular-fibrocartilage-as-traumatic-or-degenerative-a-review-of-clinical-accuracy
#17
S Löw, H Erne, T Pillukat, M Mühldorfer-Fodor, F Unglaub, C K Spies
This study examined the reliability of surgeons' estimations as to whether central lesions of the triangular fibrocartilage complex were traumatic or degenerative. A total of 50 consecutive central triangular fibrocartilage complex lesions were independently rated by ten experienced wrist surgeons viewing high-quality arthroscopy videos. The videos were reassessed after intervals of 3 months; at the second assessment surgeons were given the patient's history, radiographs and both, each in a randomized order...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28052828/forearm-instability-anatomy-biomechanics-and-treatment-options
#18
REVIEW
Julie E Adams
The forearm unit consists of the radius and ulna, a complex and interrelated set of joints (distal radioulnar joint, proximal radioulnar joint) and the soft tissue stabilizers between the 3 bones. Distally, this is represented by the triangular fibrocartilage complex at the wrist, proximally by the annular ligament at the elbow, and in the forearm by the interosseous membrane. Disruptions in any of these structures may lead to forearm instability, with consequences at each of the remaining structures.
January 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28034486/biomechanical-comparison-of-open-and-arthroscopic-transosseous-repair-of-triangular-fibrocartilage-complex-foveal-tears-a-cadaveric-study
#19
Ching-Hou Ma, Ting-Sheng Lin, Chin-Hsien Wu, Dong-Yi Li, Shih-Chieh Yang, Yuan-Kun Tu
PURPOSE: To biomechanically compare the stability between open repair and arthroscopic transosseous repair technique for reattachment of the foveal triangular fibrocartilage complex (TFCC). We also evaluated the feasibility of a new aiming device for the creation of 2 bone tunnels simultaneously during the arthroscopic technique. METHODS: Six matched pairs of fresh-frozen forearm cadaver specimens were prepared for testing. Group I specimens were treated by open repair with suture anchor...
February 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28033150/complex-distal-radius-fractures-an-anatomic-algorithm-for-surgical-management
#20
Peter Charles Rhee, Robert J Medoff, Alexander Y Shin
Most distal radius fractures result from low-energy mechanisms and can be successfully treated nonsurgically or with a variety of surgical techniques if indicated. High-energy distal radius fractures can involve extensive comminution or bone loss with concomitant ligament, soft-tissue, and neurovascular injuries. In patients with complex distal radius fractures, reconstruction of the distal radius, ulna, and triangular fibrocartilage complex can be challenging. Effective restoration of the bony architecture requires intimate knowledge of the anatomy of the distal radius, a thorough understanding of the goals of treatment, versatility in surgical approaches, and familiarity with multiple fixation options...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
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