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Wrist injuries

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
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
Schneider K Rancy, Samir K Trehan, Angela E Li, Steve K Lee, Hollis G Potter, Scott W Wolfe
Background Previous authors have reported pisotriquetral pain and subsequent pisiform excision following partial or total wrist fusion in patients with scapholunate advanced collapse (SLAC). Prior studies have not considered the potential role of SLAC biomechanics on pisotriquetral osteoarthritis (PT OA) development preoperatively. Purpose To determine the prevalence and severity of PT OA in patients with SLAC as compared with a control population. Patients and Methods Magnetic resonance imaging (MRI) studies of 24 patients with SLAC wrist and 24 sex- and age-matched control patients were analyzed...
November 2016: Journal of Wrist Surgery
Ruben Posada-Gómez, Roberto A Montaño-Murillo, Albino Martínez-Sibaja, Giner Alor-Hernández, Alberto A Aguilar-Lasserre, Miriam C Reyes-Fernández
PURPOSE: One of the most important aspects in neuromotor rehabilitation is the need of feedback for patients. The rehabilitation system's efficiency relies on the therapist's judgment, who tells the patient whether he/she is performing the exercises correctly. This process may be quite subjective, because it depends on the therapist's personal opinion. On the other hand, recent studies have shown that vibrotactile biofeedback can improve the effectiveness of interaction as it is a very helpful tool in the physiological process of neuromotor rehabilitation...
October 24, 2016: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
Cees de Baat, Paul de Baat, Anneloes E Gerritsen, Karien A Flohil, Gert-Jan van der Putten, Claar D van der Maarel-Wierink
One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma...
October 22, 2016: Special Care in Dentistry
Marko Bumbaširević, Tomislav Palibrk, Henry Dushan E Atkinson, Aleksandar Lešić
OBJECTIVES: To evaluate the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft. DESIGN: This is a prospective study of 20 consecutive patients in one center. PATIENTS AND METHODS: This study included 20 patients (19 males) with a mean SNU duration of 14.5 months. Four patients had proximal pole, 15 had waist, and 1 had a distal SNU. Patients with carpal instability, humpback deformities, carpal collapse, avascular necrosis, and marked degenerative change were excluded...
October 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Seok-Youl Choi, Jong Woong Park, Dong Hwee Kim
Ultrasonographic study is useful for decision making of treatment for focal neuropathy with unusual electrodiagnostic findings. We present a patient with severe acute radial neuropathy with sensory sparing around the distal arm secondary to twisting of the radial nerve following blunt trauma. A 24-year-old man with a 2-week history of left wrist drop and severe pain around the left elbow presented after hitting the left distal arm on the doorknob. The left wrist and finger extensions were grade 0, but elbow extension could not be tested because of severe pain during this action...
November 2016: American Journal of Physical Medicine & Rehabilitation
Luke Steven Robinson, Mitchell Sarkies, Ted Brown, Lisa O'Brien
BACKGROUND: Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. OBJECTIVE: This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs...
October 1, 2016: Injury
C M Inness, K L Morgan
Polo, one of the world's oldest sports, is played in over 80 countries. It is unique in combining the skills of a person with the agility and performance of an animal in a contact sport. There is only one report of the frequency and type of injuries in this population. Here we report risk perception, mitigation and risk factors for injuries and falls in UK polo players. Data were collected retrospectively from a random sample of 112 UK polo players by telephone questionnaire. Injuries (commonly to a shoulder or wrist) requiring a hospital visit were sustained by 17...
December 2015: Sports Medicine—Open
Jimmy Tat, Aaron M Kociolek, Peter J Keir
The most common finding in carpal tunnel syndrome is fibrosis and thickening of the subsynovial connective tissue (SSCT). While the SSCT mediates tendon gliding in the carpal tunnel, this histopathology suggests excessive shear forces are involved in injury development. Ultrasound is often used to quantify relative motion between the finger flexor tendons and SSCT as an indirect measure of "shear-strain"; however, the underlying mechanical implications of using ultrasound are not well understood. The middle flexor digitorum superficialis (FDS) tendon of 8 cadavers was moved in a combination of 2 wrist postures (neutral, flexed), 3 velocities (5, 10, 15cm/s), and 3 forces (10, 20, 30N) to assess ultrasound-based FDS-SSCT relative displacement while simultaneously quantifying tendon frictional work in the carpal tunnel...
October 6, 2016: Journal of Biomechanics
Ian L Valerio, Zachary Masters, Jonathan G Seavey, George C Balazs, Derek Ipsen, Scott M Tintle
PURPOSE: To assess the outcomes of treatment with a dermal regeneration template (DRT) in a cohort of combat casualties with severe upper extremity injuries. METHODS: Records of all active duty military patients treated with DRT at our institution between November 2009 and July 2013 were screened. Inclusion criteria were upper extremity open wounds sustained during combat, requiring split-thickness or full-thickness skin grafting for closure. The primary outcome measure was wound healing after the first attempt at definitive treatment (defined as the first application of split-thickness or full-thickness skin graft)...
October 12, 2016: Journal of Hand Surgery
I Naroura, A Zemirline, C Taleb, F Lebailly, S Facca, J J Hidalgo Díaz, S Collon, P Liverneaux
Three direct volar portals for wrist arthroscopy have been described previously: two radiocarpal and one midcarpal. The aim of this study was to systematically describe four volar arthroscopic portals through minimally invasive incisions using an inside-out approach from known dorsal portals. Four volar arthroscopic wrist portals were studied on six hand specimens using an inside-out technique: a radial radiocarpal approach (RRCA), an ulnar radiocarpal approach (URCA), a radial midcarpal approach (RMCA) and an ulnar midcarpal approach (UMCA)...
June 2016: Hand Surgery and Rehabilitation
Zeid Al-Ani, Syed Ali, Simon Beardmore, Vinay Parmar, Teik Chooi Oh
BACKGROUND: Although subspecialist orthopaedic surgeons usually request Magnetic Resonance Arthrogram (MRA) examinations, some orthopaedic surgeons may request this examination for a body part that is different from their subspecialty. The purpose of the study is to compare the MRA and the clinical findings in the subspecialist and non-subspecialist groups. METHOD: Retrospective analysis of MRA examinations over a 6-month period. Findings were compared with the clinical information...
2016: Open Orthopaedics Journal
Jorge Delgado, Diego Jaramillo, Nancy A Chauvin
Increased physical activity in childhood has resulted in a large number of sports-related injuries. Although there is overlap between the sports-related injuries seen in pediatric and adult patients, important differences exist in the injury patterns of pediatric patients. These differences are related to the continuous changes in the developing skeleton and its relationship with adjacent soft tissues. The imbalance in strength between the growing bones and the nearby tendons and ligaments makes the bones prone to acute and chronic injuries...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Oskar C Aszmann, Ivan Vujaklija, Aidan D Roche, Stefan Salminger, Malvina Herceg, Agnes Sturma, Laura A Hruby, Anna Pittermann, Christian Hofer, Sebastian Amsuess, Dario Farina
Critical soft tissue injuries may lead to a non-functional and insensate limb. In these cases standard reconstructive techniques will not suffice to provide a useful outcome, and solutions outside the biological arena must be considered and offered to these patients. We propose a concept which, after all reconstructive options have been exhausted, involves an elective amputation along with a bionic substitution, implementing an actuated prosthetic hand via a structured tech-neuro-rehabilitation program. Here, three patients are presented in whom this concept has been successfully applied after mutilating hand injuries...
October 10, 2016: Scientific Reports
Guangliang Zhang, Jihui Ju, Guangzhe Jin, Linfeng Tang, Yi Fu, Ruixing Hou
PURPOSE: The purpose of this study was to explore effective strategies of replantation or revascularization for the treatment of hand degloving injuries. METHODS: Ten patients who had received replantation or revascularization surgery for hand degloving injury between 2002 and 2014 were included for this study. The average age at the time of surgery was 34.5 years (range 18-49 years). There were nine left and one right hand replantations. The cause of injury was an industrial machine press in all of them...
September 19, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Pascal Molteni, Thomas Hügle, Maria Hügle, Corina Nüesch, Annegret Mündermann
Walking with crutches is an effective way of reducing the load on the lower extremity and is often indicated after injury or surgery. However, walking with forearm crutches with conventional cuffs can trigger symptoms including tenosynovitis in the biceps tendon, ulnar neuropraxia at the wrist, pain or skin hematoma. The purpose of this study was to test the hypothesis that a crutch cuff design with an ulnar recess reduces ulnar pressure during walking with forearm crutches. The pressure distribution between the forearm and crutch cuff was measured in 15 healthy participants for crutch walking with conventional and novel cuffs, respectively...
October 7, 2016: Assistive Technology: the Official Journal of RESNA
Anil K Bhat, Nishanth A, Ashwath Acharya, Yogesh Kumar
INTRODUCTION: Perilunate and lunate dislocations are uncommon high energy injuries and have extensive soft tissue, cartilaginous and bony damage. The most common pattern is trans-scaphoid perilunate fracture dislocation which constitutes approximately 50% of these injuries. Unusual injury pattern like Scaphocapitate syndrome can occur with fracture through scaphoid waist and capitate that rotates the proximal capitate 180° so that its proximal articular surface points distally. With this case report, we would like to present a novel presentation of an uncommon wrist injury...
April 2016: Journal of Orthopaedic Case Reports
Reza Shahryar-Kamrani, Hossein Saremi, Leila Oryadi-Zanjani, Mohammad Hossein Nabian, Azita Amoozadeh, Amir Hossein Moradi
BACKGROUND: Evolving wrist arthroscopy requires creating new portals, and creating portals reciprocally leads to increased indications for arthroscopic wrist procedures. To facilitate access to the lunate bone and fossa for new arthroscopic procedures, a new portal was used. This is a cadaveric study of this portal. OBJECTIVES: In this cadaveric study, we evaluated a portal in wrist arthroscopy for procedures involving the lunate bone and lunate fossa. MATERIALS AND METHODS: Seventeen wrists from 10 fresh cadavers were included in this study...
July 2016: Iranian Red Crescent Medical Journal
Max Stuelcken, Daniel Mellifont, Adam Gorman, Mark Sayers
The wrist/hand complex forms the crucial final link in the kinetic chain between the body and the racquet and therefore has a number of important roles in the production of all tennis strokes. However, the internal and external loads that are created at the wrist during these strokes have the potential to contribute to pain and injury. Therefore, the purposes of this narrative review are to (1) determine the extent of the problem of wrist pain/injury in tennis players, (2) identify bony and soft tissue structures of the wrist that are susceptible to damage as a result of tennis play and (3) explore factors that may influence the development of wrist pain/injury in tennis players...
October 3, 2016: Sports Medicine
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