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Jun Zhang, Xin Ran Ji, Ye Peng, Jian Tao Li, Li Hai Zhang, Pei Fu Tang
BACKGROUND: A die-punch fracture is a depression fracture of the lunate fossa of the distal radius. We propose a morphological classification of die-punch fractures that includes five types: center depression fractures, vertical depression fractures, volar depression fractures, dorsal depression fractures, and double die-punch fractures. METHODS: The radiographs of 112 die-punch fractures treated between January 2005 and January 2015 were retrospectively reviewed...
October 21, 2016: Journal of Orthopaedic Surgery and Research
S Mahjoub, B Dunet, P Thoreux, A C Masquelet
Perilunate fracture-dislocation is rare. We report the case of a 24-year-old male who fell from his motorcycle and presented with a transverse lunate fracture with perilunate ligament damage. The initial diagnosis based on X-rays was confirmed by CT scan. A dorsal approach was used to obtain good reduction, double screw fixation and ligament reinsertion protected by temporary K-wires. To the best of our knowledge, this is the first case of transverse lunate fracture within perilunate fracture-dislocation. The patient returned to normal activities after 6 months...
June 2016: Hand Surgery and Rehabilitation
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
Ezequiel Ernesto Zaidenberg, Pablo Roitman, Gerardo Luis Gallucci, Jorge Guillermo Boretto, Pablo De Carli
Background: In recent years the use of biodegradable suture anchors for treating tendon and ligament pathology in hand surgery became popular. These materials are biocompatible, radiolucent, and load sharing, as they incrementally transfer load to surrounding bone during the resorption process. Despite these numerous advantages, polyglycolic (PGA) and poly-L-lactic acid (PLLA) have become a problem because of the potential risk for foreign body reactions. Methods: This article presents a case of an intraosseous foreign body reaction and massive osteolysis of the proximal carpal after dorsal lunate dislocation repair with bioabsorbable suture anchors...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Morag Allan Campbell
Puerperal insanity has been described as a nineteenth-century diagnosis, entrenched in contemporary expectations of proper womanly behaviour. Drawing on detailed study of establishment registers and patient case notes, this paper examines the puerperal insanity diagnosis at Dundee Lunatic Asylum between 1820 and 1860. In particular, the study aims to consider whether the class or social status of the patients had a bearing on how their conditions were perceived and rationalized, and how far the puerperal insanity diagnosis, coloured by the values assigned to it by the medical officers, may have been reserved for some women and not for others...
October 3, 2016: History of Psychiatry
Jouni Havulinna, Jarkko Jokihaara, Pasi Paavilainen, Olli V Leppänen
Coronal plane fracture of lunate in Kienböck disease is a challenging problem with no proven treatment. We present a technique for the treatment. A vascularized bone graft from the distal radius employing the fourth and fifth extracompartmental artery pedicles is used as a mechanical support in order to enable fracture union. The technical pearls and pitfalls are described and a clinical case is presented.
September 20, 2016: Journal of Hand Surgery
Stephanie Y Pun, Andreas Hingsammer, Michael B Millis, Young-Jo Kim
BACKGROUND: Surgical treatment for pincer femoroacetabular impingement (FAI) of the hip remains controversial, between trimming the prominent acetabular rim and reverse periacetabular osteotomy (PAO) that reorients the acetabulum. However, rim trimming may decrease articular surface size to a critical threshold where increased joint contact forces lead to joint degeneration. Therefore, knowledge of how much acetabular articular cartilage is available for resection is important when evaluating between the two surgical options...
September 8, 2016: Clinical Orthopaedics and related Research
Jade Shepherd
Through an examination of previously unseen archival records, including patients' letters, this article examines the treatment and experiences of patients in late Victorian Broadmoor Criminal Lunatic Asylum and stakes the place of this institution within the broader history of therapeutic regimes in British asylums. Two main arguments are put forth. The first relates to the evolution of treatment in Victorian asylums. Historians tend to agree that in the 1860s and 1870s 'psychiatric pessimism' took hold, as the optimism that had accompanied the growth of moral treatment, along with its promise of a cure for insanity, abated...
October 2016: Medical History
Sadegh Saberi, Aidin Arabzadeh, Amir Reza Farhoud
INTRODUCTION: Lunate fracture is a rare injury. Most reports are associated with other wrist injuries such as perilunate dislocation and distal radius fracture. Isolated lunate fracture has been reported even more rarely. The choice of treatment and outcomes are consequently undetermined. CASE PRESENTATION: In this case report we will describe a lunate avulsion fracture as an isolated injury after a fall from nine meters treated operatively by excision of the comminuted avulsed fragment...
May 2016: Trauma Monthly
Maxwell Wingelaar, Patrick Newbury, Nicholas S Adams, Andrew J Livingston
No abstract text is available yet for this article.
2016: Eplasty
Keiichiro Oura, Hisao Moritomo, Toshiyuki Kataoka, Kunihiro Oka, Tsuyoshi Murase, Kazuomi Sugamoto, Hideki Yoshikawa
BACKGROUND: The purposes of this study were to quantitatively analyze osteophyte formation of the distal radius following scaphoid nonunion and to investigate how fracture locations relate to osteophyte formation patterns. METHODS: Three-dimensional surface models of the scaphoid and distal radius were constructed from computed tomographic images of both the wrists of 17 patients' with scaphoid nonunion. The scaphoid nonunions were classified into 3 types according to the location of the fracture line: distal extra-articular (n = 6); distal intra-articular (n = 5); and proximal (n = 6)...
August 30, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Mohamed Ali Sbai, Hichem Msek, Sofien Benzarti, Monia Boussen, Riadh Maalla
Treatment of Kienböck's disease has historically been determined by staging, ulnar variance, and presence or absence of arthritic changes. With the advent of newer techniques of vascularized bone grafting, the status of the cartilage shell of the lunate has become another factor that can influence the procedure performed. The purpose of this article is to describe the technique of Kuhlmann vascularized bone graft for Kienböck's disease. In addition, the indications, contraindications, and outcomes are described...
2016: Pan African Medical Journal
Takaaki Shinohara, Ryogo Nakamura, Etsuhiro Nakao, Hitoshi Hirata
We retrospectively reviewed 12 patients (3 men and 9 women, with a mean age of 72 years) who were surgically treated for carpal tunnel syndrome associated with Kienböck disease. All patients except 1 were incidentally diagnosed with Kienböck disease and had little or no wrist pain. Radiographic tests revealed advanced Kienböck disease in all patients. Intraoperative findings indicated that the site of maximum compression on the median nerve was located at the level of the carpal tunnel inlet in 11 patients, and the volar dislocated fragment of the lunate was located proximally adjacent to the floor of the carpal tunnel inlet...
August 2016: Nagoya Journal of Medical Science
Luca Daniele, Andrew McLean, Nicholas Cocks, Michael Kalamaras, Randy Bindra, S L Ezekiel Tan
PURPOSE: The aim of distal radial fracture treatment is to achieve optimal function through the restoration of normal anatomy, including volar tilt. The accuracy of assessing volar tilt on standard lateral radiographs compared with anatomic tilt lateral (ATL) radiographs is uncertain. This study aimed to investigate the anatomy of the articular surface of the distal radius, in particular measuring the angle between the dorsal and volar rims at several points from radial to ulnar, to ascertain whether volar tilt is uniform between the scaphoid and lunate facet and to explore consistency between standard lateral and ATL views...
August 28, 2016: Journal of Hand Surgery
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
G Xiong, Z Xiao, H Wang, S Guo, J Tao
Seventeen fresh lunates with stage III Kienböck's disease were scanned with micro-computed tomography. Four regions of interest were selected to measure trabecular parameters, which were compared with those from normal lunates. Within the three regions in the distal surface, there was more compact trabecular bone in the middle region when compared with the palmar and dorsal regions. In the central part, the trabeculae of the Kienböck's lunates were much thicker than those in normal lunates. The diameters of the palmar nutrient foramina of the Kienböck's lunates were significantly smaller than those in normal lunates...
August 24, 2016: Journal of Hand Surgery, European Volume
Teun Teunis, Niels H Bosma, Bart Lubberts, Dirk P Ter Meulen, David Ring
We applied quantitative 3D computed tomography to 50 complete articular AO type C fractures of the distal radius and tested the null hypothesis that fracture fragments can be divided according to Melone's concept (radial styloid and volar and dorsal lunate facet fragments) and that each fragment has similar (1) displacement and (2) articular surface area. Thirty-eight fractures fit the Melone distribution of fragments. Radial styloid fragments were most displaced, and volar lunate fragments were least displaced...
April 2016: Journal of Hand and Microsurgery
Alexia Hernandez-Soria, Soumen Das De, Zina Model, Steve K Lee, Scott W Wolfe
PURPOSE: The objective of this study was to examine the effect of altering the capitolunate relationship on coronal-plane wrist motion after scaphoidectomy and simulated 4-corner arthrodesis. Two positions of different capitolunate alignments were compared: "anatomic" (unchanged from pre-fusion) and "lunate-covered" (capitate translated to cover the lunate). We hypothesized that wrist resting posture would be altered and radial-ulnar motion would diminish after 4-corner arthrodesis in the lunate-covered position when compared with normal wrists...
August 11, 2016: Journal of Hand Surgery
Alicia Cowan, Joao Panattoni
Kienböck disease, or lunate avascular necrosis, can lead to chronic wrist pain and instability. Its etiology appears to be multifactorial including variations in adjacent anatomical structures, interrupted blood supply, and trauma. Capitate-hamate fusion is the second most commonly diagnosed carpal coalition and not treated unless symptomatic. Coalitions may alter the wrist mechanics depending on their extent. No prior reports have associated Kienböck disease with capitate-hamate coalition. We present 2 cases with congenital capitate-hamate fusion and lunate AVN...
October 2016: Journal of Hand Surgery
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