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Radioulnar distal joint

Akio Minami, Yukinobu Kamiya, Yasuaki Tojo, Satoko Matsumoto Harmon, Kota Suda
BACKGROUND: The Sauvé-Kapandji (SK) procedure is one of several surgical options in the treatment of distal radioulnar disorders by osteoarthritis (OA) and rheumatoid arthritis (RA). While satisfactory postoperative clinical results were obtained in most cases, instability of the proximal ulnar stump and radioulnar convergence are the most common complications. Minami et al. have developed a modification of the SK procedure that maintains the transverse diameter of the distal radioulnar joint and stabilizes the proximal ulnar stump, using a half-slip of the extensor carpi ulnaris tendon...
March 15, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Yuji Tomori, Takuya Sawaizumi, Mitsuhiko Nanno, Shinro Takai
The Sauvé-Kapandji procedure is a reliable option for patients with various disorders of the distal radioulnar joint (DRUJ). However, postoperative pain over the proximal ulnar stump frequently develops during forearm rotation or when lifting heavy objects, although many clinically satisfactory results have been reported. This stump pain has been suggested to result from dynamic instability of the proximal ulnar stump. Several types of tenodesis have recently been performed simultaneously with the Sauvé-Kapandji procedure to stabilize the proximal ulnar stump and thus relieve the associated pain...
March 2018: Medicine (Baltimore)
Jonny K Andersson, Martina Åhlén, Daniel Andernord
BACKGROUND AND PURPOSE: To investigate the outcome of open versus arthroscopic repair of injuries of the triangular fibrocartilage complex (TFCC). METHODS: An electronic literature search of articles published between January 1, 1985, and May 26, 2016, in PubMed, Embase, and the Cochrane Library was carried out in May 2016 and updated in March and December 2017. Studies comparing open and arthroscopic repair of TFCC injury with a mean follow up of more than 1 year were eligible for inclusion...
March 13, 2018: Journal of Experimental Orthopaedics
Ji Hun Park, Dongmin Kim, Heesu Park, Inwon Jung, Inchan Youn, Jong Woong Park
PURPOSE: This study examined the influence of triangular fibrocartilage complex (TFCC) deep fiber tears on wrist proprioception. METHODS: The study involved 48 subjects: 24 with deep fiber TFCC tears and 24 with healthy wrists. A specially created sensor measured wrist proprioception in 3 axes of movement. Absolute differences between target and subject-reproduced angles were compared in injured and healthy wrists and in injured and contralateral patient wrists...
March 6, 2018: Journal of Hand Surgery
Yuki Bessho, Toshiyasu Nakamura, Masao Nishiwaki, Takeo Nagura, Morio Matsumoto, Masaya Nakamura, Kazuki Sato
We investigated the relationship between the radial inclination of the distal radius and distal radioulnar joint stability. Six fresh-frozen upper extremities were used. Radial inclination was decreased by 10° and 20° and increased by 10° from the original radial inclination. Distal radioulnar joint stiffness was assessed with an intact radioulnar ligament and after partial and then complete sectioning of the radioulnar ligament. Radial angulation deformities significantly increased distal radioulnar joint stiffness when the radioulnar ligament is totally or partially attached to the ulnar fovea...
January 1, 2018: Journal of Hand Surgery, European Volume
Ricardo Kaempf de Oliveira, Pedro José Delgado, Samuel Ribak, Jayme Augusto Bertelli, Fabiano da Silva Marques
A 40-year-old woman presented with Madelung deformity and severe arthritic changes at both the radiocarpal and the distal radioulnar joints. She was treated by using her lunate as an osteochondral graft into the radius allowing reconstruction of the lunate fossa. The scaphoid and triquetrum were removed concomitantly and a Sauve-Kapandji procedure was performed. Complete bone healing was achieved. Ten years later, an excellent functional result was maintained, with a pain-free wrist, an acceptable wrist joint range of motion, as well as a favorable aesthetic appearance...
March 3, 2018: Journal of Hand Surgery
Benjamin T K Ding, Kaamini Pillay, Sreedharan Sechachalam
We assessed whether radial shaft fracture obliquity measurements on radiographs could predict intra-operative distal radioulnar joint instability. We also clinically validated previously described predictors of distal radioulnar joint instability, which included a fracture line within 7.5 cm of the lunate fossa, radial shortening >5 mm, and ulna styloid fracture. We retrospectively analysed the radiographs of all surgically managed patients in our unit with radial shaft fractures from 2006 through 2016...
January 1, 2018: Journal of Hand Surgery, European Volume
Daniel Tordjman, Richard M Hinds, S Steven Yang, John T Capo
Radial shaft convergence in distal radius fractures is often misdiagnosed. This common deformation is often associated with a radial translation of the distal fragment. This parameter has to be corrected because of the increased risk of distal radioulnar joint instability due to detensioning of the distal interosseous membrane if there is an associated triangular fibrocartilage complex lesion. A new radiologic sign for diagnosis of proximal radius convergence during distal radius fracture is presented as well as technical tips for correction of this deformity...
March 2018: Techniques in Hand & Upper Extremity Surgery
Jun-Feng Zhao, Tian-Jian Zhang, Quan-Yang Gao, Chao-Feng Zhao, Lu-Li Han, Gang Chen
OBJECTIVE: To observe the effect of different manipulative reduction for children's distal radioulnar fracture and dorsal dislocation. METHODS: From June 2013 to June 2014, 80 children with distal radioulnar fracture and dorsal dislocation were treated by bone setting manipulative reduction including 51 males and 29 females with an average age of 6.5 years old ranging from 3 to 14 years old. Time from injury to treatment was 1 h to 6 d, 31 cases were on the right, 49 cases were on the left...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Li-Chun Liu, Wen-Jun Ding, Xiao-Xiang Zhou, Da-Dong Zhu, Jin-Liang Huang
OBJECTIVE: To assess the clinical effects of artificial radial head prosthesis replacement for the treatment of comminuted fracture of the radial head. METHODS: From June 2011 to June 2015, 25 patients with radial head comminuted fracture were treated with artificial radial head replacement, including 10 males and 15 females, ranging in age form 24 to 61 years old(mean, 40 years old). The functional recovery of the patients suffering from limb and elbow in different periods, the activity degree of the elbow joint and the function of the elbow in the latest follow-up were compared...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jayson C Johnson, Ferris M Pfeiffer, Jill E Jouret, David M Brogan
BACKGROUND: This study compares the effectiveness of a peripheral capsular repair with a knotless arthroscopic transosseous ulnar tunnel repair (TR) in restoring distal radioulnar joint (DRUJ) stability and stiffness in the setting of a massive triangular fibrocartilage complex (TFCC) tear. METHODS: Eight matched pairs of fresh-frozen cadaveric forearms were tested. Each forearm was tested in supination and pronation using 3-dimensional (3D) optical tracking devices prior to any intervention...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Kate D Bellevue, Mary K Thayer, Michael Pouliot, Jerry I Huang, Douglas P Hanel
PURPOSE: The Aptis total distal radioulnar joint (DRUJ) prosthesis is a semiconstrained implant designed for treatment of DRUJ arthritis and instability. The purpose of this study was to analyze short-term complications of this device. METHODS: We performed a retrospective chart review of patients undergoing semiconstrained DRUJ arthroplasty from 2007 to 2015 at a single institution. Records were analyzed for complications and the need for subsequent surgical procedures...
December 22, 2017: Journal of Hand Surgery
Maria Moloney, Simon Farnebo, Lars Adolfsson
The aims of this study were to investigate the functional result and rate of osteoarthritis 15-25 years after a TFCC-repair. Forty-seven patients completed the questionnaire Patient Rated Wrist Evaluation (PRWE), and 43 had new X-rays. Fifty-seven percent had a simultaneous arthroscopy. Sixteen patients had later additional surgery to the wrist, of these eight had a reoperation of the TFCC-injury due to recurrent instability. Radiographs showed that 17.5% had developed radiocarpal osteoarthritis and 34% osteoarthritis in the distal radioulnar joint...
December 19, 2017: Journal of Plastic Surgery and Hand Surgery
Shingo Abe, Hisao Moritomo, Kunihiro Oka, Kazuomi Sugamoto, Kenji Kasubuchi, Tsuyoshi Murase, Hideki Yoshikawa
The purpose of this study was to investigate the differences in three-dimensional carpal kinematics between type 1 and 2 lunates. We studied 15 instances of wrist flexion to extension (nine type 1, six type 2), 13 of radial to ulnar deviation (seven type 1, six type 2), and 12 of dart-throwing motion (six each of type 1 and 2) in 25 normal participants based on imaging with computerized tomography. Mean proximal translation of the distal articular midpoint of the triquetrum relative to type 2 lunates during wrist radioulnar deviation was 2...
January 1, 2017: Journal of Hand Surgery, European Volume
Won-Taek Oh, Ho-Jung Kang, Yong-Min Chun, Il-Hyun Koh, Hae-Mo-Su An, Yun-Rak Choi
PURPOSE: To compare clinical and radiologic outcomes and complication rates of the arthroscopic wafer procedure (AWP) and ulnar shortening osteotomy (USO) for idiopathic ulnar impaction syndrome (UIS). METHODS: From May 2009 to June 2014, 42 patients who were aged 45 years or older with idiopathic UIS underwent either the AWP or USO under the following identical surgical indications: (1) less than 4 mm of positive ulnar variance, (2) Palmer classification 2C or 2D lesion of the triangular fibrocartilage complex, (3) stable distal radioulnar joint (DRUJ) and/or lunotriquetral joint, and (4) no evidence of osteoarthritis of the DRUJ or ulnocarpal joint...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Hiromasa Akino, Shunpei Hama, Masataka Yasuda, Kenta Minato, Masahiro Miyashita
Distal ulnar fractures often occur with distal radius fractures (DRFs), and ulnar styloid fractures commonly occur in the setting of DRF. However, isolated ulnar head fractures are rare. We report a case of isolated ulnar head fracture in which we performed bone resection because the ulnar head bone fragment fractured when internal screw fixation was attempted. His outcome at 18 months postoperatively was considered excellent. However, we do not advocate bone resection other than failure of fixation and the difficult case to perform internal fixation...
2017: Case Reports in Orthopedics
Ji Hun Park, Dongmin Kim, Jong Woong Park
PURPOSE: Arthroscopic repair of a peripheral triangular fibrocartilage complex (TFCC) tear is a promising, minimally invasive surgical technique, especially in patients with symptomatic distal radioulnar joint (DRUJ) instability. The purpose of this study was to evaluate the clinical result of arthroscopic one-tunnel transosseous foveal repair for peripheral TFCC tears. METHODS: Sixteen patients who underwent TFCC foveal repair were retrospectively evaluated. The mean follow-up period was 31...
November 9, 2017: Archives of Orthopaedic and Trauma Surgery
Marc Mespreuve, Ludo Coenen
INTRODUCTION: A cortical lined impaction on the radiodorsal side of the ulnar head may be at the origin of a "second ulnar groove" (SUG). The goal of this article is to illustrate this MRI sign, prompting for further investigation of the distal radioulnar joint (DRUJ). Hence associated soft tissue pathology may be detected, which may lead to instability. MATERIAL AND METHODS: Following an anterior luxation of the ulna at the DRUJ a second cortical lined groove in a previously normal distal ulna was discovered...
November 2017: European Journal of Radiology
Jean Jose, Azael Arizpe, Carlos M Barrera, Nisreen Shabbir Ezuddin, David Chen
The triangular fibrocartilage complex (TFCC) is an intricate ligamentous and cartilaginous structure that helps transmit axial load across the wrist, and provide stability to the ulnocarpal and distal radioulnar joints (DRUJ). Because the blood supply to the TFCC varies depending on location, certain types of tears are more amenable to surgical repair than others. Since Palmer proposed his classification system of TFCC tears in 1989, only 1 case of a "bucket-handle" type tear has been reported. In this article, we describe two new cases of bucket-handle tears of the TFCC...
October 27, 2017: Skeletal Radiology
Michael Chu-Kay Mak, Pak-Cheong Ho
Injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. Volar and dorsal radioulnar ligaments and their foveal insertion are the most important stabilizing components of the TFCC. In irreparable tears, anatomic reconstruction of the TFCC aims to restore normal biomechanics and stability of the distal radioulnar joint. We proposed a novel arthroscopic-assisted technique using a palmaris longus tendon graft. Arthroscopic-assisted TFCC reconstruction is a safe and effective approach with outcomes comparable to conventional open reconstruction and may result in a better range of motion from minimizing soft tissue dissection and subsequent scarring...
November 2017: Hand Clinics
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