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Distal radio ulnar joint

J Phadnis, A C Watts
The Essex Lopresti lesion is a rare triad of injury to the radial head, interosseous membrane of the forearm and distal radio-ulnar joint, which results in longitudinal instability of the radius. If unrecognized this leads to chronic pain and disability which is difficult to salvage. Early recognition and appropriate treatment is therefore desirable to prevent long-term problems. The aim of this article is to review the pathoanatomy of longitudinal radius instability and use the existing literature and authors' experience to provide recommendations for recognition and treatment of acute and chronic forearm instability, including description of the author's technique for interosseous membrane reconstruction...
October 2016: Der Orthopäde
N Schmelzer-Schmied
OBJECTIVE: The goal of this operation technique is a stable refixation of the triangular fibrocartilage complex (TFCC) to the fovea ulnaris. The stability of the distal radio-ulnar joint (DRUJ) should be re-established. The patients pain and the feeling of instability should be reduced. INDICATIONS: Lesions of the foveal component of the TFCC resulting in DRUJ instability. Combined lesions of both components of the TFCC. Complete detachment of the TFCC from the ulna either without fracture of the styloid process of the ulna or with fracture (floating styloid)...
August 2016: Operative Orthopädie und Traumatologie
J C Vélez-de Lachica, C A Brambila-Botello, L A Valdez-Jiménez
The main function of the forearm is the supination, which is achieved largely through the biomechanical characteristics and stability of the distal radio-ulnar joint. There are several surgical techniques for the treatment of distal radio-ulnar dislocations isolated or associated with a fracture. We report the case of a canine trainer who was bitten at the wrist and distal forearm that came to the emergency department in where distal ulnar dislocation with muscle tendon exposure was diagnosed. Due to the offending agent and multiple soft tissue injuries the treatment with standard techniques was impossible...
July 2015: Acta Ortopédica Mexicana
I Yagci, M Akdeniz Leblebicier, B Mansiz Kaplan, D Ozturk Gokbakan, G Akyuz
OBJECTIVES: To compare the nerve cross sectional areas (CSA) of patients with RA without any sign of peripheral neuropathy to healthy controls. METHODS: Clinical, electrophysiological and sonographic assessments were done by three blinded researchers. The patients who had an electrodiagnostic or clinical of peripheral neuropathy were excluded from the study. Nerve CSA were measured in various levels; hamatum hook, pisiform bone, radio-ulnar joint, distal 1/3 of forearm, and elbow for median nerve; radio-ulnar joint, pisiform bone, distal 1/3 of forearm, and medial epicondyle for ulnar nerve...
January 2016: Acta Reumatológica Portuguesa
Fadi Bouri, Mazhar Fuad, Ayman Elsayed Abdolenour
INTRODUCTION: Volar dislocation of the distal radioulnar joint is a rare injury which is commonly missed in the emergency departments. A thorough review of literature showed very few reported cases and the cause for irreducibility varied in different cases, Lack of suspicion and improper X-ray can delay the diagnosis. CASE PRESENTATION: Our article discusses a case 40 year old construction worker, who presented to the Emergency with work-related injury, complaining of left wrist pain, deformity and inability to rotate his forearm...
2016: International Journal of Surgery Case Reports
N Bigorre, Y Saint Cast, B Cesari, F Rabarin, G Raimbeau
HYPOTHESIS: Early medical management of rheumatoid arthritis with biotherapy has changed the traditional musculoskeletal damage from this disease. When the distal radio-ulnar joint (DRUJ) is involved, classic procedures may be inappropriate. We chose a hemi-arthroplasty of the DRUJ joint (Eclypse™) in patients with persistent synovitis and chondrolysis with a stable joint. The aim of this study was to assess the intermediate term results of this approach in these specific cases. MATERIALS AND METHODS: We report a retrospective study of 5 Eclypse arthropasties implanted between March 2005 and March 2011...
May 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
S Delclaux, T T Trang Pham, N Bonnevialle, C Aprédoaei, M Rongières, P Bonnevialle, P Mansat
BACKGROUND: Distal radius malunion is a major complication of distal radius fractures, reported in 0 to 33% of cases. Corrective osteotomy to restore normal anatomy usually provides improved function and significant pain relief. We report the outcomes in a case-series with special attention to the potential influence of the initial management. MATERIAL AND METHODS: This single-centre retrospective study included 12 patients with a mean age of 35years (range, 14-60years) who were managed by different surgeons...
May 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
F J Winkler, M Mann, R Habenicht, W Hülsemann
BACKGROUND: Clinodactyly is a digital angulation in the radio-ulnar plane. Mostly it is seen on the little finger. The middle phalanx typically has a triangular or trapezoid shape (delta phalanx), resulting in radial deviation of the distal phalanx. Resection of the longitudinal epiphyseal bracket (physiolysis) with fat graft interposition is a possible surgical technique, which uses children's growth potential to correct the axial deviation. AIM: The purpose of our study was to review the degree of correction at least 2 years postoperatively and after an average of 5 years postoperatively, and to find out if children´s age influences the results...
February 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Christian von Rüden, Mario Morgenstern, Christian Hierholzer, Simon Hackl, Franz Ludwig Gradinger, Alexander Woltmann, Volker Bühren, Jan Friederichs
INTRODUCTION: In this cohort study, the surgical revision concept of open compression plating and autologous bone grafting with and without additional application of BMP for treatment of aseptic ulna and/or radius shaft nonunion was evaluated. The purpose was to evaluate the clinical and radiological outcome, and to determine any difference in osseous healing, range of time between revision surgery and bone healing, and postoperative complications between the cohort groups. PATIENTS AND METHODS: Between 01/2005 and 03/2015, a prospective, randomised, controlled cohort study was performed in a Level I Trauma Centre...
April 2016: Injury
Cyprian Olchowy, Mateusz Łasecki, Urszula Zaleska-Dorobisz
Ultrasound imaging of the musculoskeletal system is superior to other imaging methods in many aspects, such as multidimensional character of imaging, possibility of dynamic evaluation and precise assessment of soft tissues. Moreover, it is a safe and relatively inexpensive method, broadly available and well-tolerated by patients. A correctly conducted ultrasound examination of the wrist delivers detailed information concerning the condition of tendons, muscles, ligaments, nerves and vessels. However, the knowledge of anatomy is crucial to establish a correct ultrasound diagnosis, also in wrist assessment...
June 2015: Journal of Ultrasonography
Jorge L Orbay, Michael R Mijares, Cecilia G Berriz
BACKGROUND: When designing a radial head replacement, the magnitude and direction of forces applied across the proximal radio-ulnar joint (PRUJ) and the radiocapitellar joint must be included. These designs often focus on axial loads transmitted to the radial head by the capitellum; however, the radial head also bears a significant transverse force at the PRUJ. Load transmission by the central band of the interosseous ligament induces a force component in a lateral direction perpendicular to the axis of the limb, which is borne by the articular surfaces of the proximal and distal radio-ulnar joints...
January 2016: Clinical Biomechanics
P Saffar, A Badina
Treatment of Madelung's deformity is still controversial. We reviewed retrospectively 19 patients with Madelung's deformity (two bilateral, 21 cases) who underwent surgery to the radius and ulna to improve range of motion, decrease pain and improve appearance of the wrist. Nineteen patients underwent 21 distal radial osteotomy procedures using three different techniques: subtraction, addition or dome osteotomy. Ulnar shortening and redirection of the distal ulna was performed in 12 cases; a long oblique osteotomy was used in 10 of these cases...
December 2015: Chirurgie de la Main
Bing-bing Zhang, Zhi-guo Yuan, Jian-jun Shao, Shi-ning Yang, Xi-ping Chai
OBJECTIVE: Radial corrective osteotomy is an established but challenging treatment for distal radial malunion. There is an ongoing discussion about whether an opening or closing-wedge osteotomy between should employed. The purpose of the present study was to retrospectively compare the clinical and radio graphic results between conventional opening-wedge osteotomy and closing-wedge technique. METHODS: From January 2004 and December 2012,42 patients with extra-articular distal radial malunion were managed with corrective osteotomy and were followed for a minimum of one year...
July 2015: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Ilker Yagci, Merve Akdeniz Leblebicier, Basak Mansiz Kaplan, Demet Ozturk Gokbakan, Gulseren Akyuz
OBJECTIVES: To compare the nerve cross sectional areas (CSA) of patients with RA without any sign of peripheral neuropathy to healthy controls. METHODS: Clinical, electrophysiological and sonographic assessments were done by three blinded researchers. The patients who had an electrodiagnostic or clinical of peripheral neuropathy were excluded from the study. Nerve CSA were measured in various levels; hamatum hook, pisiform bone, radio-ulnar joint, distal 1/3 of forearm, and elbow for median nerve; radio-ulnar joint, pisiform bone, distal 1/3 of forearm, and medial epicondyle for ulnar nerve...
July 25, 2015: Acta Reumatológica Portuguesa
Giuseppe Solarino, Giovanni Vicenti, Antonella Abate, Massimiliano Carrozzo, Girolamo Picca, Biagio Moretti
PURPOSE: To evaluate the clinical outcomes of radial head excision for multifragmentary radial head fracture in patients over 65 years old. METHODS: We retrospectively examined 30 patients over 65 years of age treated with radial head excision for comminuted radial head fractures. Patients were evaluated through clinical examinations, administrative questionnaires (DASH--Disabilities of the Arm, Shoulder and Hand; MEPS--Mayo Elbow Performance Score, VAS--Visual Analog Scale) and plain films...
October 2015: Aging Clinical and Experimental Research
Katarina Barbaric, Gordan Rujevcan, Marko Labas, Domagoj Delimar, Goran Bicanic
Malunion of distal radius fracture is often complicated with shortening of the radius with disturbed radio- ulnar variance, frequently associated with lesions of triangular fibrocartilage complex and instability of the distal radioulnar joint. Positive ulnar variance may result in wrist pain located in ulnar part of the joint, limited ulnar deviation and forearm rotation with development of degenerative changes due to the overloading that occurs between the ulnar head and corresponding carpus. Ulnar shortening osteotomy (USO) is the standard procedure for correcting positive ulnar variance...
2015: Open Orthopaedics Journal
J M Zuidam, R W Selles, M de Kraker, S E R Hovius
The surgical strategy of treatment of the opposable triphalangeal thumb is correction of the radio-ulnar deviation, reduction of the additional length and joint stabilization. The commonest procedures are: (1) removal of the extra phalanx and stabilization of the remaining joint; and (2) a combined reduction osteotomy with resection of the distal joint followed by arthrodesis. We treated 20 patients (33 hands). In 17 hands the extra phalanx was removed, and in 16 hands we used the combined osteotomy procedure of distal joint removal and arthrodesis...
March 2016: Journal of Hand Surgery, European Volume
Chris Yuk Kwan Tang, Jason Pui Yin Cheung, Boris Fung
Distal Radioulnar Joint (DRUJ) dislocation is a commonly missed injury. A high clinical suspicion is required as the dislocation may not be obvious in the conventional views of radiographs. Volar DRUJ dislocations are far less common than the dorsal ones. Since triangular fibrocartilage complex (TFCC) is the major stabilizer of DRUJ, it is common that the irreducible DRUJ dislocation is associated with TFCC tear. We report a patient who had irreducible volar DRUJ dislocation blocked by the volar lip of sigmoid notch, with only isolated volar capsule rupture...
2014: Hand Surgery
Paragjyoti Gogoi, Anshuman Dutta, Arun Kumar Sipani, Arup Kumar Daolagupu
Congenital deficiency of part of distal ulna affecting the distal radio-ulnar joint is a rare disorder. It is even rarer to find the association of proximal radio-ulnar joint dislocation along with distal ulnar deficiency. This type of congenital forearm anomaly is difficult to treat. Conversion to a single bone forearm in the expense of pronation-supination movement is a viable option. By doing so the elbow and wrist can be stabilized; however movement is possible in only one plane. We are describing here a girl of 8 years having proximal radio-ulnar joint dislocation along with deficiency of distal ulna treated by converting into a single bone forearm...
2014: Case Reports in Orthopedics
Aletta Pfaff, Sietske D de Klerk, Hein P Stallmann
A 17-year-old boy had a painful left wrist after he fell while playing hockey. Examination showed volar displacement of the distal part of the ulna; the ulnar styloid prominence was absent. X-rays showed isolated volar displacement of the distal ulna. The diagnosis 'distal radio-ulnar joint dislocation' was made. Treatment consisted of K-wire fixation and an upper arm cast. He reached functional recovery.
2014: Nederlands Tijdschrift Voor Geneeskunde
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