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https://www.readbyqxmd.com/read/27896458/prognostic-factors-in-the-treatment-of-carpal-scaphoid-non-unions
#1
F Schuind, F Moungondo, W El Kazzi
In this literature review, the authors analyse the prognostic factors in the curative treatment of scaphoid non-unions. The main negative prognostic factors are smoking, the time elapsed since the fracture, and avascular necrosis of the proximal fragment. If the latter is present, the revascularization by a pedicle or microsurgical bone autograft is probably the treatment of choice. In non-unions without evidence of osteonecrosis, vascularized bone grafts are probably not superior to conventional bone grafts, which can presently be performed under arthroscopic control, with minimal morbidity...
November 28, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27890195/-carpal-malalignment-following-distal-radius-fracture
#2
B Coulet, M-O Gauci, C Lazerges, M Chammas
Adaptive carpal malalignment is the consequence of malunion of the distal radius. Since the radial metaphysis and capitate have to be aligned, any disorientation of the radial epiphysis will force the proximal carpal row to adapt, as it is the only mobile element. There are two types of adaptation depending where the compensative occurs: (1) midcarpal - leading to flexion between the lunate and capitate, with the lunate maintaining a normal relationship with the radial epiphysis axis; (2) radiocarpal - combining flexion and dorsal displacement of the lunate relative to the axis of the radial epiphysis, with the midcarpal joint remaining aligned...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27886841/management-of-upper-extremity-injury-in-divers
#3
REVIEW
Steven C Haase
Modern competitive diving-especially platform diving-applies dramatic stress to the upper extremity. Some stress occurs during handstand-style takeoffs, but more force is delivered to the hand, wrist, elbow, and shoulder during hands-first entry. Hand positions that minimize the amount of splash result in forceful wrist extension. This repetitive impact can lead to chronic upper extremity pain and acute injuries that require operative intervention. Many divers use taping and bracing to prevent or treat this type of injury, but these are only modestly effective...
February 2017: Hand Clinics
https://www.readbyqxmd.com/read/27856939/magnetic-resonance-imaging-investigation-of-radio-lunate-relations-use-in-assessing-distal-radial-fracture-reduction
#4
G Medlock, J M Wohlgemut, I M Stevenson, A J Johnstone
: Reformatted magnetic resonance imaging scans of 27 normal wrists were examined in incremental degrees of rotation around the central axis of the radial shaft to 30° in both directions from true lateral. A line was superimposed on the outer border of the radial dorsal cortex and continued distally to the carpal region. Measurements were made from the superior pole of the lunate to this line. This distance did not change significantly with rotation. This allows a quick and accurate way of assessing distal radial fracture reduction from poorly taken lateral radiographs...
November 16, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27855045/-four-corner-fusion-in-patients-with-wrist-arthritis
#5
María Francisca Vázquez-Alonso, Alberto Viñas-Silva
Scapholunate advance collapse (SLAC) and Scaphoid nonunion advance collapse (SNAC), are the two most common patterns of postraumatic wrist arthritis. SLAC wrist develops after attenuation, either traumatically or atraumatically, of the scapholunate ligament. Atraumatic causes of SLAC wrist include calcium pyrophosphate dehydrate deposition disease, reumathoid arthritis, neuropathic diseases, and b2-microglobulin asociated amyloid deposition diseases. On the other hand, SNAC wrist develops following a scahpoid fracture that has progressed to a nonunion...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27830329/management-of-scaphoid-nonunion-with-iliac-crest-bone-graft-and-k-wire-fixation
#6
Erin Meisel, Alex Seal, Caroline A Yao, Alidad Ghiassi, Milan Stevanovic
PURPOSE: Scaphoid nonunion can occur in both non-operative and operatively treated scaphoid fractures. Without treatment, this can lead to a predictable pattern of carpal collapse and degenerative arthritic change and patients can experience both pain and functional loss in the early and late phases of progression. An operative technique with a high success rate for union is important. This paper describes a technique for treatment of scaphoid nonunion with K-wire fixation and iliac crest cancellous bone graft...
November 9, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27811625/internal-bone-grafting-for-the-treatment-of-scaphoid-nonunions
#7
Utkan Aydin, Sunil M Thirkannad
Scaphoid fracture is the most common carpal fracture of the upper extremity and a significant proportion of these can eventually progress to nonunion. Excision of pseudoarthrosis and fibrous scar tissue at the nonunion site is regarded as one of the important steps in management of scaphoid nonunions. We describe a technique of internal bone grafting, where curettage of the nonunion site was performed through a drill hole in the scaphoid and bone graft was packed through this same hole before fixation with a headless compression screw...
November 2, 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27806538/epidemiology-of-the-upper-extremity-trauma-in-a-traumatic-center-in-iran
#8
Maryam Ameri, Kamran Aghakhani, Ebrahim Ameri, Shahrokh Mehrpisheh, Azadeh Memarian
INTRODUCTION: Orthopedic injuries are the most common types of traumatic injuries and present as fractures of the limbs, pelvis, and vertebrae or lesions in soft tissues, muscles, ligaments, and tendons. The upper limb fractures occur in distal radius and ulna, metacarpals, fingers, scapula, and carpal bones, Proximal, diaphysis, distal humerus, clavicle, proximal ulna and radio and distal humero and humero, radio, ulna, and metacarpo. The objective of this project was to accurately describe the occurrence of injuries of the upper extremity and the mechanisms of such injuries in a representative sample of Iranian population...
August 10, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27793442/pulling-harder-than-the-hamate-tolerates-evaluation-of-hamate-injuries-in-rock-climbing-and-bouldering
#9
Christoph Lutter, Andreas Schweizer, Thomas Hochholzer, Thomas Bayer, Volker Schöffl
OBJECTIVE: Hamate hook fractures are rare injuries, comprising 2% to 4% of all carpal fractures. Climbing athletes seem to be affected more frequently than others, as they strain the passive and active anatomical structures of their hands and fingers to maximum capacity during training or competing. This stress is transmitted to the hook of the hamate by tightened flexor tendons, which creates high contact pressure to the ulnar margin of the carpal tunnel. Injuries of the hamate hook, caused by contact pressure of the anatomical structures, are rare and occur nearly exclusively during climbing...
December 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/27788215/comparison-of-diagnostic-accuracy-of-radiation-dose-equivalent-radiography-multidetector-computed-tomography-and-cone-beam-computed-tomography-for-fractures-of-adult-cadaveric-wrists
#10
Jakob Neubauer, Matthias Benndorf, Carolin Reidelbach, Tobias Krauß, Florian Lampert, Horst Zajonc, Elmar Kotter, Mathias Langer, Martin Fiebich, Sebastian M Goerke
PURPOSE: To compare the diagnostic accuracy of radiography, to radiography equivalent dose multidetector computed tomography (RED-MDCT) and to radiography equivalent dose cone beam computed tomography (RED-CBCT) for wrist fractures. METHODS: As study subjects we obtained 10 cadaveric human hands from body donors. Distal radius, distal ulna and carpal bones (n = 100) were artificially fractured in random order in a controlled experimental setting. We performed radiation dose equivalent radiography (settings as in standard clinical care), RED-MDCT in a 320 row MDCT with single shot mode and RED-CBCT in a device dedicated to musculoskeletal imaging...
2016: PloS One
https://www.readbyqxmd.com/read/27777813/the-etiology-and-pathogenesis-of-kienb%C3%A3-ck-disease
#11
Gregory Ian Bain, Simon Bruce Murdoch MacLean, Chong Jin Yeo, Egon Perilli, David M Lichtman
Kienböck disease is a condition that typically occurs in the "at-risk" patient, in the "at-risk" aspect of the proximal condyle of the "at-risk" lunate. In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. The lunate fracture commences at the point the lunate cantilevers over the edge of the distal radius, and then takes on the shape of the radius. We postulate that the stress fracture violates the parallel veins of the venous subarticular plexus-leading to localized venous hypertension and subsequent ischemia and edema of the fatty marrow...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27770167/-surgical-treatment-of-a-complex-adolescent-carpal-fracture-a%C3%A2-rare%C3%A2-injury-to-the-growing-skeleton
#12
D Saul, J C Ammon, F August
We report the case of a 15-year-old boy with combined fractures of the scaphoid, capitate, and hamate that represents a rare variation of the well-known Fenton's syndrome. Fixation was performed for the unstable fractures of the scaphoid and capitate with the use of cannulated Herbert screws and K‑wires respectively. K‑wires were removed after 6 months, with subsequent physiotherapy. After 6 months, CT confirmed complete consolidation of the two surgically treated carpal fractures and the conservatively treated fracture of the hamate...
October 21, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27764034/triple-fracture-of-the-intra-articular-second-metacarpal-head-intra-articular-fourth-metacarpal-base-and-ulnar-styloid-of-an-ice-hockey-player-a-case-report
#13
Hiroyoshi Hagiwara, Takashi Ajiki, Suguru Hagiwara, Naoya Sugimoto, Katsushi Takeshita
We present a case of simultaneous ipsilateral fractures at the intra-articular second metacarpal head, intra-articular fourth metacarpal base, and ulnar styloid. These fractures were caused by the peculiar condition of a blow to the fist during an ice hockey game; the hand was struck while it was gripping a stick. The specific combination of these fractures has not been previously reported in the literature. In this incident, axial compression force was transmitted from the second and fourth metacarpal heads while skipping the third metacarpal head to the ulnar side of the wrist via the carpometacarpal joints and carpal bones...
July 27, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/27725994/-acute-scaphoid-fractures-management-under-consideration-of-the-new-s3-level-guideline
#14
M Schädel-Höpfner, B Bickert, C Dumont, P Laier, R Meier, A Nusche, T Pillukat, H Rosenthal, R Schmitt, F Siemers, A Zach, M Jung
BACKGROUND: Scaphoid fractures represent the most common carpal fractures and are often problematic and frequently lead to nonunion with osteoarthritis and collapse of the wrist. The reasons for the nonunion are manifold. Therefore, the main goal of diagnosis and therapy of acute fractures is to achieve bony union and to restore the anatomic shape of the scaphoid. In the long run, only this can preserve the normal function of the wrist. METHODOLOGY: The given recommendations are based on the new S3-level guideline of the AWMF (Association of the Scientific Medical Societies)...
October 10, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27695881/-secondary-tendon-reconstruction-on-the-thumb
#15
B Bickert, T Kremer, U Kneser
Closed tendon ruptures of the thumb that require secondary reconstruction can affect the extensor pollicis longus (EPL), extensor pollicis brevis (EPB) and flexor pollicis longus (FPL) tendons. Treatment of rupture of the EPB tendon consists of refixation to the bone and temporary transfixation of the joint. In the case of preexisting or posttraumatic arthrosis, definitive arthrodesis of the thumb is the best procedure. Closed ruptures of the EPL and FPL tendons at the wrist joint cannot be treated by direct tendon suture...
September 30, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27692801/risk-of-prolonged-opioid-use-among-opioid-na%C3%A3-ve-patients-following-common-hand-surgery-procedures
#16
Shepard P Johnson, Kevin C Chung, Lin Zhong, Melissa J Shauver, Michael J Engelsbe, Chad Brummett, Jennifer F Waljee
PURPOSE: To evaluate prolonged opioid use in opioid-naïve patients after common hand surgery procedures in the United States. METHODS: We studied insurance claims from the Truven MarketScan databases to identify opioid-naïve adult patients (no opioid exposure 11 months before the perioperative period) who underwent an elective (carpal tunnel release, carpometacarpal arthroplasty/arthrodesis, cubital tunnel release, or trigger finger release) or trauma-related (closed distal radius fracture fixation, flexor tendon repair, metacarpal fracture fixation, or phalangeal fracture fixation) hand surgery procedure between 2010 and 2012 (N = 77,573 patients)...
September 7, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27682293/analysis-of-soft-tissue-complications-of-volar-plate-fixation-for-managing-distal-radius-fractures-and-clinical-effect-while-preserving-pronator-quadratus
#17
J Fan, B Jiang, B Wang, K Chen, F Yuang, J Mei, G-R Yu
The aim of the study was to analysis soft-tissue complications of volar plate fixation and it's prevention strategies along with exploring clinical effects of preserving pronator quadratus (PQ) muscle. From February 2011 to February 2013, sixty-five patients with distal radius fracture underwent open reduction and internal fixation with the volar locking palmar plates. The group with preserving PQ involved 30 patients and group with PQ repair involved 35 patients. Surgeons must took great care of not -letting drill pierce dorsal cortical bone rapidly and dorsal carpal tangential fluoroscopy was also taken in addition to lateral fluoroscopy to get accurate screw length...
August 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/27679785/surgical-treatment-of-unstable-distal-radius-fractures-with-a-volar-variable-angle-locking-plate-clinical-and-radiological-outcomes
#18
Kavin Khatri, Vijay Sharma, Kamran Farooque, Vivek Tiwari
BACKGROUND: Unstable distal end radius fractures are difficult to manage and so various treatment modalities have been described. The use of variable-angle locking plates is promoted for the management of these fractures. OBJECTIVES: This study aimed to evaluate the functional and radiological outcomes in unstable distal end radius fractures treated with variable-angle locking plates. PATIENTS AND METHODS: We reviewed 23 unstable distal end radius fractures that were treated at our institution with volar variable-angle locking plates...
June 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/27637547/-diagnosis-of-the-scaphoid-bone-fractures-nonunion-circulation-perfusion
#19
T Kahl, F K Razny, J P Benter, K Mutig, K Hegenscheid, S Mutze, A Eisenschenk
The clinical relevance of scaphoid bone fractures is reflected by their high incidence, accounting for approximately 60 % among carpal fractures and for 2-3 % of all fractures. With adequate therapy most scaphoid bone fractures heal completely without complications. Insufficient immobilization or undiagnosed fractures increase the risk of nonunion and the development of pseudarthrosis.X-ray examination enables initial diagnosis of scaphoid fracture in 70-80 % of cases. Positive clinical symptoms by negative x‑ray results require further diagnostics by multi-slice spiral CT (MSCT) or MRI to exclude or confirm a fracture...
September 16, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27595962/closed-rupture-of-the-flexor-tendon-secondary-to-sclerosis-of-the-hook-of-the-hamate-a-report-of-two-cases
#20
Hiroshi Yamazaki, Shigeharu Uchiyama, Masato Hosaka, Hiroyuki Kato
Closed flexor tendon ruptures in the little finger can be caused by fracture or nonunion of the hook of the hamate, but no case of the disorder secondary to the sclerosis and thinning of the hamate hook has been reported. We report two rare cases with this complication due to rough surface of the hamate hook. Carpal tunnel view radiographs and computed tomography showed the sclerosis and thinning of the hook.
October 2016: Journal of Hand Surgery Asian-Pacific Volume
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