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carpal fracture

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
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
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
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
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
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
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
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
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: J Hand Surg Asian Pac Vol
T Lögters, J Windolf
Fractures of the carpal bones are uncommon. On standard radiographs fractures are often not recognized and a computed tomography (CT) scan is the diagnostic method of choice. The aim of treatment is to restore pain-free and full functioning of the hand. A distinction is made between stable and unstable carpal fractures. Stable non-displaced fractures can be treated conservatively. Unstable and displaced fractures have an increased risk of arthritis and non-union and should be stabilized by screws or k‑wires...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Toshihiro Hosokawa, Ryo Oda, Shogo Toyama, Daigo Taniguchi, Daisaku Tokunaga, Hiroyoshi Fujiwara, Toshikazu Kubo
INTRODUCTION: Spontaneous flexor tendon rupture is usually caused by trauma, systemic diseases, or carpal bone and joint disorders. Here we report a case of spontaneous flexor tendon rupture occurring in a systemic lupus erythematosus (SLE) patient following nonunion of the hamate hook after an insufficiency fracture, and which was also associated with tendon degeneration caused by SLE. CASE PRESENTATION: A 57-year-old woman was diagnosed with SLE 22 years ago and being treated with oral prednisolone...
2016: International Journal of Surgery Case Reports
Frederico Barra de Moraes, Rodrigo Cunha Ferreira, Stéphanie Zago Geraldino, Renato Silva Farias, Ricardo Pereira da Silva, Mário Yoshihide Kuwae
The wrist is a region that is very vulnerable to injuries of the extremities. Among these injuries, fractures of the pyramidal bone (or triquetrum) in association with dislocation of the hamate and carpal instability are uncommon. They are generally correlated with high-energy trauma and may be associated with neurovascular deficits, muscle-tendon disorders, skin lesions or injuries to other carpal bones. Thus, in this report, one of these rare cases of transtriquetral perihamate fracture-dislocation with carpal instability is presented, diagnosed by means of radiography on the right wrist of the patient who presented pain, edema and limitation of flexion-extension of the carpus after trauma to the region...
July 2016: Revista Brasileira de Ortopedia
Sarah L Pownder, Stacy Cooley, Kei Hayashi, Abraham Bezuidenhout, Matthew F Koff, Hollis G Potter
A 5-year-old, spayed female Weimaraner dog was evaluated for progressive left forelimb lameness localized to the carpus. Magnetic resonance imaging (MRI) was used to arrive at a presumptive diagnosis of intermedioradial carpal (IRC) bone fracture with avascular necrosis (AVN). To the authors' knowledge, this is the first report of naturally occurring AVN of the canine IRC diagnosed using MRI.
August 2016: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
O-Wern Low, Andre E J Cheah
Carpal tunnel syndrome is a common complication associated with distal radius fractures. Open carpal tunnel release in the same setting as open reduction and internal fixation of distal radius fractures is widely accepted. In this paper, we describe the technical details of a minimally invasive carpal tunnel release in the same setting as the fixation of a distal radius fracture via the same incision. Two options of minimally invasive techniques are described: The Knifelight® (Stryker, Kalamazoo, Michigan, USA) instrument and the single portal carpal tunnel release system (Agee, 3M Healthcare, St Paul, Minnesota, USA)...
February 2016: J Hand Surg Asian Pac Vol
Munn Yi Tina Lee, Yeo Chong Jin
Spontaneous rupture of flexor tendons within the carpal tunnel is rare in the absence of rheumatoid arthritis. Other predisposing conditions such as gout, infection, pisotriquetrial osteoarthritis, as well as hook of hamate fracture non-union, have previously been reported. However, tendon ruptures of the hand in the presence of acromegaly, as well as spontaneous ruptures within the carpal tunnel, have not been described in the literature.
February 2016: J Hand Surg Asian Pac Vol
Nikolas H Kazmers, Stephanie Thibaudeau, L Scott Levin
This article demonstrates a technique for the treatment of scaphoid fracture waist and proximal pole nonunions with avascular necrosis using a free vascularized medial femoral condyle flap. We present our surgical technique and representative case examples in which the scapholunate ligament, a key structure required to preserve carpal kinematics, is spared.
September 2016: Journal of Hand Surgery
Peter Jørgsholm, Niels Thomsen, Jack Besjakov, Sven Abrahamsson, Anders Björkman
Background and purpose - The epidemiology and optimal diagnostics of wrist injuries in children are not knotwn. We describe fractures revealed by magnetic resonance imaging (MRI) in a prospective population of children and adolescents with posttraumatic radial-sided wrist tenderness, and compare the diagnostic value of radiographs and computed tomography (CT) with that of MRI. Patients and methods - From 2004 to 2007, patients less than 18 years of age who presented at our emergency department were included in the study...
October 2016: Acta Orthopaedica
Brigite De Lima Dantas, Alexane Durand, Tim Parkin, Cameron Broome
OBJECTIVES: 1) To describe a radiographic method for determination of joint orientation lines and anatomical joint angles in orthogonal planes of feline radii; 2) to establish a range of normal radial joint orientation angles and anatomical axes in a feline population; and 3) to assess the repeatability and reliability of this methodology. METHODS: The radial anatomical axis, elbow and carpal joint reference lines, and the intersecting angles of each: anatomical medial proximal (aMPRA) and lateral distal radial angles (aLDRA), anatomical caudal proximal (aCdPRA) and distal radial angles (aCdDRA), and sagittal procurvatum (SP) were determined on the orthogonal radiographs of 14 feline limbs...
July 19, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Michelle Griffin, Ibrahim Roushdi, Liza Osagie, Sonja Cerovac, Shamim Umarji
BACKGROUND: Perilunate dislocations (PLDs) are uncommon high-energy injuries that may result in significant morbidity if inadequately treated. We report the midterm outcomes following surgical intervention and the validity of the Patient-Rated Wrist Evaluation (PRWE) score as an assessment tool post injury. METHODS: We prospectively present outcomes in 16 patients with perilunate injuries. Definitive surgical management comprised fixation of all fractures and anatomical reconstruction of ruptured ligaments where possible...
March 2016: Hand: Official Journal of the American Association for Hand Surgery
Chuan Li, Xiaoshan Xu, Yongyue Su, Tianhua Zhou, Xinyu Fan, Yongqing Xu
BACKGROUND: Scaphoid fracture is a common carpal fracture, and its treatment often requires fixation devices. This study aimed to investigate the efficacy and safety of a memory alloy nail-feet-fixation (MANFF) device in treating scaphoid fractures. METHODS: Sixty-six patients with closed scaphoid fractures were treated using the MANFF device between August 2011 and November 2013. Surgical outcomes were assessed using the Mayo wrist score, including pain intensity, functional status, range of motion and grip strength...
July 2016: ANZ Journal of Surgery
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