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Distal radio ulnar

R H van Leerdam, M M E Wijffels, M Reijnierse, W Stomp, P Krijnen, I B Schipper
: This study evaluated the value of computed tomography scans for the diagnosis of distal radioulnar joint instability. A total of 46 patients, conservatively treated for a unilateral distal radius fracture, were evaluated. Clinical instability was tested using the stress test and clunk test. A computed tomography scan of both wrists was performed in pronation and supination. Two independent observers reviewed the computed tomography scans using: the radioulnar line, subluxation ratio, epicentre and radioulnar ratio methods...
January 1, 2017: Journal of Hand Surgery, European Volume
T Nakamura, K Abe, M Nishiwaki, T Iwamoto, K Sato
: We examined the medium- to long-term outcome of the original reconstruction technique of the radioulnar ligament using a half-slip of the extensor carpi ulnaris tendon for chronic foveal avulsion of the triangular fibrocartilage complex. We treated 37 wrists in 36 patients with a minimum follow-up of 5 years. Of 36 patients, 12 had more than 10 years follow-up. At final follow-up, 30 patients (31 wrists) reported no pain, five patients (five wrists) reported mild occasional pain and one patient reported severe persistent pain...
December 8, 2016: Journal of Hand Surgery, European Volume
D Fontès
Distal radius fracture is actually quite rarely isolated and triangular fibrocartilaginous complex (TFCC) is often involved with the same mechanism of injury. A contemporary management of the treatment of the initial fracture is ideal and so benefits from a routine arthroscopic management. Nevertheless, in the absence of diagnosis and therefore early treatment, the symptoms may be located at the ulnar crossroads and justify specific treatment of TFCC. It is generally conducted after an accurate arthroscopic lesion classification guiding a procedure, depending on the lesion vascularization as well as its possible destabilization potential (debridement, capsular suture or foveal reattachment)...
December 2016: Hand Surgery and Rehabilitation
C Fontaine, R Bry, P Laronde, E Guerre, A Aumar
Extensive anatomical knowledge is needed in order to correctly treat distal radius fractures: normal and pathological osteology of the distal radius, distal radio-ulnar joint and radiocarpal joint-both on the descriptive and functional level-the neurovascular and muscular environments of the distal radius-which are essential to the surgical approaches-and the angles that need to be restored during the reduction. All of these concepts are broached in this article.
December 2016: Hand Surgery and Rehabilitation
G M Hohenberger, M J Maier, C Dolcet, A H Weiglein, A Schwarz, V Matzi
The objective of this study was to determine the precise departure points of the articular branches innervating the distal radio-ulnar joint from the anterior and posterior interosseous nerves. The study sample consisted of 116 upper limbs from adult human cadavers. The articular branches were prepared under the dissection microscope to take measurements using the radial styloid process as point of reference. The articular branch departed from the anterior interosseous nerve at a mean distance of 2.9 cm proximal to the styloid for a radius length of 20...
November 15, 2016: Journal of Hand Surgery, European Volume
Adam H Breiteneicher, Bo Norby, Kurt S Schulz, Sharon C Kerwin, Don A Hulse, Derek B Fox, W Brian Saunders
OBJECTIVE: To determine the effect of sliding humeral osteotomy (SHO) on frontal plane thoracic limb alignment in standing and recumbent limb positions. STUDY DESIGN: Canine cadaveric study. SAMPLE POPULATION: Canine thoracic limbs (n=15 limb pairs). METHODS: Limbs acquired from healthy Labrador Retrievers euthanatized for reasons unrelated to this study were mounted in a limb press and aligned in a standing position followed by axial loading at 30% body weight...
October 13, 2016: Veterinary Surgery: VS
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
Liborio Ferrante, Gianluca Faggioli, Rodolfo Pini, Rosalinda D'Amico, Raffaella Mauro, Andrea Stella
PURPOSE: Generally the steal syndrome occurs in proximal arterial-venous fistulas and only exceptionally with distal vascular access because of the high number of arteries supplying the hand. We describe a rare case of steal syndrome of a proximalized distal radio-cephalic fistula stealing from both the radial and ulnar artery through the palmar arch. METHODS: An 86 year old man was admitted because of a cyanotic, swollen left hand with trophic lesions at the third finger...
February 2016: International Journal of Artificial Organs
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
Julien Al Shakarchi, Aurangzaib Khawaja, Deirdre Cassidy, J Graeme Houston, Nicholas Inston
BACKGROUND: The fistula first initiative has promoted arteriovenous fistulas (AVFs) as the vascular access of choice. To preserve as many future access options as possible, multiple guidelines advocate that the most distal AVF possible should be created in the first place. Generally, snuff box and radiocephalic (RC) are accepted and well-described sites for AVFs; however, the forearm ulnar-basilic (UB) AVF is seldom used or recommended. The aim of this study is to assess and systematically review the evidence base for the creation of the UB fistula and to critically appraise whether more attention should be given to this site...
April 2016: Annals of Vascular Surgery
N Bonnevialle
Radial head fractures are fairly common (20% of all traumatic elbow injuries). Non-operative treatment is indicated in non-displaced fractures, and direct stable internal fixation allowing early elbow mobilisation in most other cases. For severely comminuted fractures precluding stable fixation, replacement of the radial head was introduced in the 1970s as a better alternative to simple radial head resection, which can induce instability of the elbow and/or forearm, most notably in patients who have complex fractures with concomitant lesions to other structures...
February 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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
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