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Carpal instability

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44 papers 25 to 100 followers
By Rajesh Purushothaman Additional Professor of Orthopaedics, Government Medical College, Kozhikode, Kerala, India
https://www.readbyqxmd.com/read/23306292/the-management-of-scapholunate-wrist-instability-a-review
#1
REVIEW
Andrzej Zyluk, Bernard Piotuch
An injury to the ligament linking the scaphoid with the lunate is the most common and and budrened with the most negative sequelae cause of the carpal instability. It occurs most frequently as an associated injury at fractures of the distal radius. A review of methods of treatment of the pathology is provided, according to clinical advancement, duration form original trauma and condition of articular structures. Technical complexity of methods is directly related to severity of intrarticular changes. In early, dynamic instabilities, a simple, temporary scapholunate arthrodesis with K-wires is is an useful procedure, preventing further development of chronic instsbility...
October 5, 2012: Polish Orthopedics & Traumatology
https://www.readbyqxmd.com/read/10874224/lunotriquetral-instability-diagnosis-and-treatment
#2
REVIEW
A Y Shin, M J Battaglia, A T Bishop
Isolated injury of the lunotriquetral interosseous ligament complex and associated structures is less common and is poorly understood compared with the other proximal-row ligament injury, scapholunate dissociation. The spectrum of injuries ranges from isolated partial tears to frank dislocation, and from dynamic to static carpal instability. The diagnosis may be difficult to establish because of the many possible causes of ulnar-sided wrist pain and the often normal radiographic appearance. The mechanism of injury is variable and includes attrition by age, positive ulnar variance, and perilunate or reverse perilunate injury...
May 2000: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/26188693/management-of-lunotriquetral-instability-a-review-of-the-literature
#3
REVIEW
T C van de Grift, M J P F Ritt
UNLABELLED: Lunotriquetral ligament injury is a relatively common cause of ulnar-sided wrist pain. Injury ranges from partial stable ligament tears to extensive perilunate instability. Clinical decision-making largely depends on the chronicity, instability and cause of the ligament injury. Conservative treatment is generally regarded as first choice of treatment of mild lunotriquetral instability; however, outcome studies on conservative treatment are lacking. Temporary arthroscopic pinning and/or debridement are minimally invasive procedures of preference...
January 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/26205710/midcarpal-instability-a-comprehensive-review-and-update
#4
REVIEW
Timothy Niacaris, Bryan W Ming, David M Lichtman
Midcarpal instability has been well described as a clinical entity but the pathokinematics and pathologic anatomy continue to be poorly understood. This article presents a comprehensive review of the existing knowledge and literature-based evidence for the diagnosis and management of the various entities comprising midcarpal instability. It discusses the limitations of the current understanding of midcarpal instability and proposes new directions for furthering knowledge of the causes and treatment of midcarpal instability and wrist pathomechanics in general...
August 2015: Hand Clinics
https://www.readbyqxmd.com/read/26598109/midcarpal-instability
#5
REVIEW
D G Hargreaves
Midcarpal instability is a collective term for a number of conditions where the instability of the wrist is predominantly between the proximal and distal carpal rows. It has been regarded as relatively rare and infrequently requires surgical treatment. Palmar midcarpal instability is the most commonly found type of midcarpal instability and can be responsible for causing a clunking and painful wrist. The diagnosis is made on clinical grounds using the midcarpal instability provocative tests. Standard imaging and arthroscopic inspection do not usually confirm a definite diagnosis, but are important in excluding other pathologies...
January 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/17560408/the-diagnosis-and-treatment-of-scapholunate-instability
#6
REVIEW
Jennifer Manuel, Steven L Moran
Scapholunate instability is the most common form of carpal instability. Pain produced by this condition is caused by the wrist's inability to sustain physiologic loads because of an injury to the linkage between the scaphoid and lunate. The term scapholunate instability may describe a wide spectrum of clinical conditions ranging from mild wrist dysfunction and partial ligamentous tear to debilitating pain with associated rupture of the scapholunate interosseus ligament complex. This article reviews the pathophysiology of scapholunate instability and its identification and treatment...
April 2007: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/18656780/scapholunate-instability-current-concepts-in-diagnosis-and-management
#7
REVIEW
Christina E Kuo, Scott W Wolfe
Injuries to the scapholunate joint are the most frequent cause of carpal instability and account for a considerable degree of wrist dysfunction, lost time from work, and interference with activities. The complex arrangement and kinematics of the 2 rows of carpal bones allows for an enormous degree of physiologic motion, and a hierarchy of primary and secondary ligaments serves to balance an inherently unstable structure. Although insufficient to cause abnormal carpal posture or collapse on static radiographs, an isolated injury to the scapholunate interosseous ligament may be the harbinger of a relentless progression to abnormal joint mechanics, cartilage wear, and degenerative change...
July 2008: Journal of Hand Surgery
https://www.readbyqxmd.com/read/26205699/carpal-ligament-anatomy-and-biomechanics
#8
REVIEW
Nicholas Pulos, David J Bozentka
A fundamental understanding of the ligamentous anatomy of the wrist is critical for any physician attempting to treat carpal instability. The anatomy of the wrist is complex, not only because of the number of named structures and their geometry but also because of the inconsistencies in describing these ligaments. The complex anatomy of the wrist is described through a review of the carpal ligaments and their effect on normal carpal motion. Mastery of this topic facilitates the physician's understanding of the patterns of instability that are seen clinically...
August 2015: Hand Clinics
https://www.readbyqxmd.com/read/23021178/scapholunate-instability-current-concepts-in-diagnosis-and-management
#9
Alison Kitay, Scott W Wolfe
Injuries to the scapholunate joint are the most frequent cause of carpal instability and account for a considerable degree of wrist dysfunction, lost time from work, and interference with activities. Although it is insufficient to cause abnormal carpal posture or collapse on static radiographs, an isolated injury to the scapholunate interosseous ligament may be the harbinger of a relentless progression to abnormal joint mechanics, cartilage wear, and degenerative changes. Intervention for scapholunate instability is aimed at arresting the degenerative process by restoring ligament continuity and normalizing carpal kinematics...
October 2012: Journal of Hand Surgery
https://www.readbyqxmd.com/read/26205700/carpal-ligament-injuries-pathomechanics-and-classification
#10
REVIEW
Daniel J Lee, John C Elfar
Carpal instability is a complex array of maladaptive and posttraumatic conditions that lead to the inability of the wrist to maintain anatomic relationships under normal loads. Many different classification schemes have evolved to explain the mechanistic evolution and pathophysiology of carpal instability, including 2 of the most common malalignment patterns: volar intercalated segment instability and the more common dorsal intercalated segment instability. Recent classifications emphasize the relationships within and between the rows of carpal bones...
August 2015: Hand Clinics
https://www.readbyqxmd.com/read/20467868/midcarpal-instability-a-radiological-perspective
#11
REVIEW
Andoni Paul Toms, Adrian Chojnowski, John G Cahir
Midcarpal instability (MCI) is the result of complex abnormal carpal motion at the midcarpal joint of the wrist. It is a form of non-dissociative carpal instability (CIND) and can be caused by various combinations of extrinsic ligament injuries that then result in one of several subtypes of MCI. The complex patterns of injury and the kinematics are further complicated by competing theories, terminology and classifications of MCI. Palmar, dorsal, ulna midcarpal instability, and capitolunate or chronic capitolunate instability are all descriptions of types of MCI with often overlapping features...
May 2011: Skeletal Radiology
https://www.readbyqxmd.com/read/27569785/carpal-kinematics-and-kinetics
#12
REVIEW
Robin N Kamal, Adam Starr, Edward Akelman
The complex interaction of the carpal bones, their intrinsic and extrinsic ligaments, and the forces in the normal wrist continue to be studied. Factors that influence kinematics, such as carpal bone morphology and clinical laxity, continue to be identified. As imaging technology improves, so does our ability to better understand and identify these factors. In this review, we describe advances in our understanding of carpal kinematics and kinetics. We use scapholunate ligament tears as an example of the disconnect that exists between our knowledge of carpal instability and limitations in current reconstruction techniques...
October 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/10447183/definition-of-carpal-instability-the-anatomy-and-biomechanics-committee-of-the-international-federation-of-societies-for-surgery-of-the-hand
#13
(no author information available yet)
No abstract text is available yet for this article.
July 1999: Journal of Hand Surgery
https://www.readbyqxmd.com/read/6728443/wrist-ligamentous-anatomy-and-pathogenesis-of-carpal-instability
#14
J K Mayfield
The key wrist ligaments are volar and intracapsular. The pathogenesis of carpal instability is dependent on the loading mechanism, hand position, and ligament and bone biomechanics. Ligament elongation with associated intercarpal and carpal instability can be present.
April 1984: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/8522742/analysis-of-carpal-instability-ii-clinical-applications
#15
J C Hodge, L A Gilula, C F Larsen, P C Amadio
An analytic scheme for carpal instability patterns has been described to help standardize reporting of these conditions. Six categories to be recognized in each case are chronicity, constancy, etiology, location, direction, and pattern. Examples are presented to illustrate the use of this scheme.
September 1995: Journal of Hand Surgery
https://www.readbyqxmd.com/read/8522741/analysis-of-carpal-instability-i-description-of-the-scheme
#16
REVIEW
C F Larsen, P C Amadio, L A Gilula, J C Hodge
There is a lack of a generally agreed analysis of carpal instability that can assist in the diagnosis, give guidelines for treatment, and ensure unity when reporting results of treatment. Based on the literature and using six categories describing chronicity, constancy, etiology, location, direction, and pattern of the instability, we present a proposal for a standardized analysis. Using this analysis, an instability should be presented with information in all six categories. The analysis may be expanded and developed according to future needs...
September 1995: Journal of Hand Surgery
https://www.readbyqxmd.com/read/19643339/management-of-carpal-instability-in-athletes
#17
REVIEW
Joseph F Slade, Matthew D Milewski
Hand and wrist injuries are common in most athletic events and sports. Carpal fractures and ligamentous injuries are common in athletes and require physicians, trainers, and therapists who treat and diagnosis these injuries to have an understanding of the carpal bone anatomy and vascularity along with the potential for progression to instability. Research is still needed to further investigate the optimal treatments of all carpal injuries in athletes along with designing new means to prevent these injuries.
August 2009: Hand Clinics
https://www.readbyqxmd.com/read/24461233/post-traumatic-carpal-instability
#18
REVIEW
C Chantelot
The complexity of the carpus explains the difficulty treating carpal injuries. Lesions are dominated by perilunate dislocation, scapholunate dislocation, and scaphoid fractures. The other injuries are trivial. Symptoms include pain and loss of wrist strength, reversible for an acute and well-treated lesion. Too often, these ligament injuries are diagnosed late. For delays longer than 6 weeks, ligament repair is ineffective. These old, complex lesions are potentially highly arthritic in the radiocarpal and mediocarpal joints...
February 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/26581604/the-role-of-arthroscopy-in-carpal-instability
#19
REVIEW
T R Lindau
Carpal instability is predominantly caused by trauma and presents as a painful wrist with signs and symptoms of weakness, clicking, clunking and a sense of giving way. Wrist arthroscopy is widely regarded as the 'gold standard' in diagnosing and understanding carpal instability. This article is based on an extensive literature search to evaluate the evidence behind the use of wrist arthroscopy in the assessment and management of these patients. There is convincing evidence supporting the role of arthroscopy in diagnosis and assessment of factors involved in the development of carpal instability, but weak evidence for the effectiveness of arthroscopic techniques in the actual treatment of this condition...
January 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/26586689/imaging-in-carpal-instability
#20
REVIEW
N K Ramamurthy, A J Chojnowski, A P Toms
Carpal instability is a complex and heterogeneous clinical condition. Management requires accurate identification of structural injury with an understanding of the resultant movement (kinematic) and load transfer (kinetic) failure. Static imaging techniques, such as plain film radiography, stress views, ultrasound, magnetic resonance, MR arthrography and computerized tomography arthrography, may accurately depict major wrist ligamentous injury. Dynamic ultrasound and videofluoroscopy may demonstrate dynamic instability and kinematic dysfunction...
January 2016: Journal of Hand Surgery, European Volume
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