Avascular Necrosis of the Scaphoid Treated by Total Excision and Radial Advancement Osteotomy

1995 ◽  
Vol 20 (6) ◽  
pp. 736-740 ◽  
Author(s):  
I. GÜNAL ◽  
V. ÖZTUNA ◽  
N. KÖSE ◽  
S. SEBER
Keyword(s):  
Clinical Study ◽  
Avascular Necrosis ◽  
Total Excision ◽  
Active Motion ◽  
Ulnar Deviation ◽  
Extensor Carpi Radialis

Total scaphoid excision and radial advancement osteotomy has been investigated in a eadaverie and clinical study. In three below-elbow fresh amputation specimens, the technique was utilized and stability was checked by radiographs. Instability on ulnar deviation was prevented by extensor carpi radialis longus tenodesis. Four patients were treated in this way. The wrist was immobilized in a below-elbow splint for 45 days, then active motion was encouraged. After 10 months, three patients had excellent results and one patient had good result using the criteria of Cooney et al (1987).

Resection Arthroplasty of the Metacarpophalangeal Joints in Rheumatoid Arthritis

1995 ◽  
Vol 20 (5) ◽  
pp. 707-715 ◽  
Author(s):  
W. RÜTHER ◽  
B. VERHESTRAETEN ◽  
B. FINK ◽  
K. TILLMANN
Keyword(s):  
Rheumatoid Arthritis ◽  
Patient Satisfaction ◽  
Retrospective Study ◽  
Pain Relief ◽  
Wrist Joint ◽  
Resection Arthroplasty ◽  
Full Extension ◽  
Active Motion ◽  
Ulnar Deviation ◽  
Careful Patient

In a retrospective study of resection arthroplasty of the MP joints in rheumatoid arthritis, 23 patients (32 hands, 128 joints) have been followed for 15 to 22 years. Patient satisfaction was high, and all patients had significant pain relief. Active motion of the joints averaged 35°, ranging from full extension to 35° of flexion. Ankyloses developed in five hands (13 joints, 10%). Ulnar deviation of more than 15° occurred in six patients (ten hands, 30%). Over the course of several years a significant remodelling of the joints was to be observed. In six hands (19%) the metacarpal heads became spontaneously restored to ball-shaped geometry. Gross metacarpal resorption was observed in nine hands (30%), causing significant shortening of the metacarpals. In one-third of patients the final result was rated as good, fair and poor, respectively. Careful patient selection is mandatory. Patients with mutilating arthritis should be excluded from the procedure; rheumatoid destruction of the wrist joint definitely influences the final result.

Clinical Study on Avascular Necrosis of Femoral Head in Adult

1987 ◽  
Vol 22 (2) ◽  
pp. 469
Author(s):  
Ik Dong Kim ◽  
Soo Young Lee ◽  
Poong Taek Kim ◽  
Byung Chul Park ◽  
Young Wook Choi ◽  
...  
Keyword(s):  
Clinical Study ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Necrosis Of Femoral Head

Brachialis Muscle Transfer to the Forearm Muscles in Obstetric Brachial Plexus Palsy

2006 ◽  
Vol 31 (3) ◽  
pp. 261-265 ◽  
Author(s):  
J. A. BERTELLI
Keyword(s):  
Brachial Plexus ◽  
Hand Function ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer ◽  
Wrist Extension ◽  
Active Motion ◽  
Obstetric Brachial Plexus Palsy ◽  
Brachialis Muscle ◽  
Obstetric Brachial Plexus ◽  
Extensor Carpi Radialis

Tendon transfers are frequently needed to improve hand function in obstetric brachial plexus injuries. The reconstruction cannot always be achieved using local donor transfers in the forearm as these are not always available. In such cases, we propose the use of the brachialis muscle as a useful donor for transfer. Five adolescents with obstetric brachial plexus palsy were operated on to reconstruct wrist extension and/or pronation using the brachialis muscle transfer to the pronator teres ( n = 1) extensor carpi radialis brevis ( n = 1) and extensor carpi radialis longus ( n = 3). Twelve months after surgery, average active motion recovery was 20° for wrist extension and 14° for pronation. Active and passive range of motion was similar.

Wrist Position Affects Loading of the Dorsal Scaphoid: Possible Effect on Extrinsic Scaphoid Blood Flow

2001 ◽  
Vol 26 (1) ◽  
pp. 34-40 ◽  
Author(s):  
G. R. BUTTERMANN ◽  
M. D. PUTNAM ◽  
J. D. SHINE
Keyword(s):  
Blood Flow ◽  
Vascular Supply ◽  
Internal Diameter ◽  
Ulnar Deviation ◽  
Dorsal Ridge ◽  
Injection Techniques ◽  
Cadaver Studies ◽  
Biomechanical Factors ◽  
Extensor Carpi Radialis ◽  
Biomechanical Tests

Cadaver studies using radial artery injection techniques were used to study the vascular supply along the dorsal ridge of the scaphoid. These revealed an intraarticular membrane between the wrist capsule and the dorsal ridge of the scaphoid through which arteriolar vessels (25–100 μm internal diameter) passed. Biomechanical tests revealed that the extensor carpi radialis brevis may apply significant pressure to the dorsal ridge of the scaphoid when the wrist is flexed. The highest pressures occurred with the wrist flexed at 60° or 90° and in slight (15°) ulnar deviation. The authors suggest that these vascular and biomechanical factors may contribute to the aetiology for idiopathic osteonecrosis of the scaphoid.

SURGICAL CORRECTION OF ULNAR DEVIATION DEFORMITY OF THE WRIST IN PATIENTS WITH BIRTH BRACHIAL PLEXUS PALSY SEQUELAE

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 161-165
Author(s):  
Praveen Bhardwaj ◽  
Harshil Parekh ◽  
Hari Venkatramani ◽  
S. Raja Sabapathy
Keyword(s):  
Brachial Plexus ◽  
Hand Function ◽  
Brachial Plexus Palsy ◽  
Rotational Deformity ◽  
Ulnar Deviation ◽  
Self Confidence ◽  
Shoulder Deformity ◽  
Extensor Carpi Radialis ◽  
Birth Brachial Plexus Palsy

Ulnar deviation deformity of the wrist in patients with birth brachial plexus palsy is an important cosmetic concern among the patients and their relatives; especially in the patients who have recovered the basic limb functions. Though there is ample literature available regarding the management of the shoulder deformity there is paucity of literature regarding management of wrist ulnar deviation deformity. We report our experience with correction of this deformity in five cases with isolated ulnar deviation deformity without forearm rotational deformity or weakness of the wrist muscles. All the patients underwent extensor carpi ulnaris (ECU) to extensor carpi radialis longus (ECRL) tendon transfer. At a minimum of 18 months follow-up all the patients and their families were satisfied with the cosmetic appearance of the limb. Correction of the deformity improves the appearance of the limb, improves self-confidence of the child, and allows them to integrate well into the society. Interestingly, the patients expressed improvement in their grip strength and overall hand function after this surgery. The notable functions which improved were easy reach of the hand-to-mouth for feeding and easy handling of the things requiring bimanual activities. Although the main aim of this operation was to correct the appearance of the hand it was found to be also functionally useful by the patients and hence we are encouraged to report it for wider use. The results were maintained during the follow-up period of as long as 47 months.

FUNCTIONAL AND KINEMATIC ANALYSIS OF A WRIST RADIAL HEMIARTHROPLASTY DESIGN

2018 ◽  
Vol 21 (01) ◽  
pp. 1850005
Author(s):  
Alexander W. Hooke ◽  
Eric Wagner ◽  
Kurt Pettersson ◽  
Per Fischer ◽  
Marco Rizzo
Keyword(s):  
Range Of Motion ◽  
Moment Arm ◽  
Ulnar Deviation ◽  
Functional Changes ◽  
Flexor Carpi Radialis ◽  
Moment Arms ◽  
Flexion Extension ◽  
Flexion Moment ◽  
The Mean ◽  
Extensor Carpi Radialis

Purpose: A biomechanical functional assessment was performed on a newly designed wrist hemiarthroplasty implant with aimed to identifying differences between the native wrist and wrist following the hemiarthroplasty procedure with [Formula: see text] and without a proximal row carpectomy (Hemi). Methods: Six cadaveric wrists were mounted on a custom testing fixture and underwent a series of functional tests to investigate differences in range of motion, muscles moment arms, and axis of rotation between the intact and post-operative wrists. The tested movements included manually-driven flexion-extension, radial-ulnar deviation, dart throwers motion, and circumduction. Results: The only significant change in range of motion was a decrease in flexion between the intact [Formula: see text] and both the Hemi [Formula: see text] and [Formula: see text] [Formula: see text] conditions. Minor differences in the mean position and variability of the axis of rotation’s piercing point were identified. A statistically significant decrease in the flexion moment arm of the flexor carpi radialis was identified between the intact ([Formula: see text][Formula: see text]mm) and [Formula: see text] ([Formula: see text][Formula: see text]mm) conditions. Statistically significant decreases were also identified in the radial deviation moment arms of the extensor carpi radialis brevis’ between the intact ([Formula: see text][Formula: see text]mm) and [Formula: see text] ([Formula: see text][Formula: see text]mm) conditions and the flexor carpi radialis’ between the intact ([Formula: see text][Formula: see text]mm) and Hemi ([Formula: see text][Formula: see text]mm) conditions as well as in the ulnar deviation moment arm of the extensor carpi ulnaris between the intact ([Formula: see text][Formula: see text]mm) and Hemi ([Formula: see text][Formula: see text]mm) conditions. Conclusions: While some statistically significant functional changes were identified between the native and hemiarthroplasty wrist, the findings suggest that post-operative function is equally acceptable in hemiarthroplasty with and without resection of the proximal carpal row.

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