Proximal Scaphoid Costo-Osteochondral Replacement Arthroplasty

1998 ◽  
Vol 23 (2) ◽  
pp. 201-208 ◽  
Author(s):  
M. J. SANDOW
Keyword(s):  
Grip Strength ◽  
Proximal Pole ◽  
Function Score ◽  
Scapholunate Ligament ◽  
Medium Term ◽  
Wrist Motion ◽  
Osteochondral Autograft ◽  
Replacement Arthroplasty ◽  
Wrist Function

Deficiency of the proximal pole of the scaphoid due to fracture or necrosis was treated by costo-osteochondral replacement arthroplasty using rib bone/cartilage autografts in 22 patients who were followed prospectively and assessed at a median 24 month follow-up (range, 12–72 months). Improvement of wrist function occurred in all patients with increased motion, improved grip strength and less pain. The average modified Green and O’Brien Wrist Function Score improved from 53 out of 100 preoperatively to 80 at the most recent review. All patients were graded fair or poor at initial review and all but three improved to good or excellent at the most recent assessment. Despite the absence of the scapholunate ligament, carpal alignment did not deteriorate in any patient and there were no graft non-unions or significant complications. In the short and medium term a costo-osteochondral autograft can satisfactorily restore mechanical integrity of the scaphoid proximal pole and maintain wrist motion while avoiding the potential complications of alternative replacement arthroplasty techniques.

Four-corner arthrodesis with a dorsal locking plate: 4–9-year follow-up

2020 ◽  
Vol 45 (7) ◽  
pp. 673-678
Author(s):  
Lionel Athlani ◽  
Sophie Sabau ◽  
Nicolas Pauchard ◽  
François Dap ◽  
Gilles Dautel
Keyword(s):  
Sick Leave ◽  
Grip Strength ◽  
Locking Plate ◽  
Contralateral Side ◽  
Level Of Evidence ◽  
Wrist Motion ◽  
Flexion Extension ◽  
Preoperative Status ◽  
Wrist Function

We report the outcomes of four-corner arthrodesis for advanced wrist collapse in 50 patients (51 wrists) using a dorsal locking plate. At a mean follow-up of 6 years (range 4–9), pain was significantly reduced and wrist function was significantly improved compared with preoperative status. After four-corner arthrodesis, grip strength was 80% of the contralateral side, and wrist motion averaged 50° flexion–extension and 30° radioulnar deviation. Immobilization time was 5 weeks (4–6) and sick-leave was 3 months (2–5) following surgery. There were seven nonunions (14%) that underwent repeat arthrodesis. Three wrists were later converted to total arthrodesis due to persisting pain. Radiographic dorsal impingement was found in five wrists after four-corner arthrodesis and did not require reoperation. The outcomes appear not remarkably different from those reported using other fixation methods other than an apparent earlier return to activities. Level of evidence: IV

scholarly journals Scaphoid Fracture Reconstruction with Rib Autograft: Case Report and Literature Review

2021 ◽  
Vol 20 (1) ◽  
pp. 32-40
Author(s):  
Mantas Fomkinas ◽  
Mantas Kievišas ◽  
Kęstutis Braziulis ◽  
Rytis Rimdeika
Keyword(s):  
Literature Review ◽  
Bone Fractures ◽  
Case Reports ◽  
Scaphoid Fracture ◽  
Adverse Outcomes ◽  
Scaphoid Bone ◽  
Proximal Pole ◽  
Function Score ◽  
Osteochondral Autograft ◽  
Wrist Function

Objective. To evaluate the results of scaphoid bone proximal pole reconstruction with rib osteochondral autograft due to comminuted scaphoid fracture. Material and methods. We present a clinical case of fragmented scaphoid bone proximal pole fracture reconstruction by rib osteochondral autograft. The modified wrist function score of Green and O’Brien and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) outcome measuring scales were used for clinical evaluation before and 6 months after the reconstruction. Additio­nally, a literature review was conducted for case reports and previous literature reviews describing scaphoid bone proximal pole fracture surgical treatment. Medline (PubMed), ScienceDirect and UpToDate databases were used. Results. Conventional treatment methods for the treatment of comminuted proximal pole scaphoid bone fractures are often inappropriate due to technical issues or potential adverse outcomes. In these cases, reconstruction with rib autograft is possible. The study patient’s modified wrist function score of Green and O’Brien increased from 75 to 95 points out of 100 at 6 months postoperatively, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score decreased from 13.64 to 4.55 points. The results of this technique have been investigated in several studies (Sandow, 1998, 2001; Veitch et al., 2007). All subjects (22, 47 and 14 patients, respectively), except one, experienced improvement of wrist function – enhanced wrist movement, grip strength, reduced pain and restored wrist function to the pre-injury performance level. Conclusions. Scaphoid bone proximal pole fragmented fracture reconstruction with osteochondrial rib autograft achieves favorable recovery of wrist function and avoids complications or unfavorable functional consequences of alternative surgical procedures.

Extensor Carpi Ulnaris Problems at the Wrist–Classification, Surgical Treatment and Results

2005 ◽  
Vol 30 (3) ◽  
pp. 265-272 ◽  
Author(s):  
C. ALLENDE ◽  
D. LE VIET
Keyword(s):  
Surgical Treatment ◽  
Grip Strength ◽  
Triangular Fibrocartilage Complex ◽  
Ulnar Styloid ◽  
Wrist Motion ◽  
Extensor Carpi Ulnaris ◽  
Lunotriquetral Ligament ◽  
Triangular Fibrocartilage

Twenty-eight extensor carpi ulnaris lesions at the wrist were treated surgically between 1990 and 2002. Fifteen patients had an isolated extensor carpi ulnaris tenosynovitis or tendinopathy, five had extensor carpi ulnaris dislocation, four had an extensor carpi ulnaris subluxation and four had an extensor carpi ulnaris rupture. Seventeen patients first developed their symptoms while playing sports. At a mean follow-up of 23 months, twenty-two patients had returned to their previous activities. Seven of the 27 patients had lost more than 30% of their grip strength and five had restricted wrist motion. Two needed an extensor carpi ulnaris tenolysis. Pure isolated extensor carpi ulnaris lesions are rare and associated ulnar sided lesions (eleven triangular fibrocartilage complex tears and four lunotriquetral ligament tears), as well as possible predisposing factors (seven anomalous tendon slips, four ulnar styloid non-unions and one flat extensor carpi ulnaris tendon groove), were frequent. A classification of extensor carpi ulnaris tendon and subsheath lesions was developed to allow the surgeon to adequately evaluate the different components of these lesions.

Modified Viegas dorsal capsuloplasty for chronic partial injury of the scapholunate ligament in young athletes: outcomes at 24 months

2020 ◽  
Vol 45 (9) ◽  
pp. 945-951
Author(s):  
Norman Della Rosa ◽  
Gianluca Sapino ◽  
Fabio Vita ◽  
Pietro G. di Summa ◽  
Roberto Adani
Keyword(s):  
Scapholunate Ligament ◽  
High Demand ◽  
Young Athletes ◽  
Level Of Evidence ◽  
Wrist Motion ◽  
Ligament Tear ◽  
Competitive Activity ◽  
Scapholunate Ligament Tear ◽  
Retrospective Investigation

The treatment of chronic scapholunate ligament tears in patients with high demand, such as young athletes, is difficult as traditional techniques are associated with some loss of wrist motion and grip strength. This retrospective investigation studied young athletes (≤20 years old) with chronic scapholunate ligament lesions and a minimum follow-up of 24 months, treated with a modified Viegas dorsal capsuloplasty. Twenty-six young athletes (mean age 17 years) were included. A partial scapholunate ligament tear (Geissler III) was seen in 25 patients. At the last follow-up, a significantly different improvement was seen in all measured parameters and all patients could return to their original competitive activity, within 6 months (range 4–12) after surgery. Level of evidence: IV

GREATER ARC INJURIES OF THE WRIST TREATED BY INTERNAL AND EXTERNAL FIXATION — SIX CASES WITH MID-TERM FOLLOW-UP

Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 159-166 ◽  
Author(s):  
G. Kohut ◽  
A. Smith ◽  
M. Giudici ◽  
U. Büchler
Keyword(s):  
Grip Strength ◽  
External Fixation ◽  
Cartilage Damage ◽  
Carpal Instability ◽  
Proximal Pole ◽  
Residual Pain ◽  
Perilunate Dislocation ◽  
Determining Factor ◽  
Arthritic Changes

Six cases of greater arc injury, defined as a perilunate dislocation of the carpus with a fracture of at least both the scaphoid and the capitate, were treated by open reposition and both internal and external fixation. Revascularisation of the capitate by implantation of the first dorsal intermetacarpal artery was attempted in three cases. At a mean follow-up of six years and four months, all patients complained of residual pain in the wrist. Carpal mobility and grip strength were reduced, and all patients showed mild or moderate arthritic changes. Progressive cartilage damage over the proximal pole of the capitate seems to be a determining factor in the outcome. Open reposition and both internal and external fixation are recommended in order to possibly diminish the incidence of arthritis and minimise secondary carpal instability.

Scapholunate Ligament Repair and Capsulodesis for the Treatment of Static Scapholunate Dissociation

1998 ◽  
Vol 23 (6) ◽  
pp. 776-780 ◽  
Author(s):  
J. D. WYRICK ◽  
B. D. YOUSE ◽  
T. R. KIEFHABER
Keyword(s):  
Grading System ◽  
Scapholunate Ligament ◽  
Scapholunate Dissociation ◽  
Ligament Repair ◽  
Wrist Motion ◽  
Normal Side ◽  
Scapholunate Instability ◽  
Clinical Grading ◽  
Radiographic Grading

Twenty-four patients were treated with scapholunate ligament repair and dorsal capsulodesis for scapholunate dissociation. Seventeen patients were available for follow-up at an average of 30 months. The average interval between injury and surgery was 3 months. At final follow-up, no patients were pain-free. Average total wrist motion was 60% and grip strength 70% of the opposite normal side. The average preoperative scapholunate angle was 78° and was corrected to a normal 47° at surgery. The average final scapholunate angle was 72°, which was not significantly different from the preoperative value. The scapholunate gap likewise was not significantly changed postoperatively. Only two patients had an excellent or good outcome using a clinical grading system, and six out of 17 scored good or excellent using a radiographic grading system. In conclusion, repair of the scapholunate ligament with dorsal capsulodesis failed to provide consistent pain relief and maintain carpal alignment in patients with static scapholunate instability.

The Ulno-Carpal Abutment Syndrome

1995 ◽  
Vol 20 (2) ◽  
pp. 171-177 ◽  
Author(s):  
A. H. SCHUURMAN ◽  
K. E. BOS
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Dramatic Improvement ◽  
Distal Ulna ◽  
Fair Result ◽  
Extensor Carpi Ulnaris ◽  
Clinical Scoring ◽  
Wrist Function

Seven wrists in six patients with ulno-carpal abutment syndrome were treated by a subchondral distal ulna resection (wafer procedure). The average follow-up was 36 months. Wrist function was evaluated using a clinical scoring chart. The parameters were pain, range of motion, grip strength and activities. One patient had a poor result, one a fair result and the remaining had good to excellent results. In all cases grip strength showed dramatic improvement. Complications were limited to palpable subcutaneous nylon sutures requiring removal in three patients and extensor carpi ulnaris tendinitis in one.

Successful conversion of wrist prosthesis to arthrodesis in 11 patients

2016 ◽  
Vol 42 (1) ◽  
pp. 84-89 ◽  
Author(s):  
O. Reigstad ◽  
T. Holm-Glad ◽  
R. Thorkildsen ◽  
C. Grimsgaard ◽  
M. Røkkum
Keyword(s):  
Grip Strength ◽  
Iliac Crest ◽  
Substantial Reduction ◽  
Bone Union ◽  
Level Of Evidence ◽  
Osteoarthritis Of The Wrist ◽  
Wrist Function ◽  
Daily Function ◽  
Wrist Arthroplasty

From 2001 to 2015, 11 wrists in 11 patients with osteoarthritis of the wrist had failed wrist arthroplasties, which were subsequently converted to arthrodesis using intercalated corticocancellous autograft from the iliac crest and fixation with an arthrodesis plate or a customized peg. Clinical and radiological bone union was achieved in all the operated wrists. At final follow-up of ten patients after 6 years, they had a substantial reduction in pain and improvement in daily function and grip strength compared with those before arthrodesis. We conclude from outcomes of this series that the conversion to arthrodesis after failed wrist arthroplasty is worthwhile and reliably improve wrist function over failed wrist arthroplasty. The results suggest that the patients who will have wrist arthroplasty can be assured that in case of failure the conversion to arthrodesis will produce outcomes comparable with those after primary arthrodesis. Level of evidence: IV

scholarly journals The Functional Outcomes and Complications of Different Reconstruction Methods for Giant Cell Tumor of the Distal Radius: Comparison of Osteoarticular Allograft and Three-Dimensional-Printed Prosthesis

2020 ◽  
Author(s):  
Yitian Wang ◽  
Li Min ◽  
Minxun Lu ◽  
Yong Zhou ◽  
Jie Wang ◽  
...  
Keyword(s):  
Grip Strength ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Three Dimensional ◽  
Osteoarticular Allograft ◽  
Allograft Reconstruction ◽  
Mayo Score ◽  
3D Printed ◽  
Wrist Function

Abstract Background: En bloc excision has been increasingly used for the management of giant cell tumors(GCTs) in the distal radius. An osteoarticular allograft has been used extensively for decades, and custom-made prosthesis reconstruction has been more recently applied. We aimed to compare the clinical outcomes of the two procedures. Methods: We retrospectively analyzed 30 patients with Campanacci III or recurrent GCTs of the distal radius for follow-up at a mean of 33.2 months. In total, 15 underwent osteoarticular allograft reconstruction (allograft group) and 15 received cementless three-dimensional(3D)-printed prosthesis reconstruction (prosthesis group) between March 18, 2013, and May 20, 2018. All patients underwent by clinical and radiological examinations, including pre- and postoperative active range of motion (ROM) of the wrist, VAS score, grip strength, degenerative change of wrist, Mayo wrist score and Musculoskeletal Tumor Society (MSTS) score. Complications were evaluated using the Henderson classification. Results: Both groups showed significantly increased ROM, grip strength, Mayo score and MSTS score postoperatively. Furthermore, the extension, flexion, MSTS, and Mayo score were significantly higher in the prosthesis group. There was no significant difference in grip strength and VAS between the groups. In allograft group, one patient had a late infection one had resorption of allograft without allograft bone fracture. and four had wrist subluxation. All patients had degenerative changes (mean 9 months). In the prosthesis group, three patients developed wrist subluxation, three had separation of the distal radioulnar joint, and none of the patients developed wrist degeneration. Conclusions: Our study compared the objective functional outcomes and complications of two reconstructive methods for Campanacci III or recurrent GCT in the distal radius. 3D-printed prosthesis replacement can partially preserve wrist function better than allograft reconstruction in the short-term. During the design of 3D-printed prosthesis, preoperative morphological assessment of the affected proximal row carpal is helpful to control postoperative dislocation. After allograft reconstruction, wrist degeneration, which has been demonstrated in all patients, severely influence their wrist function. Therefore, compared to allograft reconstruction, 3D-printed prosthesis reconstruction has irreplaceable advantages at early-stage application, especially in wrist function, however, further studied with a larger number of cases and longer follow-up.

RECURRENT DORSAL WRIST GANGLION: AETIOLOGY AND TREATMENT

Hand Surgery ◽  
1996 ◽  
Vol 01 (01) ◽  
pp. 7-9 ◽  
Author(s):  
Susan L. Filan ◽  
Timothy J. Herbert
Keyword(s):  
Pain Relief ◽  
Clinical Signs ◽  
Wrist Pain ◽  
Scapholunate Ligament ◽  
Successful Method ◽  
Wrist Function ◽  
Dorsal Wrist Ganglion ◽  
Radial Wrist Pain

Seven patients with symptomatic recurrent dorsal wrist ganglia were treated by excision of the origin of the ganglion from the scapholunate ligament combined with dorsal capsulorrhaphy. All patients presented with radial wrist pain associated with recurrent dorsal wrist ganglia. Examination revealed localised tenderness over the scapholunate joint with clinical signs of scaphoid instability in every case. Postoperatively, all patients reported pain relief and improved wrist function. There have been no recurrences, with an average follow-up of 14 months (range 12–22 months). Dorsal capsulorrhaphy appears to be a successful method of relieving symptoms, improving wrist function and preventing ganglion recurrence.

Sign in / Sign up

Export Citation Format

Share Document