Open Treatment of Scapholunate Ligament Disruptions

2014 ◽  
Keyword(s):  
Scapholunate Ligament ◽  
Open Treatment

The Use of Contact Biomechanics to Study the Intact, Proximal Row Carpectomy and Scaphoid Excision, Four Bone Fusion Wrist

2020 ◽  
Vol 16 (3) ◽  
pp. 189-193
Author(s):  
David H. Wei ◽  
Peter Tang
Keyword(s):  
Proximal Row Carpectomy ◽  
Scapholunate Ligament ◽  
Bone Fusion ◽  
Pressure Sensitive ◽  
Sensitive Film ◽  
Radiocarpal Joint ◽  
Pressure Sensitive Film ◽  
Number Of Authors

The study of contact biomechanics of the wrist is a challenge. This is partly due to the relatively small size of the joint as well as the lack of space in the radiocarpal joint which makes the delivery of investigative materials such as pressure sensitive film without causing artifact, difficult. Fortunately, a number of authors have studied the intact wrist, the scapholunate ligament injured wrist, the proximal row carpectomy and the scaphoid excision, four bone fusion. Despite some contrasting findings, there are some general concepts that we understand about wrist mechanics.

Open Treatment of Osteochondral Lesions of the Talus With Bone Grafting and Particulated Juvenile Cartilage Allografting

2021 ◽  
pp. 193864002110097
Author(s):  
Suhas P. Dasari ◽  
Thomas M. Langer ◽  
Derek Parshall ◽  
Brian Law
Keyword(s):  
Therapeutic Option ◽  
Symptomatic Improvement ◽  
Pain Scale ◽  
Osteochondral Lesions ◽  
Outcome Scores ◽  
Scale Scores ◽  
Open Treatment ◽  
Bone Autograft

Background: Large cystic osteochondral lesions of the talus (OLT) are challenging pathological conditions to treat, but particulated juvenile cartilage allografts (PJCAs) supplemented with bone grafts are a promising therapeutic option. The purpose of this project was to further elucidate the role of PJCA with concomitant bone autografts for treating large cystic OLTs with extensive subchondral bone involvement (greater than 150 mm2 in area and/or deeper than 5 mm). Methods: We identified 6 patients with a mean OLT area of 307.2 ± 252.4 mm2 and a mean lesion depth of 10.85 ± 6.10 mm who underwent DeNovo PJCA with bone autografting between 2013 and 2017. Postoperative outcomes were assessed with radiographs, Foot and Ankle Outcome Scores (FAOS), and visual pain scale scores. Results: At final follow-up (27.0 ± 12.59 weeks), all patients had symptomatic improvement and incorporation of the graft on radiographs. At an average of 62 ± 20.88 months postoperatively, no patients required a revision surgery. All patients contacted by phone in 2018 and 2020 reported they would do the procedure again in retrospect and reported an improvement in their symptoms relative to their preoperative state, especially with pain and in the FAOS activities of daily living subsection (91.93 ± 9.04 in 2018, 74.63 ± 26.86 in 2020). Conclusion: PJCA with concomitant bone autograft is a viable treatment option for patients with large cystic OLTs. Levels of Evidence: Level IV

scholarly journals Motion and Strength Analysis of 2-Tine Staple and K-Wire Fixation in Scapholunate Ligament Stabilization in a Cadaver Model

2021 ◽  
Vol 3 (2) ◽  
pp. 67-73
Author(s):  
Daniel Hess ◽  
Anthony Archual ◽  
Zachary Burnett ◽  
Hans Prakash ◽  
Emily Dooley ◽  
...  
Keyword(s):  
Strength Analysis ◽  
Scapholunate Ligament ◽  
Wire Fixation

An Alternative Approach Using Circummandibular Wiring for Treatment of Dentoalveolar Fractures in Children: A Case Report

2021 ◽  
pp. 194338752199028
Author(s):  
José Henrique Santana Quinto ◽  
Andressa Bolognesi Bachesk ◽  
Lucas Costa Nogueira ◽  
Liogi Iwaki Filho
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Alternative Methods ◽  
Alveolar Process ◽  
Fractures In Children ◽  
Alternative Approach ◽  
Open Treatment ◽  
Segmental Fractures

The prevalence of dentoalveolar injuries in children is approximately 25%, with falls from own height being one of the main etiologies. Diagnosis is based on the clinical evaluation associated with complementary imaging tests. The treatment of choice depends on the type of damage and structure affected. For alveolar process fractures, closed reduction and semi-rigid dental splinting for 4 to 6 weeks is generally satisfactory. However, some cases, such as severe segmental fractures, require open treatment to ensure adequate reduction and stabilization of the displaced alveolar segment, which is usually achieved by titanium miniplates and screws. Nevertheless, there are situations where this type of fixation is not possible, requiring alternative methods. Therefore, this article describes a surgical technique performed by open reduction, associating semi-rigid dental splint and circummandibular wiring in pediatric patient diagnosed with dentoalveolar fracture through clinical examination (with bone fracture displacement) and tomography. The technique promoted a good prognostic to the patient, proving to be a viable alternative for treating dentoalveolar fractures.

scholarly journals Kinematic analysis of two scapholunate ligament reconstruction techniques

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110258
Author(s):  
Seungbum Chae ◽  
Junho Nam ◽  
Il-Jung Park ◽  
Steven S. Shin ◽  
Michelle H. McGarry ◽  
...  
Keyword(s):  
Kinematic Analysis ◽  
Clinical Relevance ◽  
Ligament Reconstruction ◽  
Operative Time ◽  
Efficient Technique ◽  
Scapholunate Ligament ◽  
Interosseous Ligament ◽  
Flexion Extension

Purpose: This study compares the kinematic changes after the procedures for scapholunate interosseous ligament (SLIL) reconstruction—the modified Brunelli technique (MBT) and Mark Henry’s technique (MHT). Methods: Ten cadaveric wrists were used. The scapholunate (SL) interval and angle and radiolunate (RL) angle were recorded using the MicroScribe system. The SL interval was measured by dividing the volar and dorsal portions. Four motions of the wrist were performed—neutral, flexion, extension, and clenched fist (CF) positions—and compared among five conditions: (1) intact wrist, (2) volar SLIL resection, (3) whole SLIL resection, (4) MBT reconstruction, and (5) MHT reconstruction. Results: Under the whole SLIL resection condition, the dorsal SL intervals were widened in all positions. In all positions, the dorsal SL intervals were restored after MBT and MHT. The volar SL interval widened in the extension position after volar SLIL resection. The volar SL interval was not restored in the extension position after MBT and MHT. The SL angle increased in the neutral and CF positions under the whole SLIL resection condition. The SL angle was not restored in the neutral and CF positions after MBT and MHT. The RL angle increased in the neutral and CF positions under the whole SLIL resection condition. The RL angle was not restored in the neutral and CF positions after MBT and MHT. Conclusion: The MBT and MHT may restore the dorsal SL interval. No significant differences in restoration of the SL interval between MBT and MHT were found in the cadaveric models. Clinical relevance: No significant differences between MBT and MHT were found in the cadaveric models for SLIL reconstruction. When considering the complications due to volar incision and additional procedures in MHT, MBT may be a more efficient technique in terms of operative time and injury of the anterior structures during surgery, but further research is needed.

Endoscopic vs Open Treatment of Laryngotracheal Stenosis

2013 ◽  
Vol 149 (2_suppl) ◽  
pp. P21-P21
Author(s):  
Sid Khosla ◽  
Michael J. Rutter ◽  
Alessandro de Alarcon ◽  
Guri Sandhu ◽  
Stacey L. Halum ◽  
...  
Keyword(s):  
Laryngotracheal Stenosis ◽  
Open Treatment

RADIOGRAPHIC SIGNS OF STATIC CARPAL INSTABILITY WITH DISTAL END RADIUS FRACTURES: IS CURRENT TREATMENT ADEQUATE?

Hand Surgery ◽  
2012 ◽  
Vol 17 (03) ◽  
pp. 325-330 ◽  
Author(s):  
D. L. J. Bunker ◽  
G. Pappas ◽  
P. Moradi ◽  
M. B. Dowd
Keyword(s):  
Current Treatment ◽  
Carpal Instability ◽  
Radiographic Study ◽  
Scapholunate Ligament ◽  
Radius Fractures ◽  
Distal Radial Fractures ◽  
Middlesex Hospital ◽  
Wrist Instability ◽  
Before And After

Patients presenting with distal end radius fractures may have concomitant carpal instability due to disruption of the scapholunate ligament. This study examined the incidence of static radiographic signs of carpal instability in patients with distal radial fractures before and after fracture treatment. We performed a retrospective radiographic study of 141 patients presenting to Central Middlesex Hospital, London between January 2002–May 2004 with distal end radius fractures. We used abnormal scapholunate angle as the primary indicator of possible carpal dissociation. Abnormal scapholunate angles were noted in 39% of patients at presentation and 35% of patients after treatment with no statistically significant intra-patient variability. Persistent static radiographic signs of carpal instability are high in this subset of patients. The long-term morbidity of persistent wrist instability may be avoided by early radiological diagnosis with clinical correlation to identify carpal ligament injuries and initiate treatment that addresses both the bony and ligamentous components of the injury.

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