Bone and joint injuries—wrist and forearm

Author(s):  
David Warwick ◽  
Roderick Dunn ◽  
Erman Melikyan ◽  
Jane Vadher

Bone and joint injuries—wrist and forearm 100Forearm fractures 102Ulnar corner injuries 106Fractures of the distal radius in adults 108Fractures of the distal radius in children 118Fractures of the scaphoid 120Fractures of the other carpal bones 127Carpal ligament rupture and dislocations ...

Author(s):  
Hongje Kang

The midcarpal instability is the state with instability between the proximal and distal carpal rows, without dissociation between carpal bones. It can be divided into the intrinsic one that is caused by ligament hyperlaxity, and extrinsic one that is caused secondarily by the malunion of distal radius. The pathophysiology of the intrinsic one is still unknown, and the treatment is also controversial. On the other hand, the extrinsic one can be treated by corrective osteotomy of the radial malunion. This review investigated the comprehension, definition, classification, symptoms, diagnosis, and treatment of the midcarpal instability.


2012 ◽  
Vol 6 (1) ◽  
pp. 531-534 ◽  
Author(s):  
NA Siddiqui ◽  
SP Sarkar

Lunate dislocations are well described in the volar direction as part of the perilunate dislocation, sometimes together with fractures of the other carpal bones or distal radius, as described by the anatomical studies of Mayfield [1]. It is a result of disruption of the complex inter-carpal and radiocarpal ligaments that hold the well conforming carpus in their normal position. Given the strength of these structures a significant trauma is required to cause them to fail. However, we present a case of a patient who not only presented with relatively trivial trauma that resulted in a lunate dislocation, but it was also in the dorsal direction and not associated with any fracture or neurological compromise. In addition, she presented several days after her injury. We treated her with closed manipulation and percutaneous K-wire fixation followed by a short period of immobilisation in a Plaster-of-Paris cast, with rapid return to full duties at work. As many volar lunate dislocations may be missed at presentation, we suggest that in patients with relatively trivial trauma there should also be a suspicion of the lunate dislocating dorsally, which may be treated successfully without the aggressive open surgery usually required in volar perilunate dislocations.


2003 ◽  
Vol 28 (6) ◽  
pp. 568-570 ◽  
Author(s):  
S. GANGOPADHYAY ◽  
G. PACKER

A retrospective review of 24 patients with dorsal incisions for open reduction and internal fixation of Frykman VII/VIII distal radius fractures using a dorsal plate was performed. Half of them had a longitudinal incision while the other half had a T-shaped incision. No difference in the healing properties or wound morbidity could be demonstrated between the two groups. However, the T incision provided improved exposure of the distal radius and patient satisfaction with its cosmetic result was superior. The horizontal limb was well camouflaged within the transverse skin crease on the dorsal aspect of the wrist. The vertical limb did not extend into the dorsum of the hand and could, therefore, be hidden by appropriate clothing.


2018 ◽  
Vol 39 (2) ◽  
pp. 593
Author(s):  
Tiago Carmagnani Prada ◽  
Anderson Coutinho da Silva ◽  
Bruno Watanabe Minto

Cranial cruciate ligament rupture (CCrLR) is a common condition found in the small animal routine, being correlated to traumas, obesity, genetic factors, and primary osteoarthritis (OA) in dogs. Affected animals show articular instability that, if not corrected surgically, may cause secondary OA and loss of limb function. The aim of this study was to compare short-term results of the intra-articular technique for knee stabilization after CCrLR using a surgical button associated with polyester yarn (Group A), the surgical button associated with nylon yarn (Group B), and surgical toggle associated with polyester yarn (Group C). Eighteen dogs presenting CCrLR, weight varying from 5 to 35 kg, and different sex and breed were divided into three groups of six individuals. OA radiographic grade, pre- and post-operative lameness, surgical time, and the macroscopic aspect of cartilage were assessed. The intra-articular technique was performed by passing a suture through two tunnels, drilled in the femoral condyle and tibial crest to stabilize the knee joint. Twelve animals presented a decreased lameness and normal limb function after 15 days. On the other hand, four dogs from Group B presented complications: two dogs had suture rupture after 30 days and other two showed muscular contracture with decreased range of motion, followed by loss of limb function. In Group A, one dog showed suture rupture after 15 days and other had suture infection after 30 days. In Group C, dogs recovered normal limb function without complications. Therefore, surgical toggle associated with polyester yarn was better than the other studied materials.


1972 ◽  
Vol 26 ◽  
pp. 71-78
Author(s):  
Joe Ben Wheat

The Olsen-Chubbuck Bone Bed (Table 15) produced a total of 4264 non-articulated bones, of which 4007 were found in the eastern part of the site, where nearly every bone was recorded. The figure of 257 bones recorded for the central and western parts of the site is undoubtedly low, although it is indicative of the generally lesser concentration of individual bones as well as articulated units in that part of the arroyo.It should not be imagined that all of the non-articulated bones represent complete butchering of those bones. No doubt, some of the individual bones became disarticulated through weathering between the butchering phase and final entombment in the bone deposit. This would certainly appear to be the case with such elements as vertebrae, sternal and costal elements, tarsal and carpal bones, phalanges, patellae, sesamoids, and isolated teeth. On the other hand, the butchering process, itself, probably resulted in the disarticulation of certain other kinds of skeletal parts. Removal and breakage of the mandible to get to the tongue, the consequent removal of the hyoid, breakage of the ribs, removal of the legs from the pelvis and the scapula, and removal of the lower leg, are examples of this kind of disarticulation. Even so, some of the leg components, such as femora and tibiae, humeri, radii, and ulnae, may have weathered apart. Some bones may also have been pulled apart by scavengers, but it should be noted in passing that remarkably little evidence was found that the bones had been gnawed by such animals. In any case, it would be difficult to assess completely the role played by weathering, washing, settling, and possible disturbance by scavengers, in the ultimate position of the bones. Even after covering, settling must have continued, and occasional animal burrows must have played a part in the final position of loose bones.


2012 ◽  
Vol 17 (4) ◽  
pp. 147
Author(s):  
Ki-Bum Choi ◽  
Sung-Woo Huh ◽  
Seong-Eun Kim ◽  
Jung-Woo Lee ◽  
Seok-Whan Song ◽  
...  

2019 ◽  
Vol 08 (03) ◽  
pp. 215-220 ◽  
Author(s):  
S. Ruatti ◽  
M. Boudissa ◽  
P. Grobost ◽  
G. Kerschbaumer ◽  
J. Tonetti

Purpose Giant cell tumor of the distal radius are frequent lesions, and different types of surgeries have been described. Functional results, after conservative treatment or arthrodesis, often find a decreased strength and range of motion. The sacrifice of the distal radioulnar joint could be one of the causes. We report the case of a 26-year-old patient who presented with a Campanacci Grade III giant cell tumor of the distal radius. We managed his case by the association of en bloc resection and allograft reconstruction with the preservation of distal radioulnar joint. Hypothesis This procedure could improve functional results, without increasing the risk of recurrence at 2 years follow-up. Case Report The originality of our technique was the possibility of distal radioulnar joint conservation. We preserved a long portion of cortex bone all through the ulnar side of the distal radius. We then used an allograft of distal radius, fixed by a reconstruction anatomical plate. Results At 2 years follow-up, the range of motion was 100° with 60° of palmar flexion, 40° of extension, 75° of pronation, and 70° of supination. Radial and ulnar inclination were 10 and 15°, respectively. MTS (Musculoskeletal Tumor Society Score) 1993 was 88% and DASH score was 6. Concerning grip strength, it was measured at 85% in comparison with the other side. Pronation and supination strengths were 80 and 73%, respectively, in comparison with the other side. At follow-up, standard X-rays showed no recurrence. The allograft was well integrated. Conclusion Conservative treatment of the distal radioulnar joint allowed an almost ad integrum recovery, concerning strengths and range of motion. It allows a better functional recovery, without increasing the risk of recurrence.


Author(s):  
Kastanis G ◽  
Spyrantis M. ◽  
Magarakis G. ◽  
Kapsetakis P. ◽  
Pantouvaki A.

While the isolated fractures of proximal or distal radius are very common injuries in adults and account to 14% and 18% of all extremity fractures the simultaneous ipsilateral fractures of proximal and distal end of radius are quite uncommon. We present two cases (females 64 and 56 years old) with ipsilateral fractures of radial head and distal end of radius due to a fall. No signs of ligamentous injuries were found in preoperative magnetic resonance imaging’s (MRI). Firstly we treated the distal radius fracture in both cases with volar locking plate, secondly we approached the radial head fracture: in one case (Maison type I) conservatively (plaster of Paris) and in the other case (Maison type III) with radial head replacement. The aim of this study has two objectives: first to increase the awareness of diagnosing this bipolar injury in the emergency department and second to introduce the modalities of treatment.


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