Capitolunate arthrodesis maintaining carpal height for the treatment of SNAC wrist

2009 ◽  
Vol 35 (3) ◽  
pp. 198-201 ◽  
Author(s):  
G. Dimitrios ◽  
K. Athanasios ◽  
K. Ageliki ◽  
S. Spiridon
Keyword(s):  
Iliac Crest ◽  
Proximal Part ◽  
Scaphoid Nonunion ◽  
Iliac Crest Graft ◽  
Fusion Technique ◽  
Wrist Motion ◽  
Clinical And Radiological Results ◽  
Snac Wrist ◽  
Carpal Height

The clinical and radiological results of a modified midcarpal fusion technique for scaphoid nonunion advance collapse were retrospectively studied in eight patients. All had partial resection of the proximal part of the fractured scaphoid, limited radial styloidectomy, scaphocapitate and lunocapitate arthrodesis, using a block of iliac crest graft to maintain carpal height. All united without complications and wrist motion, grip strength and carpal height were improved postoperatively. The modified Mayo wrist score at follow-up was 70%. Three patients continued to have some pain and one patient had a poor result.

Cylinder-Shaped Bone Graft for Scaphoid Nonunion

2018 ◽  
Vol 23 (01) ◽  
pp. 96-101
Author(s):  
Hitoshi Hatanaka ◽  
Minoru Takasaki ◽  
Hiroko Furusho ◽  
Yasuhiro Omori
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Bone Graft ◽  
Iliac Crest ◽  
Bone Grafts ◽  
Scaphoid Nonunion ◽  
Wrist Motion ◽  
Operative Outcomes

Background: Wedge-shaped bone grafts that are internally fixed by a Herbert-type screw are a well-established surgical treatment for scaphoid nonunion. A procedure using cylinder-shaped bone grafts was also reported, but preoperative wrist functions were not assessed. In addition, it was not reported whether the humpback deformity of the scaphoid nonunion was corrected. The purpose of the current study was to compare preoperative wrist functions in cases of scaphoid nonunion with those observed at final follow-up, using cylinder-shaped bone grafts The humpback deformity of the scaphoid nonunion was also evaluated.Methods: We conducted a retrospective study to examine operative outcomes from 2008 to 2015. Twelve wrists in 12 patients (average age, 41 years; range, 17–67), with a mean follow-up of 19 months, were included in the current study. Cylinder-shaped bone grafts were obtained from the iliac crest with a newly designed trephine and fixed with a Herbert-type screw. We reviewed both the preoperative wrist functions and those obtained at final follow-up.Results: Union was achieved in 11 of 12 nonunion cases. Preoperative wrist functions, except for the range of wrist motion, significantly improved by final follow-up.Conclusions: We conclude that the use of cylinder-shaped bone grafts improves preoperative wrist functions in cases of scaphoid nonunion.

Four corner arthrodesis limited to the centre using a scaphoid one piece graft and a dorsal circular plate

2009 ◽  
Vol 35 (1) ◽  
pp. 38-42 ◽  
Author(s):  
G. Mantovani ◽  
C. Mathoulin ◽  
W. Y. Fukushima ◽  
A. B. Cho ◽  
M. A. Aita ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Circular Plate ◽  
Central Area ◽  
Dash Score ◽  
Cancellous Bone Graft ◽  
Scaphoid Nonunion ◽  
Scapholunate Dissociation ◽  
Wrist Motion ◽  
Technical Modifications

We present 20 patients, who had a four corner arthrodesis, from July 2006 to March 2008, using a dorsal circular plate, to treat scaphoid nonunion and scapholunate dissociation with advanced collapse (SNAC, SLAC). The surgical technique was a fusion restricted to the central area filled with one piece of cancellous bone graft taken from the excised scaphoid. Wrist motion, grip strength, and Disabilities of Arm Shoulder and Hand (DASH) score improved after surgery at a mean follow-up of 20.2 months. Fusion occurred in 19/20 patients. Two patients (10%) had persistent pain. The rest had a good clinical result. We found that four-corner fusion using a dorsal circular plate using the specific technical modifications was successful.

Wrist Arthrodesis Using an Embedded Iliac Crest Bone Graft

1993 ◽  
Vol 18 (5) ◽  
pp. 595-600 ◽  
Author(s):  
E. LENOBLE ◽  
H. OVADIA ◽  
D. GOUTALLIER
Keyword(s):  
Bone Graft ◽  
Grip Strength ◽  
Iliac Crest ◽  
Delayed Union ◽  
Iliac Crest Bone Graft ◽  
Iliac Crest Graft ◽  
Wrist Arthrodesis ◽  
Carpometacarpal Joints ◽  
Dorsal Branch

34 patients treated by the iliac crest bone graft technique for wrist arthrodesis were reviewed. The average age was 45.6 years and the mean follow-up was 45 months. The procedure is performed through a straight ulnar approach and the head of the ulna is removed. A longitudinal trench is created in both distal radius and carpus preserving the anterior, posterior and lateral cortices. A curved trapezoidal monocortical iliac crest bone graft is embedded inside the trench. The position of the arthrodesis automatically follows the curvature of the graft. No fixation device is used. A short-arm cast is applied for 2 to 3 months. All arthrodeses except two fused within 3 months. Pain was completely relieved in 85% of the cases. Pronation and supination returned to normal 5 months post-operatively. Grip strength was increased in 80% of the cases. The carpometacarpal joints remained pain-free even when not fused. Complications were rare: two lesions of the dorsal branch of the ulnar nerve; two cases of delayed union due to errors in technique, and displacement of the graft in one case. Although it is technically demanding, the embedded iliac crest graft wrist arthrodesis improves pronation and supination as a result of resection of the distal radio-ulnar joint, preserves or improves grip strength, and relieves pain.

Non-Vascularized Tri-Cortical Iliac Crest Graft–A Reliable Option in the Management of Scaphoid Waist Non-Unions

2021 ◽  
Vol 26 (03) ◽  
pp. 383-389
Author(s):  
Vivek Singh ◽  
Nagaraj Manju Moger ◽  
Pragadeeshwaran Jaisankar ◽  
Surjala Rajkumar ◽  
Sunny Chaudhary ◽  
...  
Keyword(s):  
Iliac Crest ◽  
Wrist Joint ◽  
Successful Outcome ◽  
Iliac Crest Bone Graft ◽  
Bony Union ◽  
X Rays ◽  
Iliac Crest Graft ◽  
Non Union ◽  
Functional Scores

Background: Scaphoid non-union often leads to a change in biomechanics of the wrist joint. Various types of bone grafts and different sites of harvest have been described in the literature for scaphoid reconstruction. This study was conducted to assess the clinical and radiological outcome after non-vascularised tri-cortical iliac crest bone graft for non-union of scaphoid waist fractures. Methods: 12 adult patients who underwent reconstruction of scaphoid waist non-union with tricortical iliac crest grafting and internal fixation with headless compression screws (11 cases) and k-wires (1 case) were prospectively analysed. There were 11 males and 1 female (mean age 23.9 years). The mean duration of presentation was 5.7 months following injury. Outcome following surgery were analyzed clinically by range of movements (ROM) and functional scores like DASH and modified Mayo wrist score and radiologically by X-rays and Non contrast CT of the wrist. Radiological assessment included scaphoid length, radio-lunate (RL) angle and scapho-lunate (SL) angle at latest 6 months follow up. Results: Bony union was achieved in 10 cases (union rate 83%). All the cases which achieved union had a significant improvement in radiological and clinical outcome criterias at 6-month follow-up interval. 1 patient had persistent non-union and 1 had k-wire back out with fixation failure. Conclusions: It is important to restore scaphoid length and to correct flexion deformity for a successful outcome. This can reliably be acheived by a carefully planned wedge-shaped iliac crest graft along with secure fixation with a headless compression screw.

Radiolunate Arthrodesis in the Rheumatoid Wrist: A Retrospective Clinical and Radiological Longterm Follow-Up

2002 ◽  
Vol 27 (1) ◽  
pp. 61-72 ◽  
Author(s):  
N. BORISCH ◽  
P. HAUSSMANN
Keyword(s):  
Retrospective Study ◽  
Joint Space ◽  
Carpal Collapse ◽  
Radiological Results ◽  
Rheumatoid Wrist ◽  
Clinical And Radiological Results ◽  
Radiolunate Arthrodesis ◽  
Midcarpal Joint ◽  
Carpal Height

A retrospective study was performed to investigate the clinical and radiological results of radiolunate arthrodesis in the rheumatoid wrist. Ninety-one wrists in 78 patients were assessed at a mean follow-up of 60 months. Most patients were pain-free and content with the overall result. In 68 wrists the carpus had been repositioned or maintained in neutral or slightly ulnar alignment and no further translation occurred. Midcarpal dislocation occured in ten and midcarpal rotation in 13 wrists. The midcarpal joint underwent further arthritic destruction in 34 wrists and secondary arthrosis in 32 wrists. In 25 wrists the midcarpal joint space remained unchanged. Radiolunate arthrodesis can successfully be performed in wrists even with advanced destruction. In cases with fixed carpal collapse, anatomical repositioning of the lunate and restoration of carpal height should not be attempted as this causes midcarpal dislocation or rotation or precipitates secondary arthrosis.

scholarly journals Surgical Treatment for Müller-Weiss Disease

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0053
Author(s):  
Ming-Zhu Zhang ◽  
Guang-rong Yu
Keyword(s):  
Iliac Crest ◽  
Unknown Etiology ◽  
Bone Block ◽  
Complete Fusion ◽  
Talonavicular Joint ◽  
Iliac Crest Graft ◽  
Surgical Methods ◽  
Reasonable Approach ◽  
American Orthopaedic

Category: Midfoot/Forefoot Introduction/Purpose: Müller-Weiss disease is an uncommon osteonecrosis of the tarsal navicular of unknown etiology. Most of them could be treated by non-surgical methods. But some severe deformity and fail to conserved methods. In those cases, surgery may be a reasonable approach. Methods: From January 2005 to Septermber 2016, we treated 69 patients suffering from Müller-Weiss disease, using the surgical arthrodesis of the talonavicular joint and naviculocuneiform joint with tricortical autologous iliac crest block fixed by screws and plate. Results: All Maceira grades were included. We reviewed the medical records of the patients and took the radiological preoperative and postoperative evaluation. The preoperative and postoperative clinical functions were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot Scale. To treat Müller-Weiss disease, we introduced a surgical arthrodesis of the talonavicular joint and naviculocuneiform joint with tricortical autologous iliac crest bone block fixed by screws and plate. The median follow up was 26 months. All the feet fused solidly. The median time for complete fusion was 13 weeks. The median AOFAS ankle-hindfoot score improved from 45 points preoperatively to 86 points at last follow-up. Conclusion: The results of this series demonstrate the arthrodesis of the TNJ and NCJ with tricortical autologous iliac crest graft is a reasonable way for treatment of Müller -Weiss disease. Based on our experience with the patients, we believe that emphasis of the restoration of the length and alignment of the medial column could achieve a good outcome.

Smith–Robinson Procedure with an Autologous Iliac Crest Graft and Caspar Plating: Report of 65 Patients with an Average Follow-up of 22 Years

2016 ◽  
Vol 90 ◽  
pp. 244-250 ◽  
Author(s):  
Benedikt W. Burkhardt ◽  
Moritz Brielmaier ◽  
Karsten Schwerdtfeger ◽  
Salman Sharif ◽  
Joachim M. Oertel
Keyword(s):  
Iliac Crest ◽  
Iliac Crest Graft

scholarly journals Repair of symptomatic bilateral L5 spondylolysis with autogenous iliac crest graft and temporary intersegmental pedicle screw fixation in youth

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhi-Cheng Zhang ◽  
Yang Zhang ◽  
Li-Zhi Zhang ◽  
Kai Guan ◽  
Guang-Min Zhao ◽  
...  
Keyword(s):  
Back Pain ◽  
Pedicle Screw ◽  
Iliac Crest ◽  
Screw Fixation ◽  
Symptom Relief ◽  
Healing Time ◽  
Pedicle Screw Fixation ◽  
Improvement Rate ◽  
Iliac Crest Graft

Abstract Background When symptomatic spondylolysis fail to respond to nonoperative treatment, surgical management may be required. A number of techniques have been described for repair by intrasegmental fixation with good results; however, there are still some problems. We reported a repair technique with temporary intersegmental pedicle screw fixation and autogenous iliac crest graft. The aim of present study is to assess the clinical outcomes of L5 symptomatic spondylolysis with this technique. Methods A retrospective analysis of 128 patients with L5 spondylolysis treated with this method was performed. According to CT scan, the spondylolysis were classified into 3 categories: line, intermediate, and sclerosis type. The diagnostic block test of L5 bilateral pars defect was done in all patients preoperatively. The sagittal and axial CT images were used to determine the bone union. The healing time, complications, number of spina bifida occulta, Japanese Orthopedic Association (JOA) score, and VAS for back pain were recorded. After fixation removal, the rate of ROM preservation at L5S1 was calculated. Results There were 97 patients (194 pars) followed with mean follow-up of 23 months (range, 12–36 months). The union rate of pars was 82.0% at 12 months and 94.3% at 24 months postoperatively. Low back pain VAS significantly (P < 0.05) improved from preoperative mean value of 7.2 to 1.3 at the final follow-up postoperatively (P < 0.05). JOA score increased significantly postoperatively (P < 0.05) with average improvement rate of 79.3%. The rates of L5S1 ROM preservation were 79.8% and 64.0% after fixation removal at 1 and 2 years postoperatively. There were 3 patients of delayed incision healing without other complications. Conclusions Although sacrificing L5S1 segment motion temporarily, more stability was obtained with intersegmental fixation. This technique is reliable for spondylolysis repair which has satisfactory symptom relief, high healing rate, low incidence of complications, and preserve a large part of ROM for fixed segment.

scholarly journals Perilunate Lesions – Clinical and Radiological Results with a Minimum of 2 Years of Follow-up

2021 ◽  
Vol 49 (01) ◽  
pp. 013-018
Author(s):  
Elisabete Ribeiro ◽  
Nuno Oliveira ◽  
Juvenália Ribeiro ◽  
Pedro Varanda ◽  
Luis Filipe Rodrigues
Keyword(s):  
Poor Prognosis ◽  
Contralateral Side ◽  
Pinch Strength ◽  
Dash Score ◽  
Adequate Treatment ◽  
Clinical And Radiological Results ◽  
Carpal Height ◽  
And Cartilage ◽  
Over Time

AbstractPerilunate injuries are complex and rare lesions with circumferential carpal bones, ligamentous and cartilage involvement. Despite optimal surgical treatment, poor prognosis is expected and usually gets worse over time. Our aim was to address clinical and radiological outcomes after 2 years of follow-up. Seven wrists were revised with average age of 35.59 ± 14.01 (range 21–56) years old and mean follow-up of 44.10 ± 14.24 (range 25.60–68.63) months. At the latest follow-up, mean postoperative VAS score for pain was 2.71 ± 3.40 and DASH score was 10.48 ± 10.54. Patients returned to work in 5.00 ± 3.15 months. Strength and Range of Motion (ROM) parameters were ∼80% of the contralateral side, with exception for extension (61%) and radial deviation (73%). After 2 years of follow-up, radiographic arthrosis was observed in 29% of the cases. One of these patients was symptomatic and was proposed for arthrodesis. Mean carpal height was 1.51 ± 0.81 and scapholunate angle was 41.58 ± 22.82°. A correlation was observed between arthritis found at final follow-up and grip (r = −0.8660; p < 0.001) and pinch strength (r = −0.8885; p < 0.001). In conclusion, despite characteristic guarded prognosis, efforts to perform a prompt and adequate treatment are helpful. Clinical and radiological outcomes may not be related. Thus, it is of main importance to understand patients' perception of their sequelae.

Analysis of the Survival of Dental Implants Installed in Reconstructed Maxilla with Autogenous Iliac Crest Graft: 7- to 9-Year Follow-Up

2019 ◽  
Vol 45 (6) ◽  
pp. 427-436 ◽  
Author(s):  
Carolina Santos Ventura de Souza ◽  
Rafael Ortega-Lopes ◽  
Andres Caceres Barreno ◽  
Marcio de Moraes ◽  
José Ricardo Albergaria-Barbosa ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Dental Implants ◽  
Iliac Crest ◽  
Smoking Status ◽  
Sample Population ◽  
Anterior Maxilla ◽  
Iliac Crest Graft ◽  
Assess Patient Satisfaction ◽  
Late Loss

The aim of this study was to analyze the survival of dental implants installed in maxillae reconstructed with autogenous iliac crest grafts and to assess patient satisfaction with the treatment by means of a questionnaire. The study conducted medical record reviews and clinical/radiographic assessments of 10 patients with severe maxillary atrophy who had undergone reconstruction with autogenous iliac crest grafts and rehabilitation with dental implants between 2008 and 2011. Patients were assessed for the survival of the implants, considering implant diameter and length, smoking status, diagnosis of diabetes, type of loss, and region of implant loss. In addition, a questionnaire with specific questions on the patients' satisfaction with the treatment was administered. Seventy-six implants were installed in the sampled patients, and only 1 loss was observed (late loss in the anterior maxilla region) after an average follow-up of 7.9 years, which corresponds to a 98.60% survival rate. The installed implants were of the most frequently used dimension (3.75 × 10 mm). One sampled patient was diabetic, and a second patient was both diabetic and a smoker. No loss of implants was observed in these 2 patients. All patients reported being completely satisfied with the treatment and would undergo the procedure again or refer it to a friend/relative. Six patients reported regular maintenance of the prosthesis, and only 3 had changed the prosthesis prior to the time of questionnaire administration. The results of this limited study with a restricted sample population suggest that the reconstruction of the maxilla with an autogenous iliac crest graft provides both adequate implant survival and patient satisfaction.

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