Radiographic evaluation of a novel horizontal dorsal intercarpal capsulodesis as a treatment of pre-arthritic scapholunate dissociation: a cadaver study

2014 ◽  
Vol 40 (5) ◽  
pp. 502-511 ◽  
Author(s):  
E. Payet ◽  
D. Bourguignon ◽  
I. Auquit-Auckbur ◽  
F. Duparc ◽  
F. Dujardin

Dorsal capsulodesis is an important part of the treatment of pre-arthritic scapholunate instability. We designed an experimental study using 14 fresh-frozen cadaver wrists to demonstrate the efficacy of a new horizontal dorsal intercarpal capsulodesis. We sectioned the scapholunate ligament to create a scapholunate dislocation. Several radiographic views, static and ‘in stress’, were recorded and we statistically compared the scapholunate interval before and after the section of the scapholunate ligament, and after the creation of the capsulodesis. The results showed a significant decrease of the scapholunate interval after the creation of the capsulodesis, especially in neutral and maximal ulnar deviation of the wrist. They also proved that our cadaveric model is reliable. This study demonstrated that this novel capsulodesis reduces the scapholunate interval in a cadaveric model.

2015 ◽  
Vol 43 (2) ◽  
pp. 179-186 ◽  
Author(s):  
J. P. Stromps ◽  
J. Eschweiler ◽  
M. Knobe ◽  
H. O. Rennekampff ◽  
K. Radermacher ◽  
...  

Neither the complex motions of the scapholunate joint, nor the kinematic changes that occur as a result of injury to it, are fully understood. We used electromagnetic tracking within affected bones to evaluate the physiologic motions in the planes of flexion and extension, and of radial and ulnar deviation of human cadaver wrists, before and after complete transection of the scapholunate ligaments. Despite individual variance between each wrist, we were able to establish a pattern in the changes that occurred after scapholunate ligament injury. During the motions examined, the scaphoid showed an increase in translational deviation in almost all motion axes. In contrast, the movement of the lunate seemed to be impaired, especially in radial-ulnar deviation.


1998 ◽  
Vol 23 (6) ◽  
pp. 776-780 ◽  
Author(s):  
J. D. WYRICK ◽  
B. D. YOUSE ◽  
T. R. KIEFHABER

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.


2012 ◽  
Vol 3 (2) ◽  
pp. ar.2012.3.0037 ◽  
Author(s):  
Jung Ho Bae ◽  
Sam P. Most

This study was designed to measure the efficacy of a nasal valve suspension technique and determine the adequate traction length without creation of nasofacial fullness in a cadaveric model. Seven fresh frozen cadaveric heads were evaluated. Minimal cross-sectional (MCA) areas were measured with a transient-signal acoustic rhinometer (Ecco Vision; Hood Instruments, Pembroke, MA) before and after suspension. The adequate traction length, which did not cause obvious changes, was determined. Five millimeters of lateral nasal valve traction was determined to be the maximal traction achievable without creating facial fullness. After lateral nasal suspension, average MCA increased by 13.7%. Average distance to the MCA from the nostril changed from 1.57 to 1.76 cm. Postsuspension values were significantly higher than the presuspension values (p < 0.05). Nasal valve suspension with 5 mm of lateral traction has a significant impact on nasal valve area without obvious nasofacial changes.


1984 ◽  
Vol 23 (04) ◽  
pp. 209-213
Author(s):  
B. J. Northover

SummaryAnalysis of electrocardiograms tape-recorded from patients admitted to hospital with acute myocardial infarction revealed that the pattern of ventricular extrasystolic activity was not significantly different among those who subsequently developed ventricular fibrillation and those who did not. Episodes of ventricular fibrillation occurred predominantly within 4 hours from the start of infarction. Patients were 3 times less likely to survive an episode of ventricular fibrillation if they also had left ventricular failure than if this feature was absent. Management of episodes of ventricular fibrillation was compared in patients before and after the creation of a specially staffed and equipped coronary care unit. The success of electric shock as a treatment for ventricular fibrillation was similar before and after the creation of the coronary care unit. An attempt was made to determine which features in the management of ventricular fibrillation in this and in previously published series were associated with patient survival.


2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0018
Author(s):  
Caitlin Curtis Crocker ◽  
Eildar Abyar ◽  
Sean Young ◽  
Fatemah Razaghi ◽  
Gerald McGwin ◽  
...  

Category: Ankle; Hindfoot Introduction/Purpose: Flexor Hallucis Longus (FHL) tendon transfer to the calcaneus is a common adjuvant procedure in the treatment of Achilles pathology. The FHL tendon can be harvested using a posterior incision where the tendon is dissected along its course into the fibroosseous tunnel. Alternatively, the FHL may be harvested through a separate plantar medial incision as it crosses the flexor digitorium longus at the Knot of Henry. This study aims to quantify FHL tendon lengths achieved through the two common approaches utilizing pair matched cadavers. Methods: Seven pair matched fresh-frozen cadaver legs without signs of musculoskeletal abnormalities were used for this assessment. One leg in each pairing underwent a single incision harvest while the contralateral leg underwent an accessory medial plantar harvest. After dissecting the tendon, a calcaneus tunnel was prepared from dorsal to plantar in both calcanei in standard fashion. Two measurements were obtained. The first measurement was taken from the distal aspect of the muscle belly to the distal end of the tendon. The tendon was then pulled through the calcaneus, and the foot was held in tension at 20 degrees of plantar flexion. The second measurement was taken from site where tendon entered the calcaneous to the distal end of the tendon graft. The measurements were analyzed using Wilcoxon Signed Ranks Test and Fischer Exact Test. Results: Using a posterior incision, the mean tendon measurement from calcaneous tunnel to the distal end of the tendon was 4.0 cm. Using an accessory plantar medial incision, the mean tendon measurement from the calcaneous tunnel to the distal end of the tendon was 7.2 cm. The average tunnel length obtained using an accessory medial incision was significantly greater than the length obtained using the single incision approach (p= 0.0003, p=0.0022, and p=0.0016). The accessory plantar medial incision obtained an FHL tendon tunnel length that was an average of 2.9 cm greater than the posterior incision. Conclusion: The single incision approach provided sufficient length to safely anchor the FHL into the calcaneus which suggests that the accessory plantar medial approach is not necessary for routine FHL transfers to the calcaneus with interference screw fixation. However, if additional length is needed for other applications such as posterior tibialis tendon dysfunction or peritoneal tendon tears, the accessory incision does provide an average of 2.9 cm of additional length.


Hand Surgery ◽  
2012 ◽  
Vol 17 (03) ◽  
pp. 325-330 ◽  
Author(s):  
D. L. J. Bunker ◽  
G. Pappas ◽  
P. Moradi ◽  
M. B. Dowd

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.


2015 ◽  
Vol 129 (9) ◽  
pp. 870-873
Author(s):  
C R Kieliszak ◽  
T R Khoury ◽  
A Singh ◽  
A S Joshi

AbstractObjectives:This study assessed the utility of current sialendoscopes in the paranasal sinuses in a cadaveric model and evaluated novel uses for sialendoscopes.Methods:Currently available sialendoscopes were used for visualisation and performing interventions in the paranasal sinuses. Ten cadaver heads were studied before and after dissection. Outcomes included ostia identification, sinus cannulation, success of mucosal biopsy collection and image clarity.Results:Marchal and Erlangen sialendoscopes were found to be effective for both visualising and cannulating the sphenoid sinuses before and after dissection. Both types demonstrated poor maxillary ostia visualisation without dissection, but did allow treatment after antrostomy. Larger diameter sialendoscopes were associated with the lowest image distortion during maxillary ostia assessment. Mucosal biopsy collection within the sphenoid sinus, but not in the maxillary sinus, was possible before dissection.Conclusion:Sialendoscopes can be used for visualisation and performing interventions in the sinonasal cavity, but their utility is mainly limited to the sphenoid sinus. They may be considered a minimally invasive method for drug delivery and/or biopsy collection in the post-operative setting for all sinuses. Design improvements are suggested.


Author(s):  
Eric Perloff ◽  
Andrew Posner ◽  
Hamza Murtaza ◽  
Khushdeep Vig ◽  
Michael Smith ◽  
...  

Abstract Background Traumatic arthrotomy of the wrist is most commonly detected using the saline load test (SLT); however, little data exists on the effectiveness of the SLT to this specific joint. The use of computed tomography (CT) scan has been validated as an alternative method to detect traumatic arthrotomy of the knee, as the presence of intra-articular air can be seen when there is violation of the joint capsule. Question/Purpose The purpose of this study was to determine the ability of CT scan to identify arthrotomy of the wrist capsule and compare the diagnostic performance of CT versus traditional SLT. Materials and Methods Ten fresh frozen cadavers which had undergone transhumeral amputation were initially used in this study. A baseline CT scan was performed to ensure no intra-articular air existed prior to intervention. After baseline CT, an arthrotomy was created at the 6R radiocarpal portal site. The wrists then underwent a postarthrotomy CT to identify the presence or absence of intra-articular air. Following CT, the wrists were subjected to the SLT to detect the presence of extravasation from the arthrotomy. Results Nine cadavers were included following baseline CT scan. Following arthrotomy, intra-articular air was visualized in eight of the nine cadavers in the postarthrotomy CT scan. Air was seen in the radiocarpal joint in eight of the nine wrists; midcarpal joint in seven of the nine wrists; and distal radioulnar joint in six of the nine wrists. All wrists (nine of the nine) demonstrated extravasation during the SLT. The mean volume of extravasation occurred at 3.7 mL (standard deviation = 2.6 mL), with a range of 1 to 7 mL. Conclusion CT scan correctly identified eight of the nine simulated traumatic arthrotomies. Injection of 7 mL during the SLT was necessary to identify 100% of the arthrotomies. Clinical Relevance CT scan is a sensitive modality for detection of traumatic arthrotomy of the wrist in a cadaveric model.


2021 ◽  
Author(s):  
◽  
Roald Egbert Harro Bomans

<p>Introduced mammalian predators, namely possums, stoats and rats, are the leading cause of decline in native avifauna in New Zealand. The control of these species is essential to the persistence of native birds. A major component of mammal control in New Zealand is carried out through the aerial distribution of the toxin sodium monofluoroacetate (otherwise known as 1080). The use of this toxin, however, is subject to significant public debate. Many opponents of its use claim that forests will ‘fall silent’ following aerial operations, and that this is evidence of negative impacts on native bird communities. With the continued and likely increased use of this poison, monitoring the outcomes of such pest control operations is necessary to both address these concerns and inform conservation practice. The recent growth in autonomous recording units (ARUs) provides novel opportunities to conduct monitoring using bioacoustics. This thesis used bioacoustic techniques to monitor native bird species over three independent aerial 1080 operations in the Aorangi and Rimutaka Ranges of New Zealand.  In Chapter 2, diurnal bird species were monitored for 10-12 weeks over two independent operations in treatment and non-treatment areas. At the community level, relative to non-treatment areas, the amount of birdsong recorded did not decrease significantly in treatment areas across either of the operations monitored. At the species level, one species, the introduced chaffinch (Fringilla coelebs), showed a significant decline in the prevalence of its calls in the treatment areas relative to non-treatment areas. This was observed over one of the two operations monitored. Collectively, these results suggest that diurnal native avifaunal communities do not ‘fall silent’ following aerial 1080 operations.  The quantity of data produced by ARUs can demand labour-intensive manual analysis. Extracting data from recordings using automated detectors is a potential solution to this issue. The creation of such detectors, however, can be subjective, iterative, and time-consuming. In Chapter 3, a process for developing a parsimonious, template-based detector in an efficient, objective manner was developed. Applied to the creation of a detector for morepork (Ninox novaeseelandiae) calls, the method was highly successful as a directed means to achieve parsimony. An initial pool of 187 potential templates was reduced to 42 candidate templates. These were further refined to a 10-template detector capable of making 98.89% of the detections possible with all 42 templates in approximately a quarter of the processing time for the dataset tested. The detector developed had a high precision (0.939) and moderate sensitivity (0.399) with novel recordings, developed for the minimisation of false-positive errors in unsupervised monitoring of broad-scale population trends.  In Chapter 4, this detector was applied to the short-term 10-12 week monitoring of morepork in treatment and non-treatment areas around three independent aerial 1080 operations; and to longer-term four year monitoring in two study areas, one receiving no 1080 treatment, and one receiving two 1080 treatments throughout monitoring. Morepork showed no significant difference in trends of calling prevalence across the three independent operations monitored. Longer-term, a significant quadratic effect of time since 1080 treatment was found, with calling prevalences predicted to increase for 3.5 years following treatment. Collectively, these results suggest a positive effect of aerial 1080 treatment on morepork populations in the lower North Island, and build on the small amount of existing literature regarding the short- and long-term response of this species to aerial 1080 operations.</p>


Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 179-187 ◽  
Author(s):  
Ronit Wollstein ◽  
Frederick W. Werner ◽  
Roee Rubenstein ◽  
Christopher R. Nacca ◽  
Richard A. Bilonick ◽  
...  

The purpose of this study was to establish a normal measure of scaphoid position in the radioulnar plane in standard neutral, radial and ulnar deviation posteroanterior radiographs. This measurement may allow indirect evaluation of the radiocarpal ligaments and comparison between normal and pathologic states (following radius fractures, perilunate dislocations). Measurements were trialed on 74 normal wrist radiographs and 25 cadaver wrists. We evaluated the distance between the radial styloid and the scaphoid and corresponding scaphoid width. The ratio of distance/width at the mid styloid level (0.35, imprecision SD = 0.1) had the lowest random error and is therefore the most precise measurement of true scaphoid translation. This measurement is independent of scapholunate ligament integrity and may provide a better assessment of the radiocarpal component of ulnar translational instability. Abnormal movement of the scaphoid in the radioscaphoid joint likely reflects ligamentous injury. Identifying and addressing these injuries may prevent the development of arthritis.


Sign in / Sign up

Export Citation Format

Share Document