Scaphotrapeziotrapezoid osteoarthritis after scaphotrapezial ligament injury.
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Biomedical subjects
Publications and source records attributed to J Laulan.
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Authors report three cases of psoriatic onycho-periostitis (great toe in two cases, thumb in one case). In a recent study, they demonstrated that osteoperiostitis of the distal phalanx of the great toe was significantly more frequent in patients with psoriatic arthritis than in other groups (cutaneous psoriasis, rheumatoid arthritis, spondylarthropathy, connective tissue diseases, and control subjects), suggesting that the existence of osteoperiostitis of the distal phalanx of the great toe is valuable for the diagnosis of psoriatic arthropathy.
Since Roles and Maudsley's publication, in 1972, it has been admitted that the entrapment of the posterior interosseous nerve (PION) is a possible cause of lateral elbow pain. In the radial tunnel, at least 4 or 5 compressive structures have been described. The arcade of Frohse is a well known compressive cause while the medial edge of the extensor radialis brevis (ECRB) muscle is less frequently incriminated. An anatomic study of 45 supper limbs from 40 cadavers was performed to analyse the relations between the medial edge of the ECRB and the PION. The medial edge of the ECRB was a real fibrous arch in 43 cases (95%). It crossed over the PION in 42 cases, 9 mm more proximally than the arcade of Frohse. So the relationships between the ECRB and PION are very close in 93% of cases. The proximal edge of the supinator muscle was fibrous in 40% of cases but always supple. These findings suggest that the ECRB is a possible cause of PION entrapment. Its role is underestimated in pathology. The frequent association between lateral epicondylitis and PION compression can be explained by the presence of this fibrous structure. Lateral elbow pain must be considered as a regional pathology. The treatment has to deal with every pathological aspect.
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The authors report a case of posterior dislocation of the trapezoid bone together with the second metacarpal. Among the 25 cases of trapezoid dislocations reported in the literature, no similar case has been found. The patient was seen 4 months after the injury and there was also a scaphoid instability. Open reduction and a scapho-trapezio-trapezoid arthrodesis were performed. The diagnosis, the mechanism and the treatment of this very unusual injury are discussed.
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