Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Trapezoid Bone”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1992

Fractures associated with patellar ligament grafts in cruciate ligament surgery.

We reviewed retrospectively 490 patellar ligament reconstructions for cruciate ligament injuries performed from 1980 to 1990. There were six cases of patellar splitting and three displaced patellar fractures in donor knees. The fissure fractures all occurred during the removal of the patellar bone block. The displaced fractures were sustained during early rehabilitation, and in two of the three patients, involved the normal contralateral knee. The major reasons for this complication were imprecise saw cuts, spreading osteotomies, and the use of a too large patellar bone block. When a trapezoidal bone block is used to self-lock in the femoral tunnel, this should preferably be taken from the tibia. Special care is needed in rehabilitation when the graft has been taken from the contralateral knee.

Adult↗
PubMed1992

The biomechanical effects of geometric configuration of bone-tendon-bone autografts in anterior cruciate ligament reconstruction.

This study provides biomechanical support for a new technique of autograft anterior cruciate ligament reconstruction featuring circular bone plugs and endosteal interference fit fixation. Six matched pairs of fresh frozen human knees were utilized. Femoral interference fit pull-out strength was determined from material-testing-machine-generated oscillograph recordings at a strain rate of 100%/s. Circular bone plugs, obtained with a circular oscillating saw, provided 19.9% greater interference fit pull-out strength compared with identically fixed trapezoidal bone plugs. Different geometric defects were compared in three- and four-point bending on an Instron machine with frozen patellae and an artificial bone composite. Circular defects have 107% greater strength than matched trapezoidal patellar defects in three-point bending. In a bone composite, circular defects are 53% stronger than triangular and 25% stronger in four-point bending than trapezoidal defects. A new technique of harvesting bone plugs with endosteal interference fit fixation is described and biomechanically supported. To date, this technique has been performed on over 500 cases clinically without evidence of patellar fracture or fixation failure. This study demonstrates the efficacy of this simple and reproducible technique compared with previously reported procedures.

Aged↗
PubMed2004

Fixation strength of a novel bioabsorbable expansion bolt for patellar tendon bone graft fixation: an experimental study in calf tibial bone.

This biomechanical study compares the initial fixation strength of a novel bioabsorbable two-shell expansion bolt (EB) with that of a well-established interference-screw technique in bone-patellar tendon-bone (BPTB) reconstruction in a calf model. Thirty tibia plateaus (age 5-6 months) were assigned to three groups: In groups I and II, trapezoidal bone plugs of BPTB grafts were fixed with bioabsorbable poly-L-lactide interference screws (8 x 23 mm) or titanium interference screws (8 x 25 mm) respectively. In group III, semicircular grafts were fixed using bioabsorbable poly-D, L-lactide expansion bolts (5.8/8.7 x 10 x 35 mm). The tensile axis was parallel to the bone tunnel, and the construction was loaded until failure applying a displacement rate of 1 mm per second. In group II the mean ultimate loads to failure (713 N+/-218 N) were found to be significantly higher than those of groups I (487 N+/-205 N) and III (510 N+/-133 N). Measurement of stiffness showed 45 N/mm+/-13.3 in group I, 58 N/mm+/-17.4 in group II and 46 N/mm+/-6.9 in group III, and did not demonstrate significant differences. We found a correlation between insertion torque and wedge insertion force and ultimate loads to failure in all groups (r=0.53 in group I, r =0.54 in group II, and r =0.57 in group III). Cross-section planes of bone tunnel increased by 51%, 30% and 31% respectively, following insertion of screws or expansion of bolts (p<0.05). We conclude that ACL graft fixation by means of the presented expansion bolt demonstrates a fixation strength similar to the established bioabsorbable screw fixation, and is a reasonable alternative fixation method, especially since some of the specific pitfalls of screw fixation can be avoided.

Absorbable Implants↗
PubMed1996

Skeletal maturation of wrist and hand ossification centers in normal Spanish boys and girls: a study using the Greulich-Pyle method.

The skeletal maturation of the upper limb distal segment was studied in 239 Spanish boys and girls between birth and 14 years of age. The atlas of Greulich and Pyle, offering standards of skeletal development of white North American children, was used as reference. The results obtained show firstly that in absolute terms, the ossification process is earlier in girls than in boys. This difference is maximum between 5 and 11 years of age. The boys show a delay of around 3 months with respect to their North American opposites. The girls, in contrast, show a better fit to the corresponding (female) standard of the atlas. In general, the highest agreement between bone age and chronologic age is for the ossification centers of the distal epiphysis of the ulna and radius and for those of the metacarpal bones. At the level of the carpus, individual analysis of the ossification centers shows that the capitate and hamate bones in the girls evolve most in accord with chronologic age. At the other extreme, and in both sexes, the ossification centers of the trapezium and trapezoid bones are statistically furthest from chronologic age.

Adolescent↗
PubMed1991

Treatment of scaphoid nonunion by radical curettage, trapezoidal iliac crest bone graft, and internal fixation with a Herbert screw.

Ten adult male patients with scaphoid nonunions were treated by radical curettage, trapezoidal iliac crest bone grafting, and internal fixation with a Herbert screw. The mean patient age was 24.7 years, and the mean duration of the nonunion before surgery was 37.3 months. Mean follow-up time was 30.4 months. Nine of the ten nonunions healed, although one patient required a second bone-grafting procedure. The mean postoperative grip strength was 45.0 kg, and the mean postoperative pinch strength was 11.5 kg. The mean postoperative range of motion was volar flexion, 76.1 degrees; dorsiflexion, 74.2 degrees; radial deviation, 22.1 degrees; and ulnar deviation, 40.1 degrees. The scapholunate angle decreased from a mean of 72.8 degrees preoperatively to 60.6 degrees postoperatively (p less than 0.025). The mean carpal index was 0.57 postoperatively. Mean scaphoid length increased postoperatively and was within 0.2 mm of the opposite (normal) scaphoid in every patient except the single patient with a persistent nonunion (p less than 0.025). All patients returned to work (eight as laborers), and nine of ten wrists were subjectively rated as good or excellent. The results of the series suggests that treatment of displaced scaphoid nonunion by radical curettage, trapezoidal iliac crest bone grafting, and internal fixation with a Herbert screw is an effective method of treatment that reconstitutes scaphoid anatomy and promotes excellent wrist function.

Adult↗
PubMed2003

Biomechanical evaluation of press-fit femoral fixation technique in ACL reconstruction.

In this experimental study, the authors evaluated the biomechanical properties of the femoral press-fit graft fixation technique in ACL reconstruction. 20 fresh frozen distal femurs, patellae and patellar ligaments were used from 10 cadaver specimens. Three bone-patellar tendon grafts of 10 mm width were prepared from each sample; altogether 60 bone-patellar tendon grafts were prepared for the experiment. Three 9 mm wide tunnels were drilled in each distal femur at different angles (0, 15, 30, 45, and 60 degrees). This means that 60 tunnels were drilled into the 20 femurs, 12 at each angle. The trapezoid bone blocks were impacted into the holes. The primary stability and stiffness of this press-fit fixation method were measured with a Zwick 020 computer-controlled testing device using maximum-failure tensile-strength tests. The ultimate tensile strength was the greatest at 45 degrees (534+/-20 N, range 507-554), with 118+/-10 N/mm (range 99-126) stiffness, followed by 485+/-35 N (range 416-510) with 122+/-13 N/mm (range 104-136) stiffness at 30 degrees, 353+/-18 N (range 320-371) with 113+/-13 N/mm (range 83-124) stiffness at 15 degrees, and 312+/-30 N (range 261-343) with 89+/-14 N/mm (ranged:68-103) stiffness at 0 degrees. In the cases of 0, 15, 30 and 45 degrees the bone blocks were pulled out of the drilled holes, but at 60 degrees rupture of the patellar tendon or breakage of the bone block occurred more frequently. It can be seen that the ultimate tensile strength increased with the angle between the loading direction and the bone block. When compared to data in the literature, these data showed similar and satisfying biomechanical properties of femoral press-fit fixation. Because of the known advantages of an implantation-free fixation technique, the femoral press-fit fixation technique can be a good alternative in ACL surgery. These results provide the basis for future studies involving the postoperative healing process of this femoral press-fit fixation technique in porcine knees.

Adult↗
PubMed2000

[Iatrogenic tumor metastasis to the pelvis after treatment for hand osteosarcoma. A case report].

In this study, the case has been examined of a 49-year old male who initially presented with a pathological fracture of the second metacarpal. This was first treated by curettage, iliac bone graft and internal fixation, without any complementary investigation being carried out, i.e., no preliminary biopsy and histological diagnosis were made. The results of this inadequate approach were poor: neither satisfactory fixation of the fracture nor control of the primary lesion were obtained. Moreover, the definitive diagnosis was only made four months later, when biopsy findings confirmed the presence of an osteosarcoma. After neoadjuvant chemotherapy, an en-bloc resection of the second metatarsal and the trapezoid bone was carried out. At ten months post-surgery, one and a half years after the original fracture, the hand was found to be disease-free and functioning satisfactory. However, nearly a year later the discovery of a large tumor mass at the site where the iliac bone graft was originally taken necessitated resection of the hemi-pelvis, with chemotherapy prior to resection and radiotherapy following surgery. Unfortunately, this salvage procedure did not limit the spread of the disease, and subsequent pulmonary and vertebral metastases were found, leading to the death of the patient three years after the initial fracture. This particular case underlines the fact that the basic rules for the management of malignant tumors should be taken into consideration from the onset, so that a catastrophic prognosis such as that described can be avoided.

Biopsy↗
PubMed1999

[Experimental stability of a new implant-free fixation technique in ACL replacement].

The purpose of the study is to establish data on the stability of an ACL replacement. In 40 human cadaver knees, either a mid patellar ligament third with a trapezoid bone block on one side was fixed on the femoral side in a 2-diameter drill hole, or a conventional interference screw fixation was applied. Average primary stability amounted to 570 N (+/- 100 N) for the bone-blocking technique, and to 402 N ( +/- 79 N) for the interference screw fixation. When statistically tested by variance analysis, stability was significantly higher for the bone blocking technique than with interference screw fixation (p < 0.05). Thus, when using a mid-patellar ligament third for ACL reconstruction, the new implant-free technique described here appears to be a practical and reliable method for femoral graft fixation.

Adult↗
PubMed2006

Trapeziectomy and intermetacarpal ligament reconstruction with the extensor carpi radialis longus for osteoarthritis of the trapeziometacarpal joint: surgical technique and long-term results.

PURPOSE: To report the long-term results of excision of the trapezium and intermetacarpal ligament reconstruction with the extensor carpi radialis longus for thumb trapeziometacarpal osteoarthritis. METHODS: Fourteen women and 5 men were retrospectively reviewed after an average of 9 years of follow-up evaluation. Trapeziectomy was performed and the extensor carpi radialis longus was harvested by a dorsoradial approach to reconstruct the intermetacarpal ligament. All patients wore a below-elbow cast for 6 weeks. Each patient had objective and subjective assessments. Thumb shortening was measured in follow-up radiographs. RESULTS: At the final follow-up evaluation, 16 (84%) patients were free of pain and 17 patients (89%) were satisfied with the results. Grip, key strength, and pinch strength improved compared with preoperative values. The trapezium space lost 14% of its height compared with preoperative values. Thumb motion improved, and there were no cases of instability. CONCLUSIONS: Resection-arthroplasty of the trapezium with intermetacarpal ligament reconstruction with the extensor carpi radialis longus is an effective procedure that permits motion restoration and pain relief in the trapeziometacarpal joint in the long term without affecting thumb stability. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Aged↗
PubMed2006

Costochondral autograft as a salvage procedure after failed trapeziectomy in trapeziometacarpal osteoarthritis.

PURPOSE: Osteoarthritis at the base of the thumb is a common problem, especially in women. Among the many surgical procedures aimed at restoring the function of the trapeziometacarpal joint, total trapeziectomy has been shown to provide good long-term results in most patients. But in some patients continued pain may lead the surgeon to consider a revision procedure. We report the use of costochondral autograft as an interposition material in revision of trapeziectomy in trapeziometacarpal osteoarthritis and to study its usefulness. METHODS: The study design was retrospective. All of the patients had a costochondral autograft as a revision procedure after a failed trapeziectomy with ligament reconstruction. Patients were clinically assessed before and after surgery. The follow-up period was 24 months. Results were assessed as follows: good, complete relief of pain; fair, persistent mild pain and stiffness; poor, no relief of pain or any improvement with revision surgery. RESULTS: Four patients were included; there were 2 good results, 2 fair results, and no poor result. Pain relief was obtained in all patients. Thumb opposition showed a slight improvement in 1 patient and no change in the other 3 patients. Pinch strength showed no change. One case of iatrogenic injury of the sensory branch of the radial nerve was noted. CONCLUSIONS: Costochondral autograft as a revision procedure after failed trapeziectomy is a reliable procedure. These preliminary outcomes showed that the result did not compare favorably with soft-tissue interposition. Nevertheless, in case of an iterative procedure, the lack of available soft-tissue material to interpose may lead the surgeon to consider a costochondral autograft. This procedure should be considered a salvage procedure.

Carpal Joints↗
PubMed2006

Scaphotrapeziotrapezoid joint arthritis: a pilot study of treatment with the scaphoid trapezium pyrocarbon implant.

Isolated scaphotrapeziotrapezoid osteoarthritis is rare but can cause weakness and wrist pain. We present the results of a pilot study of interposition arthoplasty with a scaphoid trapezium pyrocarbon implant (STPI) by an open and arthroscopic approach for this problem. We performed this procedure in 10 hands in eight patients, all women, with a mean age of 60.5 (range 51-70) years. The average follow-up was 19 (range 2-24) months. Pre-operative X-rays in all cases identified an isolated degenerative arthritis of the scaphotrapeziotrapezoid joint. Average DASH evaluation pre-operatively of 49 was reduced to 39. All of the patients had functional improvement and returned to daily activities after 3 months. The results of this pilot study suggest that the STPI may prove a useful compromise treatment for this problem.

Aged↗
PubMed2006

The gap after trapeziectomy: a prospective study.

Thirteen patients with basal joint arthritis of the thumb were treated by simple trapeziectomy. All patients underwent radiological assessment pre-operatively and at 2, 4 and 12 weeks after surgery. Special standardised views were taken to assess changes in the 'trapezial gap'. Collapse of this was noticed up to 4 weeks following surgery but no significant change occurred thereafter. In respect of this collapse, prolonging immobilisation after 4 weeks is probably unnecessary.

Aged↗
PubMed2006

Conservative treatment versus scaphotrapeziotrapezoid arthrodesis for Kienbock's disease. A retrospective study.

Efficiency of surgical treatment in Kienböck's disease has never been proven in the long term. We retrospectively reviewed the charts of the 104 patients treated by various techniques for Kienböck's disease from 1981 to 1999 in our unit. A comparison was made between 19 cases treated conservatively (amongst 59) and 11 cases (amongst 25) treated by scaphotrapeziotrapezoid (STT) arthrodesis with a mean follow-up of 13 years. The two groups were statistically comparable in stage, age, sex ratio, number of manual workers. STT arthrodesis was responsible for an increased loss of mobility, an increase of barometric pain, a longer rehabilitation time and more fractures of lunatum than conservative treatment. Those results question about indications for STT in Kienböck's disease.

Adult↗
PubMed2001

[In vivo cinematic study of the trapezometacarpal joint].

The aim of this study was to assess the trapeziometacarpal joint kinematics from in vivo measurements, both quantifying the ranges of motion and suggesting a suitable joint model. A motion analysis system has been used to collect the spatial trajectories of markers, glued respectively on the thumb and on the hand's palm. A rigorous protocol was set up to make sure of the trapezoid bone's fixity relatively to the hand, and then to be able to characterize the movement of the first metacarpus with respect to the trapezium. The ranges of motion have been measured on two distinct movements: circumduction and flexion-extension, and different types of joints: healthy, pathological and prosthetic. The joint axes of rotation (for flexion-extension and ante-retroposition movements) have been determined on healthy subjects. The computation of rotation amplitudes and positions of joint axes was based upon the finite helical axis concept, which degenerates into finite rotation axis when translations can be neglected. Both the measurement protocol and the calculation method have been validated by comparing the computed joint center with that measured on a radiography, in the case of a spherical prosthesis. The ranges of motion obtained on the healthy subject series were consistent with values published by other authors. Comparisons have been realized between these reference joints and different cases: arthrodesis, arthrosis and prosthesis. The determination of rotation axes of a normal joint has lead to a generalized cardan joint, i.e. two non perpendicular converging rotation axes.

Algorithms↗
PubMed1985

Peri-articular reactions to microscopic erosion of silicone-polymer implants. Light- and scanning electron-microscopic studies with energy-dispersive x-ray analysis.

Two patients are described who underwent implantation of silicone-polymer prostheses: one for an arthroplasty of the left great toe after a bunionectomy, and another for replacement of fractured trapezoid bone of the left wrist. Each patient developed unexplained severe pain at the sites of surgery at 3 and 7 months postoperatively. On removal of the implants and adjacent tissues, there was a microscopic foreign-body reaction to amorphous material in the subsynovial connective tissue. Although both prostheses were grossly intact, scanning electron microscopy revealed multiple erosions on their surfaces. Energy-dispersive x-ray analysis of foreign material in the paraffin-embedded sections revealed a peak for silicon. These two cases indicate that clinically significant pathological reaction may occur as early as 3 months after silicone-polymer implantation and that energy-dispersive x-ray analysis of excised tissue is a useful and specific diagnostic procedure.

Adult↗
PubMed1985

The carpal boss: an overview of radiographic evaluation.

The carpal boss, an unmovable bony protuberance, is located on the dorsum of the wrist at the base of the second and third metacarpals adjacent to the capitate and trapezoid bones. This bony prominence may represent degenerative osteophyte formation and/or the presence of an os styloideum, an accessory ossification center that occurs during embryonic development. When this condition is symptomatic, patients present with complaints of pain and limitation of motion of the affected hand. The symptoms of carpal boss may result from an overlying ganglion or bursitis, an exterior tendon slipping over this bony prominence, or from osteoarthritic changes at this site. Radiographically, the view that best profiles the separate os styloideum is a lateral view utilizing 30 degrees of supination and ulnar deviation of the wrist. Once a diagnosis has been made, treatment can range from the use of nonsteroidal antiinflammatory medication and limited use of the wrist to surgical excision of the anatomic abnormality.

Bone Diseases↗
PubMed1990

[Corrective osteotomy of malunited distal radius fractures].

The malunion of the distal radius may result in shortening, radial impaction, volar angulation, dorsal displacement or rotatory deformity. For restoration, the anatomy and kinematics of the distal radioulnar joint and the triangular fibrocartilaginous complex (TFCC) are of importance. This nonunion consists of the articular disk, a meniscus homologue, the ulnar collateral ligament, and the dorsal and palmar radioulnar ligaments. Malunion of the distal radioulnar joint leads to an increase in loading on the individual parts, as well as pain and a decrease in supination and pronation. Osteotomy is indicated if the angulation of the malunion is more than 20 degrees in the frontal or sagittal plane. Corrective osteotomy requires detailed preoperative planning with calculation of the correct position in all planes. The most common operation that has proved to be effective is osteotomy of the radius, insertion of a trapezoidal bone graft in place, and internal fixation with a dorsal or volar plate.

Elbow Joint↗