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At least 415 records · Page 23Linked to original sources
PubMed1991

[Arthrodesis of the wrist in manual workers. Apropos of 36 cases].

We present a review of 36 patients with final radiocarpal arthrodesis done between 1976 and 1987. The series was homogeneous: patients were about 40 years old and lesions were work-related. The most frequent reason for the arthrodesis was fracture of scaphoid bone, followed by Kienbock's disease complex trauma of carpus, severe carpal sprain, and articular fracture of the distal fourth of radial bone. Thirty-one arthrodeses were done by screwed-on iliac graft, 5 by nailing following Mannerfelt technique. The two main factors in functional results were pain and loss of strength. The latter averaged 41 per cent of that of the normal side, and only 8 wrists were completely free of pain. Indications for final radio-carpal arthrodesis are discussed, taking into account the poor functional results and their repercussions on social and professional life of the patient.

Accidents, Occupational↗
PubMed1988

[A modification of the Matti-Russe operation].

The essence of this modification is the curved structure of the cavity in the scaphoid bone and of the bone graft which fits into the cavity. The indication for the Matti-Russe method extends to those cases in which the direction of the line of pseudarthrosis is unfavourable and the proximal fragment is relatively small. The mechanical stability increases, because the wall of the cavity on all sides remains equally thick.

Bone Transplantation↗
PubMed1988

[Radiologic diagnosis of injuries of the wrist].

To visualise the rupture of the scaphoid bone it will be sufficient--as has been proven--to perform two additional projections from the navicular series besides the standard x-rays of the wrist joint, namely, with the hand in writing-pen position and in hyperpronation. With this procedure, almost all (99%) of fractures detected during first examination can be diagnosed. To prove the occurrence of fractures of the wrist besides those of the os naviculare, specific x-rays are employed in accordance with the results of an on-target clinical examination. Such x-rays are, in particular: lateral radioulnar x-ray rotated by 10 degrees in volar direction to assess the os triquetrum; lateral radioulnar x-ray in 10-30 degrees supination to visualise the os pisiforme; carpal tunnel x-ray to assess the entire hollow of the hand, in particular the volar parts of os pisiforme, os hamatum (hamulus) and os trapezium. Although such fractures can partly also be diagnosed by means of a navicular series, as already stated, it is not permissible to exclude the presence of a fracture if there are no abnormal findings in the navicular quartet whereas clinical findings are positive.

Carpal Bones↗
PubMed1978

[On the roentgenologic observation of wrist flexion (author's transl)].

To analyze adduction (ulnar flexion) or abduction (radial flexion) at the wrist, a simple calculatory method is described (quitient from the length of the scaphoid bone--navicular bone or os scaphoideum--in radial and ulnar flexion), converted to angle measurement via the cosine value. The normal values are limited by the pathologic values, so that beginning lesions can be identified in this manner. Description of a few pathologic cases and of the limits and possibilities of the method.

Humans↗
PubMed1980

An overview of injuries of the wrist.

The large assortment of wrist injuries ranging from carpal instability, sprains, horizontal scaphoid, radiocarpal disorders, to fractures, especially scaphoid bone fracture, are some of the most interesting of all challenges to modern orthopedic practice.

Carpal Bones↗
PubMed1995

Office orthopedics: thumb spica casting for scaphoid fractures.

Fracture of the scaphoid bone of the wrist is a common orthopedic problem and is accurately diagnosed by determining the mechanism of injury based on the history, performing a specific physical examination maneuvers and interpreting radiographic findings. Skill in the application of the thumb spica cast enables the family physician to provide appropriate and definitive care for many of these patients.

Adult↗
PubMed1993

An unusual insertion of the palmaris longus muscle.

In the course of an anatomical dissection at the School of Medicine, a variant form of the palmaris longus muscle was found on the right side; the fellow muscle of the left side being normal. The palmaris longus concerned was found to arise by fleshy fibers from the common tendon for the flexores antebrachii muscles to be divided into a lateral and a medial tendon. The lateral tendon of the muscle was inserted onto the thenar fascia and the scaphoid bone while the medial tendon was being inserted onto the hypothenar fascia and the triquentral bone.

Adolescent↗
PubMed2000

Role of conventional and vascularized bone grafts in scaphoid nonunion with avascular necrosis: A canine experimental study.

The effectiveness of vascularized and conventional bone grafts in the treatment of carpal fracture nonunion with avascular necrosis was evaluated in 12 adult dogs. The proximal third of the radiocarpal bone was removed bilaterally and frozen in liquid nitrogen. Its replacement, leaving a 4-mm gap, simulated a scaphoid fracture nonunion with avascular necrosis. A dorsal radius inlay graft was placed across the gap. The graft was nonvascularized, or conventional on one side, and vascularized with a reverse-flow arteriovenous pedicle on the other. Following a healing period, quantitative assessment of bone blood flow, fracture healing, and bone remodeling was conducted. Seventy-three percent of the vascularized grafts and none of the conventional grafts healed. At 6 weeks, bone blood flow in the proximal pole was significantly higher on the side of the vascularized graft. Quantitative histomorphometry of the avascular proximal segment demonstrated significantly higher levels of fluorochrome-labeled osteoid- and osteoblast-covered trabecular surfaces on the vascularized graft side. These experimental data support the potential clinical application of pedicled reverse-flow vascularized grafts in the treatment of carpal fracture nonunions with avascular necrosis, including proximal pole scaphoid nonunions.

Animals↗
PubMed2000

Vascularized metacarpal bone graft for scaphoid non-union and Kienböck's disease.

A new vascularized bone graft from the base of the second metacarpal was used to treat scaphoid non-union and Kienböck's disease. In two patients with scaphoid non-union, the procedure promoted healing, even when the proximal segment was poorly vascularized. In one patient with Kienböck's disease, the graft held stable and wrist pain was markedly reduced. Further clinical experience may establish this procedure as an option for carpal bone fractures or disease.

Adult↗
PubMed1988

Treatment of ununited fractures of the scaphoid by iliac bone grafts and Kirschner-wire fixation.

Of 151 ununited fractures of the scaphoid that were treated with iliac bone grafts and Kirschner-wire fixation through a volar approach, all but four (97 per cent) healed in an average of seventeen weeks, Three of the four failures resulted from obvious technical errors. Neither the preoperative existence of necrosis of the proximal fragment nor the location of the fracture affected the results. When there was mild radiocarpal arthritis preoperatively, it did not progress postoperatively; if there was moderate radiocarpal arthritis preoperatively, progression seldom was seen if a radial styloidectomy was done. Displaced and unstable ununited fractures healed even if the deformity was not corrected completely. The principal benefit of the procedure was relief of pain rather than an increase either in motion of the wrist or in strength of grip.

Adolescent↗
PubMed2001

Longstanding nonunions of scaphoid fractures with bone loss: successful reconstruction with vascularized bone grafts.

Vascularized bone graft from the dorsum of distal radius was used to treat 22 nonunions of scaphoid fractures, with a mean delay of 4 years from the initial injury. Four of the eight patients with associated scapho-styloid arthritis also underwent a closing wedge osteotomy of the distal radius. Follow-up time ranged from 14 to 74 months. Union was accomplished in 6 to 12 weeks and wrist range of motion and grip strength improved postoperatively in all patients. Complete absence of pain was noted in 16 patients and the other six, all of whom had arthritic wrist changes or carpal collapse, only experienced pain with strenuous activities. The simple graft dissection, the avoidance of anastomoses and the lack of donor site morbidity are additional advantages to this surgical technique, which is successful even in cases with an avascular proximal pole.

Adult↗
PubMed2003

Vascularized bone graft for scaphoid nonunion.

The management of recalcitrant nonunion of the scaphoid can be frustrating. Recent understanding of the vascular anatomy of the distal radius has helped in the management of these problems. Vascularized bone grafting for scaphoid nonunion has improved the union rates. Consequently, familiarity with this procedure is an important tool for any surgeon who treats scaphoid nonunion. Although there are numerous publications discussing both the vascular anatomy of the distal radius and the scaphoid, little is written about the surgical technique. This study reviews the literature on scaphoid nonunion and outlines the authors' experience with this procedure.

Journal Article↗
PubMed2001

[Treatment of difficult scaphoid pseudarthroses by bone transplantation and additional implantation of the second dorsal metacarpal artery using the Fernandez and Eggli technique--report of experiences].

One of the procedures for the treatment of scaphoid-nonunion with loss of blood supply to the proximal fragment involves the technique described by Fernandez and Eggli (1995). After resection of the necrotic bone and inserting a corticocancellous bone graft from the iliac crest, the second dorsal intermetacarpal artery is implanted into the proximal fragment of the scaphoid. In our hospital, six patients underwent this procedure from May 1998 to June 2000 because of necrosis of the proximal pole or an unsuccessful previous operation. Union was achieved in five patients. In one case, nonunion persisted and the cystic area increased. The described technique is suitable for improvement of bone healing of the scaphoid in complicated cases. The advantages of this technique lie in the predictable anatomy of the second intermetacarpal artery and the straightforward dissection.

Adult↗
PubMed2000

Primary vascularized distal radius bone graft for nonunion of the scaphoid.

A vascularized bone graft from the dorsoradial aspect of the distal radius was used with internal fixation to treat nonunion of the scaphoid in ten patients who had not received any previous surgical treatment. Five cases were classified as Lichtman type I and five as type II. The average age was 30 years (range, 18-40 years). Associated avascular necrosis was observed in five cases. Postoperatively pain was relieved and union was achieved in all cases. The mean time to union was 6.5 weeks. Range of motion, grip strength and pinch strength were also restored satisfactorily. These results suggest that this vascularized bone graft should be used as the primary procedure in Lichtman type I and II of scaphoid nonunions, regardless of the presence of avascular necrosis of the proximal pole.

Adult↗
PubMed1998

Simultaneous dislocation of the scaphoid and hamate bones.

We report a rare case of simultaneous dislocations of the hamate and scaphoid in an 18-year-old boy. Despite the extensive damage to the wrist joint, the functional results of open reduction and suture of intercarpal ligaments have been satisfactory, without carpal instability and degenerative osteoarthritis.

Adolescent↗