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[Lunocapitate shortening arthrodesis after scaphoid and triquetrum resection: treatment of Watson stage III advanced scaphoid periarthrosis].

PURPOSE OF THE STUDY: Between 1993 and 2000, 16 patients with scaphoid periarthrosis (Watson stage III) were treated by lunocapitate shortening arthrodesis after resection of the scaphoid and triquetrum. These patients were reviewed to evaluate outcome. MATERIAL AND METHODS: Thirteen patients had antecedent trauma with scaphoid nonunion (SNAC, n=9) or scapholunate advanced collapse (SLAC, n=4). The remaining three patients had chondrocalcinosis. RESULTS: Clinical and radiological results were encouraging at a mean follow-up of 3 years (1-7 years). Fourteen patients were very satisfied and two experienced partial improvement. Persistent pain relief as well as 11% improved muscle power was achieved. Mean improvement of joint motion was 12 degrees. DISCUSSION: This technique has shown better global results than 4-corner arthrodesis. It can be applied if capitate arthrodesis is performed. Results are comparable to those of proximal row carpectomy.

Adult↗

Reconstruction of longitudinal stability of the forearm after disruption of interosseous ligament and radial head excision (Essex-Lopresti lesion).

We have presented a technique for reconstruction of the central band of the interosseous membrane in conjunction with surgical repair of the distal radial joint and radial head prosthesis. With this technique, we address all three anatomic structures that provide longitudinal stability of the forearm, specifically, (1) radial head replacement, (2) interosseous membrane reconstitution, and (3) TFCC repair.

Cartilage↗

Combined fracture of the distal radius and scaphoid in children. Report of 2 cases.

The authors report 2 cases of concomitant scaphoid and distal radial fractures, a rare combination of lesions in children. The first case was in a 13-year-old boy who presented a transverse midscaphoid fracture associated with a Salter type II distal radial fracture. The second concerned a 10-year-old boy who presented a bilateral wrist injury. On the left side, a distal forearm fracture with anterior displacement was associated with a transverse midscaphoid fracture. On the right side, there was only a distal forearm fracture. Scaphoid fracture associated with distal radial fracture seems to have been more frequently reported in the literature during the last decade, probably because it is more frequently recognised. In fact, children with distal forearm injury should be well examined both clinically and radiologically in order to search for an associated scaphoid fracture. Reduction of the radius fracture should be done carefully to avoid possible displacement of the scaphoid fracture.

Adolescent↗

[Osteochondritis dissecans of the scaphoid (Preiser's syndrome): 2 case reports].

Preiser's syndrome is a rare osteochondrosis affecting the carpal scaphoid, frequently related with an avascular necrosis. Osteoarthritic changes of the articular cartilage, local synovitis, and loose fragments are the most common findings associated with this syndrome. We report here two patients with Preiser's syndrome, one with and one without a traumatic history, both presenting with pain, swelling and functional impairment of the wrist. In one patient radiography was sufficient for the diagnosis, in the other NMR was necessary to clearly establish type and extension of the lesion. Differential diagnosis may be sometimes difficult and the therapeutic approach depends on several aspects, including etiology and type of occupational activity.

Adult↗