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At least 91 records · Page 5Linked to original sources
PubMed2000

Wrist arthroscopy without distraction. A technique to visualise instability of the wrist after a ligamentous tear.

We describe a technique for arthroscopy of the wrist which is carried out without traction and with the arm lying horizontally on the operating table. The wrist is not immobilised, which makes it possible to assess the extent of instability after a ligamentous tear. In a prospective study of 30 patients we compared this technique with conventional wrist arthroscopy, performing the new method first followed by conventional arthroscopy. The advantages are that the horizontal position of the arm allows the surgeon to proceed directly from arthroscopic diagnosis to treatment, and that no change of position is required for fluoroscopy. In terms of diagnostic sensitivity, we found our technique matched that of conventional arthroscopy. We had no difficulty in carrying out minor surgical procedures such as debridement and suturing.

Adult↗
PubMed1981

The effect of the Futuro wrist brace in pain conditions of the wrist.

In a study to assess the effects of the Futuro wrist brace (Adcock-Ingram) in 22 patients with osteoarthritis, rheumatoid arthritis, tenosynovitis and gout of the wrist, grip and pinch dynamometers were used to measure improvement in function. The study confirmed the efficacy of the wrist brace by demonstrating an average of 23.7% improvement in grip strength over the 10-day study, as well as a significant average improvement in pinch strength of 14.8% (P less than 0.05). In the subgroup of 8 rheumatoid arthritis patients a significant average increase in grip strength of 48.9% (P less than 0.025) was obtained. Both day and night pain was reduced and there was improvement in patients' ability to carry out their daily activities. The brace was found to be comfortable and easy to use.

Arthritis, Rheumatoid↗
PubMed2005

Activity patterns of wrist extensor muscles during wrist extensions and deviations.

Wrist extensor muscles are prone to certain focal musculoskeletal disorders for which the activation pattern of the extensor carpi radialis (ECR) and ulnaris (ECU) muscles may be important risk factors. Surface and intramuscular EMG of these muscles were recorded during isometric low-force wrist extension in semipronation and pronation as well as for ulnar/radial deviation, and were analyzed using root mean square (RMS) and decomposition methods. Despite shorter ECR length at semipronation, higher amplitudes of intramuscular EMG and of motor unit action potentials (MUAPs) were found in pronation than in semipronation. However, these changes were not detectable in the surface EMG. Higher ECR activity levels were also found during wrist extension compared to ulnar/radial deviation, and differences in the motor unit (MU) properties were found during ulnar deviation compared to radial deviation and extension. Remarkably, the MUAPs of ECR were almost twice as large as those of the ECU. Overall, the ECR muscle did not respond as predicted from biomechanical considerations, and in general activity level was higher than expected. This may partly explain why the tendon of the ECR often is associated with lateral epicondylitis.

Adult↗
PubMed1993

Long-term results of denervation of the wrist joint for chronic wrist pain.

The results have been evaluated of 29 patients who had wrist denervation for chronic wrist pain between 1979 and 1987. Follow-up ranged from 22 to 86 months (mean 51 months). 17 patients had denervation without a concurrent procedure. Of these, 12% became pain-free and 71% had pain with all activities or had additional surgery; 24% said they were satisfied with their treatment. The results were worse in those who had partial denervation than those who had total denervation. 12 patients had denervation performed concurrently with another pain-relieving procedure. Denervation alone was not reliable in resolving chronic wrist pain.

Adult↗
PubMed2002

Perceptual changes in illusory wrist flexion angles resulting from motor imagery of the same wrist movements.

Recent neuroimaging studies have suggested that similar cortical motor areas are recruited both by kinesthetic sensations elicited by tendon vibration and by voluntarily imaging one's own movements of the same joints. Little is known, however, as to whether kinesthetic motor imagery interacts with kinesthetic illusion. We examined such interaction by behavioral analysis in which 19 subjects imagined wrist flexion or extension, with or without illusory flexion induced by tendon vibration. Electromyograms were also recorded to monitor the peripheral modulations caused by the interaction. The kinesthetic motor imagery had a psychophysical effect on kinesthetic illusion in the absence of overt movement. It was confirmed that the subjects could imagine wrist movements without facilitating muscle activities in the absence of vibration stimuli. The electromyogram activity of the vibrated extensor muscles was significantly higher than that of non-vibrated flexor muscles. Motor imagery of wrist extension, when illusory flexion was experienced, reduced the angle of illusory flexion while enhancing extensor muscle activities in comparison with the control. On the other hand, flexion motor imagery increased the angle of illusory flexion with or without enhancement of flexor muscle activities. Our results indicate that motor imagery interacts with kinesthetic illusion with or without enhancement of activities of the related muscles. This suggests (1) that common neural substrates shared by imagery and by illusion exist and (2) that different physiological mechanisms contribute to the enhancement of muscle activities of vibrated muscles and their antagonists.

Adolescent↗
PubMed1996

Does the normal contralateral wrist provide the best reference for X-ray film measurements of the pathologic wrist?

This study compares in normal subjects the variability of wrist x-ray film measurements between the right and left sides with the variability of the distribution of those measurements within the population. Additional purposes were to evaluate possible differences of these measurements according to sex, age, side, and hand dominance. The variability when comparing both sides was found to be statistically less for the carpal height, radiolunate, scapholunate, and capitolunate angles than within the whole group of subjects, and for those measurements, there was a high correlation (r > .88) between the right and left sides. In addition, the carpal height and the carporadial ratios were lower and the capitolunate angle was higher in women than in men. There was also a significant decrease of the scapholunate angle in older individuals. The clinical implication of these findings is that in unilateral wrist diseases, the normal wrist should be used to provide the reference values of the carpal height and of the carpal angles on profile x-ray films. However, for the radial inclination and palmar tilt of the distal radius and for the ulnar variance, the normal side does not provide a better reference than normal values obtained from databases.

Adult↗
PubMed2005

Spastic wrist flexors are more severely affected than wrist extensors in children with cerebral palsy.

Morphological properties of skeletal muscle were compared between wrist flexors and extensors within the same children (n = 8, six females, two males; age range 4 to 9y, median age 7 y) with wrist muscle imbalance secondary to spastic cerebral palsy (CP). Five patients had hemiplegic CP, two diplegic CP, and one patient had tetraplegic CP. Muscle biopsies were taken during either tendon transfer or tendon lengthening procedures. Analyses included distribution of muscle fibre types, fibre sizes, and expression of developmental myosins. Extensor fibre area was significantly greater than flexor fibre area for type 2A fibres and type 2B fibres but not for type 1 fibres. Coefficient of variation (CV) of fibre size for all three fibre types was greater for flexors compared with extensors. The greatest CV was observed for the type 2A fibres in flexors (39.5 [3.6%]). A wide variation was observed for expression of developmental myosin with the magnitude of the expression being greater, but not statistically significant, in flexors compared with extensors (5.4/mm2 vs 0.53/mm2). These data demonstrate that significant secondary myopathy of wrist flexor muscles results from CP.

Age Factors↗
PubMed2001

Wrist arthrodesis with excision of the proximal carpal bones using the Ao/ASIF wrist fusion plate and local bone graft.

We present our series of 17 patients who underwent wrist arthrodesis with excision of the proximal row carpal bones using the AO wrist fusion plate and local bone graft obtained from the excised proximal carpal row. All patients were evaluated using a questionnaire to assess pain, function, ability to perform an occupation and satisfaction with the procedure. The mean follow-up was 17 months, at which time all the fusions had united. Clinical outcome scores showed that 14 and 15 of the 17 patients achieved good or excellent results with regard to their current condition and clinical improvement, respectively. Four patients required secondary surgery, two for fractures and two for instability of the distal radio-ulnar joint unrelated to the wrist fusion.

Adult↗
PubMed2006

[Radiometric assessment of wrist angle values, linear parameters of the forearm and wrist ratios].

With the device of our own invention suitable for static X-ray examination of the wrist 12 radiographic parameters were evaluated. 100 radiograms regarded normal were analyzed, obtained as a comparative in unilateral wrist trauma patients group. Age of the patients ranged from 18 to 60 years. No comparative studies in regard to sex were performed. Obtained data were statistically analyzed. Subsequent values of the radiometric parameters were obtained: scaphoid-lunate angle (SL) 48.61 degrees, radio-lunate angle (RL): -0.83 degrees, palmar inclination of the distal radius metaphysis (RI): 25.96. The most significant linear parameters measured: ulnar length 0.18 mm, ulnar transposition (UT): 0.339 mm.

Adolescent↗
PubMed1995

[Load transmission through the wrist joint: a biomechanical study comparing the normal and pathological wrist].

This study was undertaken to elucidate the correlation, if any, between pressure loading and the progress of degenerative osteoarthritis in the human wrist. Nine fresh amputated forearms were used to produce i) a pathological model of a malunion after a distal radius fracture, ii) a model of a triangular fibrocartilage (TFC) tear, and iii) a model of a scapholunate dissociated wrist (involving three specimens for each model). On pressure loading, changes in the radioulno-carpal joint and in the midcarpal joint were measured using a pressure sensor. In the malunion of the distal radial end, we found that a pressure fluctuation occurred at more than a 20 degrees dorsal tilt with greater than ulnar +2 mm variance. The loads on the TFC surface and on the scaphoid surface increased, causing the pressure loading site to move dorsally. In the model of a partial TFC resection, sufficient decompression was achieved at the resection site for ulnar 0 mm variance. However, at +2.5 mm variance, the pressure loading caused a concentrated pressure to occur on the TFC surface and the decompression became ineffective. So for a +2.5 mm variance in this model, shortening the ulnar diaphysis is suggested as adequate for a clinical reduction in pressure. In the scapholunate dissociated model, we observed decreased pressure in the radioscaphoid articulation and scaphocapitate articulation, during volar rotation of the scaphoid, while there was increased pressure in the radiolunate and in the lunocapitate articulation. In all models, the focus of the increased pressure was correlated with radiographic findings as being the same as the site of morphological degeneration, suggesting a close correlation between abnormal pressure and the progression of degenerative osteoarthritis.

Biomechanical Phenomena↗
PubMed1993

The spaghetti wrist. Simultaneous laceration of the median and ulnar nerves with flexor tendons at the wrist.

The outcome of 15 patients who sustained simultaneous laceration of the median and ulnar nerves with flexor tendons at the wrist is described. Primary nerve repair yielded satisfactory results, the median nerve achieving a better outcome than the ulnar nerve. Most patients regained a functional range of wrist movement. Flexor tendons yielded the poorest results. A functional, albeit impaired outcome can usually be anticipated following this severe injury.

Adolescent↗
PubMed1990

[Anatomy of the articular nerves of the wrist. Implications for wrist denervation techniques].

The knowledge of the anatomy of the wrist articular nerves is at the base of the denervation technique. After a dissection of 12 adult wrists, we specify the situation and the relation of these nerves at the level where they are accessible to a surgical approach. The 10 articular branches of Wilhelm are described successively. The posterior interosseous is the most voluminous and most constant. Some branches need a specific surgical approach: anterior and posterior interosseous nerve, lateral cutaneous nerve, articular branch of the first web. Other nerves are cut blindly after skin undermining (perforating branches from cutaneous nerves). Some branches appear inaccessible to a cautious surgery because they are closely tight to other motor branches (deep branches of the cubital nerve). Finally some branches described by Wilhelm were not found in our dissections: branches of the median palmar cutaneous nerve, and direct branch of the cubital nerve.

Classification↗
PubMedDate not supplied

Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand.

Hand and wrist injuries in sports are some of the most common injuries reported. This review discusses common overuse injuries of the wrist including tendon injuries such as de Quervain's syndrome, subluxation of the extensor carpi ulnaris, and the common dorsal carpal impingement syndrome. The main focus of this section is the discussion of traumatic injuries to the hand in the athlete. Included is a discussion and review of fractures of the phalanges and metacarpals, common proximal interphalangeal joint injuries, and thumb carpal metacarpal and metacarpophalangeal joint injuries. Emphasis is placed on more common injuries seen regarding diagnosis, indications for non-operative versus operative treatment, and time to return to athletic competition.

Athletic Injuries↗
PubMed2003

[Patient-rated wrist questionnaire: preliminary report on a proposed French version of a North American questionnaire designed to assess wrist pain and function].

We present a French translation of a North American self-assessment questionnaire (Patient Rated Wrist Questionnaire or PRWE). This questionnaire was developed by Joy MacDermid and members of the IWI (International Wrist Investigators). Three years were needed to establish the specific items and questions to get a valid and reliable questionnaire. It includes 5 questions on pain and 10 questions on function. All the questions were rated on a 0-10 scale. The questionnaire provides several scoring options with a total of 100. MacDermid assessed the responsiveness of three questionnaires (DASH, SF-36 and PRWE) in 59 patients after distal radius fractures. Standardised response means (SRM) were calculated to indicate responsiveness. The PRWE was the most responsive. The French version was evaluated on 20 patients. All the questions were understood. The mean writing time was 5 minutes (3 min - 7 min).

Adult↗
PubMed1987

Difficult wrist fractures. Perilunate fracture-dislocations of the wrist.

Perilunate dislocations of the wrist have a common pathway of disruption that occurs from extensive dorsiflexion injuries. Open reduction and internal fixation of these injuries is required to provide accurate alignment and the option for ligament repair. Both dorsal and palmar surgical incisions may be indicated. Associated injuries to the median nerve must be recognized. Treatment includes scaphoid and radial styloid stabilization with multiple K-wires or internal compression screw (Herbert or Association for the Study of Internal Fixation [ASIF] screws). In these injuries, the lunate must be reduced first and stabilized. The scaphoid proximal segment follows the lunate unless the scapholunate (SL) ligament is torn. The distal scaphoid fragment, capitate, and triquetrum are reduced and aligned with the lunate and need to be held with K-wires. Ligament repair and augmentation may be necessary at both scapholunate and lunotriquetal areas if there has been serious ligament injury. Palmar ligament repair is often required, and we recommend a palmar exploration in most patients along with release of the median nerve. Surgical treatment results of perilunate fracture-dislocations of the wrist appear better than conservative treatment methods, but complications following both indicate the need for improved internal fixation and fracture-dislocation realignment. These fractures are a real challenge to the treating surgeon who must use patience, precise surgical techniques, and careful roentgenographic study (including tomograms and traction views) to assure the best result.

Adolescent↗
PubMed1997

Wrist dermatitis: contact allergy to neoprene in a keyboard wrist rest.

A case of allergic contact dermatitis to a keyboard wrist rest containing neoprene is reported. The patient, who had a history of sensitivity to rubber products, developed an acute vesicular reaction of the palmar aspects of her distal wrists, followed by eczematous patches of her extremities and face. Treatment with prednisone, a 3-week tapering dose (60, 40, 20 mg), cleared the dermatitis. The widespread uses of neoprene are discussed and suggest that neoprene will become a common source of contact dermatitis as the potential sources of exposure increase.

Adult↗
PubMed1997

Total wrist arthroplasty. Experience with a noncemented wrist prosthesis.

Experience with an improved total wrist prosthesis developed in 1986 is reported. It could be shown that a solid osseointegration of the prosthesis can be achieved without use of cement. The most important prerequisite is to place the prosthetic components correctly into solid bone stock. Ten revisions were necessary, most directly related to technical errors or improper selection of patients. Thirty-eight prostheses were implanted in 33 patients. The length of followup ranged from 3 to 9.5 years (average, 5.5 years). Patient satisfaction, pain, daily activities, motion, grip strength, and radiographs were evaluated. The overall results were excellent in 20, good in 10, fair in two, and poor in six wrists.

Adult↗
PubMed1998

Treatment of hand and wrist pain. A randomized clinical trial of high voltage pulsed, direct current built into a wrist splint.

To determine the effectiveness of high voltage pulsed current (HVPC) in reducing chronic hand edema, 120 individuals were randomly assigned to one of two treatment groups. Group I clients were given an appropriate sized wrist splint, incorporating an energized, high voltage pulsed unit. Group II clients were given an identical splint with a non-energized unit. Each client received daily treatments at the worksite consisting of 30 minute sessions totaling 20 treatments during a 35 day period. Pre-treatment and post-treatment evaluations included measurements of pain, grip strength, and edema volume; repetitive task testing; and Semmes-Weinstein Monofilament sensory testing. In the energized group, post-treatment evaluation showed statistically significant decreases in the amount of stimulation required to stimulate the median nerve and the amount of hand edema and pain. The energized group also had improved repetitive task times. None of these improvements occurred in the non-energized group. Based on these results, HVPC appears to be an effective method for minimizing the severity of repetitive stress injuries of the wrist.

Chronic Disease↗