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At least 973 records · Page 54Linked to original sources
PubMed2005

Relationship between dorsal ganglion cysts of the wrist and intraosseous ganglion cysts of the carpal bones.

Soft tissue ganglion cysts are the most common benign tumours of the wrist; their pathogenesis remains controversial. We prospectively screened the radiographic appearance of the wrists of 51 patients presenting to a single surgeon with dorsal wrist ganglions during a one-year period. Postero-anterior and lateral radiographs were systematically performed looking for possible associated intraosseous ganglion cysts. There were 51 dorsal soft tissue ganglion cysts in 51 patients. We detected 29 associated intraosseous ganglia in 24 patients (47%): 16 ganglia in the lunate bone (55%), 5 in the capitate bone, 7 in the scaphoid and 1 in the trapezoid. Mean size of the intraosseous ganglia was 3 mm (range, 2 to 5 mm). This high prevalence of intraosseous ganglia in association with soft tissue ganglia has to our knowledge never been reported previously. A common aetiology for these two types of ganglion cysts may explain this high association rate.

Bone Cysts↗
PubMed2005

Percutaneous osteosynthesis versus cast immobilisation for the treatment of minimally and non-displaced scaphoid fractures. Functional outcomes after a follow-up of at least 12 month.

The authors compare the functional outcome of 26 patients successfully treated by percutaneous osteosynthesis and 24 patients successfully treated by a short-arm thumb cast for the acute scaphoid fracture after a follow-up of at least 12 months. The patients treated by percutaneous osteosynthesis showed a significantly better range of wrist motion at the time of re-examination. Differences in persistent complaints and in grip strength compared to the uninjured wrist between both groups were statistically insignificant yet slightly in favour of the surgically treated patients. The higher suitability of percutaneous osteosynthesis is further supported by the significantly lower failure rate compared to conservative treatment. Based on these results, percutaneous osteosynthesis seemed to be the more favourable method of treatment of minimally and non-displaced scaphoid fractures than conservative treatment.

Adolescent↗
PubMed2000

Adverse tissue reactions to bioabsorbable fixation devices.

Among 2528 patients operated on using pins, rods, bolts, and screws made of polyglycolic acid or polylactic acid, 108 (4.3%) were affected by a clinically significant local inflammatory, sterile tissue reaction. The three most common indications for the use of these fixation devices were a displaced malleolar fracture, a chevron osteotomy for hallux valgus, and a displaced fracture of the radial head. In 107 patients, the reaction was elicited by a polyglycolic acid implant, and in one patient by a polylactic acid implant. The incidences were 5.3% (107 of 2037) and 0.2% (one of 491), respectively. The adverse tissue responses to polyglycolic acid were seen 11 weeks after the operation, on average, whereas the reaction to polylactic acid occurred 4.3 years after fixation of an ankle fracture. The mild reactions consisted of a painful erythematous papule of a few weeks' duration. Those of medium severity had a sinus that discharged remnants of the implant for up to 6 months. In the patients affected by severe reactions, extensive osteolytic lesions developed at the implant tracks. The histopathologic picture was that of a nonspecific foreign body reaction. In four patients with vigorous reactions, an arthrodesis of the wrist or ankle later was necessary because of severe osteoarthritis. Several markers of increased risk of the occurrence of a foreign body reaction were found. These included a poorly vascularized bone section such as scaphoid, use of a quinone dye as an additive in the polymer, and an implant geometry with large surface area (screw versus pin or rod). For polyglycolic acid implants, the risk of an adverse tissue response in a given clinical situation can be estimated from the findings of this study. For slow degrading polymers like polylactic acid, however, the ultimate biocompatibility still is unsettled, and additional clinical research with long followup is required.

Absorbable Implants↗
PubMed2005

Case report: False negative 16 detector multislice CT for scaphoid fracture.

We discuss a case of a 19-year-old man with scaphoid trauma. We describe the imaging findings on three sets of radiographs, bone scintigraphy, CT and MRI. CT failed to identify a scaphoid fracture, which was present on 6 week radiographs, MRI and scintigraphy. The case illustrates that despite multidetector technology, CT still relies upon cortical and or trabecular displacement to demonstrate fractures.

Adult↗
PubMed1986

[Aplasia of the thenar eminence: a partial and distal form of radial ray dysplasia. 6 cases].

Six cases of thenar muscle aplasia are reported. Aplasia of the abductor pollicis brevis and opponens pollicis muscles was noted in all cases. The flexor pollicis brevis muscle was inconstantly involved and the abductor pollicis muscle was normal. The aplasia was unilateral in five cases and bilateral in one. Bone dysplasia of the scaphoid, first metacarpal and thumb was associated with muscle aplasia. Arterial dysplasia was also observed in four cases. In all cases electrophysiological examination showed that the thenar branch of the median nerve was not involved. Electromyography showed no sign of denervation of the thenar muscles. Motor and sensory conduction velocities of the hand nerves were normal. Thenar aplasia is considered a partial and distal form of the radial ray defect caused by a focal embryonic necrosis before the differentiation stage.

Abnormalities, Multiple↗
PubMed1989

Acute scaphoid fracture with scapholunate gap.

Disruptive forces from wrist trauma are thought to fracture bone or disrupt ligaments. Two cases are presented to demonstrate the simultaneous occurrence of acute scaphoid fracture and scapholunate gap. Recommended treatment in acute cases is open reduction and internal fixation of the fracture and open stabilization of the scaphoid. In chronic cases, we recommend open reduction and internal fixation with bone graft to the scaphoid nonunion combined with fusion of the scaphoid-trapezium-trapezoid joint.

Adolescent↗
PubMed1988

Management of greater arc carpal fractures.

Greater arc injuries are fracture dislocations that involve the perilunar carpal bones. The commonest of these injuries is the dorsal transscaphoid perilunate fracture dislocation. The recommended treatment for acute injuries is open reduction and Kirschner wire fixation of the scaphoid fracture through a dorsal midline approach. Stability to the midcarpal joint is thus provided and no further pins are needed. Established scaphoid nonunions are treated by bone grafting and Herbert screw fixation through a volar approach. Scaphocapitate fracture syndrome is treated by open reduction and pin fixation of the displaced capitate fragment through the dorsal approach. If the scaphoid is displaced it is also openly reduced and pinned.

Carpal Bones↗
PubMed2005

[Partial midcarpal arthrodesis with excision of the scaphoid for the treatment of advanced carpal collapse].

OBJECTIVE: To eliminate painful arthrosis between the radius and scaphoid and between the lunate and capitate. Stabilization of the carpus with preservation of useful range of motion between the radius and the lunate. INDICATIONS: Painful arthrosis of radioscaphoid joint due to an old lesion of the scapholunate ligament or a long-standing scaphoid pseudarthrosis with loss of carpal height (advanced carpal collapse, stage II) and eventual additional midcarpal arthrosis (stage III). CONTRAINDICATIONS: More complex Damage of carpal ligaments. Arthrosis of radiolunate joint. Ulnar displacement of the lunate. Rheumatoid arthritis. Calcium pyrophosphate deposition disease (relative). SURGICAL TECHNIQUE: Dorsal approach. Excision of scaphoid. Removal of articular cartilage between capitate and lunate and between hamate and triquetrum. Repositioning of capitate in relation to the lunate. Osteosynthesis with several Kirschner wires. POSTOPERATIVE MANAGEMENT: Immobilization in a plaster cast for 8 weeks; then, early removal of the wires. RESULTS: From 1993 to 2001, 64 partial midcarpal arthrodeses with excision of the scaphoid were performed in 62 patients. 26 of the patients operated up to 1999 were followed up for 27 months and evaluated with the Cooney Score and the DASH Score. The Cooney Score significantly improved, from 46 points preoperatively to 76 points postoperatively. Postoperative DASH Score was 22. Postoperative range of motion, 64 degrees extension/flexion, had hardly changed compared with the preoperative value. Strength increased from 24 to 34 kg on average. Out of the 55 patients available for follow-up (29 interviewed by telephone) 35 were completely satisfied, 13 satisfied with reservations, and seven dissatisfied. 24 patients had no activity-related pain. Different degrees of activity related pain were reported by 28 patients, and pain during minor activities or at rest was reported by three patients.

Arthralgia↗
PubMed2001

Intercarpal fusion for the treatment of scaphoid nonunion.

Salvage of the ununited scaphoid may not always be feasible or advisable, hence the availability of a number of alternative techniques which prioritize restoration of pain relief and range of motion. The role of intercarpal fusion reflects the importance of midcarpal stabilization when the scaphoid is resected. While scaphocapitate and scaphocapitolunate fusions have been described, these techniques provide less pain relief than midcarpal fusion with scaphoid excision, and are associated with an increased risk of radioscaphoid arthritis. In this article, the author will address the rationale for, technique of, and outcome after midcarpal arthrodesis and scaphoid excision.

Arthritis↗
PubMed2002

Surgical treatment of nonunion and avascular necrosis of the proximal part of the scaphoid in adolescents.

BACKGROUND: The purpose of this retrospective study was to examine the clinical and radiographic results of treatment of proximal scaphoid nonunion and avascular necrosis with vascularized bone graft from the distal part of the radius in adolescent patients. METHODS: Between 1993 and 1996, three adolescents with a proximal scaphoid nonunion and avascular necrosis underwent vascularized bone-grafting and internal fixation. The mean age at the time of the fracture was 14.8 years (14.4, 14.6, and 15.3 years), and the mean time interval between the fracture and the surgery was 19.3 months (six, seventeen, and thirty-five months). We retrospectively reviewed all available clinical and radiographic data from the time of fracture to the time of the last follow-up. All patients were examined clinically and radiographically at the time of the review, at a mean of 5.5 years (five, five, and 6.5 years) after surgery. RESULTS: All fractures healed at a mean of 3.4 months (2.75, 3.0, and 4.5 months) postoperatively. Final follow-up radiographs showed union and revascularization of the proximal part of the scaphoid with no evidence of degeneration of the radiocarpal joint. None of the patients had limiting pain or scapholunate instability demonstrated on physical or radiographic examination. Dorsiflexion and radial deviation of the affected wrist were decreased by a mean of 22 degrees (10 degrees, 22 degrees, and 35 degrees ) and 15 degrees (5 degrees, 20 degrees, and 20 degrees ), respectively, compared with those of the normal wrist. CONCLUSION: Grafting with vascularized radial bone is an effective treatment, leading to union and good function, for nonunion and avascular necrosis of the proximal part of the scaphoid in adolescents.

Adolescent↗
PubMed2004

Gadolinium enhanced MR assessment of proximal fragment vascularity in nonunions after scaphoid fracture: does it predict the outcome of reconstructive surgery?

This study investigated whether the outcome of bone graft and internal fixation surgery for nonunion of scaphoid fractures could be predicted by gadolinium-enhanced MR assessments of proximal fragment vascularity. Sixteen established scaphoid fracture nonunions underwent gadolinium-enhanced MR scanning before surgical treatment with bone grafting and internal fixation. No relationship was found between MR enhancement and the outcome of surgery. Union was achieved in eight of the 12 nonunions with more than 50% enhancement, and three of the four with less than 50% enhancement, of the proximal pole. Furthermore, union was achieved in both of the nonunions which had less than 25% enhancement of the proximal pole. We conclude that enhanced MR assessments of the vascularity of the proximal fragment of a scaphoid fracture nonunion do not accurately predict the outcome of reconstructive surgery.

Adult↗
PubMed1981

[Posterior dislocation of the scaphoid: report of one case (author's transl)].

The authors have observed one case of dislocation of the scaphoid posterior to the radius. There had been a complex trauma of the wrist with disruption of the palmar and dorsal ligaments, the capitate bone being interposed between the scaphoid and the lunate. A good result was obtained by a closed reduction with fixation by two pins through the scaphoid, lunate and capitate.

Adult↗
PubMed1991

A personal technique for treatment of scaphoid non-union.

We describe a personal technique for the treatment of scaphoid non-union, consisting of styloidectomy of the radius associated with axial perforation of the scaphoid, emptying of the bone, filling it again by cancellous bone taken from the styloid and securing it with a peg obtained from the cortex of the same styloid. 52 patients out of 77 operated on with this technique were reviewed. Results are shown and seem to be better than those found in literature.

Adolescent↗
PubMedDate not supplied

[Hemimelica epiphysialis dysplasia (author's transl)].

Hemimelica Epiphysialis Dysplasia is a rare osteochondrodystrophy producing cartilaginous epiphysial hypertrophy with hemimelic topography involving preferentialy the lower limb. Lesions are generally medialy situated (medial condyle of the femur, medial malleolus talus, tarsal scaphoid and first metatarsal bone). 8 cases of patients are discussed with a follow up of 4 years. The evolution is to a massive ossification of the hypertrophic cartilaginous areas. The issue is a fast arthrosic degeneration of the involved joints (mainly the ankle, more rarely the knee). The surgical procedures are often unsuccessful.

Adolescent↗
PubMed1992

[Long-term spontaneous course of carpal instability].

The authors report on the natural history of 26 cases of carpal instabilities observed over a period of 25 to 74 months. Apart from the subjective criterion pain, the parameters range of motion and grip strength have been documented in the course of their development. In addition, radiographic findings have been evaluated. We confirm that carpal instabilities can lead to degenerative arthrosis. The expectation that there would be a progressive deviation from the norm of the angles between radius, scaphoid, lunate, and capitate bones measured in lateral radiographs did not prove to be true.

Adult↗
PubMed2005

A three-dimensional finite element model of the radiocarpal joint: distal radius fracture step-off and stress transfer.

Displaced intra-articular distal radius fractures are difficult to treat, with numerous associated complications. The potential onset of post-traumatic osteoarthritis (OA) is a major concern. The relationship between malreduced intra-articular fracture of the distal radius and subsequent early onset of radiocarpal OA is clinically important, yet poorly understood. To better understand this presumed mechanical relationship, detailed information regarding joint loading, kinematics and associated stress distributions must be obtained. Toward this end, a three-dimensional finite element (3D FE) contact model of the radiocarpal joint has been developed, including the radius, lunate, scaphoid, articulations between these bones and selected soft tissues near the joint. FE model geometry was derived from cryomicrotome sections of a cadaver wrist. Radiocarpal contact stress distributions in the intact and simulated malreduced fracture conditions, previously collected using a cadaveric intra-articular fracture model, are used to establish validity of the computational model. Finally, a section of the distal radius constituting the entire lunate fossa was displaced 1,2 and 3 mm to represent a depressed lunate die-punch fracture.

Cartilage, Articular↗
PubMedDate not supplied

[Hemimelic epiphyseal dysplasia. Apropos of a case].

Dysplasia epiphysealis hemimelica (tarsomegaly, Trevor's disease) is a rare osteochondrodystrophy producing cartilaginous epiphysial hypertrophy of hemimelic type involving mainly the lower limb. Lesions are generally medialy located (medial condyle of the femur, medial malleolus, talus, tarsal scaphoid and first metatarsal bone) and clinical signs are not specific; therefore radiological diagnosis is very important. The disease gives rise to a massive ossification of the hypertrophic cartilaginous areas and fast degenerative changes (arthrosis) of the involved joints. Surgery is often unsuccessful.

Child, Preschool↗