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At least 163 records · Page 9Linked to original sources
PubMed2003

Functional outcome following extensor synovectomy and excision of the distal ulna in patients with rheumatoid arthritis.

We prospectively measured hand and wrist function in rheumatoid patients undergoing excision of the distal ulna. Range of motion, visual analogue pain scores and grip strength were measured in 22 wrists, and the Jebsen hand function test was administered to seven patients, preoperatively and at 3 and 12 months. At 1 year there were improvements in forearm pronation (P=0.04), supination (P=0.03) and wrist extension (P=0.02), but a reduction in flexion (P=0.009). Active radial deviation was reduced and ulnar deviation increased. There was a significant improvement in grip strength (P=0.05) and reduction in wrist pain (P=<0.0001). At 1 year the Jebsen hand function test showed improvements in simulated feeding, stacking checkers, and lifting large empty cans. Excision of the distal ulna in rheumatoid patients results in an improvement in some aspects of hand function.

Adult↗
PubMed1998

Avulsion fracture at the fovea of the ulna. A report of two cases.

We report two cases of avulsion fractures at the fovea of the ulna. This injury is caused by a strong distraction force which avulses the insertion of the triangular ligament at the fovea of the ulna. This injury can be classed as an injury to the triangular fibrocartilage complex.

Adult↗
PubMed1998

Attritional rupture of flexor tendons by the head of the ulna associated with a chronic longitudinal radioulnar dissociation.

A 62-year-old woman sustained multiple attritional ruptures of the flexor tendons at the wrist caused by displacement of the head of the ulna. She had had injuries of the wrist and elbow when she was young, which were thought to have caused chronic longitudinal radioulnar dissociation with palmar dislocation of the head of the ulna. Attrition of the flexor tendons by the dislocated ulnar head during pronation and supination was the major mechanism for the ruptures in this case. She was successfully treated with tendon transfer and resection of the ulnar head.

Chronic Disease↗
PubMed1976

The pronator quadratus in motions and in stabilization of the radius and ulna at the distal radioulnar joint.

Based upon the findings of dissections of 15 forearms and clinical observations in patients with disturbed architecture of the distal radioulnar joint, the pronator quadratus was found to be composed of two heads. A superficial head originated from the ulna and passed transversely to its insertion into the radius. It averaged 5.1 cm. in length, 4.5 cm. in width, 0.2 cm. in thickness, with a cross-sectional area of 0.95 cm.2 and a contractile volume of 2.6 cm.3. The deep head ran obliquely from a more proximal origin on the ulna to a distal insertion on the radius, with an average length of 4.0 cm., average width of 3.2 cm., and a thickness of 0.4 cm. Its average cross-sectional area was 1.64 cm.2 and its contractile volume 2.5 cm.3. A group of fibers occasionally was noted deep to both heads, running at right angles to them and paralleling the direction of the fibers of the interosseous membrane. The superficial head initiates pronation while the deep head coapts the joint surfaces and stabilizes the joint.

Adult↗
PubMed1986

Resection of the distal ulna with and without implant arthroplasty in rheumatoid arthritis.

Eighteen patients who had rheumatoid wrist surgery with resection of the distal ulna, with or without implant arthroplasty, were reviewed at an average follow-up of 32 months. Subjective and objective clinical findings did not confirm any advantage to the routine use of implant arthroplasty of the distal ulna. Moreover, a bone resorptive process, which was identified in all implant cases, may cause clinical symptoms and prosthetic instability and may warrant reoperation. The histologic findings supported a granulomatous reaction to a foreign body as a cause of the resorptive process. Histologic examination showed a synovial type of membrane and the feasibility was raised of an enzymatic cause.

Adult↗
PubMed1987

Ulna-minus variance and Kienböck's disease.

A 29-year-old woman meat wrapper with long-standing bilateral carpal tunnel syndrome had an incidental finding of severe unilateral ulna-minus variance caused by a childhood injury. Despite the strenuousness of the patient's occupation and the severity of the abnormality, there was no clinical or radiologic evidence of lunatomalacia (kienböck's disease) on the affected side, indicating that there is not necessarily a direct causal relationship between ulna-minus variance and lunatomalacia.

Adult↗
PubMed1997

Ulna-shortening osteotomy after failed arthroscopic debridement of the triangular fibrocartilage complex.

Over a 4-year period, 160 wrist arthroscopies were performed at 1 institution. Ninety-seven patients had central or nondetached ulnar peripheral tears of the triangular fibrocartilage complex (TFCC). All these patients underwent debridement with an arthroscopic shaver. Thirteen of the 97 had persistent pain in the TFCC region for more than 3 months after surgery. At an average of 8 months after failed arthroscopic debridement of the TFCC, all 13 patients underwent a 2-mm-long ulna-shortening osteotomy with fixation by a 3.5-mm 6-hole dynamic compression plate. At follow-up examination (an average of 2.3 years later), 12 of the 13 had complete relief of pain at the ulnar side of the wrist. One patient continued to complain of pain with moderate to heavy activity use of her hand. Four of the 13 had postoperative complications: 1 had traumatic pull-out of the screws requiring reinsertion and distal radius bone graft, 1 had nonunion at 4 months after surgery that required iliac crest bone graft, and 2 had pain necessitation hardware removal. All 4 of these patients had no further problems at final follow-up evaluation. There was no statistically significant difference between the arthroscopic debridement alone cohort and the arthroscopy/ulna-shortening subgroup relative to ulnar variance or incidence of associated lunotriquetral ligament tears. On the basis of these findings the authors recommend a 2-mm-long ulna-shortening osteotomy for patients whose previous arthroscopic debridement for central or nondetached peripheral TFCC was unsuccessful in eliminating ulnar-sided wrist pain.

Adult↗
PubMed1988

[The Ilizarov method for lengthening and correction of the ulna in radial club hand].

The revolutionary method of treatment of fractures and their complications according to Ilizarov' can also be applied in congenital deformities. Ilizarov uses "compactotomy" and distraction of 1 mm a day, in order to cause a "driving osteogenesis" and the stimulus to regenerate the bone and soft tissues near it and connected to it. In this way it is possible to obtain progressive lengthening of a limb or bone fragment. Bone stumps are fixed with crossed Kirschner wires, and such as we can obtain at the same time a lengthening of nerves, vessels, tendons, muscles; and that, in one of his patients, Ilizarov succeeded in reaching an elongation until 25 cm! Our patient is a 12 years old boy, affected by bilateral radial club hand, congenital heart and kidney diseases. After both wrist centralization requiring soft tissues release, we established that the right forearm showed persistent shortening and radial bowing of the ulna. So we used the Ilizarov's method, mending both deformities and reaching an elongation of the ulna of 7.5 cm. A remarkable both functional an aesthetic improvement of the forearm has been also obtain without any loss of function of soft tissues, such as trophic troubles, functional loss of vessels, nerves, tendons, muscles and skin.

Bone Lengthening↗
PubMed2002

[Stability of the forearm after resection of the distal ulna and proximal radius in rheumatoid arthritis: report of 11 cases].

Combined resection of radial head and distal ulna could jeopardize the stability and kinematics of the forearm bones. The goals of this retrospective study was to investigate these data after resection of distal ulna and proximal radius in rheumatoid arthritis. Between 1990 and 1998, eleven patients had these bone resections combined with implantation of elbow prostheses (eight Kudo and three GSB III). Wrist surgery consisted in five wrist arthrodeses combined with Darrach procedure, four Sauvé-Kapandji procedures and two isolated Darrach procedures. Mean age at surgery was 58 years and the average follow-up was 40 months. We assessed at follow-up: 1) wrist and elbow pain according to Gschwend; 2) stability of the forearm bones (cubitus valgus angle, impingement of the proximal radial stump with humerus, giving away accident of the ulnar distal stump); 3) wrist and elbow mobility. At follow-up six patients had no pain at the elbow and five had slight occasional pain. At the wrist, five patients had no pain and six slight occasional pain. Elbow motion was increased (from mean 83 degrees [50 degrees-100 degrees] to mean 110 degrees [85 degrees-135 degrees]) excepted in supination which slightly decreased (from mean 3 degrees [40 degrees-90 degrees] to mean 75 degrees [85 degrees-90 degrees]). Mean wrist mobility was impaired because of the five combined radiocarpal arthrodeses. If these five wrist arthrodeses were excluded, the mean ranges of motion were: 10 degrees in flexion, 16 degrees in extension, 2 degrees in radial deviation, 14 degrees in ulnar deviation. At follow-up, no patient had giving away accident of the ulnar distal stump nor impingement between radial stump and humerus in full flexion. Average cubitus valgus was 10 degrees. This study pointed out the predominant effect of the interosseous membrane in stability of the forearm bones.

Adult↗
PubMed2005

Surgical treatment of open diaphyseal fractures of both the radius and ulna.

BACKGROUND: This study was designed to determine the effects of surgical treatment of acute, open and displaced diaphyseal fractures of both the radius and ulna by early debridement, reduction and internal fixation with a dynamic compression plate (DCP). METHODS: From 1991 to 2003, data from 25 patients with acute, open and displaced diaphyseal fractures of both the radius and ulna were collected and evaluated retrospectively. Twenty-four patients were managed with early surgical debridement, open reduction and internal fixation with a DCP, and 1 fracture was reduced and fixed 3 days after the initial injury. The mean follow-up period was 74.7 months (standard deviation [SD], 38.6 months; range, 16-150 months). All patients had complete functional and radiographic assessments. RESULTS: Twenty-four patients (96%) achieved normal union in a mean of 20.2 weeks (SD, 3.8 weeks; range, 12-24 weeks). One patient with an open type I fracture had nonunion. Functional outcomes showed that 15 patients had excellent results, 8 had satisfactory results, 1 had an unsatisfactory result, and there was 1 failure. There was 1 delayed superficial wound infection. CONCLUSION: Early meticulous debridement, good open reduction and internal fixation with a small DCP proved very effective in the management of type I and II open fractures of both the radial and ulnar diaphyses.

Adult↗
PubMed2002

An analysis of the constraint properties of the distal radioulnar ligament attachments to the ulna.

Nine cadaver upper extremities were tested to evaluate the constraint properties of the dorsal and palmar radioulnar ligaments at their foveal and styloid attachments to the ulna. The specimens were tested by anterior and posterior displacement of the radius relative to the ulna with the forearm in pronation, supination, and neutral rotation. There were no statistically significant differences in the relative percent of constraint contribution of the styloid and foveal ligament insertions. In neutral forearm rotation total displacement after sectioning both ligament insertions tended to be larger in palmar than in dorsal displacement. A similar trend was observed with 60 degrees forearm supination. In the pronated position, however, the trend was reversed with larger total displacement in dorsal displacement.

Aged↗
PubMed2000

Distal radioulnar joint incongruity after shortening of the ulna.

Coronal sections of the distal radioulnar joint (DRUJ) were studied in 13 preserved cadaveric wrists specimens before and after 2 mm of shortening of the ulna. The DRUJs were subclassified on the basis of the DRUJ angle and depth of the sigmoid notch. The changes in extent and location of area of contact and radioulnar separation were noted. Although reduction in area of contact occurred in every specimen and DRUJ type, the maximum radioulnar separation and reduction in area of contact occurred in the DRUJ type IB and IIB. This could be a possible factor producing point loading and subsequent occurrence of DRUJ remodelling in the long-term after shortening of the ulna.

Aged↗
PubMedDate not supplied

[Femur-fibula-ulna (FFU) complex in the 33rd week of gestation: ultrasonography, radiology, pathology and differential diagnosis. Case report].

We present a case of a 27 year old I. gravida, I. para. Despite of regular ultrasonographic examination the diagnosis of skeletal malformation at the fetus was not before 33. weeks of gestation. It was the rare type of a bothside femur-fibula-ulna (FFU) complex. The FFU-complex is a no lethal malformation with typical unilateral combination from defects of femur and fibula, with contralateral defect of ulna. Dependent to involvement of malformated limbs the FFU-complex is classifiable in four groups. Only in 10 % all limbs are affected. Our case (type IV) showed a peromelia of both upper limbs with stumps of humeri, bothside aplasia of fibula and missing from 4. and 5. toes. There fetus were without nonlimb congenital abnormalities. The etiology of FFU-complex is unknown, the occurrence sporadic. There are never found genetic abnormalities. Familial recurrence is not described. There is no maternal or paternal age effect on FFU-complex. The differential diagnosis must include malformations with reduction anomalies of extremities, like thalidomide syndrome, splenogonadal fusion with limb malformations, Roberts syndrome, oroacral complex or acheiropodia. Mark off are amniotic band too.

Abnormalities, Multiple↗
PubMedDate not supplied

[Wrist joint deformities caused by multiple cartilaginous exostoses of the distal ulna].

On the basis of follow-up examinations it was found that exostoses at the distal ulna often result in shortening of the ulna and curvation of the radius. The resulting deformation of the wrist joint is particularly common in girls with exostoses which are over 7 mm wide and affect the ulnar epiphyseal cartilage. Particularly in the period of growth before puberty the progress of the deformation is considerable. Thus, female patients of group 3 in particular have to be examined carefully; in many cases surgery is necessary, in order to prevent further deformation and possibly even destruction of the radio-ulnar joint.

Adolescent↗