Journal of Wrist Surgery最新文献

{"title":"Classifications of Triangular Fibrocartilage Complex Lesions.","authors":"Toshiyasu Nakamura","doi":"10.1055/s-0043-1778082","DOIUrl":"10.1055/s-0043-1778082","url":null,"abstract":"","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"13 1","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10803149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Surgical Treatment of Vaughan-Jackson Syndrome.","authors":"Joshua L Mcintyre, Paul H C Stirling, Jane Mceachan","doi":"10.1055/s-0043-1775994","DOIUrl":"10.1055/s-0043-1775994","url":null,"abstract":"<p><p><b>Background</b>  Vaughan-Jackson syndrome (VJS) is the attritional rupture of the extensor tendons secondary to arthritis or inflammation affecting the distal radioulnar joint. The surgical outcomes following Darrach's procedure and tendon transfers are not well described. The primary aim of this study was to report patient-reported functional outcome measures after surgery for VJS. Secondary aims were to report health-related quality-of-life scores, patient satisfaction, and complications <b>Methods</b>  A single-center retrospective study was performed to identify patients who underwent surgical intervention for the management of VJS. Patient-reported outcomes were measured using the Patient-Rated Wrist and Hand Evaluation (PRWHE), Quick version of the Disability of the Arm, Shoulder, and Hand (QuickDASH), EuroQoL 5-dimensions 5-Likert (EQ-5D-5L), and calculation of the Net Promoter Score (NPS). <b>Results</b>  We report postoperative patient-reported functional outcome measures for 12 cases of VJS treated with distal ulna excision and extensor tendon transfer. The mean age was 69 years (range: 45-87 years; standard deviation [SD]: 14.1), and eight patients were females. Five patients had rheumatoid arthritis, and there was one case each of seronegative polyarthritis, ankylosing spondylitis, and CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia.) syndrome; the rest of the patients had osteoarthritis. At a mean of 53 months of follow-up, the mean PRWHE score was 34.5 (SD: 17.9), the mean QuickDASH score was 28.2 (SD: 18.6), and the mean EQ-5D-5L score was 0.71 (SD: 0.203). Ten patients were satisfied and the NPS was 42. Postoperatively eight patients had pain scores reported as none or mild, three as moderate, and one as severe. Two patients required further operations, both undergoing total wrist arthrodesis. <b>Conclusion</b>  Although a degree of functional deficit persists after Darrach's procedure and tendon transfer for treatment of VJS, there are also high levels of patient satisfaction, a good NPS, and a low rate of operative reintervention. <b>Level IV</b>  evidence.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"13 4","pages":"328-332"},"PeriodicalIF":0.7,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplifying the Decision-Making Process in the Treatment of Kienböck's Disease.","authors":"Richard Tee, Stephen Butler, Eugene T Ek, Stephen K Tham","doi":"10.1055/s-0043-1778064","DOIUrl":"10.1055/s-0043-1778064","url":null,"abstract":"<p><p><b>Background</b>  In recent years, the classification and treatment algorithm for adult Kienböck's disease (KD) has expanded. However, the priority of the investigations done in determining its management has not been discussed, as not every patient with KD requires magnetic resonance imaging (MRI) or wrist arthroscopy. <b>Materials and Methods</b>  We discuss the role of these investigations and emphasize the importance of computed tomography (CT) imaging in evaluating the cortical integrity of the lunate and its role in the decision-making process and management of KD. <b>Results</b>  We put forward an investigative algorithm that places into context the investigative roles of MRI, arthroscopy, and CT. <b>Conclusion</b>  KD is a rare condition, and there is a lack of comparative studies to help us choose the preferred treatment. The decision on the management options in adult KD may be made by determining the integrity of the lunate cortex and deciding whether the lunate is salvageable or not by CT scan. MRI may provide useful information on the vascular status if the lunate cortex is intact, and the lunate is salvageable. If the lunate is fragmented, it is not salvageable, and MRI does not provide useful information. Arthroscopy has a role in selective cases.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"13 4","pages":"294-301"},"PeriodicalIF":0.7,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in Patients with Bilateral Distal Radius Fractures.","authors":"Stephanie A Kwan, Richard McEntee, Samir Sodha, Moody Kwok, Pedro K Beredjiklian, Jacob E Tulipan","doi":"10.1055/s-0043-1777023","DOIUrl":"10.1055/s-0043-1777023","url":null,"abstract":"<p><p><b>Background</b>  Fractures of the distal radius that occur bilaterally are comparatively uncommon, with the incidence of these injuries and patient outcomes following different modes of treatment being unknown. <b>Purpose</b>  This article evaluates the demographics, management, and functional outcomes of patients that sustain bilateral distal radius fractures (DRFs). <b>Materials and Methods</b>  We retrospectively identified 85 patients that sustained bilateral DRF and were treated at a single institution from 2016 to 2019. Thirty-four patients were treated operatively, 41 patients were treated nonoperatively, and 10 patients were treated operatively in one extremity and nonoperatively in the other. Fractures were classified by a single fellowship-trained orthopaedic hand surgeon. Range of motion (ROM) data and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were collected. Differences between the three groups with regards to demographics, mechanism of injury (MOI), and complications were recorded. <b>Results</b>  The pediatric population had significantly higher energy MOIs compared to the adult population. There was no difference between the groups with regard to associated injuries or complications. The pediatric population had significantly more AO type A fractures compared to the adult population, which had a bimodal distribution of AO type A and C fractures. The pediatric population saw significantly more patients undergo nonoperative treatment. Both populations had a higher rate of operative intervention for bilateral DRF than noted in the literature for unilateral. In the adult population there were no significant differences in DASH scores between the operative and nonoperative groups. <b>Conclusion</b>  Bilateral DRFs appear to have a similar bimodal age distribution to unilateral DRF. Younger patients undergo nonoperative management more commonly than operative or mixed management. Postoperative ROM and complications appear to be equivalent across all three groups regardless of age. <b>Level of Evidence</b>  Level IV, Prognostic study.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"14 1","pages":"49-56"},"PeriodicalIF":0.7,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finite Element Modeling of the Human Wrist.","authors":"Toshiyasu Nakamura","doi":"10.1055/s-0043-1776327","DOIUrl":"10.1055/s-0043-1776327","url":null,"abstract":"","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"12 6","pages":"477"},"PeriodicalIF":0.7,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10781515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wrist Motion Assessment in Tennis Players using Three-Dimensional Motion Capture and Dynamic Electromyography.","authors":"Jacqueline S Israel, Stacy R Loushin, Sabine U Tetzloff, Todd Ellenbecker, Kenton R Kaufman, Sanjeev Kakar","doi":"10.1055/s-0043-1777024","DOIUrl":"10.1055/s-0043-1777024","url":null,"abstract":"<p><p><b>Background</b>  Tennis players often present with ulnar-sided wrist pain, which may reflect repetitive stress and/or faulty mechanics. There is a role for investigating the biomechanics of tennis strokes and how they may relate to wrist pathology. The purpose of this study was to investigate whether three-dimensional motion capture technology and dynamic electromyography (EMG), when used to study groundstrokes in elite junior tennis players, reveals patterns of upper extremity motion that may correlate with the development of clinically relevant pathology. <b>Case Description</b>  Three-dimensional kinematic and EMG data were collected from two United States Tennis Association-ranked adolescent tennis players during groundstrokes. There were several observed differences in the two players' degree and timing of pronation/supination, ulnar/radial deviation, and flexion/extension during their strokes. <b>Clinical Significance</b>  Advanced motion capture technology facilitates a nuanced understanding of complex movements involved in groundstroke production. This methodology may be useful for identifying athletes who are at risk for injury and guiding rehabilitation for players experiencing pain. <b>Level of Evidence</b>  IV.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"13 3","pages":"264-271"},"PeriodicalIF":0.7,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial Midcarpal Instability Treated with Radioscaphocapitate Ligament Recession: A Case Report.","authors":"Janice Chin-Yi Liao, David Meng Kiat Tan","doi":"10.1055/s-0043-1770079","DOIUrl":"10.1055/s-0043-1770079","url":null,"abstract":"<p><p><b>Background</b>  Midcarpal instability is an uncommon entity characterized by pain and clunking as the wrist moves from radial deviation to ulnar deviation. Management is primarily nonoperative. In patients with persistent symptoms, operative treatments are divided into soft tissue reconstruction and limited midcarpal arthrodesis. <b>Case Description</b>  We present a rare case of radial midcarpal instability associated with radioscaphocapitate (RSC) ligament injury. A 20-year-old man presented with radial-sided wrist pain and clunking with radial deviation after a fall. Wrist arthroscopy confirmed the pathology of an RSC ligament injury resulting in an extended posture of the scaphoid and a catch-up clunk from sudden flexion of the scaphoid in radial deviation. His RSC ligament was recessed and he had excellent outcome at 1 year follow-up. <b>Literature Review</b>  Midcarpal instability was reported by Lichtman et al as a painful wrist click in ulnar deviation and classified according to the direction of the subluxation. Radial midcarpal instability was later described by Caputo et al in patients with rotatory subluxation of the scaphoid. We present a previously unreported form of radial midcarpal instability as it does not quite fit into the type III midcarpal instability with ligament laxity of the scaphotrapeziotrapezoid joint and type IV with scapholunate ligament disruption. The painful wrist click occurs in radial deviation as the result of an RSC ligament injury. <b>Clinical Relevance</b>  We performed arthroscopic thermal capsulorrhaphy of the ulnar arcuate ligaments and dorsal capsule and an open proximal recession of the RSC ligament. The elimination of pain and clunking accompanied by the restoration of scaphoid flexion and return to load-bearing activities validates the pathology and suggests the potential of this soft tissue procedure in the treatment of radial midcarpal instability.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"13 1","pages":"80-85"},"PeriodicalIF":0.7,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10803155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reverse Wafer Procedure","authors":"Ismail Bulent Ozcelik, Ali Cavit, Aydin Yuceturk","doi":"10.1055/s-0043-1775819","DOIUrl":"https://doi.org/10.1055/s-0043-1775819","url":null,"abstract":"Abstract Purpose This study aimed to present the results of an alternative technique for treating ulnar impaction syndrome, the “reverse wafer procedure,” and assess the mid-term clinical outcomes of patients treated with this technique. Methods A retrospective evaluation was conducted on 14 patients who underwent the reverse wafer procedure for ulnar impaction syndrome between 2013 and 2020. The inclusion criteria for the study were persistent ulnar-sided wrist pain, even after a minimum of 3 months of nonoperative treatment, the presence of a chondral lesion on the lunate, and an intact triangular fibrocartilage complex (TFCC) based on arthroscopic evaluation. Postoperative clinical and subjective functional outcomes were assessed using measures such as wrist range of motion (ROM), grip strength, the Turkish version of the quick disabilities of the arm, shoulder, and hand questionnaire (Quick DASH), and pain levels measured on a visual analog scale (VAS) and were compared with preoperative values. Patient satisfaction was also evaluated postoperatively. Results The mean follow-up period was 42.2 months (range: 24–68 months). Postoperatively, none of the patients experienced any restriction in ROM. Grip measurements significantly increased after the surgery (p = 0.003). Preoperatively, the patients had a grip strength of 41.14 kg (range 28–48 kg), which improved to 44 kg (range 30–52 kg) postoperatively. Postoperative VAS values and QDASH scores significantly decreased compared with the preoperative values (p < 0.001, p = 0.001). The mean VAS score decreased from 6.1 (range 4–8) preoperatively to 0.9 (range 0–5) postoperatively. The mean Quick DASH score decreased from 49.44 (range 25–68.3) preoperatively to 10.13 (range 3.3–36) postoperatively. When asked about their satisfaction with the operation, 13 out of 14 patients reported being highly satisfied with the results. Conclusions The reverse wafer procedure presents an alternative treatment option for ulnar impaction syndrome in cases where the TFCC is intact. The mid-term results of this described technique are promising. However, further comparative studies with longer follow-ups are necessary to support these findings. Level of Evidence IV Therapeutic.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":" 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135290922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Arthroscopic Wafer Procedure and Triangular Fibrocartilage Complex Debridement versus Ulnar Shortening Diaphyseal Osteotomy in Management of Ulnar Impaction Syndrome: A Randomized Clinical Trial","authors":"Ahmed El-Tayar, Samir El-Ghandour, Adel Ghazal, Ibrahim Rakha, Asser Sallam","doi":"10.1055/s-0043-1776399","DOIUrl":"https://doi.org/10.1055/s-0043-1776399","url":null,"abstract":"Abstract Background The literature presents great challenge in comparing the arthroscopic wafer procedure (AWP) versus ulnar shortening osteotomy (USO) in the treatment of ulnar impaction syndrome (UIS). Purpose We aimed primarily to compare the clinical and functional outcomes of AWP with triangular fibrocartilage complex (TFCC) debridement versus USO in the management of UIS. Methods The study was conducted as a randomized clinical trial including 43 patients with UIS whose ulna variance was less than 4 mm. Patients were randomly allocated to either the AWP group (21 patients) who underwent AWP and TFCC debridement or the USO group (22 patients) who underwent diaphyseal USO. Patients were followed up for at least 12 months. The primary outcome measure was the Modified Mayo Wrist (MMW) score. The Disabilities of the Arm, Shoulder, and Hand (DASH) score, the mean operative time, postoperative complications, and patient satisfaction were our secondary outcomes. Results Radiological correction of variance was achieved in all patients. The mean operative time was significantly shorter in the AWP group. The postoperative MMW and DASH scores were better in the AWP group than in the USO group. Fewer complications occurred in the AWP group (1 of 21 patients) compared with the USO group (3 of 22 patients). Conclusions AWP with TFCC debridement is a reliable and safe method for the management of UIS with a positive variance of less than 4 mm with better clinical and functional results than diaphyseal USO. Type of study/level of evidence Therapeutic type II.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"19 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135539775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic-assisted Distal Radius Fracture Fixation for Dorsoulnar Corner Fragments Using a Locked, Hooked Kirschner-Wire Technique","authors":"Mark Ross, Matthew J. White, Nicholas Smith","doi":"10.1055/s-0043-1776115","DOIUrl":"https://doi.org/10.1055/s-0043-1776115","url":null,"abstract":"Abstract Background: Distal radius fractures with dorso-ulnar corner fragments (DUC) pose a surgical challenge due to limited visualization and the risk of hardware prominence. Traditional approaches often result in inadequate reduction and fixation, leading to suboptimal clinical outcomes. Description of Technique: In this study, we introduce an arthroscopic-assisted approach for the fixation of distal radius fractures with DUC fragments. The technique utilizes locked, hooked K-wires to provide a low-profile dorsal capturing mechanism. We outline the step-by-step procedure, which includes pre-operative planning, volar plate application, and arthroscopic reduction of DUC fragments. Patients and Methods: We applied this technique to a 60-year-old female patient with an unstable intra-articular distal radius fracture and a DUC fragment. Closed reduction was initially attempted, followed by arthroscopic-assisted reduction and internal fixation using the locked, hooked K-wire technique. Results: Our technique has demonstrated its ability to withstand early movement rehabilitation protocols without fixation loss, enabling early mobilization. A custom thermoplastic splint was worn for 6 weeks, with favorable supination/pronation and wrist flexion/extension outcomes at clinical review. Conclusions: Arthroscopic-assisted fixation with locked, hooked K-wires offers a reliable solution for accurately reducing challenging DUC fragments in distal radius fractures. This approach complements standard distal radius fixation systems, providing a low-profile dorsal capturing mechanism and addressing the issue of hardware prominence, ultimately improving clinical outcomes.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"18 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135539781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}