Journal of Wrist Surgery最新文献

{"title":"Ulnar Buttress Arthroplasty without Ulnar Stump Stabilization for Giant Cell Tumor of Distal Ulna.","authors":"Love Kapoor, Venkatesan S Kumar, Mohammed T Ansari, Shah A Khan","doi":"10.1055/s-0043-1768925","DOIUrl":"10.1055/s-0043-1768925","url":null,"abstract":"<p><p><b>Purpose</b>  Reconstruction and stabilization of ulnar stump after distal ulna tumor resection is still a matter of debate. We present the outcomes of ulnar buttress arthroplasty without stabilization of the ulna stump in giant cell tumor of bone (GCTB) of the distal ulna. <b>Methods</b>  Evaluation of functional outcome was performed using Musculoskeletal Tumor Society 93 (MSTS93) score, Modified Mayo Wrist score (MMWS), and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. We also assessed the hand grip strength, range of motion at the wrist, and ulnar carpal translation. <b>Results</b>  The study included 8 patients with Campanacci grade 3 GCTB of the distal ulna with a mean follow-up of 35.5 ± 9.1 months. The mean resection length was 7.7 ± 1.3 cm. The mean hand grip strength on the operated side was noted to be 90 ± 0.04% of the contralateral side. Mean MSTS93 score was 27.9 ± 1.25, mean MMWS was 86.9 ± 4.58%, and the mean DASH score was 4.9 ± 1.67, depicting a good to excellent functional outcome with low degree of disability. No radiocarpal instability, ulnar carpal translation, prominence, or instability of the proximal ulnar stump was noted in any patient. <b>Conclusion</b>  Reconstruction of the distal radioulnar joint using iliac crest bone graft for ulnar buttress without stabilization of the ulnar stump after resection of the distal ulna is an effective reconstruction option with good functional outcome and preservation of good hand grip strength. <b>Level of Evidence</b>  Level IV, Therapeutic study.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"1 1","pages":"215-221"},"PeriodicalIF":0.7,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41620655","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":"Arthroscopic Examination of the Triangular Fibrocartilage Complex in Galeazzi Injuries: Revisiting a Complex Injury","authors":"M. M. Choudhury, Sandip Singh Saggi, Sze-Ryn Chung, Robert T. J. Yap, D. Chia, Jackson K. H. Jiang, Andrew Yuan Hui Chin","doi":"10.1055/s-0043-1776002","DOIUrl":"https://doi.org/10.1055/s-0043-1776002","url":null,"abstract":"Abstract Galeazzi fracture-dislocations result from severe trauma and can lead to loss of function of the wrist and forearm if not treated appropriately. To avoid such disasters, meticulous surgical management of the injury is necessary. The current literature talks about symptomatic distal radioulnar joint injuries in Galeazzi fracture-dislocations and the various approaches to managing instability. However, unfortunately, there is a dearth of data on the true incidence of injury to the triangular fibrocartilage in the backdrop of the severity of the mechanism of Galeazzi fractures and the damage it may cause as direct inspection of the triangular fibrocartilage complex is not done routinely as a part of management of such cases. We conducted a retrospective review of six consecutive patients with Galeazzi fracture-dislocations. Wrist arthroscopy was performed in these cases, which revealed complex tears of the triangular fibrocartilage complex involving large segments of the ligament and always involving the dorsal periphery. All tears followed the same pattern of disruption of the attachments of two sides of the triangular fibrocartilage complex. We believe our findings will pave the path to further prospective studies in understanding the degree of damage in the triangular fibrocartilage in such devastating injuries and the need for meticulous arthroscopic repair.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"67 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139370755","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":"Ulnar Impaction Syndrome and TFCC Injury: Their Relationship and Management","authors":"Jin-Hyung Im, Jin-Woo Lee, Joo-Yup Lee","doi":"10.1055/s-0043-1776759","DOIUrl":"https://doi.org/10.1055/s-0043-1776759","url":null,"abstract":"Abstract Ulnar-sided wrist pain can be caused by a number of problems, including ulnar impaction syndrome (UIS) and triangular fibrocartilage complex (TFCC) injury. Multiple studies have described the diagnostic criteria for UIS and TFCC injuries, and excellent surgical outcomes have been reported for each condition. Few studies have examined the extent to which the two independent conditions cooccur, and little is known about their relationship. Based on theories in the literature and clinical experience, we propose the possibility of TFCC injury as the cause and result of UIS in this review.","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"31 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139370825","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":"Recurrence of Scaphoid Stress Fracture: A Case Report.","authors":"Nick A Johnson,&nbsp;Tom Kurien,&nbsp;Tracy C Horton","doi":"10.1055/s-0041-1740487","DOIUrl":"https://doi.org/10.1055/s-0041-1740487","url":null,"abstract":"<p><p><b>Background</b>  Scaphoid stress fractures are rare and typically present in young, elite male athletes. Due to the infrequency in which these injuries are encountered, the optimum management is not established. <b>Case Description</b>  We present the case of a 20-year-old male gymnast with bilateral stress fractures of the scaphoid waist. Following conservative treatment, clinical and radiological signs of union were seen bilaterally. Eight months after return to normal activities, a unilateral recurrence of the stress fracture occurred. This was successfully treated with internal fixation and bone grafting. <b>Literature Review</b>  Scaphoid stress fractures are most frequently seen in gymnasts but also occur in participants of other sports involving repetitive loading of an extended wrist. This action conveys force predominantly through the waist of the scaphoid. Most case studies have reported high union rates, whether treated operatively or conservatively, and the patients returned to high-level sport with no further problems. Stress fracture recurrence has been reported in other bones such as the metatarsal and tibia but never before in the scaphoid. Our case is unusual in that the patient suffered ongoing problems due to a recurrence of the scaphoid stress fracture after returning to normal activities. <b>Clinical Relevance</b>  Clinicians should be aware that scaphoid stress fracture recurrence can occur, counsel patients accordingly, and remain vigilant after apparent union. We would recommend early fixation to allow a quicker return to function and prevention of recurrence.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"12 3","pages":"265-268"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10202588/pdf/10-1055-s-0041-1740487.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888098","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":"Septic <i>Mycobacterium Avium Intracellulare</i> Extensor Tenosynovitis of the Wrist.","authors":"Daniel G McDermott,&nbsp;Samantha M Hill,&nbsp;Kapil Desai,&nbsp;Dana Jaggessarsingh,&nbsp;Mark A Vitale","doi":"10.1055/s-0042-1749446","DOIUrl":"https://doi.org/10.1055/s-0042-1749446","url":null,"abstract":"<p><p><i>Mycobacterium avium intracellulare</i> (MAI) infections of the hand, wrist, and upper extremity are rare, but potentially devastating atypical mycobacterial infections that can affect tendon, bone, and other soft tissues of the musculoskeletal system. We present an immunocompromised patient presenting with acute swelling and pain in the dorsum of the hand and wrist that underwent a wrist extensor tenosynovectomy with intraoperative cultures revealing infection with MAI. The patient developed severe progression of the infection with osteomyelitis of the distal forearm and carpal bones, multiple subsequent extensor tendon ruptures, and dorsal skin necrosis. The infection was eradicated with a combination of surgical treatment and antibiotic therapy. The case is discussed in context of the prior scant literature of infectious tenosynovitis of the hand, wrist, and upper extremity caused by MAI. This case report and literature review outline recommendations for diagnosis and effective treatment of MAI.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"12 3","pages":"273-279"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10202564/pdf/10-1055-s-0042-1749446.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9679406","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":"Distal Radioulnar Joint Locking with Bipolar Injury.","authors":"Takeru Ichikawa,&nbsp;Taku Suzuki,&nbsp;Hiroo Kimura,&nbsp;Noboru Matsumura,&nbsp;Takuji Iwamoto,&nbsp;Masaya Nakamura,&nbsp;Morio Matsumoto","doi":"10.1055/s-0041-1742202","DOIUrl":"https://doi.org/10.1055/s-0041-1742202","url":null,"abstract":"<p><p><b>Background</b>  Locking of the distal radioulnar joint (DRUJ) induces restriction of the active and passive motion of pronation or supination of the forearm. Diagnosis of DRUJ locking due to a triangular fibrocartilage complex (TFCC) tear is sometimes difficult. <b>Case Description</b>  A 15-year-old female suffered from restriction of forearm supination after cast immobilization for the treatment of an elbow injury. The active and passive range of motion (ROM) of supination was 30 degrees, while the active ROM of pronation was normal. Radiographs of the elbow showed a fracture of the medial epicondyle and a fracture around the radial head. Radiographs of the wrist showed a subluxation of the ulnar head. Accurate diagnosis of supination restriction was difficult before surgery, so an operation was performed for the diagnosis and treatment. DRUJ locking was reduced manually and arthroscopic findings showed central perforation of the TFCC. Forearm supination improved to 90 degrees postoperatively. <b>Literature Review</b>  DRUJ locking due to a TFCC injury is rare and this condition with bipolar injury has not been reported. <b>Clinical Relevance</b>  DRUJ locking due to an injured TFCC should be considered as one of the differential diagnoses of supination contracture.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"12 3","pages":"269-272"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10202576/pdf/10-1055-s-0041-1742202.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9510013","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":"Arthroscopic Capsular Shrinkage Is Safe and Effective in the Treatment of Midcarpal Instability in a Pediatric Population: A Single-Center Experience of 51 Cases.","authors":"Rupert M H Wharton,&nbsp;Tommy R Lindau,&nbsp;Kerstin Oestreich","doi":"10.1055/s-0042-1750871","DOIUrl":"https://doi.org/10.1055/s-0042-1750871","url":null,"abstract":"<p><p><b>Objective</b>  Treatment of palmar midcarpal instability (PMCI) remains controversial and children can develop PMCI from asymptomatic hypermobility. Recently, case series have been published regarding the use of arthroscopic thermal shrinkage of the capsule in adults. Reports of the use of the technique in children and adolescents are rare, and there are no published case series. <b>Methods</b>  In a tertiary hand center for children's hand and wrist conditions, 51 patients were treated with arthroscopy for PMCI between 2014 and 2021. Eighteen out of 51 patients carried additional diagnosis of juvenile idiopathic arthritis (JIA) or a congenital arthritis. Data were collected including range of movement, visual analog scale (VAS) at rest and with load, and grip strength. Data were used to determine the safety and efficacy of this treatment in pediatric and adolescent patients. <b>Results</b>  Mean follow-up was 11.9 months. The procedure was well tolerated and no complications were recorded. Range of movement was preserved postoperatively. In all groups VAS scores at rest and with load improved. Those who underwent arthroscopic capsular shrinkage (ACS) had significantly greater improvement in VAS with load, compared with those who underwent arthroscopic synovectomy alone ( <i>p</i>  = 0.04). Comparing those treated with underlying JIA versus those without, there was no difference in postoperative range of movement, but there was significantly greater improvement for the non-JIA group in terms of both VAS at rest ( <i>p</i>  = 0.02) and VAS with load ( <i>p</i>  = 0.02). Those with JIA and hypermobility stabilized postoperatively, and those with JIA with signs of early carpal collapse and no hypermobility achieved improved range of movement, in terms of flexion ( <i>p</i>  = 0.02), extension ( <i>p</i>  = 0.03), and radial deviation ( <i>p</i>  = 0.01). <b>Conclusion</b>  ACS is a well-tolerated, safe, and effective procedure for PMCI in children and adolescents. It improves pain and instability at rest and with load, and offers benefit over open synovectomy alone. This is the first case series describing the usefulness of the procedure in children and adolescents, and demonstrates effective use of the technique in experienced hands in a specialist center. <b>Level of Evidence</b>  This is a Level IV study.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"12 3","pages":"239-247"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10202579/pdf/10-1055-s-0042-1750871.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9705208","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":"The Current Role of Arthroscopy in Traumatic Wrist Injuries: An Expert Survey.","authors":"Philip N d'Ailly,&nbsp;Marjolein A M Mulders,&nbsp;J Henk Coert,&nbsp;Niels W L Schep","doi":"10.1055/s-0042-1750875","DOIUrl":"https://doi.org/10.1055/s-0042-1750875","url":null,"abstract":"<p><p><b>Background</b>  Wrist arthroscopy has become increasingly popular for diagnosing and treating traumatic wrist injuries. How wrist arthroscopy has influenced the daily practice of wrist surgeons remains unclear. The objective of this study was to evaluate the role of wrist arthroscopy for the diagnosis and treatment of traumatic wrist injuries among members of the International Wrist Arthroscopy Society (IWAS). <b>Methods</b>  An online survey was conducted among IWAS members between August and November 2021 with questions regarding the diagnostic and therapeutic importance of wrist arthroscopy. Questions focused on traumatic injuries of the triangular fibrocartilage complex (TFCC) and scapholunate ligament (SLL). Multiple-choice questions were presented in the form of a Likert scale. The primary outcome was respondent agreement, defined as 80% answering similarly. <b>Results</b>  The survey was completed by 211 respondents (39% response rate). The majority (81%) were certified or fellowship-trained wrist surgeons. Most respondents (74%) had performed over 100 wrist arthroscopies. Agreement was reached on 4 of the 22 questions. It was agreed that the outcomes of wrist arthroscopy strongly depend on surgeons' experience, that there is sufficient evidence for the diagnostic purposes of wrist arthroscopy, and that wrist arthroscopy is better than magnetic resonance imaging (MRI) for diagnosing TFCC and SLL injuries. No agreement was reached on the preferred treatment of any type of TFCC or SLL injury. <b>Conclusion</b>  There is agreement that wrist arthroscopy is superior to MRI for diagnosing traumatic TFCC and SLL injuries, yet experts remain divided on the optimal management. Guidelines need to be developed for the standardization of indications and procedures. <b>Level of Evidence</b>  This is a Level III study.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"12 3","pages":"192-198"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10202572/pdf/10-1055-s-0042-1750875.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9971523","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":"Three Column Fixation Through a Single Incision in Distal Radius Fractures.","authors":"Giannis Kotsalis,&nbsp;Georgios Kotsarinis,&nbsp;Maria Ladogianni,&nbsp;Emmanouil Fandridis","doi":"10.1055/s-0042-1749162","DOIUrl":"https://doi.org/10.1055/s-0042-1749162","url":null,"abstract":"<p><p><b>Purpose</b>  The purpose of this study was to evaluate the clinical and functional results of 67 patients with distal radius fracture (DRF), treated with a modified surgical technique that allows three-column fixation through the same palmar approach. <b>Patients and Methods</b>  Between 2014 and 2019, we treated 67 patients using a particular surgical technique. All patients suffered DRF, classified using the universal classification system. Two different intervals were developed palmary: the first ulnarly to the flexor carpi radialis tendon for direct visualization of the distal radius and the second one radially to the radial artery for direct visualization of the styloid process. An anatomic volar locking compression plate was applied to all patients. The radial styloid process was fixed and stabilized either with Kirschner-wires or an anatomic plate through the same incision. Functional results were evaluated based on the Disabilities of the Arm, Shoulder and Hand and Mayo wrist scores. Range of motion and grip strength of the injured wrist were statistically compared with the opposite side. <b>Results</b>  The mean follow-up was 47 months (13-84). All fractures were united, and all patients recovered to the preinjury level of activity. The mean flexion-extension range was 73.8° to 55.2° and the supination-pronation range 82.8° to 67°. No infection or nonunion occurred. No major complications were reported. <b>Conclusion</b>  Open reduction and internal fixation, under specific indications, is the best treatment option in DRF. The described technique provides excellent visualization to the distal radius surfaces and allows the internal fixation of the radial columns through the same skin incision. Therefore, it can constitute an efficient choice in the treatment armamentarium of DRF.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"12 3","pages":"232-238"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10202585/pdf/10-1055-s-0042-1749162.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9583833","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":"Reconstruction of the Distal Oblique Bundle for DRUJ Instability.","authors":"Niels O B Thomsen,&nbsp;Anders Björkman","doi":"10.1055/s-0041-1740488","DOIUrl":"https://doi.org/10.1055/s-0041-1740488","url":null,"abstract":"<p><p><b>Background</b>  Treatment algorithm for disruption of the triangular fibrocartilage complex (TFCC) from the ulnar fovea includes direct TFCC repair, tendon reconstruction of the radioulnar ligaments, or a salvage procedure in cases with painful distal radioulnar joint (DRUJ) degeneration. <b>Case Description</b>  We describe our surgical technique for reconstruction of the distal oblique bundle (DOB), to attain DRUJ stability in a young man, after failed attempts of direct TFCC reinsertion and radioulnar ligament reconstruction with the Adams procedure. <b>Literature Review</b>  Reconstruction of the central band of the interosseous membrane is well recognized for Essex-Lopresti injuries that demonstrate longitudinal forearm instability. The role for reconstruction/reinforcement of the DOB to restore DRUJ stability after TFCC injury has not gained the same recognition and needs further clarification. <b>Clinical Relevance</b>  DOB reconstruction technique described is extra-articular and technically straightforward. We believe that the procedure could be considered for patients with an irreparable TFCC injury as a part of the treatment algorithm for younger patients, who otherwise would face a more extensive salvage procedure.</p>","PeriodicalId":46757,"journal":{"name":"Journal of Wrist Surgery","volume":"12 3","pages":"261-264"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10202563/pdf/10-1055-s-0041-1740488.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9871501","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}