scholarly journals Bifocal osteosynthesis to treat radial shortening deformity with dislocation of the inferior radioulnar joint

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Junjie Guan ◽  
Hongjiang Ruan ◽  
Jimin Yin ◽  
Yimin Chai ◽  
Qinglin Kang
Keyword(s):  
Wound Care ◽  
Delayed Union ◽  
Ilizarov Method ◽  
Radioulnar Joint ◽  
Outcome Scores ◽  
Post Operation ◽  
And Function ◽  
Pin Track ◽  
Radiographic Data

Abstract Background Several methods have been reported to correct deformity and shortening of the distal radius. However, the results are not entirely satisfactory. The results of bifocal osteosynthesis were retrospectively analyzed in this study. Methods Eight patients treated with bifocal osteosynthesis were evaluated retrospectively. Pre-operative and post-operative clinical and radiographic examinations were performed. Subjective symptoms and objective joint function were assessed. Radiographic data of the extent of radial lengthening and distal radial articular angle were collected. Results The mean follow-up period was 46 months (37–68 months). Satisfactory wrist appearance and radial lengthening was achieved in all patients. All patients were satisfied with the wrist appearance and willing to undergo the same treatment again. The range of motion (ROM) of the forearm and wrist was significantly improved. Pin-track infections occurred in two patients, for which they received wound care and oral antibiotics. Complications such as fixation device failure, tendon rupture, fracture of regenerated bone or nerve impairment did not occur. The duration of lengthening depended on the shortening of the radius. Delayed union in the docking site was observed in two patients and union was achieved after bone grafting. Conclusions Bifocal osteosynthesis using the Ilizarov method provides a useful method for correction of radial shortening deformity with dislocation of the inferior radioulnar joint. Despite the fact that we did not validate pre-and post-operation functional outcome scores, all patients were satisfied with the wrist appearance and function.

Patient-reported outcomes after Silastic replacement of the trapezium for osteoarthritis

2011 ◽  
Vol 37 (3) ◽  
pp. 263-268 ◽  
Author(s):  
N. G. Burke ◽  
J. Walsh ◽  
C. J. Moran ◽  
G. Cousins ◽  
D. Molony ◽  
...  
Keyword(s):  
Rank Correlation ◽  
Dominant Hand ◽  
Work Related ◽  
Spearman’S Rank Correlation ◽  
Trapeziometacarpal Osteoarthritis ◽  
Patient Reported ◽  
Outcome Scores ◽  
And Function ◽  
Mean Time

This retrospective study evaluated 69 Swanson trapezium replacements performed between 1990 and 2009 for trapeziometacarpal osteoarthritis in 58 patients. Pain and function were assessed using the Michigan Hand Questionnaire and the Disability of the Arm, Shoulder and Hand questionnaire. Patients had a mean age of 62 years at the time of surgery, with a mean time of 7.7 years (range 9 months to 19 years) from surgery to follow-up interview. There was no association between outcome scores and the length of follow-up, suggesting that the results are maintained over time (Spearman’s rank correlation test < ±0.2). Scores for activities of daily living and work-related activities were higher when surgery was on the dominant hand ( p < 0.05). Silicone trapezium replacement remains a good option for patients with painful trapeziometacarpal osteoarthritis that has not responded to nonoperative management.

Midterm Functional Outcome of the Linked Semiconstrained Distal Radioulnar Joint Prosthesis

2021 ◽  
Author(s):  
Jaak Warlop ◽  
Maarten Van Nuffel ◽  
Luc De Smet ◽  
Ilse Degreef
Keyword(s):  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Visual Analog Scale Score ◽  
Distal Radioulnar Joint ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Therapeutic Study ◽  
And Function

Abstract Background A painful unstable distal radioulnar joint (DRUJ) can seriously compromise hand and wrist function. The semiconstrained prosthesis was developed to restore DRUJ function. To date, most outcome reports are coauthored by the designer. Questions Does independent reporting confirm the promising results of the semiconstrained DRUJ prosthesis? Are complication and failure rates acceptable? Patients and Methods We evaluated patients with the semiconstrained DRUJ implant and a minimum follow-up of 2 years. We monitored patient satisfaction and function with functionality questionnaires and measured wrist range of motion, grip, and key pinch strength. Statistical analysis was done using descriptive statistics, Pearson correlation coefficients, linear and logistic regression. Results We included 41 patients with 42 implants. Mean follow-up was 46 months (range: 24–102 months). Eighty percent of wrist had undergone previous surgery. We found a mean pronation of 83 degrees (0–90 degrees), supination of 70 degrees (0–90 degrees), flexion of 42 degrees (0–90 degrees), extension of 49 degrees (0–90 degrees), ulnar deviation of 24 degrees (0–60 degrees), and radial deviation of 14 degrees (0–40 degrees). Grip and key pinch strength were 20.1 (1–50 kg) and 6 kg (1–12 kg), respectively. Average patient-rated wrist and hand evaluation score was 42.7 (0–95), disabilities of the arm, shoulder and hand score was 38 (0–88), and visual analog scale score was 3.6 (0–8). We found a 43% complication rate (mostly minor: ulnar or radial tendinopathy, temporary hypoesthesia) with 24% reoperation and 92% prosthesis survival rate. Conclusion The linked semiconstrained DRUJ prosthesis has its value in the surgical treatment of DRUJ failure. Currently, most implants are used in secondary surgery and multioperated wrists. More research is required to assess the value of the DRUJ prosthesis as a primary procedure. Level of evidence This is a level IV, therapeutic study.

Lengthening of the Forearm by Callus Distraction

1996 ◽  
Vol 21 (2) ◽  
pp. 151-163 ◽  
Author(s):  
M. ABE ◽  
H. SHIRAI ◽  
M. OKAMOTO ◽  
T. ONOMURA
Keyword(s):  
Distal Radius ◽  
Radial Head ◽  
Callus Formation ◽  
Congenital Dislocation ◽  
Growth Disturbance ◽  
Distal Ulna ◽  
And Function ◽  
Pin Track ◽  
Delayed Consolidation

Ten patients aged 3 to 13 years (mean, 9 years and 7 months) underwent forearm lengthening by callotasis. The indications for lengthening were shortening and/or deformity of the forearm due to exostosis of the distal ulna in five cases, enchondroma of the distal ulna in one, growth disturbance after fracture of the distal radius in one, radial club hand in one, congenital amputation of the forearm in one and congenital dislocation of the radial head in one. Four had lengthening of the ulna, one of the radius and five of both the radius and the ulna. The average lengthening achieved was 30 mm. Complications encountered were pin track discharge in three cases, callus fracture in five, delayed consolidation of the callus in one and no callus formation in one. Review after 1 to 7 years follow-up (with a mean of 4 years and 9 months) showed satisfactory improvement in appearance and function especially in patients who had tumorous conditions or traumatic epiphyseal arrest.

scholarly journals Bisphosphonate-related atypical femoral fractures: A novel strategy to improve patient outcomes

2020 ◽  
Vol 27 (2) ◽  
pp. 192-197
Author(s):  
Rajpreet Sahemey ◽  
AP Nikolaides ◽  
S Bhattacharya ◽  
A Simons ◽  
P Makrides
Keyword(s):  
Femoral Fractures ◽  
Delayed Union ◽  
Bisphosphonate Therapy ◽  
Rigid Fixation ◽  
Intraoperative Complication ◽  
Intramedullary Canal ◽  
Cephalomedullary Nailing ◽  
Novel Strategy ◽  
Radiographic Data

Background: Atypical femoral fracture (AFF) is a serious adverse event associated with bisphosphonate therapy and prone to complications and delayed union. We propose a technique and management strategy to maximise bone healing and outcomes. Methods: We report on a cohort of patients with AFF using our novel technique of preparing the intramedullary canal and rigid fixation with cephalomedullary nailing. Patients were admitted under a multidisciplinary team with rehabilitation goals of early mobilisation and teriparatide initiation. Clinical and radiographic data were retrospectively reviewed. Results: Twenty-eight AFFs were treated with a mean follow-up of 58.5 weeks and a mean age of 75.2 years old. All cases achieved radiological union by a mean of 6 months and post-operative thigh pain experienced up to 8.7 weeks. No cases underwent revision or experienced intraoperative complication. Conclusion: Our surgical technique and multidisciplinary management are reproducible with excellent results in patients with this rare yet challenging injury.

scholarly journals Open Galeazzi's Fracture-Dislocation in a 13-Year-Old Boy: A Case Report

2020 ◽  
Author(s):  
Valentino Coppa ◽  
Filippo M. Senes
Keyword(s):  
Case Report ◽  
Complete Recovery ◽  
Distal Radioulnar Joint ◽  
Fracture Dislocation ◽  
Case Description ◽  
Radial Fracture ◽  
Radioulnar Joint ◽  
Complex Injury ◽  
And Function

Abstract Background Galeazzi's fracture-dislocation (GFD) is a rare and complex injury consisting of a radial fracture associated with distal radioulnar joint (DRUJ) dislocation. Case Description We are presenting a case of a boy, who at the onset showed an open GFD and his assessment after a 1-year follow-up. As a treatment, closed reduction and long-arm cast were performed. At the last follow-up, the patient presented a complete recovery of range of motion and function of the affected wrist. Literature Review To the best of our knowledge, in the current literature, there are no reported cases of open GFD. Clinical Relevance Although open GFD is rare this case report may suggest orthopaedic surgeon how to approach and manage it.

scholarly journals Efficacy and Sagittal Parameters of Debridement and Bone Grafting using Internal Fixation in the Treatment of Kyphotic Cervical Tuberculosis: A Case Series

2021 ◽  
Author(s):  
Haopeng Luan ◽  
Kai Liu ◽  
Qiang Deng ◽  
Weibin Sheng ◽  
Maierdan Maimaiti ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Case Series ◽  
Cervical Vertebra ◽  
Fixation Group ◽  
Post Operation ◽  
Group A ◽  
Sagittal Parameters ◽  
Radiographic Data

Abstract Background: To evaluate the efficacy of debridement and bone grafting using internal fixation in the treatment of kyphotic cervical tuberculosis, and analyze the changes of pre-operation and post-operation sagittal parameters, which related to the surgical indications.Methods: Clinical and radiographic data of patients with kyphotic cervical TB treated by debridement and BGIF at our hospital from January 2010 to December 2017 were analyzed retrospectively. The sagittal parameters of the cervical vertebra at the pre-operation, post-operation, and last follow-up were documented and were compared. Results: Eighteen patients of simple anterior approach debridement and fusion with internal fixation (group A), and 5 patients underwent anterior debridement and fusion, combined with posterior internal fixation (group AP). In the comparison of preoperative sagittal parameters, significant improvement after surgery was observed in both groups, included Cobb angle, SCA, C2-C7SVA, and CG-SVA (P < 0.05). There were no significant differences in T1 Slope, NT, and TIA (P > 0.05).Conclusions: In the treatment of kyphotic cervical TB, the characteristics of the lesion, the degree of kyphosis and spinal cord nerve compression damage can be presented clearly by the radiographic sagittal parameters, which does a favor to individualize the choice of surgical approach safely and effectively.

Review of Palmer and Werner (1981) on the triangular fibrocartilage complex of the wrist anatomy and function

2017 ◽  
Vol 2 (6) ◽  
pp. 350-354
Author(s):  
Teun Teunis ◽  
David Ring
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Original Publication ◽  
Radioulnar Joint ◽  
Triangular Fibrocartilage ◽  
Wrist Anatomy ◽  
And Function

This classic discusses the original publication by Palmer and Werner (1981) on the anatomy and function of a set of soft tissue stabilising the distal radioulnar joint. They labelled this confluent structure the triangular fibrocartilage complex (TFCC) of the wrist, and concluded that abnormalities were typically degenerative and usually asymptomatic. Eight years later Dr Palmer published a follow-up taking a different perspective. In this article he differentiated between traumatic and degenerative TFCC lesions and outlined surgical treatment for each type. The debate about the diagnosis, interpretation and treatment of TFCC abnormalities today is captured by the contrast between both articles.

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

Desmoid tumour of the distal forearm involving the distal radioulnar joint

2020 ◽  
Vol 13 (11) ◽  
pp. e237097
Author(s):  
Apoorv Sehgal ◽  
Pratyush Shahi ◽  
Avijeet Prasad ◽  
Manoj Bhagirathi Mallikarjunaswamy
Keyword(s):  
Distal Radioulnar Joint ◽  
Treatment Modalities ◽  
Desmoid Tumour ◽  
X Rays ◽  
Distal Forearm ◽  
Left Wrist ◽  
Radioulnar Joint ◽  
Magnetic Resonance Imaging Mri ◽  
Epidemiology Investigation

A 32-year-old woman presented with progressive pain and swelling of the left wrist for 6 months. Physical examination revealed a firm, tender, oval swelling over the left wrist. X-rays showed a pressure effect on the distal radius and ulna. Magnetic Resonance Imaging (MRI) revealed a well-defined, asymmetrical, dumbbell-shaped soft-tissue lesion involving the interosseous region of the distal forearm and extending until the distal radioulnar joint (DRUJ). Core needle biopsy confirmed the diagnosis of desmoid tumour. Marginal excision of the tumour was done. At the 2-year follow-up, the patient was doing well and had painless and improved left wrist motion. Desmoid tumour involving the DRUJ has not been previously reported. We, through this case, report new observation and discuss the epidemiology, investigation of choice, treatment modalities, and the need for a regular follow-up for appendicular desmoid tumours.

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