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Palmar midcarpal surgery

Sebastian Farr, Florian Schachinger, Werner Girsch
Midcarpal instability (MCI) is a form of the carpal instability nondissociative pattern and can be differentiated into dorsal, palmar, or extrinsic MCI. Dorsal MCI can frequently be observed in adolescent or adult patients due to trauma or hyperlaxity of the palmar intrinsic carpal ligaments. Clinical stress tests and cinematography are capable to depict the ligamentous instability centered around the capitolunate area. We describe a novel technique which aims to address palmar ligamentous hyperlaxity by plication of the radioscaphocapitate, radiolunotriquetral, and arcuate ligaments, thus closing the so-called space of Poirier...
November 19, 2018: Techniques in Hand & Upper Extremity Surgery
C S Hagen, T Saam, N Kammer, T Holzbach, R E Giunta, E Volkmer
AIM: Therapy of scapholunate advanced collapse (SLAC) wrist should be guided by the degree of arthritic changes within the radioscaphoid and midcarpal joints (stage 1-3 after Watson). Diagnostic investigations usually include X-ray imaging and wrist arthoscopy. In the present study, the interrater reliability of SLAC wrist stage classification by means of X-ray image analysis was evaluated between radiologists and hand surgeons. Ultimately, the influence of diagnostic wrist arthroscopy on the final stage classification was determined...
June 2015: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Marc Garcia-Elias
Symptomatic scaphotrapeziotrapezoidal (STT) joint osteoarthritis may occasionally require surgery. In the absence of dorsal midcarpal instability, acceptable results may be obtained by an excisional STT joint arthroplasty. After distal scaphoid resection, however, forces are no longer transmitted along the radial column of the wrist. This often results in slight malrotation of the proximal row into extension. To mitigate this problem, different strategies have been proposed (dorsal midcarpal capsulodesis, palmar radioscaphoid capsulodesis, tendon interposition, or pyrocarbon implant interposition)...
March 2011: Journal of Hand Surgery
Kent H Chou, Franklin H Chou, Robert J Goitz
We treated a 6-year-old child able to extend her wrist only to within 30 degrees of the neutral position secondary to posttraumatic palmar midcarpal instability with palmar and dorsal capsulodesis and pinning. More than 8 years after surgery, she has no complaints referable to her wrist and has 30 degrees of active wrist extension. Although unpredictable in adults, soft-tissue reconstruction is a treatment option in the pediatric patient with posttraumatic palmar midcarpal instability.
March 2010: Journal of Hand Surgery
Hajime Ishikawa, Akira Murasawa, Kiyoshi Nakazono
PURPOSE: Pain-free stability of the wrist is a prerequisite for the rheumatoid hand to maintain power and perform various tasks. The purpose of this study was to investigate whether a radiocarpal (radiolunate, radioscapholunate, or radiolunotriquetral) arthrodesis produces a stable wrist and whether the results remain satisfactory for more than 10 years. METHODS: A retrospective review was performed on 25 wrists of 25 patients with rheumatoid arthritis who had radiocarpal arthrodesis...
July 2005: Journal of Hand Surgery
Charles A Goldfarb, Peter J Stern, Thomas R Kiefhaber
PURPOSE: Palmar midcarpal instability (PMCI) is one type of nondissociative carpal instability. The optimal treatment for PMCI is uncertain. The purpose of this investigation was to evaluate the results of capitate-lunate-triquetrum-hamate (4-corner) arthrodesis for PMCI. METHODS: Over a 10-year period 8 patients were treated with 4-corner arthrodesis for PMCI. The instability was diagnosed clinically and confirmed with cineradiography. The symptomatic instability began in all patients after a notable trauma; 6 of the patients were injured at work and 2 were injured in a motor vehicle accident...
March 2004: Journal of Hand Surgery
R C Whitton, N J Kannegieter, R J Rose
OBJECTIVE: To examine the relationship between medial palmar intercarpal ligament (MPICL) tearing and postoperative performance in racing horses. MATERIALS AND METHODS: The postoperative performance of 42 horses in which the midcarpal joint was examined arthroscopically was followed prospectively. Intra-articular variables examined were the severity of MPICL tearing, subchondral bone damage and articular cartilage damage. Using a scoring system based on the class of race and the position in the race, a mean score was calculated for up to five races before and after surgery...
November 1999: Australian Veterinary Journal
G Feldkamp, T L Whipple
Wrist arthroscopy is a new approach to the diagnosis and treatment of chronic wrist pain and pathology, that could not be achieved by conventional diagnostic instruments. The arthroscopy allows detailed assessment to articular surfaces, chronic synovitis, triangular fibro-cartilage tears, lesions of the intercarpal and palmar ligaments, and intraarticular fractures of the radius. The technique is very demanding and should be performed only by experienced surgeons. The dorsal portals are located with relation to the six extensor compartments...
November 1992: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
L Ambrose, M A Posner
Instability of the ulnar side of carpus centers around the triquetrum, which is suspended by the ulnar triquetral ligaments and supported proximally by the TFCC. The triquetrum guides the lunate by an interosseous membrane and stout palmar ligaments that provide a relatively rigid connection between the two bones. Disruption of the LT ligament is frequently associated with pathology in the ulnar carpal area and may progress to triquetral instability, VISI, and finally, degenerative arthritic changes on the ulnar side of the carpus...
November 1992: Hand Clinics
C W McIlwraith
Tearing of the medial palmar intercarpal ligament is described in 45 intercarpal (midcarpal) joints in 42 horses (37 racehorses, 5 non-racehorses). Of the 37 racehorses, there were 20 Quarter Horses, 14 Thoroughbreds and 3 Standardbreds. The patients had been referred for arthroscopic surgery for removal of osteochondral chip fragments that had been diagnosed radiographically or diagnostic arthroscopy of a persistent carpal problem. The problem was unilateral in 39 horses and bilateral in 3. The presenting clinical signs were lameness and/or persistent synovial effusion...
September 1992: Equine Veterinary Journal
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