Background: This study focuses on the relationship between forearm muscles, carpal ligaments, and their impact on scapholunate joint stability across varying forearm rotations. This is crucial for optimizing pre and postoperative rehabilitation strategies for scapholunate joint dysfunction.
Purpose: Our study aims to understand the kinetic influence of forearm muscles on scapholunate joint instability.
Background: Recent research interest has grown in exploring the role of muscles, isometric contraction, proprioception, and neuromuscular control in addressing dynamic scapholunate and lunotriquetral joint instability, marking a shift in the understanding of wrist stability.
Purpose: To present a comprehensive review of the carpal ligaments anatomy and wrist biomechanics, with a particular focus on the role of proprioception in dynamic carpal stability and their role in managing scapholunate (SL) and lunotriquetral (LTq) dynamic instabilities.
Study Design: We conducted a systematic search of the literature and review of the most relevant papers published and indexed in pubmed, related to wrist biomechanics, proprioception and its contribution to carpal dynamic stability.
Purpose: We describe a new radiologic test to assess the integrity of the scapholunate ligament in dynamic scapholunate dysfunction.
Methods: A bilateral forearm-holding device was designed to perform a comparative radiographic assessment of the scapholunate joint gap during resisted isometric contraction of the extensor carpi ulnaris muscle with full supination of the forearm. The concept is based on the known scaphoid pronation effect of this muscle.
COVID-19 has affected us all. The following collection of short essays highlights various aspects of the pandemic and how it has impacted hand surgery and lessons learned, from the perspective of the Federation of European Societies for Surgery of the Hand (FESSH) Executive Committee members. A range of topics were individually chosen by each of the five committee members and presented.
View Article and Find Full Text PDFArch Orthop Trauma Surg
April 2021
Introduction: Traumatic injuries of the triangular fibrocartilage complex (TFCC) are frequent reasons for ulnar wrist pain. The assessment of the extent of articular disc (AD) degeneration is important for the differentiation of acute injuries versus chronic lesions.
Materials And Methods: The AD of the TFCC of eleven human cadaver wrists was dissected.
Purpose: Several options exist for treating scaphoid nonunion. For selected cases, some authors recommend using a volar buttress plate. The aim of the study was to report the clinical and radiological outcomes achieved at a minimum of 3 years' follow-up of treating scaphoid nonunion with a scaphoid volar plate.
View Article and Find Full Text PDFThis article reviews the results of a series of cadaver investigations aimed at clarifying the role of muscles in the stabilization of ligament-deficient wrists. According to these studies, isometric contraction of some forearm muscles induces midcarpal (MC) supination (ie, the abductor pollicis longus, extensor carpi radialis longus, and flexor carpi ulnaris), whereas other muscles induce MC pronation (ie, the extensor carpi ulnaris). Because MC supination implies tightening of the volar scaphoid-distal row ligaments, the MC supination muscles are likely to prevent scaphoid collapse of wrists with scapholunate ligament insufficiency.
View Article and Find Full Text PDFObjective: To compare the long-term results of 2 surgical techniques for forearm chronic exertional compartment syndrome (CECS) in professional motorcycling racers and to study a new diagnostic variable for CECS, TRest.
Design: Retrospective case series.
Level Of Evidence: 4.
Background: The triangular fibrocartilage complex is the main stabilizer of the distal radioulnar joint. While static joint stability is constituted by osseous and ligamentous integrity, the dynamic aspects of joint stability chiefly concern proprioceptive control of the compressive and directional muscular forces acting on the joint. Therefore, an investigation of the pattern and types of sensory nerve endings gives more insight in dynamic distal radioulnar joint stability.
View Article and Find Full Text PDFThe dorsal sensory branch of the ulnar nerve (DSBUN) is at risk in setting the 6U wrist arthroscopy portal. Although surgeons know the risk and are careful when they set the 6U portal, DSBUN injuries still occur. The purpose of the present anatomical study was to evaluate the possibility that DSBUN undergoes dynamic anatomical variations in its location during wrist arthroscopy.
View Article and Find Full Text PDFReconstructive procedures such as proximal row carpectomy or partial arthrodesis have been commonly proposed for advanced Kienböck disease (Lichtmann IIIB to IV). The purpose of this study is to evaluate an alternative surgical technique to advanced Kienböck disease: lunate excision and replacement with pedicled vascularized scaphoid graft and partial radioscaphoidal arthrodesis. The main advantage of the proposed intervention is to preserve mobility while not jeopardizing prime clinical outcomes such as pain.
View Article and Find Full Text PDFBizarre parosteal osteochondromatous proliferation (BPOP), also called Nora's lesion, is an unusual, benign, bony lesion frequently found in the hand. Originally, two of the key radiological features used to describe such lesions were: (1) a lack of corticomedullar continuity and (2) an origin from the periosteal aspect of an intact cortex. The authors present 2 unique cases of histologically proven BPOP in which the integrity of the cortex was affected.
View Article and Find Full Text PDFResection arthroplasty is an old, and yet reliable, solution for the isolated osteoarthritis (OA) of some joints of the hand. With complication low rates, this technically undemanding option is ideal for scapho-trapezial-trapezoidal joint OA, as well as for the OA of the carpometacarpal joints of the fingers. This paper reviews its indications, surgical technique, and results.
View Article and Find Full Text PDFThe etiology of Kienböck disease is still unknown and, consequently, the ideal treatment is in doubt. Many different hypotheses have been suggested. There are reasons to believe that there are mechanical, vascular, and metabolic factors predisposing to the disease, and probably some factors triggering the development of the process.
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