Scapholunate Advanced Collapse (SLAC) and Scaphoid Nonunion Advanced Collapse (SNAC): A Review of Treatment Options for Stage II.

Scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) represent clinical entities identified by a pattern of predictable degenerative changes. They are the most common causes of wrist arthritis. Both entities can remain asymptomatic for many years and may go undiagnosed.

The Distal Oblique Bundle in the Distal Forearm: From Anatomical Features to Clinical Implementation.

Background and objective The distal oblique bundle (DOB) is nowadays recognized as the thickest component of the distal interosseous membrane (DIOM). It is neither thought to be a clear-cut ligament, and nor does it follow the typical configuration of the rest of the DIOM. It is not always present and some studies have raised disputes about its prevalence and a few anatomical features.

Reconstruction of the forearm interosseous membrane: a biomechanical study of three different techniques.

Reconstruction of the interosseous membrane has the potential to re-establish a normal loading pattern through the forearm and enhance stability after an Essex-Lopresti lesion. The aim of our study was to assess the capacity of three different techniques, which all use a regionally harvested autograft, to restore longitudinal stability. Simulation of the Essex-Lopresti lesion was done by excising the radial head and sectioning the interosseous membrane in seven cadaveric specimens.

Essex-Lopresti injuries: an update.

Reconstruction of the central band of the interosseous membrane is an emerging procedure implemented in the treatment of longitudinal radioulnar dissociation (LRUD), usually in its chronic setting, after Essex-Lopresti injuries of the forearm.There are no sufficient clinical data to support reconstruction of the central band of the interosseous membrane in acute LRUD injuries.Clinical and cadaveric studies comparing autografts (palmaris longus, flexor carpi radialis and bone-patellar-bone), allografts (Achilles tendon) and synthetic ligaments have not shown superiority of one technique another; however, they have shown special concerns with respect to the use of synthetic grafts.

Central band reconstruction for the treatment of Essex-Lopresti injury : A novel technique using the brachioradialis tendon.

Longitudinal stability of the forearm is mainly provided by three structures: the radiocapitellar contact, which acts as the primary stabilizer, the central band of the interosseous ligamentous complex (IOLC) and the intact triangular fibrocartilage complex (TFCC). In an Essex-Lopresti lesion the forearm becomes fully destabilized, since all of these three components are injured. Fixation or replacement of the radial head with a metallic prosthesis along with repair of the TFCC and stabilization of the distal radioulnar joint (DRUJ) are well-established treatment goals.

Anatomic Characteristics of the Distal Oblique Bundle of the Interosseous Membrane of the Forearm.

The distal oblique bundle of the forearm is a structure that has been under vigorous investigation for the past decade. It is part of the distal interosseous membrane (DIOM) and seems to have an important stabilizing effect in the distal radioulnar joint. In this essay, we have tried to summarize the anatomical characteristics of the structure.

Distal Oblique Bundle in the Distal Interosseous Membrane of the Forearm: Review of Current Knowledge.

The distal oblique bundle has been recognized as a distinct structure of the distal interosseous membrane of the forearm since 2009, when Noda et al. named it. Our minireview will attempt to summarize knowledge gathered and provide guidelines toward possible questions that arise when reading studies about this topic.

International Federation of Societies for Surgery of the Hand 2013 Committee's report on wrist dart-throwing motion.

This report updates information on wrist dart-throwing (DT) motion, based on the most recent research published on the kinematics, kinetics, and clinical applications of DT motion. A wide range of DT planes exists. "Pure" DT motion is done along an oblique plane that intercepts the coronal and sagittal planes at the zero position, and occurs almost exclusively at the midcarpal joint with near zero scaphoid and lunate motion.

Biomechanical properties of the scapholunate ligament and the importance of its portions in the capitate intrusion injury.

Background: Repair of the dorsal component of the scapholunate ligament alone is the usual surgical treatment for scapholunate injuries. Recent literature has suggested that additionally repairing the palmar component of the scapholunate ligament leads to improved and lasting clinical outcomes. The aim of this study was to determine the biomechanical properties of both portions of scapholunate ligaments derived from the same wrist and compare them with the whole scapholunate ligament.

Biomechanical properties of interosseous proximal carpal row ligaments.

The Scapholunate (S-L) and Lunotriquetrum (L-Tr) ligaments have been extensively studied in the literature. A wide range of measurements has been reported for ultimate load and stiffness with different mechanical protocols. In this study, we examined the mechanical properties of both ligaments harvested from the same wrist.

2007 IFSSH committee report of wrist biomechanics committee: biomechanics of the so-called dart-throwing motion of the wrist.

The dart-throwing motion (DTM) plane can be defined as a plane in which wrist functional oblique motion occurs, specifically from radial extension to ulnar flexion. Most activities of daily living are performed using a DTM. The DTM utilizes the midcarpal joint to a great extent.

Static indentation test for neocartilage surface hardness in repair of periosteal articular cartilage defects.

The objective of this study was to determine whether hardness of the superficial layer is a useful parameter to characterise cartilage produced by periosteal neochondrogenesis, using rabbit knee lesions as a model. A cartilage defect was created in the right hind knee of anesthetised young adult rabbits, and the defect was then covered with an autologous periosteal graft. At one and eight months postsurgery, rabbits were euthanised, and the articular cartilage lesion sites were evaluated for the histological parameters in a modified O'Driscoll scale, which is the current 'gold standard' for new cartilage properties.

Neurovascular injury during primary total hip arthroplasty caused by a threaded acetabulum cup.

We report an iatrogenic neurovascular injury during hip arthroplasty surgery. During insertion of a threaded titanium cup into a dysplastic acetabulum (lack of anterior wall), both the common femoral artery and nerve were crushed. It is therefore recommended that, if the soft tissues are exposed and can interfere with the instruments, inserts that require rotation should not be selected to be placed in the acetabulum.

Beware of the ulno-palmar distal radial fragment.

Five patients sustained isolated fractures of the ulnopalmar rim of the distal radius. In three cases the fragment was small and was classed as an avulsion fracture of the short radiolunate ligament. Palmar wrist subluxation occurred in all cases, four during treatment in a cast or splint.

Does the term scaphocapitate syndrome need to be revised? A report of 6 cases.

This is a retrospective study of six patients with displaced fractures of the neck of the capitate. In four of the six patients the diagnosis was delayed by at least 1 week. After open reduction and internal fixation the results were assessed as excellent (three cases), fair (two cases) or poor (one case).

Simultaneous ipsilateral diaphyseal fractures of the femur and tibia: treatment and complications.

We present our experience of intramedullary nailing (IM) and external fixation in the treatment of 54 patients with ipsilateral diaphyseal fractures of the femur and tibia. Eight femoral and 24 tibial fractures were open. They were classified into three groups: IM nailing of both fractures (group A, 19 patients); IM nailing of the femoral and external fixation of the tibial fracture (group B, eight patients); and external fixation of both fractures (group C, 27 patients).

Perilunate dislocations and fracture-dislocations. Closed and early open reduction compared in 28 cases.

27 patients (28 cases), were treated for perilunate dislocations in 20 and fracture-dislocations in 8. Capitate displacement was dorsal in 27 cases and palmar in 1 case, and in 16, the scaphoid was fractured. There was no substantial delay of treatment.

The unstable capitolunate and radiolunate joints as a source of wrist pain in young women.

A retrospective study of 12 young women (14 cases) complaining of chronic wrist pain, obscure numbness and reduction of grip strength is presented. The average duration of the complaints was 7.3 years.

Late management of post-traumatic palmar carpal subluxation: a case report.

Only a few cases of palmar carpal subluxation associated with an ulnovolar fragment from the distal radius have been reported previously. We report a case which was treated operatively six months after the injury.