Midterm Outcome of Bone-Ligament-Bone Graft and Dorsal Capsulodesis for Chronic Scapholunate Instability.

Purpose: To assess midterm outcomes of our bone-ligament-bone (BLB) grafts for chronic scapholunate (SL) instability and better define criteria for their use.

Methods: We conducted a retrospective review of 26 patients treated with BLB grafts and dorsal capsulodesis between 1997 and 2009. Twenty-four patients were reviewed.

[Intramedullary fixation of displaced middle phalangeal neck fractures].

Middle phalanx neck fracture is an unusual injury. In order to prevent malunion and stiffness, a surgical treatment is usually recommended. Owing to the distal localization of the fracture, internal fixation is demanding.

A mechanical comparison of bone-ligament-bone autografts from the wrist for replacement of the scapholunate ligament.

A study was performed to compare the mechanical properties of two intracarpal ligaments with those of the dorsal component of the scapholunate interosseous ligament (SLIL). Trapezoid-to-second metacarpal, capitate-to-trapezoid ligaments, and the dorsal part of the SLIL were obtained as bone-ligament-bone grafts from fresh frozen cadavers. Their respective load to failure and stiffness were measured under uniaxial load on a servohydraulic machine and compared.

Osteoligamentoplasty and limited dorsal capsulodesis for chronic scapholunate dissociation.

Treatment of chronic scapholunate dissociation remains unsatisfactory. As the dorsal part of scapholunate interosseous ligament (SLIL) seems to be the "critical corner" of the scapholunate stability, its replacement by an analogous structure could restore scapholunate stability. A procedure is described which combines reconstruction of the dorsal region of the SLIL by means of an osteoligamentous autograft, harvested at the carpus (dorsal trapezoidometacarpal II ligament) and limited dorsal capsulodesis.

[Psychogenic spastic hand].

Twelve patients seen over a 8-year period with psychogenic spasms of the hand are reported. Six elderly patients presented with extrinsic flexion of the two or three medial fingers with sparing of the thumb and index. Six other patients had various hand attitudes following coincidental but not causal trauma to the upper extremity.

Open dislocation of the trapezoid.

Isolated dislocation of trapezoid is rare. We report here a new case of open dorsal dislocation of the trapezoid following a high energy crush injury of the left hand in a factory worker. It was associated with multidigital mutilation and metacarpal fractures.

Assessment of bullet disruption in armed conflicts.

Under international humanitarian law, the Hague Declaration of 1899 forbids the use of small arms ammunition that disrupts in the body after impact. However, assessment of whether bullets have undergone disruption is subjective and accusations that one or both sides of a conflict have used such ammunition cannot be substantiated. We describe a method by which disruption of bullets after impact can be assessed objectively.