Influence of forearm rotation on the kinetic stabilizing efficiency of the muscles that control the scapholunate joint. Clinical application in proprioceptive and neuromuscular rehabilitation programs.

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.

Case report illustrating use of serial elastic tension digital neoprene orthoses (ETDNO) protocol in the treatment of proximal interphalangeal joint flexion contracture.

Introduction: This case report details the application of a treatment regimen using a serial elastic tension digital neoprene orthosis (ETDNO) protocol for a patient with an eight-month-old finger crush injury who experienced recurrence of a 45º proximal interphalangeal joint (PIPJ) flexion contracture two months after arthrolysis.

Purpose Of The Study: To illustrate how the application strategy of ETDNO can increase the daily total end range time (TERT) and modify finger stiffness.

Results: The patient reached full extension following 15 weeks of ETDNO treatment.

Necrotizing fasciitis: Usefulness of the LRINEC score in a third-level hospital.

Aim: To review patients seen in the emergency room, diagnosed with necrotizing fasciitis (NF) and the correlation of such complications with the Laboratory Risk Indicator for Necrotizing fasciitis scale (LRINEC). The purpose of this study is to assess the use of the LRINEC score for early diagnosis of NF and its prognostic use in a consecutive series of cases treated at our hospital.

Methods: Retrospective observational study including patients with a diagnosis of NF in the emergency room of a tertiary hospital over 11 years.

Kinetic dysfunction of the wrist with chronic scapholunate dissociation. A cadaver study.

Background: Most laboratory studies investigating scapholunate dissociations are based on normal cadaver arms with serially sectioned ligaments. It is assumed that the kinetic behavior of a ligament-sectioned wrist is similar to a scapholunate dissociation. We tested five cadaver wrists with real injuries.

The anterior limited approach of the elbow for the treatment of capitellum and trochlea fractures: Surgical technique and clinical experience in eight cases.

When a coronal fracture affects the capitellum and the trochlea, the Kocher lateral approach may be inadequate for the correct visualisation, reduction and fixation of the fracture. In such cases an associated medial elbow approach may be required, or a posterior transolecranon approach may be preferred. The anterior limited approach to the elbow (ALAE) could be a valid option when treating these types of fracture, as it does not involve the detachment of any muscle group or ligament, thereby facilitating the recovery process.

A biomechanical comparison of the modified Bunnell pullout and Teo intraosseous suture techniques for attachment of tendon to bone.

We compared the biomechanical properties of the Teo intraosseous suture technique with the modified Bunnell pullout technique in a cadaver model after a tendon to bone repair. Thirty-six fresh-frozen cadaveric fingers were assigned randomly to three groups (Teo, Bunnell and control groups). They were loaded cyclically from 2 to 15 N at 25 mm/min, for 500 cycles.

The Role Of The Carpometacarpal Ligaments Of The Thumb In Stability And The Development Of Osteoarthritis Lesions : An Anatomical Study.

This study aims to assess ligament lesions and subluxations of the carpometacarpal (CMC) joint of the thumbs and the role that these ligament ruptures play in the pathophysiology of osteoarthritis (OA). Twenty-five fresh-frozen cadaver hands were dissected. There were 14 female and 11 male with mean age 65 years (51-92 years old).

Trapeziometacarpal Ligaments Biomechanical Study: Implications in Arthroscopy.

 In the presence of early osteoarthritis, changes to the trapeziometacarpal joint (TMJ) often result in pain and is associated with joint instability and a tendency of dorsoradial subluxation. In these instances, arthroscopy may be indicated to: (1) assess the extent of cartilage disease and the laxity of ligaments and to (2) treat TMJ instability. The purpose of our study was to biomechanically analyze which ligaments are the primary stabilizers of the TMJ.

Bicipital tuberosity bone characteristics in surgical reattachment of the distal biceps: anatomical and radiological study.

Purpose: The aim of this study was to measure the cortical thickness and bone density of the different parts of the bicipital tuberosity, to evaluate the importance of these variables on resistance to pulling out of distal biceps tendon reinsertion implants.

Methods: Sixteen cadaveric arms were used for this study. A multiple detector computed tomography was performed in each proximal radius.

Role of muscles in the stabilization of ligament-deficient wrists.

This 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.

Relationship Between Wrist Motion and Capitolunate Reduction in Four-Corner Arthrodesis.

The authors retrospectively studied 36 patients with degenerative changes associated with scaphoid nonunion and scapholunate advanced collapse treated with circular plate fixation and bone graft. The goals of the study were to review the incidence of dorsal impingement, nonunion of arthrodesis, loose hardware, broken screws, and limitation in wrist motion associated with correct or incorrect surgical capitolunate reduction. Surgical indications were scapholunate advanced collapse (3 patients), scaphoid nonunion advanced collapse (32 patients), and sequelae of irreducible perilunate dislocation (1 patient).

How to Avoid Ulnar Nerve Injury When Setting the 6U Wrist Arthroscopy Portal.

The 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.

Radial head reconstruction in elbow fracture-dislocation: monopolar or bipolar prosthesis?

Background: Monopolar and bipolar radial head prosthetic arthroplasties have been used successfully to treat elbow fracture-dislocation with unsalvageable radial head fractures. The relative stability of these two designs in different clinical situations is a topic of ongoing investigation.

Questions/purposes: We tested the effects of monopolar and bipolar fixed-neck prosthetic radial head implants on improvement in elbow coronal and axial plane laxity in a terrible triad biomechanical model that accounted for lateral collateral ligament integrity and the presence of a transverse coronoid fracture.

Transverse coronoid fracture: when does it have to be fixed?

Background: After elbow fracture-dislocation, surgeons confront numerous treatment options in pursuing a stable joint for early motion. The relative contributions of the radial head and coronoid, in combination, to elbow stability have not been defined fully.

Questions/purposes: The purpose of this study was to evaluate the effect of an approximately 50% transverse coronoid fracture and fixation in the setting of an intact or resected radial head on coronal (varus/valgus) and axial (internal and external rotational) laxity in (1) gravity varus stress; and (2) gravity valgus stress models.

Role of the extensor carpi ulnaris in the stabilization of the lunotriquetral joint. An experimental study.

Study Design: Experimental laboratory-based research in biomechanics.

Introduction: The mechanisms by which some lunotriquetral (LTq) ligament disruptions remain stable are not known.

Purpose Of The Study: To investigate the contribution of muscles in preventing carpal destabilization when the LTq ligaments are torn.

Tendon transfer fixation in the foot and ankle: a biomechanical study.

Background: Tendon transfers are often used in foot and ankle surgery. Different fixation devices and techniques have been described. The most recently developed ones are bone anchors and interference screws.

Treatment of complex hand trauma using the distal ulnar and radial artery perforator-based flaps.

The clinical value of distal ulnar or radial artery adipofascial perforator flaps is shown in a series of 30 patients with severe hand and wrist injuries and major soft tissue defects requiring coverage. There were 22 men and 8 women, aged 16-73 years. The defects were dorsal and/or palmar, with or without transpalmar or transcarpal amputation, or amputation of the thumb and/or the digits.