Arthritis predicting factors in distal intraarticular radius fractures.

Introduction: Intra-articular malunion with step off and gap formation is claimed to be crucial for radiocarpal degeneration. In addition to well-defined intraarticular malunion, the shape of the distal radius is important for unaffected wrist function. In typical intra-articular fracture patterns with a dorsoulnar and palmar ulnar fragment, alterations of the shape of the articular surface, in a kind of a cavity, without obvious step off can be observed.

Initial shortening and internal fixation in combination with a Sauvé-Kapandji procedure for severely comminuted fractures of the distal radius in elderly patients.

We identified 11 women with a mean age of 74 years (65 to 81) who sustained comminuted distal radial and ulnar fractures and were treated by volar plating and slight shortening of the radius combined with a primary Sauvé-Kapandji procedure. At a mean of 46 months (16 to 58), union of distal radial fractures and arthrodesis of the distal radioulnar joint was seen in all patients. The mean shortening of the radius was 12 mm (5 to 18) compared to the contralateral side.

[Free vascularised iliac bone graft for Kienböck's disease stage III].

Purpose: The aim of this retrospective study is to report the clinical and radiological long-term results (follow-up >10 years) after revascularisation of the lunate in Kienböck's disease using a free vascularised iliac bone graft in patients with Lichtman stage III disease.

Patients And Methods: 23 patients (14 male, 9 female) aged between 17 and 43 years were treated with a free vascularised iliac bone graft. The average follow-up time was 13 (10-15) years.

[Stabilization of perilunate and transscaphoid perilunate fracture-dislocations via a combined palmar and dorsal approach].

Objective: Restoration of the intercarpal alignment and the radio- and ulnocarpal joint in order to avoid the development of a carpal collapse with concomitant arthritis of the radiocarpal and midcarpal joint.

Indications: All perilunate and transscaphoid perilunate fracture-dislocations. An exception is a pure ligamentous injury with anatomic carpal alignment following closed reduction (computed tomography scan).

[Free vascularized iliac bone graft for the treatment of scaphoid nonunion with avascular proximal fragment].

Objective: The goal of the procedure is osseous healing of the scaphoid in an anatomic position and replacement of necrotic bone at the site of the scaphoid nonunion by a vascularized iliac bone graft.

Indications: Scaphoid nonunion with necrotic fragment in SNAC (scaphoid nonunion advanced collapse) < 1. Nonunion following previous surgery.