(1) Background: Patients treated with the two previous generations of ulnarization developed a bump related to the ulnar head becoming prominent on the radial side of the hand. To finally remedy this problem, a third generation of ulnarization was developed to keep the ulnar head contained. While still ulnar to the wrist center, the center of the wrist remains ulnar to the ulnar head, with the ulnar head articulating directly with the trapezoid and when present the trapezium. (2) Methods: Between 2019 and 2021, 22 radial club hands in 17 patients were surgically corrected with this modified version of ulnarization. (3) Results: In all 17 patients, the mean HFA (hand-forearm-angle) correction was 68.5° (range 12.2°-88.7°). The mean ulna growth was 1.3 cm per year (range 0.2-2 cm). There were no recurrent radial deviation deformities more than 15° of the HFA. (4) Conclusions: This new version of ulnarization may solve the problem of the ulna growing past the carpus creating a prominent ulnar bump. The results presented are preliminary but promising. Longer-term follow-up is needed to fully evaluate this procedure.
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http://dx.doi.org/10.3390/children8070562 | DOI Listing |
Hand Surg Rehabil
January 2025
Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar; Qatar University, College of Medicine, Dept of Health and Clinical Sciences, Doha, Qatar; Karolinska Institutet, Department of Clinical Science and Education, Stockholm, Sweden.
An ulnar nerve (UN) palsy is devastating for hand function, resulting in an intrinsic minus position or claw hand with a loss of pinch grip. Distal nerve transfers facilitate faster reinnervation of hand intrinsic muscles in cases of proximal ulnar nerve lesions. The traditional anterior interosseous nerve (AIN) to UN motor transfer is commonly used, however, this still leads to long reinnervation times for the distal intrinsic muscles, important for the thumb to index pinch grip.
View Article and Find Full Text PDFJ Hand Surg Asian Pac Vol
January 2025
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Surgeons use anatomical landmarks like the scaphoid tubercle, pisiform, trapezial tubercle and hook of hamate, along with Kaplan cardinal line (KCL) to avoid injury to the recurrent motor branch (RMB) of the median nerve during carpal tunnel release. The presence of transverse muscle fibres (TMF) overlying the transverse carpal ligament (TCL) may suggest proximity of the RMB, but their anatomical relationship is unclear. In this study, we evaluated the accuracy of anatomical landmarks to the RMB, TMF origin and insertion, and examined the relationship between TMF presence and RMB running patterns.
View Article and Find Full Text PDFJ Pediatr Orthop B
January 2025
Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Hereditary multiple exostoses is an autosomal dominant genetic condition primarily affecting long bones. Forearm deformities, including wrist ulnar deviation, ulnar shortening, radial or ulnar bowing, and radial head dislocation, are common manifestations. Gradual ulnar lengthening is suggested as a viable treatment option for managing these deformities.
View Article and Find Full Text PDFOrthop J Sports Med
January 2025
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Background: The aim of surgical treatment for posterolateral rotatory instability (PLRI) of the elbow is to restore the integrity of the lateral ulnar collateral ligament (LUCL), with ligamentous reconstruction being the preferred option for recurrent symptomatic PLRI. However, there is no clinical evidence demonstrating the superiority of reconstruction versus repair. Treatment options currently depend on the cause of the LUCL injury and surgeon preference.
View Article and Find Full Text PDFAdv Orthop
December 2024
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
The purpose of this study is to investigate the outcomes of the use of a 2.7 mm semitubular hook plate for internal fixation of unstable metaphyseal ulnar fractures. Between January 2015 and July 2019, 30 consecutive patients with a recent unstable distal ulnar fracture were included in this prospective case series.
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