The Journal of hand surgery
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To evaluate the safety and efficacy of a hybrid flexor carpi radialis (FCR) approach for volar plate osteosynthesis of displaced distal radius fractures with concurrent prophylactic carpal tunnel release (CTR) in patients without preoperative signs or symptoms of acute carpal tunnel syndrome secondary to the fracture. ⋯ Therapeutic IV.
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Hammering is a functional task in which the wrist generally follows a path of motion from a position of combined radial deviation and extension to combined ulnar deviation and flexion, colloquially referred to as a dart thrower's motion. The purpose of this study was to measure wrist and forearm motion and scaphoid and lunate kinematics during a simulated hammering task. We hypothesized that the wrist follows an oblique path from radial extension to ulnar flexion and that there would be minimal radiocarpal motion during the hammering task. ⋯ The simulated hammering task was performed using a wrist motion that followed a coupled path of motion, from extension and radial deviation to flexion and ulnar deviation. Scaphoid and lunate rotations were greatly reduced, but not minimized, compared with rotations during pure wrist flexion/extension. This is likely because an extended wrist position was maintained throughout the entire task studied.
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Fractures of the distal radius occur commonly, and volar plating has emerged as a current, successful, and popular treatment for this injury. When this technology fails, salvage procedures must be selected that aim to maximize wrist motion and minimize pain. We present a case of volar radioscapholunate wrist arthrodesis in the setting of unfeasible intraoperative volar osteotomy to treat a malunited distal radius fracture.
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Multicenter Study
Treatment of extra-articular distal radial malunions with an intramedullary implant.
Malunited distal radius fractures pose considerable problems, especially for young, active individuals. Surgical correction with osteotomy, bone grafting, and internal fixation with plates and screws has been the treatment of choice. Locked intramedullary fixation is an alternative technique to provide bony stability while minimizing soft tissue irritation in the management of acute distal radius fractures, with acceptable clinical results. The purpose of this study was to describe our experience with the use of an intramedullary device combined with grafting to repair distal radial malunions. This fixation device is inserted through the radial styloid and obtains distal fixation with 3 fixed-angle locking screws. ⋯ Therapeutic IV.
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To test the null hypothesis that there is no relationship between coping mechanisms and depression measured before surgery, and pain intensity and disability after surgery, as assessed at the time of suture removal. ⋯ Prognostic I.