The Journal of hand surgery
-
The purpose of this study was to obtain 3-dimensional and quantitative information regarding the pathological kinematics of the wrist with scaphoid nonunion using an in vivo and 3-dimensional motion analysis. We specifically tested the hypothesis that the fracture location is related to the kinematic pattern. ⋯ Carpal instability following scaphoid nonunion appears to be related to whether the fracture line passes distal or proximal to the scaphoid apex, where the dorsal scapholunate interosseous ligament and the dorsal intercarpal ligament attach. Three-dimensional imaging should be considered when assessing scaphoid nonunions to identify the exact location of the fracture. This may allow the clinician to choose the best treatment option.
-
We report an unusual variant of a palmar trapezoid dislocation with a shearing fracture of the dorsal cortex treated with mini-fragment screw fixation. This patient's treatment is compared to the few previously published reports of palmarly dislocated trapezoids to assist hand surgeons facing this uncommon injury.
-
Decreased wrist flexion and/or extension after trauma or surgery can be a challenging problem. Physical therapy, orthoses, and additional surgical interventions may not restore the desired range of motion or functionality. The purpose of this study was to assess the total arc of motion and the satisfaction scores of patients who had wrist stiffness and who were treated with a bidirectional, patient-directed orthosis that used the principles of static progressive stretch. ⋯ Therapeutic IV.
-
To evaluate the incidence and types of capitellar cartilage injuries associated with higher-grade radial head fractures. ⋯ Prognostic IV.
-
In most complete brachial plexus injuries, at least 1 root still is available for grafting. We report on the results obtained with reconstruction of the brachial plexus using short sural nerve grafts that connect nonavulsed roots to the anterior, posterior, or both divisions of the upper trunk. ⋯ Prognostic II.