Techniques in hand & upper extremity surgery
-
Tech Hand Up Extrem Surg · Sep 2014
Case ReportsPalmar reconstruction of the triangular fibrocartilage complex for static instability of the distal radioulnar joint.
This study describes a new technique that can be used for reconstructing the triangular fibrocartilage complex to correct the static palmar radius instability of the distal radioulnar joint. In the abovementioned condition, the radius is extremely unstable with respect to the ulna and dislocates palmarly in the resting position. Using a palmar approach, a palmaris longus tendon graft was sutured to the remnant of the disrupted palmar radioulnar and ulnocarpal ligaments and then anchored to the bone tunnel that was created at the ulnar fovea. This technique predominantly reinforces the palmar structure of triangular fibrocartilage complex because the palmar radioulnar ligament is the most critical stabilizer of palmar radius instability.
-
Tech Hand Up Extrem Surg · Sep 2014
Radial ridge excision for symptomatic volar tendon subluxation following de Quervain's release.
Traditional surgical release to address de Quervain's stenosing tenosynovitis can lead to the rare complication of volar tendon subluxation. This study presents a surgical procedure, which entails excision of the radial ridge as an alternative treatment to relieve pain associated with symptomatic volar tendon subluxation following de Quervain's release. The procedure was performed on 6 patients complaining of painful volar tendon subluxation of abductor pollicis longus (APL) and extensor pollicis brevis (EPB), following a first dorsal compartment release and postoperative splinting. ⋯ The APL and EPB tendons were released from dorsal retractors. All patients reported relief upon follow-up. Excision of this ridge removes the obtrusive friction to the APL and EPB tendons, allowing them to glide painlessly over the radial styloid.