Radiographic indices in one hundred fifty normal Iranian wrists

Radiography is the most widely available imaging modality. Precise evaluations of wrist x-ray can help diagnosis and evaluate the prognosis of many wrist disorders. We measured length, angles and indices in 150 posteroanterior and lateral wrist x-rays to determine normal dimensions and variations according to age and sex. All x-rays were made with standard exposure, with the wrist and forearm in a neutral position. The average carpal height ratio was 0.52 +/- 0.03 with the Youm method and 1.5 +/- 0.09 with the Nattrass method. Mean ulnar variance was +0.99 +/- 1.6 mm and mean radial inclination was 25 +/- 4 degrees. The average radial tilt was 10 +/- 5.1 degrees. Mean scapholunate angle was 50 +/- 8.4 degrees [normal range 40 -60]. Carpal height, third metacarpal and capitate length were smaller in women than in men. There was a significant positive relationship between all dimensions. Our data base may be used to follow-up in conditions such as carpal instability, osteoarthritis and osteonecrosis, as well as for clinical research

Bilateral combined Monteggia and Galeazzi fractures: a case report

We present an exceedingly rare case of left Monteggia-Galeazzi fracture-dislocation and right Monteggiadistal radius fracture occurring simultaneously in a 20-year old male patient who had fallen 13 meters from a building. The combination of Monteggia and Galeazzi fracture-dislocation in the same forearm is very rare and, to the best of our knowledge, simultaneous bilateral Monteggia and Galeazzi or distal radius fracture in the same patient, have never been reported

Axillary artery injury with proximal humerus epiphyseal separation: a rare case report

Fracture of the proximal humerus associated with vascular injury has rarely been reported in children, and only two cases have been reported in the literature. In adults this combination has been reported more frequently. We present the case of a 14 year old boy with proximal humeral epiphyseal separation and axillary artery injury

Relationship between radiographic carpal indices and grip strength

The measurement of hand grip strength has several clinical applications to evaluate chronic hand disability, response to treatment, and work capacity after hand injury. We measured hand grip strength of 41 adults and compared their maximum strength with radiographic indices. There was a significant relationship between hand grip strength and carpal height, third metacarpal and capitate length [All p-values<0.05]. In addition to established factors such as sex, upper limb muscle and joint status, wrist radiographic indices are significantly determinants of hand power grip

Enchondroma of the hand: the role of biopsy in the course of diagnosis and treatment

Enchondroma is the most frequent bone tumor of the hand, but chondrosarcoma is rare at this location. There is a high possibility of correct diagnosis of enchondroma and differentiating from its malignant counterpart by precise clinical and radiologic assessment without biopsy, a subject of debate in the literature. At the present study we substantially investigate this problem, in our patients. Case records, radiographs, and histology of 52 solitary enchondroma patients who underwent operation in our hospital between 1998 and 2010, were reviewed. Special attention paid to pre and post -op diagnoses, and compared with each other. Eighty-six percent of our patients were between the second to fourth decades of life, with a slight female predominance. In all, the primary diagnosis of enchondroma according to clinical presentation and radi-ographic appearance, supported by intraoperative gross appearance of tumor, and confirmed histologically by permanent section analysis. There was no mismatch between radiologic and histologic diagnosis. we concluded that correct diagnosis of enchondroma is almost always possible by precise clinical and radiographic assessment with no need for histologic confirmation before definitive treatment