survey on current methods of carpal height ratio measurement and suggestion of a new method

Two famous methods are commonly used for the measurement of carpal height ratio. Both methods are performed on anteroposterior radiogram and have some shortcomings. We are going to introduce a new method for measuring this index in lateral view of the wrist radiogram. This cross-sectional and case-control study was conducted on 100 anteroposterior and lateral radiograms of asymptomatic individuals and then 20 radiograms of patients with Kienbock disease in various stages of the disease. After determining new reference points on the radiograms of the [normal] group, it was tried to define the ratio by new method. In the next stage the interobserver and intraobserver agreement of the new index was assessed along with previous defined indices. All three methods had some limitations, but overall it seems that the new method has more precise reference points. With regard to inter and intraobserver variability the new index was better than the Natrass group index, but not than the Youm group index. The new index can be used as a substitute or an alternative in carpal height measurement

role of ulnar variance in kienbock's disease

The etiology of Kienbock's disease is not clear definitely. Lunate blood supply, its shape and ulnar variance have been counted as the etiologies of this disease. For years, ulnar variance supposed to be an important predisposing factor for Kienbock's disease. There are controversies on the role of ulnar variance in Kienbock's disease and it has recently been stated that negative ulnar variance is not a risk factor for Kienbock's disease. The aim of this study was to elucidate the role of the negative ulnar variance in Kienbock's disease in Iranian patients. In this study, ulnar variance was measured in standardized condition in 90 normal wrists and in 67 patients with Kienbock's disease who had undergone surgery over the past 15 years. The correlation between age, sex and ulnar variance was assessed. We tried to determine the role of ulnar variance in the development of Kienbock's disease. Mean ulnar variance in the control group was 0.477 millimeter and in the group with Kienbock's disease, it was -0.995 millimeter. Regarding age, both groups were similar and after stratification by sex, we found that sex had no role in the development of disease. The correlations between age and ulnar variance, and sex and ulnar variance in the control group were not statistically significant. However, comparing case and control groups, we found statistically significant correlation between negative ulnar variance and Kienbock's disease. In spite of recent reports, negative ulnar variance is a predisposing risk factor for the development of Kienbock's disease

[Bilateral simultaneous posterior elbow fracture / dislocation: a case report]

Elbow dislocation, though not a rare injury has been only occasionally reported to occur bilaterally. An extremely rare case of upper extremity trauma is reported in which bilateral simultaneous posterior elbow dislocation associated with bilateral radial neck fractures had occurred. To the best of our knowledge, this hasn't been reported previously. Although radial head excision has been reported to be associated with good outcome in cases of elbow dislocations with fracture of radial neck, the trend has been toward preservation of the head and it seems that this is a more logical approach