Correlation between Global Wrist Laxity and Movement of the Scaphoid and the Lunate in Various Places During Radio Ulnar Deviation of the Wrist

Introduction: In the intact wrist, three dimensional motionsof the carpal bones has been reported as a screw displacementaxis representation of the motion as the angular motion ofthe bones or as translations between the bones, however thelatter has frequently been quantified as a displacement in thedirection of the screw axis. Current research aimed to establishcorrelation between global wrist laxity and movement of thescaphoid and the lunate in various places during radio ulnardeviation of the wrist.Material and methods: The proposed study was a prospectivestudy conducted in the Department of Orthopedics, RMCH,Bareilly, UP, comprising 100 healthy volunteers with equal sexration who never had any symptoms pertaining to their wristjoint. An informed written consent was obtained. Standardposterolateral and true lateral radiograph of wrist were madeto exclude any radiological abnormality. PA and lateralradiograph were obtained in full radial and ulnar deviation.A custom-made positioning device was used to ensure properplacement of the hand and wrist during the examination.Results: We observed that the age varied from 21 years to 40years. Radial deviation varied from 10 to 25 degree with meanof 18.06 degree. Ulnar deviation varied from 25 to 60 degreewith mean of 36.51 degree. Laxity score varied from 31 to 100with mean of 64.20.Conclusion: Within the limitations of the present study,it can be concluded that the ulnar deviation of the wrist isseen to cause radial translation ad dorsal rotation of theproximal carpal row. Similarly, the radial deviation was seento cause ulnar translation and volar rotation of the proximalcarpal row.

Luxación radio-cubital distal expuesta por mordedura canina no asociada con fractura: Técnica quirúrgica reconstructiva mediante anclaje para sindesmosis e injerto tendinoso. Reporte de caso / Exposed distal radio-ulnar dislocation by dog bite: Reconstructive surgical technique using a soft tissue graft and a syndesmotic fixation implant. Case report

La función principal del antebrazo es la pronosupinación, la cual se logra en gran medida mediante la estabilidad y características biomecánicas de la articulación radio-cubital distal. Existen diversas técnicas quirúrgicas para el tratamiento de las luxaciones radio-cubitales distales aisladas o asociadas con fractura. Presentamos el caso de un paciente entrenador canino quien fue mordido a nivel de la muñeca y antebrazo distal acudiendo al Servicio de Urgencias en donde se diagnostica una luxación cubital distal con exposición músculo tendinosa. Debido al agente lesivo y las múltiples lesiones de partes blandas resultó imposible realizar las técnicas habituales de tratamiento. Se describe la técnica utilizada para el manejo de este paciente mediante la colocación de injerto tendinoso autólogo de gracilis, plasma rico en plaquetas y dos sistemas de anclaje para sindesmosis de tobillo. Se inmovilizó por seis semanas e inició rehabilitación subsecuente y valorándolo a las 12, 18 y 28 semanas mediante la escala de MAYO, DASH y PRWE encontrando un resultado bueno que implica la reincorporación a las actividades laborales y cotidianas del paciente con un mínimo dolor y limitación.

The main function of the forearm is the supination, which is achieved largely through the biomechanical characteristics and stability of the distal radio-ulnar joint. There are several surgical techniques for the treatment of distal radio-ulnar dislocations isolated or associated with a fracture. We report the case of a canine trainer who was bitten at the wrist and distal forearm that came to the emergency department in where distal ulnar dislocation with muscle tendon exposure was diagnosed. Due to the offending agent and multiple soft tissue injuries the treatment with standard techniques was impossible. We describe the technique of treatment of this patient by placing autologous gracilis tendon graft, platelet rich plasma and two anchoring systems for ankle syndesmosis. Immobilization was maintained for six weeks with a subsequent rehabilitation and posterior valuation at 12, 18 and 28 weeks by the scale of MAYO, PRWE and DASH and finding a good result which implies the return to work and daily activities of the patient with minimal pain and limitation.

Traumatic radio ulnar dissociation / 中华创伤骨科杂志

Objective To investigate the mechanism of radioulnar dissociation, an uncommon special injury, and its clinical diagnosis and treatment. Methods From 1990 to 1998, 4 patients with concurrent injuries of the proximal and distal radio ulnar joints were treated in my department. Of the 3 cases diagnosed early, 2 were treated with open reduction and internal fixation and 1 with closed reduction. The remaining one patient, whose radio ulnar dissociation was diagnosed 2 months later, had to be treated by secondary operation. Results The 4 patients were followed up for 16 months to 8 years (averaging 46 months). All had excellent results. Conclusion The early accurate diagnosis and early treatment of concurrent injuries of the elbow and the distal radio ulnar joint produce satisfactory results.

Proximal Radio-Ulnar Translocation Associated with Elbow Dislocationon: Case Report / 대한정형외과학회잡지

A translocation of the proximal radius and ulna combined with a posterior dislocation of the elbow is quite rare. To the best of our knowledge, the only case with this condition, who had been treated using a closed method was reported by MacSween in 1978. This paper reports a ten-year-old girl who fell from a desk onto her outstretched left hand. The initial radiographs showed a simple posterior dislocation of the elbow. However, the radiographs taken after the closed reduction revealed a translocation of both forearm bones. It was possible to relocate both bones using a closed method, and the patient recovered from the associated ulnar nerve palsy at five weeks post-trauma. At the follow-up examination three months post-trauma, the nerve was found to be fully regenerated using electromyography and a nerve conduction study, and the patient regained the full range of elbow motion without pain. When a posterior dislocation of the elbow occurs, close attention is needed in order to detect the combined translocation of the proximal radio-ulnar joint. If treated early, a closed reduction leads to a good result. However, a careful physical examination and a thorough investigation of the radiographs are necessary.

Three small muscles of the proximal radio-ulnar joint in Thais.

A post-mortem study on the frequency of occurrence of the muscles of the annular ligament of the radius was carried out on 68 male and 74 female Thais, 144 elbows. The age of those studied ranged from 16 to 98 years. Three small muscles of the proximal radio-ulnar joint, the medial tensor muscle of the annular ligament of the radius, the lateral tensor muscle of the annular ligament of the radius and accessory supinator muscle were found in 89 cases (61.8%), 66 cases (45.8%) and three cases (2%), respectively. Lateral tensor muscle of the annular ligament of the radius was commonly found on the right side of males more than on the left side, and on the right side of females (p < 0.05).

Treatment of the Bilateral Congenital Radio / 대한정형외과학회잡지

The congenital radio-ulnar synostosis is a rare malformation which often completely perevents pronation and supination of the forearm. Recently, this disese has no good result by treatment including various operative techniques. The authors have experience a case of the congenital radio-ulnar synostosis, which was corrected by modified Green method and satisfactory result was obtained.