ABSTRACT
A retrospective two-center outcome study was designed to evaluate the results of capitolunate arthrodesis with scaphoid and triquetrum excision mainly for scapholunate advanced collapse patterns of arthritis. Fourteen wrists in 14 patients were evaluated objectively by standard parameters and subjectively by the Short Musculoskeletal Functional Assessment at an average of 28 months after surgery (range, 14-51 months). All patients were men between the ages of 20 and 70 years (average, 49 years). Two patients had a painful nonunion and one had persistent pain despite conversion to a solid wrist arthrodesis. One patient had x-ray evidence of progressive radiolunate narrowing, but only occasional pain. Postoperative wrist flexion-extension arc was 53 degrees and radioulnar deviation arc was 18 degrees. Grip and pinch strengths were 71% and 75%, respectively, of the normal contralateral wrist. The results of our study indicate that capitolunate arthrodesis with scaphoid and triquetrum excision is comparable to other motion-preserving operative procedures for scapholunate advance collapse.
Subject(s)
Arthrodesis/instrumentation , Carpal Bones/surgery , Lunate Bone/surgery , Osteoarthritis/surgery , Scaphoid Bone/surgery , Adult , Aged , Carpal Bones/diagnostic imaging , Carpal Bones/injuries , Follow-Up Studies , Hand Strength/physiology , Humans , Lunate Bone/diagnostic imaging , Lunate Bone/injuries , Male , Middle Aged , Osteoarthritis/diagnostic imaging , Osteoarthritis/etiology , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Radiography , Range of Motion, Articular/physiology , Reoperation , Scaphoid Bone/diagnostic imaging , Scaphoid Bone/injuries , Wrist Injuries/complications , Wrist Injuries/diagnostic imaging , Wrist Injuries/surgeryABSTRACT
Isolated capitate fractures are rare and may be underdiagnosed, especially when fracture displacement is minimal or absent. Our case report of a nondisplaced capitate waist fracture exemplifies the need for careful evaluation because initial plain radiographs were considered normal and appropriate treatment was delayed. This report also documents the use of magnetic resonance imaging in diagnosing such fractures.
Subject(s)
Carpal Bones/injuries , Fractures, Bone/diagnosis , Magnetic Resonance Imaging , Adult , Fractures, Bone/diagnostic imaging , Humans , Male , RadiographyABSTRACT
Crush injuries to the hand and forearm from mechanical devices and heavy equipment are a frequently seen injury in heavily industrialized areas. These injuries are particularly difficult due to their unpredictability, individualized nature and often devastating results. To optimize the outcome for these patients, it is essential to educate the nursing staff on emergent as well as ongoing care, form a systemized plan of care, and recruit patient and family support. A multiskilled group effort will be required to allow the patient with crushed tissue to realize optimal potential and return to a functional position in society.
Subject(s)
Forearm Injuries/nursing , Hand Injuries/nursing , Soft Tissue Injuries/nursing , Adult , Humans , Male , Neurologic Examination , Nursing Diagnosis , Nursing RecordsSubject(s)
Finger Injuries/surgery , Muscle, Skeletal/injuries , Wounds, Nonpenetrating/surgery , Adult , Finger Injuries/diagnosis , Follow-Up Studies , Hand Strength/physiology , Humans , Male , Muscle, Skeletal/surgery , Rupture , Tendon Injuries/diagnosis , Tendon Injuries/surgery , Wounds, Nonpenetrating/diagnosisABSTRACT
Because the clinical diagnosis of rupture of a digital flexor tendon was uncertain 10 days after primary repair, magnetic resonance imaging was used for evaluation, correlating precisely with the surgical pathology. This non-invasive tool can be very helpful in the early post-operative period when active flexion is not possible to aid in the clinical diagnosis of tendon rupture.
