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
We present a statistical analysis of the problem of ordering large genomic cloned libraries through overlap detection based on restriction fingerprinting. Such ordering projects involve a large investment of effort involving many repetitious experiments. Our primary purpose here is to provide methods of maximizing the efficiency of such efforts. To this end, we adopt a statistical approach that uses the likelihood ratio as a statistic to detect overlap. The main advantages of this approach are that (1) it allows the relatively straightforward incorporation of the observed statistical properties of the data; (2) it permits the efficiency of a particular experimental method for detecting overlap to be quantitatively defined so that alternative experimental designs may be compared and optimized; and (3) it yields a direct estimate of the probability that any two library members overlap. This estimate is a critical tool for the accurate, automatic assembly of overlapping sets of fragments into islands called "contigs." These contigs must subsequently be connected by other methods to provide an ordered set of overlapping fragments covering the entire genome.
