ABSTRACT
Between 1989 and 1995, 33 patients were treated with a Kapandji-Sauvé procedure for malunited fracture of the distal radius and instabilities of the distal radioulnar joint. Thirty patients were followed up with a mean follow-up time of 91 months. Fourteen patients underwent a measurement of bone density of the distal forearm. Twenty-eight patients showed good ossification of the distal radioulnar arthrodesis. Forearm rotation improved by 17.3 %. Mean grip strength was 72 % of that of the contralateral hand. Evaluation by the Cooney score resulted in 10 % very good, in 65 % good, 22 % fair and in 3 % poor results. The measurement of bone density of the distal radius showed an increase of rotation and flexure firmness. The cortical density remained constant. In the subcortical bone of the distal radius, we found a decrease of the trabecular density in the radial part.
Subject(s)
Arthrodesis/methods , Bone Density , Fractures, Malunited/surgery , Radius Fractures/surgery , Wrist Joint/surgery , Adult , Aged , Arthroscopy , Bone Plates , Female , Follow-Up Studies , Fracture Fixation, Internal/methods , Hand Strength , Humans , Male , Middle Aged , Osteotomy , Patient Satisfaction , Radiography , Radius Fractures/diagnosis , Radius Fractures/diagnostic imaging , Time Factors , Ulna/surgeryABSTRACT
In a prospective study we investigated the results of 18 patients with Kienböck's disease stage II as defined by Decoulx, treated with transposition of the pedicled pisiform. In eight cases of minus variance of the ulna, a radius shortening osteotomy was performed. There was an average follow-up of 30 months, X-ray investigations were done every six months after operation. 17 patients had less pain, 14 patients showed an improved range of motion of 30 degrees. Magnetic resonance imaging proved vitalizing of the pisiforme in 16 cases.
Subject(s)
Carpal Bones/transplantation , Lunate Bone/surgery , Microsurgery/methods , Osteochondritis/surgery , Osteonecrosis/surgery , Adolescent , Adult , Arteries/surgery , Carpal Bones/blood supply , Female , Follow-Up Studies , Humans , Lunate Bone/blood supply , Lunate Bone/pathology , Magnetic Resonance Imaging , Male , Osteochondritis/diagnosis , Osteonecrosis/diagnosis , Postoperative Complications/diagnosis , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Evaluation, therapeutical possibilities, and surgical planning for the restoration of bilateral grip function are described, based upon a 34-year-old engineer presenting after severe bilateral frostbite of the hands and feet with loss of all fingers and toes. Finally, the given level of amputation and remaining components of the hand together with distraction-lengthening of both thumbs permitted restoring a basic grip on both sides in combination with bone and soft tissue procedures.
