RESUMO
This study reviews the results of a four-bone ligamentous weave reconstruction for treatment of chronic complete scapholunate separation. This reconstruction between the radius, lunate, capitate, and scaphoid employs a dorsal and palmar approach weaving a long strip of the extensor carpi radialis brevis through the four bones reducing and stabilizing the scaphoid and lunate with a wire loop. Thirty-six consecutive cases of operated chronic complete scapholunate separation were evaluated in a 2- to 10-year follow-up. Average length of follow-up was 4.8 years. Average age was 34 years. Average postoperative range of motion was 52 degrees extension and 37 degrees flexion. Grip strength averaged 73% of the noninvolved side. All preoperative scapholunate gaps seen on radiographs were greater than 4 mm, at surgery greater than 1.0 cm, and the postoperative gaps radiographically averaged 3.3 mm. Eighty-six percent of patients returned to preinjury activities including heavy labor. The most significant finding was no x-ray evidence of advancing arthritic changes.
Assuntos
Ossos do Carpo/lesões , Luxações Articulares/cirurgia , Ligamentos/cirurgia , Tendões/cirurgia , Adulto , Doença Crônica , Feminino , Seguimentos , Humanos , Masculino , Técnicas de Sutura , Transferência Tendinosa , Fatores de Tempo , PunhoRESUMO
Two cases of aneurysmal bone cyst occurred in the hand. One involved the distal phalanx and followed a crushing injury to the tip of the finger; amputation of the part resulted in cure. The other involved almost all of the first metacarpal and was resected and replaced by an iliac bone graft. The appearance of an aneurysmal bone cyst in roentgenograms and after angiography usually is not diagnostic, although benign, progressive growth and potential for recurrence require complete removal.
