RESUMO
We carried out a retrospective study to analyse the long-term outcome of 36 patients after radial shortening osteotomy for treatment of Lichtman Stage IIIA Kienböck disease at a mean follow-up of 12.1 years (range 5.4-17.5). At review, seven wrists had progressed to Stage IIIB, eight wrists to Stage IV and 21 remained in Stage IIIA. Motion and grip strength were significantly improved. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score at review was 12 points (range 0-52), and patient satisfaction was high. Apart from plate removals in 14 patients and one wrist denervation, no subsequent surgical procedures were done. Radial shortening yields good long-term clinical results, but does not prevent radiographic progression of disease in some patients. LEVEL OF EVIDENCE: Therapeutic IV.
Assuntos
Osteonecrose/cirurgia , Osteotomia , Rádio (Anatomia)/cirurgia , Articulação do Punho , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteonecrose/diagnóstico por imagem , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
This paper describes the surgical technique to reconstruct the distal radioulnar ligaments using the palmaris longus tendon as inaugurated by Brian Adams. A video can be approach online.
Assuntos
Instabilidade Articular/cirurgia , Ligamentos Articulares/lesões , Ligamentos Articulares/cirurgia , Transferência Tendinosa/métodos , Traumatismos do Punho/cirurgia , Humanos , Instabilidade Articular/diagnóstico , Técnicas de Sutura , Traumatismos do Punho/diagnósticoRESUMO
We report the case of 35-year-old woman with severe Madelung's deformity. Having undergone a Kapandji-Sauvé-procedure with wide excision of the distal ulna, the patient suffered from painful instability of the ulnar stump. Although a corrective osteotomy of the distal radius had been performed, severe ulnar inclination of the distal radius remained, leaving persisting pain. Implantation of a constrained distal radioulnar joint prosthesis combined with a renewed extraarticular corrective osteotomy of the distal radius was performed. The peg of the radial plate of the prosthesis was placed in the screw hole of the large-fragment lag screw removed after the Kapandji-Sauvé-procedure.
