1/73. Communicating defects of the triangular fibrocartilage complex without disruption of the triangular fibrocartilage: a report of two cases.Perforations or communicating defects of the triangular fibrocartilage complex have been more commonly identified after Palmer published his classification system (J hand Surg 1989;14A:594-606). To his variants of class 1B (traumatic) ulnar avulsion with or without distal ulnar fracture, a third category may be added: defects of the ulnar collateral ligament without any associated disruption of the triangular fibrocartilage. The ulnar collateral ligament can be defined as an ulnar capsular structure between the more discrete elements of the triangular fibrocartilage and the ulnar ligaments, with the defect or perforation being distal to the intact triangular fibrocartilage and exiting into the floor of the extensor carpi ulnaris sheath. We present 2 cases that illustrate the diagnosis, the use of both magnetic resonance imaging and arthrography to confirm the diagnosis, the associated dorsal ulnar cutaneous nerve pain distribution, and the open direct and retinacular flap repair.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/73. Transverse carpal ligament disruption associated with simultaneous fractures of the trapezium, trapezial ridge, and hook of hamate: a case report.Traumatic disruption of the transverse carpal ligament associated with fractures of the trapezial ridge and hook of hamate is a known entity. Only one report of a coronal fracture of the trapezium has been mentioned in the literature. We report a combination of these two injury patterns. diagnosis was aided by computed tomography. Treatment involved excision of the trapezial ridge and hook of hamate fragments with lag screw fixation of the trapezial body fracture.- - - - - - - - - - ranking = 1.6666666666667keywords = ligament (Clic here for more details about this article) |
3/73. Dynamic axial carpal instability: a case report.The concept of distal carpal row dissociation is not new. It has occurred secondary to high-energy crush or blast injuries, with resultant axial dislocations of both carpal rows and metacarpals. Axial carpal sprains without disruption or dynamic axial carpal instability have not been previously described. The evaluation of this new type of carpal instability with radiographs, tomography, arthrography, and magnetic resonance imaging failed to demonstrate its etiology. Arthroscopic evaluation of the midcarpal and radiocarpal joints demonstrated a dynamic axial carpal instability with incompetence of the capitohamate and scapholunate ligaments. Stabilization of the axial instability by capitohamate arthrodesis relieved the chronic wrist pain.- - - - - - - - - - ranking = 0.33333333333333keywords = ligament (Clic here for more details about this article) |
4/73. wrist arthroscopy and dislocation of the radiocarpal joint without fracture.The authors report a rare case of dorsal dislocation of the radiocarpal joint without any bony lesion associated. The traumatic cause was a high energy motorbike accident. Fractures of the other limbs were associated. The authors report the clinical, radiological, and arthroscopic features. wrist arthroscopy showed a complete tear of all the extrinsic ligaments, a radial avulsion of the triangular fibrocartilage complex, and the integrity of the intracarpal ligaments, which guided the treatment. The dislocation was treated by closed reduction and radiocarpal pinning. The authors propose wrist arthroscopy in radiocarpal dislocation for diagnosis of soft tissue and cartilaginous lesions to guide the treatment (close or open).- - - - - - - - - - ranking = 0.66666666666667keywords = ligament (Clic here for more details about this article) |
5/73. Dynamic radial translation instability of the carpus.We report a case of a dynamic radial translation instability of the carpus, secondary to avulsion of the ulnocarpal ligaments and attenuation of the short radiolunate ligament. In addition, there was a peripheral detachment of the distal radioulnar ligaments causing distal radioulnar instability. Reattachment of the avulsed ligaments combined with a Sauve-Kapandji procedure resulted in an excellent function, which was maintained 10 years after surgery.- - - - - - - - - - ranking = 1.3333333333333keywords = ligament (Clic here for more details about this article) |
6/73. Ulnar translocation instability of the carpus after a dorsal radiocarpal dislocation: a case report.An unusual case of ulnar translocation of the carpus after a radiocarpal dislocation is described. Persistent instability was noted despite attempted reattachment of the avulsed palmar capsuloligamentous structures. A successful outcome occurred after radiolunate arthrodesis and external fixation of the wrist.- - - - - - - - - - ranking = 0.33333333333333keywords = ligament (Clic here for more details about this article) |
7/73. Osteoligamentoplasty and limited dorsal capsulodesis for chronic scapholunate dissociation.Treatment of chronic scapholunate dissociation remains unsatisfactory. As the dorsal part of scapholunate interosseous ligament (SLIL) seems to be the "critical corner" of the scapholunate stability, its replacement by an analogous structure could restore scapholunate stability. A procedure is described which combines reconstruction of the dorsal region of the SLIL by means of an osteoligamentous autograft, harvested at the carpus (dorsal trapezoidometacarpal II ligament) and limited dorsal capsulodesis. The limited dorsal capsulodesis is performed using the scaphotriquetral head of the dorsal intercarpal ligament left attached to the distal pole of the scaphoid and fixed with a bone anchor on the dorsal aspect of the lunate. The osteoligamentous autograft prevents scapholunate dissociation and dorsal scaphoid subluxation. The dorsal capsulodesis limits scaphoid flexion and allows synergistic scapholunate mobility. This combination should stabilize the scaphoid in the horizontal as well as sagittal planes. The advantages of this technique are: 1) a single incision; 2) replacement of a ligament by an analogous autograft; 3) faster healing by bone-to-bone apposition; 4) more anatomic and physiologic reconstruction. Three patients are presented to illustrate the technique.- - - - - - - - - - ranking = 3.3333333333333keywords = ligament (Clic here for more details about this article) |
8/73. A trans STT, trans capitate perilunate dislocation of the carpus. A case report.We report a case of carpal injury not previously described, associating three lesions of the carpus secondary to a hyperextension mechanism: fracture of the capitate, scapho-trapezio-trapezoid sprain and lunotriquetral ligament rupture. The patient was operated by percutaneous pinning after closed reduction. The capitate fracture was not fixed. At follow-up, the patient had no restriction of his everyday activities and was very satisfied.- - - - - - - - - - ranking = 0.33333333333333keywords = ligament (Clic here for more details about this article) |
9/73. Anchor limited arthrodesis of the wrist.We present a case of lunate dislocation with total disruption of all ligaments and, consequently, nutrient vessels. The injury was handled by fusion of the lunate with the scaphoid, capitate and triquetrum. This 'anchor fusion' has led to a very good long-term result.- - - - - - - - - - ranking = 0.33333333333333keywords = ligament (Clic here for more details about this article) |
10/73. Traumatic disruption of a fibrocartilage lunate-triquetral coalition--a case report and review of the literature.Whilst osseous coalitions of the lunate and the triquetrum are known to be asymptomatic, fibrocartilage lunate-triquetral coalitions can present an uncommon cause for ulnar-sided wrist pain. To diagnose this condition a high degree of suspicion is needed. We present a case with painful post-traumatic disruption of a fibrocartilage lunate-triquetral coalition that was primary misdiagnosed to be a disruption of the interosseous lunotriquetral ligament and was initially treated arthroscopically. Persistent symptoms lead to X-ray examination of the opposite wrist, revealing a complete osseous lunate-triquetral coalition. CT and MRI investigations demonstrated the fibrocartilage coalition of the affected wrist. Subsequently, lunotriquetral fusion using a cannulated Herbert screw was performed and settled the symptoms completely.- - - - - - - - - - ranking = 0.33333333333333keywords = ligament (Clic here for more details about this article) |
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