Cases reported "Wrist Injuries"

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1/39. magnetic resonance imaging of growth plate injuries: the efficacy and indications for surgical procedures.

    In 23 patients with growth plate injuries, magnetic resonance imaging (MRI) studies were performed a total of 31 times to evaluate the physis which showed plain radiographic evidence of possible damage. Fourteen patients clinically showed growth arrest, and 10 patients required a Langenskiold operation. In 3 patients who underwent this operation, subsequent premature total fusion of the physis adversely affected the postoperative results. We propose that the merging shape of the arrest line with calcification of the provisional zone of the metaphysis shown by MRI indicates poor viability of the physis. MRI provided useful information on the appearance of the growth plate and changes in the metaphysis, both of which affected the prognosis and the results of the surgical procedures.
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keywords = operative
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2/39. Transstyloid radiocarpal dislocation.

    We presented two cases of a transstyloid radiocarpal dislocation which required operative treatment and resulted in satisfactory outcomes. This lesion has been liable to confuse with some types of intra-articular fractures of the distal radius such as Barton's fracture. Previous reports were also critically reviewed.
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keywords = operative
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3/39. Traumatic axial dislocation of the carpus: a case report of transscaphoid pericapitate transhamate axial dislocation.

    Traumatic axial dislocation of the carpus in a 20-year-old man is described. This injury was accompanied by a crushing injury to the hand. The disruption pattern was different from those of previously reported cases. Despite the restoration of painless wrist motion postoperatively, grip strength remained below normal. Early accurate reduction, fixation, and range of motion (ROM) exercise are the treatment of choice in such complex injuries.
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ranking = 1
keywords = operative
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4/39. Wrist arthroscopy through a volar radial portal.

    PURPOSE: To quantitatively describe the neurovascular relationships of a volar radial wrist arthroscopy portal and to evaluate whether volar wrist arthroscopy identified additional pathology of the dorsal capsular structures and the palmar region of the scapholunate interosseous ligament that was not seen through the dorsal portals. TYPE OF STUDY: This study was an anatomic study and retrospective chart review. methods: cadaver dissections established the neurovascular anatomy of the volar radial portal. Measurements were taken from the portal to the radial artery and its superficial palmar branch; the superficial radial nerve, the median nerve, and its palmar cutaneous branch; and the pronator quadratus. A dorsal capsulotomy was performed to assess the ligamentous interval. A chart review of 30 patients in whom a volar radial portal was used was performed. Intraoperative pathology identified through volar wrist arthroscopy that was not visible through a dorsal portal was recorded. Postoperative neurovascular complications were noted. RESULTS: There was a greater than 3 mm safe zone surrounding the portal that was free of any neurovascular structures. There were no complications from the use of the portal. Additional pathology that was not visible from a dorsal portal was identified in 10 cases. This included 1 case of hypertrophic synovitis of the dorsal capsule, 1 patient with an avulsion of the radioscapholunate ligament, 1 patient with a tear restricted to the palmar region of the scapholunate interosseous ligament, and 7 patients with tears of the dorsal radiocarpal ligament. CONCLUSIONS: This study provides a safe, standardized approach to the volar radial aspects of the radiocarpal and midcarpal joints. Volar wrist arthroscopy identified additional pathology of the palmar scapholunate interosseous ligament and dorsal capsular structures in 30% of the patients. The volar radial portal should be considered for inclusion in the arthroscopic examination of any patient with radial-sided wrist pain.
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ranking = 2
keywords = operative
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5/39. Posttraumatic volar tendon subluxation out of the first extensor compartment: a case report.

    Symptomatic volar subluxation of the abductor pollicis longus and the extensor pollicis brevis tendons developed in a 29-year-old man after a sprain that occurred with the wrist in flexion and ulnar deviation. The extensor retinaculum, which forms the extensor compartment, was partially avulsed from its insertion on the radius. Palmar abduction and extension of the thumb with the wrist flexed produced subluxation of the tendons over the volar side of the radius ridge where the retinaculum forming the first extensor compartment attached. Nonoperative treatment including steroid injection and splinting was ineffective. Surgery was performed to reconstruct a new tendon restraint with part of the extensor retinaculum.
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ranking = 1
keywords = operative
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6/39. Acute dorsal trans-scaphoid perilunate fracture-dislocations: medium-term results.

    The purpose of this study was to investigate the medium-term results (mean follow-up, 8 years) of a series of 14 trans-scaphoid dorsal perilunate fracture-dislocations treated operatively at an average of 6 days following injury. Eleven underwent open reduction and internal fixation through a dorsal approach. Combined palmar and dorsal approaches were used in only three cases, for open reduction and internal fixation in two and proximal row carpectomy in one. The Mayo wrist score revealed five excellent, three good, five fair and one poor result. The average score was 79% (range 55-95%). All internally fixed scaphoids healed and no lunate or scaphoid fragment avascular necrosis with collapse was observed. Carpal alignment was satisfactory in most cases. Post-traumatic radiological midcarpal and/or radiocarpal arthritis were almost always observed at follow-up, but this did not correlate with the Mayo wrist score.
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ranking = 1
keywords = operative
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7/39. Flexor carpi radialis tendon rupture following chronic wrist osteoarthritis: a case report.

    A patient is reported with a history of multiple tendon ruptures including biceps, flexor hallucis longus and achilles tendons. He presented with closed rupture of the flexor carpi radialis tendon following long standing tendonopathy and scapho-trapezio-trapezoid arthrosis. Non-operative treatment was elected because of low physical demands on the upper extremity. Early management of scapho-trapezio-trapezoid arthritis can prevent flexor carpi radialis tendon rupture.
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ranking = 1
keywords = operative
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8/39. Loose body in the wrist: diagnosis and treatment.

    PURPOSE: The purpose of this study was to report on 10 cases of symptomatic loose bodies in the wrist joints diagnosed using arthroscopy. TYPE OF STUDY: Retrospective review. methods: From 1986 to 2000, we performed wrist arthroscopy for 707 patients, 10 of whom had loose bodies in the wrist joints. The clinical records were reviewed retrospectively. The patients included 8 men and 2 women, and the average age was 28 years (range, 16 to 67 years). The chief complaint was wrist pain in all patients, but locking was uncommon. Preoperative diagnosis was difficult in all but 3 cases; in those cases, an osseous component was found within the loose bodies. The remaining cases were diagnosed by wrist arthroscopy. RESULTS: The loose bodies existed in the radiocarpal joint in 5 cases, and all could be removed arthroscopically. In the other 5 cases, the loose bodies were in the distal radioulnar joint, and arthrotomy was needed to remove them. After removal of the loose bodies, the pain was relieved in all cases without any surgical complications. CONCLUSIONS: Loose bodies in the wrist joint should be included in the differential diagnosis for chronic wrist pain. Wrist arthroscopy is of value because the preoperative diagnosis is usually difficult.
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ranking = 2
keywords = operative
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9/39. rehabilitation techniques for ligament injuries of the wrist.

    The goal of treatment after any wrist injury is a pain-free, stable joint with sufficient strength and mobility to carry out the daily recreational, and occupational tasks required by the individual. Treatment varies considerably depending on the age of the patient, the severity of the initial injury, the operative procedure performed, and the specific guidelines requested by the referring physician.
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ranking = 1
keywords = operative
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10/39. Dorsal wrist syndrome repair.

    Dorsal wrist pain with or without a palpable dorsal wrist ganglion is a common complaint. Watson developed the concept of the dorsal wrist syndrome (DWS) which is an entity encompassing pre-dynamic rotary subluxation of the scaphoid and the overloaded wrist. We reviewed 20 cases of DWS treated surgically. There were nine males (11 wrists) and nine females (nine wrists). Post-operative follow-up ranged from five to 67 months (mean, 37 months). At operation, we observed SLL tears in eight wrists and dorsal ganglia in 12 cases. Following surgery, 12 cases reported being pain free, five had mild pain, two moderate pain and one case reported severe pain. Post-operative extension/flexion was 73/70 average. Post-operative grip strength was 28 kg average. We believe that excision of the posterior interosseous nerve and the dorsal capsule including the ganglion, if present, provides pain relief in DWS.
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ranking = 3
keywords = operative
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