– Discussion: – injury must occur to both interosseous and capsular ligaments for rotational instability of the scaphoid to occur; – dorsal approach to the wrist: – reduce scaphoid into the extended position; – surgeons gloved finger presses the distsal pole of scaphoid into an extended position; – K wire is inserted … Read more
– Discussion: – anatomy and ligamentous contraints: – ligaments of the wrist – SL interosseous ligament – SLD is most common and most significant ligament injury of wrist; (carpal instability); – risk factors: ulna minus configuation, slope of radial articular surface, and lunotriquetral coalition; – spectrum of injury: (increasing severity) – ref: Association of lesions of … Read more
Distal avulsion fractures of the scaphoid. Long-Term Results of Fracture of the Scaphoid. A Follow-up Study of More Than Thirty Years. Percutaneous screw fixation for fractures of the scaphoid Complications of scaphoid silicone arthroplasty. Kinematic considerations of the wrist Prosthetic silicone scaphoid strains: effects of intercarpal fusions. Complications and results of scapho-trapezio-trapezoid arthrodesis. Silicone-rubber implant arthroplasty … Read more
– See: Differential Diagnosis of Dorsal Wrist Pain – Discussion: – scaphoid impaction syndrome occurs usually as result of repetitive hyperextension stresses such as occur in floor exercises of gymnasts, when weight lifters rest the weight bar on their palms, or from excessive push-ups; – occasionally single forceful injury will … Read more
– See: Avascular Necrosis of the Scaphoid – Discussion: – often result from undiagnosed or undertreated non displaced scaphoid fractures, especially when associated w/ carpal instability; – even when found as late as 6 mo after the injury, frx of scaphoid, esp at the waist and distal location, may go on to heal; … Read more
– Discussion: – indicated for patients w/ delayed unions or non unions of scaphoid waist; – cautions: distal-waist fractures may not be amenable to this form of fixation if the screw threads cross the fracture site; – Technique: – see: volar surgical approach: – may result in … Read more
– Work Up for Scaphoid Fracture: (w/ discussion) – clinical differential diagnosis: – distal radius frx – transscaphoid perilunate dislocation: – scaphoid impaction syndrome – radiographs and determination of stability (CT scan) – non diagnostic radiograph (bone scan) – tubercle frx – transverse waist frx – proximal pole frx – treatment: … Read more
– Discussion: – scaphoid shift maneuver is performed by placing the examiner’s thumb over palmar aspect of the distal pole of the scaphoid; – constant pressure is maintained with the examining thumb as the wrist is moved from a position of extension, ulnar deviation to flexion, radial deviation, and back again; … Read more
– Discussion: – scapholunate advanced collapse (SLAC) refers to a specific pattern of osteoarthritis and subluxation which results from untreated chronic scapholunate dissociation or from chronic scaphoid non-union; – degenerative changes occur most often in areas of abnormal loading; – radial-scaphoid joint is involved initially, followed by … Read more
– Discussion: – indicated for arthritic RU Joint w/ limitation of motion; – may be useful for rheumatoid patients w/ ulnar translocation, as well as the caput ulna syndrome; – procedure involves resection of a portion of distal ulna shaft and fusion of the ulnar head to the radius; … Read more