China
Africa
Explore chapters and articles related to this topic
Surgery of the Wrist
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Ramon Tahmassebi, Sirat Khan, Kalpesh R Vaghela
If a spider plate is being used, the four bones are reduced with temporary wires, and a reamer is used to create a dorsal trough in which the plate will sit and be recessed so as not to cause impingement. Cortical and/or locking screws are used to create compression and stable fixation of the four bones. If headless screws are being used, the mid-carpal joint must be denuded of all articular cartilage until bleeding cancellous bone is seen. Strong ligamentous attachments between capitate and hamate mean that this joint does not necessarily need preparation or stabilization with an implant. If the lunotriquetral ligament remains intact, the same rationale can be applied. Bone graft can be used to fill defects and to maintain carpal height. Again, temporary K-wire stabilization allows placement of guide wires along the central axes of the two columns. Note must be taken of the obliquity of the triquetro-hamate joint in relation to the more horizontally orientated luno-capitate joint. Screw lengths are determined ensuring that the heads are sufficiently buried so as not to cause injury to the surfaces of the lunate fossa or TFCC (Figure 8.12).
Forearm and hand
Published in Pankaj Sharma, Nicola Maffulli, Practice Questions in Trauma and Orthopaedics for the FRCS, 2017
Pankaj Sharma, Nicola Maffulli
Q24 A 23-year-old mechanic has a 2-week history of pain and clicking in his right wrist. He sustained an injury to the wrist prior to the onset of symptoms, which he thought was just a sprain. On examination the wrist is swollen and he is diffusely tender over the dorsolateral part of the wrist. Standard radiographs of the wrist do not show any fracture, but dorsal translation of the capitate is noted. What should be the next investigation of choice?
Test Paper 4
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
A young adult man presents with a painful left wrist following a fall from height. A lateral view of the wrist shows loss of co-linearity of the radius/lunate/capitate axis with the capitate displaced dorsally. What injury is this constellation of findings compatible with? Midcarpal dislocationPerilunate dislocationLunate dislocationVolar intercalated segmental instabilityDorsal intercalated segmental instability
Two cases of pyrocarbon capitate resurfacing after comminuted fracture of the capitate bone
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
Aleid C. J. Ruijs, Joël Rezzouk
The first case (NJ) is an 18-year-old male right-hand dominant student, who presented with a traumatic injury of his right wrist after a scooter accident. On admission, radiographies (Figure 1(A,B)) showed a perilunate dislocation with associated fracture of the scaphoid waist and proximal pole of the capitate, also known as scapho-capitate syndrome or Fenton’s Syndrome [4]. There was also an avulsion fracture of the ulnar styloid. On the day of injury, an open reduction and temporary fixation were carried out. Using a dorsal approach, we found a marked comminution of the proximal pole of the capitate, a complete tear of the lunotriquetral ligament, a grade IV cartilage lesion at the level of the dorsal side of the lunate facet of the distal radius and a scaphoid waist fracture. K-wires were used to stabilize the scaphoid fracture, the lunotriquetral ligament was primarily sutured, and a spanning external fixator (PoingFIX wrist fixator, Small Bone Innovations, Morrisville, PA, US) from the radius to the metacarpal level was placed to provide temporary distraction at the carpal level. The remnants of the proximal pole of the capitate were removed (Figure 2(A)).
Simultaneous non-union of scaphoid and capitate: a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
Ryunosuke Fukushi, Kohei Kanaya, Kousuke Iba, Toshihiko Yamashita
In the present case, the capitate fracture had occurred at the middle portion, suggesting differences in the mechanism of occurrence between scaphocapitate syndrome and the condition in our case. We considered the following mechanism underlying the middle third fracture of the capitate. The transverse axis of the radius rotation might have transferred from the lunate to the proximal fragment of the scaphoid due to the non-union of the distal third of the scaphoid. Then, the lever arm from the rotation axis of the wrist to the radius might have moved farther, and the dorsal end of the radius might have hit the middle of the capitate, thus, resulting in a capitate fracture. The proximal fragment of the capitate might not have rotated because the fragment was larger.
Successful closed reduction of a trans-scaphoid perilunate dislocation in a 11-year-old boy: a case report
Published in Acta Chirurgica Belgica, 2023
Pierre Meynard, Audrey Angelliaume, Luke Harper, Gilles Mouret, Eric Hammel
Acute perilunate dislocation is an uncommon injury in adults and even more in children [1]. Indeed, bone immaturity and the inherent vulnerability of the distal radius usually protect childrens’ carpus from traumatic injury [2,3]. Acute perilunate dislocation happens after high-impact injury with hyperextension of the wrist [2–10]. The diagnosis is suspected by the presence of acute wrist pain and confirmed with the findings in radiographs or computed tomography images [1]. The capitate is moved dorsal or palmar to the lunate and carpal fractures can be associated.