Triangular Fibrocartilage Complex Repair/Reconstruction
The triangular fibrocartilage complex (TFCC) is an intricate structure that plays an important role in providing distal radioulnar joint stability and load transmission at the ulnar wrist. Understanding this structure is critical for creating treatment plans based on patient history, physical examination, and imaging. Arthroscopic, arthroscopic-assisted, and open surgical treatment options exist for tears meeting distinct surgical criteria that are discussed in this article. Although long-term comparative outcomes studies are limited, long-term retrospective outcome studies of TFCC repair and reconstructive techniques demo...
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Authors: Lauren M. Shapiro, Jeffrey Yao Source Type: research
Dry Wrist Arthroscopy in the Management of Ulnar Wrist Pain Disorders
The use of wrist arthroscopy has evolved to being a powerful tool to not only diagnose but also treat wrist disorders. With the improvement in technology and surgical technique, many of the procedures can be done using dry wrist arthroscopy (DWA). DWA can be used to treat a wide spectrum of ulnar wrist disorders. In this article, we aim to highlight some technical pearls as well as show its use to treat common ulnar wrist pain disorders. (Source: Hand Clinics)
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Authors: Marion Burnier, Sanjeev Kakar Source Type: research
LT Ligament Tears
Lunotriquetral (LT) ligament injuries are uncommon, however, should be considered in patients with ulnar-sided wrist pain. LT injuries are often associated with other injuries but can occur in isolation. Understanding the anatomy and pathomechanics will aid in making the diagnosis. Similar to other injuries, a thorough history and focused physical examination is critical. Radiographs may show normal findings; however, advanced imaging can support the diagnosis. Arthroscopy remains the gold standard for diagnosis. Most patients do well with conservative management; however, injury acuity and severity will direct surgical ma...
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Authors: Gregory K. Faucher, Mark Christian Moody Source Type: research
Ulnocarpal Impaction
Ulnocarpal impaction syndrome is a common cause for ulnarsided wrist pain caused by an abutment between the ulnar head and the lunotriquetral complex. This pain is typically triggered by load bearing and rotation of the forearm. Radiographic examination is often associated with positive ulnar variance and cysts in the lunate, edema of the ulnoproximal lunate is shown in MRI. Operative treatment aims to reduce load on the lunate, either by open ulnar shortening osteotomy or arthroscopic wafer procedure. (Source: Hand Clinics)
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Authors: Nico Leibig, Florian M. Lampert, Max Haerle Source Type: research
Treatment Options for Distal Radioulnar Joint Arthritis
The distal radioulnar joint is a complex anatomic structure that allows for a combination of rotation and translation with extrinsic and intrinsic stabilizers that maintain stability through a delicate equilibrium. Traumatic, congenital, inflammatory, and degenerative processes can disturb this sensitive balance, resulting in distal radioulnar joint arthritis. We discuss the joint ’s anatomy and biomechanics and the clinical approach to the patient. We review the surgical treatment options, expected outcomes, and their shortcomings. Selecting the best surgical intervention often means choosing the procedure with the set ...
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Authors: Gina Farias-Eisner, Stephen D. Zoller, Nicholas Iannuzzi Source Type: research
Distal Radioulnar Joint Instability
This article describes the pathophysiology of distal radioulnar joint instability with attention to the anatomic structures involved and provides information about evaluation and treatment. (Source: Hand Clinics)
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Authors: Brandon Boyd, Julie Adams Source Type: research
Advanced Imaging of Ulnar Wrist Pain
Ulnar-sided wrist pain can be a diagnostic challenge for clinicians and radiologists. The ulnar wrist has complex morphology and is composed of many small bone and soft tissue structures. Within these structures, a wide variety of pathologic conditions can occur. To successfully diagnose and treat these pathologic conditions, clinicians and radiologists must have a strong understanding of the advanced imaging techniques available to them. In this review, the authors present a brief review of the normal ulnar wrist anatomy, discuss the differential diagnosis of ulnar-sided wrist pain, and examine the indications for differe...
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Authors: R. Timothy Kreulen, Suresh K. Nayar, Yasmin Alfaki, Dawn LaPorte, Shadpour Demehri Source Type: research
Hook of Hamate Fractures
Hook of hamate fractures are uncommon injuries with unclear prevalence. Classic presenting symptoms include volar-ulnar hand/wrist pain and weakness in grip, with possible ulnar nerve paresthesias. Patient factors, such as activity level and desired return to work/sport, shape the most appropriate treatment regimen although excision of the hook has been adopted by most surgeons. Overall, once patients receive the correct diagnosis and are treated, good outcomes with high satisfaction rates are expected. (Source: Hand Clinics)
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Authors: Andrea Tian, Charles A. Goldfarb Source Type: research
Ulnar-sided Wrist Pain
HAND CLINICS (Source: Hand Clinics)
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Authors: Dawn Laporte Source Type: research
Copyright
ELSEVIER (Source: Hand Clinics)
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Source Type: research
Contributors
KEVIN C. CHUNG, MD, MS (Source: Hand Clinics)
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Source Type: research
Contents
Dawn LaPorte (Source: Hand Clinics)
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Source Type: research
Forthcoming Issues
Use of Sonography in Upper Extremity Surgery: Innovative Concepts and Techniques (Source: Hand Clinics)
Source: Hand Clinics - October 1, 2021 Category: Orthopaedics Source Type: research
Nonsurgical Approaches to Neuroma Management
Symptomatic neuromas and chronic neuropathic pain are significant problems affecting patients ’ quality of life and independence that are challenging to treat. These symptoms are due to structural and functional changes that occur peripherally within neuromas, as well as alterations that occur centrally within the brain and spinal cord. A multimodal approach is most effective, with goals t o minimize opioid use, to capitalize on the synergistic effects of nonopioid medications and to explore potential benefits of novel adjunctive treatments. (Source: Hand Clinics)
Source: Hand Clinics - July 10, 2021 Category: Orthopaedics Authors: Yusha Liu, Dennis S. Kao Source Type: research
Traditional Neuroma Management
With the development of newer techniques for symptomatic neuroma treatment, such as regenerative peripheral nerve interface and targeted muscle reinnervation, transposition and coverage techniques often have been referred to as “passive techniques.” In spite of its negative connotation, these passive techniques yield positive results in a majority of patients treated. The exp erienced surgeon has more options than ever before in the prevention and management of problematic neuromas. Critical appraisal of the current literature reveals no single, optimal standard of care. Instead, surgeons have a plethora of useful te...
Source: Hand Clinics - July 10, 2021 Category: Orthopaedics Authors: Brian W. Starr, Kevin C. Chung Source Type: research
