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Orthopaedics & Traumatology, Surgery &... Feb 2015Painful wrist osteoarthritis can result in major functional impairment. Most cases are related to posttraumatic sequel, metabolic arthropathies, or inflammatory joint... (Review)
Review
Painful wrist osteoarthritis can result in major functional impairment. Most cases are related to posttraumatic sequel, metabolic arthropathies, or inflammatory joint disease, although wrist osteoarthritis occurs as an idiopathic condition in a small minority of cases. Surgery is indicated only when conservative treatment fails. The main objective is to ensure pain relief while restoring strength. Motion-preserving procedures are usually preferred, although residual wrist mobility is not crucial to good function. The vast array of available surgical techniques includes excisional arthroplasty, limited and total fusion, total wrist denervation, partial and total arthroplasty, and rib-cartilage graft implantation. Surgical decisions rest on the cause and extent of the degenerative wrist lesions, degree of residual mobility, and patient's wishes and functional demand. Proximal row carpectomy and four-corner fusion with scaphoid bone excision are the most widely used surgical procedures for stage II wrist osteoarthritis secondary to scapho-lunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC) wrist. Proximal row carpectomy is not indicated in patients with stage III disease. Total wrist denervation is a satisfactory treatment option in patients of any age who have good range of motion and low functional demands; furthermore, the low morbidity associated with this procedure makes it a good option for elderly patients regardless of their range of motion. Total wrist fusion can be used not only as a revision procedure, but also as the primary surgical treatment in heavy manual labourers with wrist stiffness or generalised wrist-joint involvement. The role for pyrocarbon implants, rib-cartilage graft implantation, and total wrist arthroplasty remains to be determined, given the short follow-ups in available studies.
Topics: Arthrodesis; Arthroplasty; Biomechanical Phenomena; Bone Transplantation; Carpal Bones; Decision Trees; Denervation; Humans; Osteoarthritis; Prostheses and Implants; Radiography; Range of Motion, Articular; Wrist Joint
PubMed: 25596986
DOI: 10.1016/j.otsr.2014.06.025 -
Hand Clinics Nov 2017After reviewing this article, readers should have a comprehensive understanding of the indications for diagnostic arthroscopy, technical considerations in performing a... (Review)
Review
After reviewing this article, readers should have a comprehensive understanding of the indications for diagnostic arthroscopy, technical considerations in performing a systematic evaluation of the wrist, and limitations of this technique.
Topics: Arthroscopes; Arthroscopy; Cartilage, Articular; Humans; Ligaments, Articular; Wrist Injuries; Wrist Joint
PubMed: 28991570
DOI: 10.1016/j.hcl.2017.06.004 -
Hand Clinics Nov 2021Extensor carpi ulnaris tendon subluxation can be a challenging diagnosis as a cause of wrist pain. The tendon is stabilized by a tough subsheath. This subsheath is... (Review)
Review
Extensor carpi ulnaris tendon subluxation can be a challenging diagnosis as a cause of wrist pain. The tendon is stabilized by a tough subsheath. This subsheath is vulnerable to tears in acute wrist movements, especially those combining supination, flexion, and ulnar deviation. The patient presenting acutely may experience swelling, tenderness, and pain. In a chronic setting, the complaint is often an unstable wrist. The diagnosis can be made with a thorough examination, and ultrasonography can be used to evaluate the dynamics of the tendon. Surgical repair with a flap of extensor retinaculum to re-create the tendon's stabilizing subsheath is recommended.
Topics: Forearm; Humans; Joint Dislocations; Tendon Injuries; Tendons; Wrist Joint
PubMed: 34602128
DOI: 10.1016/j.hcl.2021.06.005 -
Chinese Journal of Traumatology =... 2016Total wrist arthroplasty are not used as widely as total knee and hip replacement. The functional hands are requiring surgeons to design a durable and functional... (Review)
Review
Total wrist arthroplasty are not used as widely as total knee and hip replacement. The functional hands are requiring surgeons to design a durable and functional satisfying prosthesis. This article will list the main reasons that cause the failure of the prosthesis. Some remarkable and representative prostheses are listed to show the devolvement of total wrist prosthesis and their individual special innovations to fix the problems. And the second part we will discuss the part that biomechanical elements act in the total wrist replacement (TWA). Summarize and find out what the real problem is and how we can find a way to fix it.
Topics: Arthroplasty, Replacement; Biomechanical Phenomena; Humans; Joint Instability; Joint Prosthesis; Wrist Joint
PubMed: 27033274
DOI: 10.1016/j.cjtee.2015.12.003 -
Bulletin of the NYU Hospital For Joint... 2011Perilunate wrist injuries are relatively rare but devastating injuries that can alter the lifestyles of those sustaining them. It is important to recognize the magnitude... (Review)
Review
Perilunate wrist injuries are relatively rare but devastating injuries that can alter the lifestyles of those sustaining them. It is important to recognize the magnitude of the injury and to provide immediate and complete care to the patient. Two of the most important factors affecting outcomes are timing of the care provided and quality of the reduction and carpal alignment following definitive management. This review explores the anatomy, pathoanatomy, and biomechanics, as well as the diagnoses and different treatment options for perilunate wrist injuries available to date and their complications and outcomes.
Topics: Humans; Joint Dislocations; Wrist Injuries; Wrist Joint
PubMed: 21332444
DOI: No ID Found -
Hand Surgery & Rehabilitation Jun 2018Thanks to its remarkable mechanical properties and excellent biocompatibility, pyrocarbon is an ideal material for articular use. Various pyrocarbon implants for the... (Review)
Review
Thanks to its remarkable mechanical properties and excellent biocompatibility, pyrocarbon is an ideal material for articular use. Various pyrocarbon implants for the hand and wrist have been developed over the past 25 years, with about 15 currently available for hemi-, total and interposition arthroplasty. This article describes the production methods and mechanical properties of pyrocarbon. The author summarizes the various implants available for each type of joint, their reported results in the literature, as well as his team's experience.
Topics: Arthroplasty, Replacement; Biocompatible Materials; Carbon; Finger Joint; Humans; Joint Prosthesis; Prosthesis Design; Wrist Joint
PubMed: 29628356
DOI: 10.1016/j.hansur.2018.03.001 -
Hand (New York, N.Y.) Mar 2023
Topics: Humans; Wrist; Wrist Joint; Upper Extremity
PubMed: 36899468
DOI: 10.1177/15589447231162991 -
European Journal of Sport Science Feb 2022This study had two objectives: (a) revealing kinetic parameter differences at the fingers during a fastball and curveball, and (b) examining timing control between the...
This study had two objectives: (a) revealing kinetic parameter differences at the fingers during a fastball and curveball, and (b) examining timing control between the wrist and finger torques. The participants were eight baseball pitchers. The kinetics of the wrist and fingers were calculated using an inverse dynamics method. The peak torque and work of finger adduction during the curveball was significantly larger than that during the fastball. During the fastball pitch, the maximal correlation coefficient between the wrist flexion torque and finger flexion torque was very high ( = 0.94 ± 0.05). The reasons for this result are twofold: (a) the extrinsic finger muscles cross the wrist (biarticular muscle) and (b) the wrist flexion torque during the fastball pitch acts in the direction of acceleration of the ball. During the curveball pitch, we found two typical types of wrist and finger torque control. Furthermore, the two pitchers exerted large wrist extension and radial torque, and finger adduction torque. Although the other six pitchers hardly exerted these torques, they exerted wrist flexion torque predominantly. It was considered that the six pitchers selected wrist flexion torque as the control for the fastball and curveball pitch to confuse the batter.
Topics: Biomechanical Phenomena; Fingers; Humans; Kinetics; Torque; Wrist; Wrist Joint
PubMed: 33331246
DOI: 10.1080/17461391.2020.1866080 -
Ugeskrift For Laeger Jun 2022The ganglion cyst is the most common soft-tissue tumour of the hand and wrist. 60-70% are found dorsally on the wrist. Ultrasound and MRI-imaging can distinguish whether... (Review)
Review
The ganglion cyst is the most common soft-tissue tumour of the hand and wrist. 60-70% are found dorsally on the wrist. Ultrasound and MRI-imaging can distinguish whether the tumour is cystic or solid and may be helpful in making a diagnosis. This article reviews the different treatment techniques and rates of recurrence. Arthroscopic excision has shown promising results, but open excision remains the gold standard. The aetiology and pathogenesis of the condition is still unknown and further research is needed especially in reducing the risk of recurrence.
Topics: Ganglion Cysts; Hand; Humans; Soft Tissue Neoplasms; Wrist; Wrist Joint
PubMed: 35781363
DOI: No ID Found -
BMC Musculoskeletal Disorders Sep 2021It is controversial whether or not the carpometacarpal joint (CMCJ) should be included in total wrist arthrodesis (TWA). Complications commonly occur at this site and...
BACKGROUND
It is controversial whether or not the carpometacarpal joint (CMCJ) should be included in total wrist arthrodesis (TWA). Complications commonly occur at this site and studies examining its inclusion and exclusion are conflicting. A randomised clinical trial comparing wrist arthrodesis with CMCJ arthrodesis and spanning plate to wrist arthrodesis with CMCJ preservation and non-CMCJ spanning plate has not been performed.
METHOD
A single centre randomised clinical trial including 120 adults with end-stage isolated wrist arthritis will be performed to compare TWA with and without the CMCJ included in the arthrodesis. The primary outcome is complications in the first post-operative year. Secondary outcomes are Disabilities of the Arm, Shoulder and Hand (DASH) score, Patient Rated Wrist Evaluation (PRWE) and grip strength measured at 1, 2 and 5 years. Late complications, return to work and satisfaction will also be recorded.
DISCUSSION
It is unknown whether the CMCJ should be included in TWA. This trial will contribute to an improved understanding of optimal management of the CMCJ in total wrist arthrodesis.
TRIAL REGISTRATION
This trial was prospectively registered with the Australia New Zealand Clinical Trials Registry with identifying number ACTRN12621000169842 on the 16th February 2021. WHO: U1111-12626523.
ANZCTR
ACTRN12621000169842.
Topics: Arthrodesis; Bone Plates; Carpometacarpal Joints; Hand Strength; Humans; Randomized Controlled Trials as Topic; Treatment Outcome; Wrist; Wrist Joint
PubMed: 34496832
DOI: 10.1186/s12891-021-04644-4