Carpal injuries: Anatomy, radiology, current treatment by Philippe Saffar

By Philippe Saffar

Classification of the carpal accidents is helping us to appreciate the connection among them. The starting to be curiosity during this box has been complex through contemporary imaging suggestions. healing recommendation and therapy are nonetheless now not thoroughly outlined, even by way of the main well known experts. there's nonetheless room for brand spanking new concepts.

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80). If it is difficulte to horizontalize and instead of making a posterior approach, it may be useful to insert a pin into the scaphoid and use it as a lever. Once the scaphoid-capitate system has been stabilized, the wrist can be tilted into hyperextension and a 2nd scapholunate pin inserted while tilting the lunate slightly forward. After a peroperative radiograph to check that the bones are properly in place the ligaments are reinserted or sutured, in particular the scapholunate interosseous and the radiocapitate ligaments, which often stands out well.

The point of impact may also be at the hypothenar eminence (Fig. 42), which generally occurs in falls where the hand is positioned behind the plane of the body. The lesions then start at the triquetrolunate aspect and travel in the opposite direction, ending in the scapholunate joint which mayor may not be disrupted. These lesions are sometimes accompanied by involvement of the distal radioulnar joint. Finally, the scaphoid may be fractured in place of a scapholunate disruption. This mechanism thus corresponds to a pronation of the distal row on the proximal row.

65) may appear during the 1st year. It is usually transient and disappears after a year. A moderate degree of arthrosis may appear very late, after 10 to 20 years, sometimes without producing pain. , but especially postoperative edema which is very common in the early days. Reflex sympathetic dystrophy (Sudeck' s Carpal dislocations 41 Fig. 64. Sequelae of transscapho-perilunate dislocation: pseudarthrosis of scaphoid with necrosis Fig. 65. Transient density of lunate atrophy) may cause very severe disturbance of function, even in the best treated cases.

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