노인 통증사정을 위한 한국어 판 Short-form McGill Pain Questionnaire [SF-MPQ]의 신뢰도와 타당도

Ulnar midcarpal instability—Clinical and laboratory analysis

ADAPTIVE CARPUS (FIGURE 1)



Fig. 1: 
ADAPTIVE CARPUS-ADAPTIVE DISI: the distal articular surface of the radius is inclined 30° dorsally from an old impacted distal radius fracture. The lunate is tilted dorsally to account for dorsal inclination of the distal radius, while the capitate is in neutral position following the position of the metacarpals with the hand. Changes in the carpal alignment creates a capitolunate angle of approximately 30° and a scapholunate angle of 85°. The increased scapholunate angle creates a DISI (dorsal intercalated segmental instability) configuration.



SYNONYM: none

CLINICAL: NA

RADIOLOGIC: a carpal malalignment usually identified by a dorsal or volar tilt of the lunate caused by an extracarpal osseous abnormality, usually a distal radial malunion without ligament tears

COMMENTS: 1) every carpus must adjust in some way to alterations of the radius articular surface, the ulnar head position, and the shape or size of the carpal bones even if all of its ligaments are intact. Although these alterations of the osseous elements may disrupt the ligament anchorage, may be accompanied by ligament damage, or may secondarily develop ligament attenuation, they often begin as a normal carpus. 2) The carpus may be malaligned between the two rows or remain aligned within itself, while translating at the radiocarpal level to a new position (usually dorsal, sometimes volar, even ulnar or radial). 3) This definition refers to an extracarpal, not an intracarpal, problem. If the malalignment is due to an intracarpal problem, then the case falls into a CID, CIND, or CIC category and would not fit into the category of an adaptive carpus as described here. Any adaptive carpus, by definition, can be solved by an extracarpal intervention that does not require surgery on the carpus. However, with time an adaptive carpus may degenerate to a point that the intrinsic ligaments …

Wrist terminology as defined by the International Wrist Investigators' Workshop (IWIW)

Anaerobic prosthetic joint infection

The lockdown imposed in France to cope with the COronaVIrus Disease 2019 (COVID-19) outbreak has led to major changes in the lifestyle of French citizens. The aim of our study was to study its impact on activity related to emergencies in hand and upper limb trauma in comparison to the same reference period in 2019. All consecutive patients consulting for upper limb injury requiring urgent care at Georges-Pompidou European Hospital (HEGP), France, during the lockdown period (case group) and the equivalent period in 2019 (control group) were included. In each group, the type of accident, the anatomical location of the injury, and the treatment were reported and compared. Two hundred seventy-five patients were included in the case group in comparison to 784 patients in the control group. We observed a two-third decrease in the rate of upper limb emergencies (− 64.9%) in particular a drastic drop in the rate of road, work, and leisure accidents (10.4% vs 14.3%, p = 0.1151; 10.0% vs 22.6%, p < 0.0001; 13.1% vs 30.8%, p < 0.0001, respectively), and a clear increase in domestic accidents (66.5% vs 32.3%, p < 0.0001). The aetiologies were more dominated by lacerations of soft tissues (48.4%, vs 38.3%, p = 0.0034) and infections (8.7% vs 5.1%, p = 0.0299) with an increase in the indications for surgical management (51.2% vs 36.9%, p < 0.0001). Conversely, we observed fewer consultations for joint injuries (20.7% vs 30.7%, p = 0.0015) and fractures (22.2% vs 25.9%, p = 0.2210). The lockdown imposed in France has changes the etiologies and the management of hand and upper limb emergencies.

/pdf/impact-of-the-coronavirus-disease-2019-lockdown-on-hand-and-n5ydj8pfs6.pdf

Impact of the COronaVIrus Disease 2019 lockdown on hand and upper limb emergencies: experience of a referred university trauma hand centre in Paris, France.

Metacarpal fractures are common, accounting for 40 % of all hand injuries. The use of plates for the fixation of these fractures allows early aggressive hand therapy post-operatively, reducing post-operative stiffness. Traditionally, bicortical fixation is the standard practice, where both dorsal and palmar cortices of the metacarpal are drilled through, with screws engaging both cortices. Recent biomechanical studies have shown that unicortical fixation, where only the near cortex is drilled and engaged by the screw, results in no difference in stiffness, load to failure or failure mechanism, when compared with bicortical fixation. This trial aims to compare fracture union, complication rate and functional outcomes between unicortical and bicortical fixation for adults with displaced metacarpal fractures. All adults with displaced diaphyseal metacarpal fracture requiring plate fixation are potentially eligible to take part in this study. A total of 315 consenting patients will be randomly allocated to either unicortical or bicortical plate and screw fixation. The surgery will be performed in specialist hand trauma units across the UK. Data regarding fracture healing, hand function, quality of life, and complications will be collected at 2 weeks, 6 weeks and 6 months following surgery. This pragmatic, prospective, multi-centre, randomized controlled trial is expected to deliver results in 2018. ISRCTN 18006607
 . Registered on 19 Nov 2015.

/pdf/stability-of-unicortical-versus-bicortical-metacarpal-7i4cub3xy2.pdf

Stability of Unicortical versus Bicortical Metacarpal Fracture Internal Fixation Trial (SUBMIT): study protocol for a randomized controlled trial.

The indications of wrist arthroscopy are expanding with the advancement of technical and instrumental development. Most of the diseases in the joint can be managed by this minimally invasive technique with proper portal selection and establishment. This chapter describes in detail the various portals of radiocarpal and midcarpal joint and indications, contraindications, and arthroscopic techniques to manage various pathologies of the wrist joint, including acute and chronic scapholunate ligament injuries, acute lunotriquetral ligament injury, chronic lunotriquetral instability, arthrofibrosis of the wrist, extrinsic ligament injuries of the wrist, midcarpal instability, acute scaphoid fractures, scaphoid nonunion and scaphoid nonunion advanced collapse (SNAC) lesions, distal radius fractures, intra-articular malunions of the distal radius, perilunate injuries, Kienbock’s disease, inflammatory and degenerative arthritis of the wrist, osteochondral lesions, volar, and dorsal wrist ganglion.

Radio-Carpal and Midcarpal Arthroscopy

http://www.jhsgo.org/article/S258951412200175X/pdf

Feiran Wu

Papers

Stability of Unicortical versus Bicortical Metacarpal Fracture Internal Fixation Trial (SUBMIT): study protocol for a randomized controlled trial.

Radio-Carpal and Midcarpal Arthroscopy

Long Thoracic Nerve Palsy: When Is Decompression Indicated