- Email: [email protected]
Extended fixators for wrist fractures
Vol. llA, No.5 September 1986
Letters to the editor
validity of grip and pinch strength evaluations. J HAND SURG 9A:222-6, 1984 5. Apfel E: The effect of thumb interphalangeal joint position on strength of key pinch. J HAND SURG llA:47-51, 1986 6. Bell J, Burford Jr WL: The force/time relationship of clinically used sensory testing instruments. J HAND SURG 7:412, 1982 7. Fess EE: Documentation: Essential elements of an upper assessment battery. In Hunter JM, Schneider LH, Mackin EJ, Callahan AD, editors: Rehabilitation of the hand, ed 2. St. Louis, 1984, The CV Mosby Co
Radiolunate arthrodesis in the rheumatoid wrist To the Editor: Radiolunate arthrodesis is a factor in stability of the rheumatoid wrist. Combined with synovectomy and ulnar head resection, this procedure confers on the wrist mobility, stability, and physiologic ulnar orientation of the hand, which prevents or partially corrects ulnar deviation of the fingers. Long-term results are favorable, as long as the rheumatoid process is under control. We have recently reviewed our seven cases, which were published in 1983. I Two patients had their wrist surgically fused because of a dramatic worsening of the disease, with carpus destruction. Tire other patients had a good clinical result, with very few radiologic changes. Three traumatic cases were also operated upon using the same technique. The results were also good, but the wrist range of motion is reduced. In our series of 12 rheumatoid wrists, 61unates were screwed, under compression, to the radius. In two wrists bone grafts taken from the resected ulnar head were screwed or pinned on the ulnar border of the radius to bridge a defect. Four lunates were fixed to the radius by two Kirschner wires reinforced by an interposed bone graft; two other wrists were immobilized, with a key graft for 6 weeks. Consolidation occurred in all patients after 6 to 8 weeks. Our 7-year experience with this procedure confirms the point of view of Drs. R.L. Linscheid and J.H. Dobyns. I regret that our original paper was not mentioned in the bibliography of their recent paper. 2 A. G. Chamay, M.D. 5, Charles-Humbert 1205 Geneve, Switzerland
REFERENCES 1. Chamay A, Della Santa D, Vilaseca A: L'arthrodese radiolunaire facteur de stabilite du poignet rhumatolde. Ann Chir 2:5-17, 1983
771
2. Linscheid RL, Dobyns JH: Radiolunate arthrodesis. J HAND SURG lOA:821-9, 1985
Reply To the Editor: The work of Dr. Andre Chamay and associates became known to us during the preparation of our manuscript and influenced its direction and development. The measure of ulnar translation using the distance between the radial styloid and head of the capitate is particularly appropriate for measuring ulnar translation in rheumatoid arthritis. Their successful results helped to confirm our own observations and enthusiasm for the procedure. We regret that during the manuscript evaluation by our editorial staff the bibliographic reference was changed to the earlier publication of Dr. Chamay and associates, rather than their recent publication. We did, however, cite the article by name and noted our reliance on this article in the first paragraph of the discussion. We regret that attribution to the recent article was not contained in our bibliography. We find ourselves wholly in accord with their findings. R. L. Linscheid, M.D. Mayo Clinic Rochester, MN 55905
Extended fixators for wrist fractures To the Editor: In their article' 'External Fixators for Wrist Fractures: A Biomechanical and Clinical Study", (J HAND SURG 9A:845, 1984), Nakata et al. compared the biomechanical rigidity of four external fixation systems for fractures of the distal forearm and wrist. We were glad to read their favorable report on the performance of the AO/ ASIF Small External Fixator for hand and wrist. We would, however, like to correct one impression left by the article. In the section concerning considerations for clinical use, the cost of the AO Small External Fixator is quoted as $2610.00. That price is for the AO Small External Fixator Set, which includes instruments and implants for two complete frames similar to the frame illustrated on page 846. The cost for the components illustrated in the frame would be $1176.20. We appreciate your correcting this misimpression. F. S. Wright SYNTHES® LTD. (U.S.A.) 1690 Russell Rd. Paoli, PA 19301-1222
Letters to the editor
validity of grip and pinch strength evaluations. J HAND SURG 9A:222-6, 1984 5. Apfel E: The effect of thumb interphalangeal joint position on strength of key pinch. J HAND SURG llA:47-51, 1986 6. Bell J, Burford Jr WL: The force/time relationship of clinically used sensory testing instruments. J HAND SURG 7:412, 1982 7. Fess EE: Documentation: Essential elements of an upper assessment battery. In Hunter JM, Schneider LH, Mackin EJ, Callahan AD, editors: Rehabilitation of the hand, ed 2. St. Louis, 1984, The CV Mosby Co
Radiolunate arthrodesis in the rheumatoid wrist To the Editor: Radiolunate arthrodesis is a factor in stability of the rheumatoid wrist. Combined with synovectomy and ulnar head resection, this procedure confers on the wrist mobility, stability, and physiologic ulnar orientation of the hand, which prevents or partially corrects ulnar deviation of the fingers. Long-term results are favorable, as long as the rheumatoid process is under control. We have recently reviewed our seven cases, which were published in 1983. I Two patients had their wrist surgically fused because of a dramatic worsening of the disease, with carpus destruction. Tire other patients had a good clinical result, with very few radiologic changes. Three traumatic cases were also operated upon using the same technique. The results were also good, but the wrist range of motion is reduced. In our series of 12 rheumatoid wrists, 61unates were screwed, under compression, to the radius. In two wrists bone grafts taken from the resected ulnar head were screwed or pinned on the ulnar border of the radius to bridge a defect. Four lunates were fixed to the radius by two Kirschner wires reinforced by an interposed bone graft; two other wrists were immobilized, with a key graft for 6 weeks. Consolidation occurred in all patients after 6 to 8 weeks. Our 7-year experience with this procedure confirms the point of view of Drs. R.L. Linscheid and J.H. Dobyns. I regret that our original paper was not mentioned in the bibliography of their recent paper. 2 A. G. Chamay, M.D. 5, Charles-Humbert 1205 Geneve, Switzerland
REFERENCES 1. Chamay A, Della Santa D, Vilaseca A: L'arthrodese radiolunaire facteur de stabilite du poignet rhumatolde. Ann Chir 2:5-17, 1983
771
2. Linscheid RL, Dobyns JH: Radiolunate arthrodesis. J HAND SURG lOA:821-9, 1985
Reply To the Editor: The work of Dr. Andre Chamay and associates became known to us during the preparation of our manuscript and influenced its direction and development. The measure of ulnar translation using the distance between the radial styloid and head of the capitate is particularly appropriate for measuring ulnar translation in rheumatoid arthritis. Their successful results helped to confirm our own observations and enthusiasm for the procedure. We regret that during the manuscript evaluation by our editorial staff the bibliographic reference was changed to the earlier publication of Dr. Chamay and associates, rather than their recent publication. We did, however, cite the article by name and noted our reliance on this article in the first paragraph of the discussion. We regret that attribution to the recent article was not contained in our bibliography. We find ourselves wholly in accord with their findings. R. L. Linscheid, M.D. Mayo Clinic Rochester, MN 55905
Extended fixators for wrist fractures To the Editor: In their article' 'External Fixators for Wrist Fractures: A Biomechanical and Clinical Study", (J HAND SURG 9A:845, 1984), Nakata et al. compared the biomechanical rigidity of four external fixation systems for fractures of the distal forearm and wrist. We were glad to read their favorable report on the performance of the AO/ ASIF Small External Fixator for hand and wrist. We would, however, like to correct one impression left by the article. In the section concerning considerations for clinical use, the cost of the AO Small External Fixator is quoted as $2610.00. That price is for the AO Small External Fixator Set, which includes instruments and implants for two complete frames similar to the frame illustrated on page 846. The cost for the components illustrated in the frame would be $1176.20. We appreciate your correcting this misimpression. F. S. Wright SYNTHES® LTD. (U.S.A.) 1690 Russell Rd. Paoli, PA 19301-1222