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Ligamentous tears associated with distal fractures of the radius: Outcome after three years
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Over the past 6 years simple injuries, such as those with a normal joint and reducible ulnar head, have been treated by extensor carpi ulnaris tenodesis to reduce ulnar subluxation and improve painless motion. 38 cases with dorsal ulnar instability and 8 cases with volar instability were considered in this series. Follow-up was for a mean of 21 months; the results were evaluated by considering R.O.M. without pain. R.O.M. was determined by measuring flexion/extension and pronation/supination movements. Three complications occurred: one neuroma in continuity and 2 ruptures of tenodesis. In conclusion, for injuries of palmar Type 1 classification, this technique appears to be useful, simple, with good results and few complications.
THE J O U R N A L OF H A N D SURGERY VOL. 22B SUPPLEMENT 1
was used by a surgeon not involved in primary treatment. The final result was described as normal, nearly normal or abnormal.
Results The examined group consists of 33 patients. Eight patients had an extra-articular fracture, 13 a single intra-articular and 12 a complex intra-articular fracture. In nine patients we had a normal clinical result, a nearly normal result in 19 and an abnormal result in five patients. The mean severity score of the normal group was 0.67 (0-1), the group with nearly normal result had a mean severity score of 1.53 (0-3) and the group with an abnormal result 1.8 (1-3).
Conclusion Associated ligamentous tears seem to be of importance in the outcome result after 3 years.
Ligamentous tears associated with distal fractures of the radius: Outcome after three years. M. Fischer, R. Schaffer
Arthroscopic repair of peripheral TFCC tears: A suturing technique
St. Gallen, Switzerland
R. A. Tolat, J. K. Stanley, J. Sinha
Objective
Appley Bridge, UK
Associated ligamentous tears in patients with fracture of the distal radius are common. The aim of this study was to find out if there is a correlation between the final result and associated ligamentous tears.
Materials and methods All patients had arthroscopy at the time of injury. Ligaments were described as normal, superficially spread, partially or totally ruptured. A severity score for the torn ligaments was defined: 1 point for partially or totally ruptured scapholunate and lunotriquetral ligaments and partially or totally ruptured TFCC. The type of fracture was classified as extra-articular, single intra-articular or complex intra-articular. To determine the outcome, a modified clinical scoring system of Green and O'Brien
Traumatic lesions of the TFCC are being increasingly recognized as important causes of ulnar-sided wrist pain. Various management techniques have been described, ranging from direct suture to ulnar recession and partial or complete resection of the distal ulna. We describe a technique of arthroscopic repair of dorsal peripheral TFCC tears using the Toolhey needle through the 6R portal. This method of repair has the advantages of simplicity, ease of performance, avoidance of damage to the articular surfaces and a high index of reproducibility. We have used the technique successfully for 11 TFCC tears of the dorsal rim, with good to excellent results in those with an isolated TFCC lesion. The results are discussed, following a minimum 1 year follow-up.
Over the past 6 years simple injuries, such as those with a normal joint and reducible ulnar head, have been treated by extensor carpi ulnaris tenodesis to reduce ulnar subluxation and improve painless motion. 38 cases with dorsal ulnar instability and 8 cases with volar instability were considered in this series. Follow-up was for a mean of 21 months; the results were evaluated by considering R.O.M. without pain. R.O.M. was determined by measuring flexion/extension and pronation/supination movements. Three complications occurred: one neuroma in continuity and 2 ruptures of tenodesis. In conclusion, for injuries of palmar Type 1 classification, this technique appears to be useful, simple, with good results and few complications.
THE J O U R N A L OF H A N D SURGERY VOL. 22B SUPPLEMENT 1
was used by a surgeon not involved in primary treatment. The final result was described as normal, nearly normal or abnormal.
Results The examined group consists of 33 patients. Eight patients had an extra-articular fracture, 13 a single intra-articular and 12 a complex intra-articular fracture. In nine patients we had a normal clinical result, a nearly normal result in 19 and an abnormal result in five patients. The mean severity score of the normal group was 0.67 (0-1), the group with nearly normal result had a mean severity score of 1.53 (0-3) and the group with an abnormal result 1.8 (1-3).
Conclusion Associated ligamentous tears seem to be of importance in the outcome result after 3 years.
Ligamentous tears associated with distal fractures of the radius: Outcome after three years. M. Fischer, R. Schaffer
Arthroscopic repair of peripheral TFCC tears: A suturing technique
St. Gallen, Switzerland
R. A. Tolat, J. K. Stanley, J. Sinha
Objective
Appley Bridge, UK
Associated ligamentous tears in patients with fracture of the distal radius are common. The aim of this study was to find out if there is a correlation between the final result and associated ligamentous tears.
Materials and methods All patients had arthroscopy at the time of injury. Ligaments were described as normal, superficially spread, partially or totally ruptured. A severity score for the torn ligaments was defined: 1 point for partially or totally ruptured scapholunate and lunotriquetral ligaments and partially or totally ruptured TFCC. The type of fracture was classified as extra-articular, single intra-articular or complex intra-articular. To determine the outcome, a modified clinical scoring system of Green and O'Brien
Traumatic lesions of the TFCC are being increasingly recognized as important causes of ulnar-sided wrist pain. Various management techniques have been described, ranging from direct suture to ulnar recession and partial or complete resection of the distal ulna. We describe a technique of arthroscopic repair of dorsal peripheral TFCC tears using the Toolhey needle through the 6R portal. This method of repair has the advantages of simplicity, ease of performance, avoidance of damage to the articular surfaces and a high index of reproducibility. We have used the technique successfully for 11 TFCC tears of the dorsal rim, with good to excellent results in those with an isolated TFCC lesion. The results are discussed, following a minimum 1 year follow-up.