The Hip - book

Unstable / Displaced Scaphoid Fracture

– See: Radiographic Imaging – Discussion:     – unstable scaphoid fractures not only impact the potential for healing with non operative treatment, but they also impact on the position of             healing (and possible scaphoid non union or malunion);     – indicators of instability:            – trans-scaphoid perilunate dislocation;   … Read more

Unstable Distal Radius Fracture

– See: Radiographic Findings – Unstable Frx Patterns:     – Barton’s frx, Radial-styloid frx, and Smith’s frx, will often be unstable;     – dorsal angulation: > initial 20 deg implies instability;     – radial shortening of 5 mm or more;     – articular frxs that involve radiocarpal joint;       … Read more

Ulnar Wrist Pain

– Discussion: – distal radioulnar subluxation/dislocation  (see TFC Injury) – tear of the lunotriquetral – ulnocarpal impingement syndromes – pisotriquetral osteoarthritis – pisotriquetral loose bodies – subluxation/dislocation of the pisiform – fractures (ulnar styloid Process) – chondromalacia – calcific tendinitis – medial carpal instability – radioulnar arthritis – subluxation of the ECU The ulnar impaction … Read more

Ulnocarpal Impaction / Impingement Syndrome

– See: RU joint – Discussion:     – refers to impingement of the ulnar head against the carpi which can lead to TFCC tears and lunotriquetral ligament attrition;     – lunotriquetral ligament attrition may occur from compression and translation shear as the lunate becomes impinged against the ulnar head;     – causes:   … Read more

Ulnocarpal Impingement Syndrome

– Discussion:     – impingement of distal ulna on carpi which may arise from positive ulnar variance or non union of distal ulnar frx;     – positive ulnar varience leads to loading of the ulnocarpal joint and resultant LT disruption, lunate chondral lesion, and TFCC tears;     – diff dx: (ulnar sided … Read more

Ulnar Sided Wrist Pain

– Discussion:     – osseous related pain:           – hamate fracture            – pisiform fracture           – ulnar styloid frx           – base of the fifth metacarpal     – TFCC     – radioulnar joint           – … Read more

Ulnar Styloid Process Frx

– Anatomy:      – Tunnel V:           – overlies distal ends of radioulnar articulation on dorsum of wrist, contains EDM;     – Tunnel VI:           – in groove between the apex of ulnar styloid process & ulnar head, contains ECU tendon which is palpable from … Read more

Ulnar Translocation

– Discussion:     – most frequent radiocarpal instability;     – the lunate is translocated ulnarly, and therefore is not supported by the radius;     – ulnar translationn is also commonly seen in disease such as RA or in Madelung’s deformity;             – in RA, may occur along … Read more

Ulnar Variance

– Discussion:     – mean ulnar variance is 0.9 mm (range: 4.2 to 2.3 mm);     – functional anatomy:            – w/ neutral variance, 80% of load is born by radius and 20% by ulna;            – 2.5 mm increase in ulnar varience will increase … Read more