– 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
– 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
– 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
– 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
– 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
– Discussion: – osseous related pain: – hamate fracture – pisiform fracture – ulnar styloid frx – base of the fifth metacarpal – TFCC – radioulnar joint – … Read more
– 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
– 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
– 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
– See: – Vascular Problems of the Wrist and Hand: – Discussion: – traumatic thrombosis of superficial palmar arch of ulnar artery resulting from repetitive use of hand as hammer; – in this maneuver, maximum force of the blow occurs over hook hamate bone, stie of … Read more