Introduction The metacarpal bones make up the bony arch connecting the phalanges to the carpus and are one of the most commonly fractured bone in the hand. Knowledge of the unique metacarpal anatomy, musculotendinous attachments, and surrounding neurovascular structures can…
Treatment of perilunate injuries may be accomplished via a number of different approaches. Open repair of perilunate injuries can be accomplished via an all-dorsal, all-volar, or combined dorsal and volar approach. Due to the complexity of some ligamentous disruptions and…
Introduction Perilunate injuries represent a challenge to the hand and wrist surgeon. Complex anatomy and kinematics, coupled with missed diagnoses and oft-delayed presentation, make the achievement of excellent outcomes difficult. It is our goal to present the essential information—anatomy, pathoanatomy,…
Volar Percutaneous Technique Indications The indications for volar percutaneous fixation of scaphoid fractures include nondisplaced scaphoid fractures, or minimally displaced fractures that can be reduced using K-wires as joysticks. In particular, the volar approach is useful for more distal fractures…
Relevant Anatomy The scaphoid bone functions as a link between the proximal and the distal carpal rows through ligamentous attachments and articular mechanics. It has a fairly complex and certainly unique anatomy. It is often described as having a peanut…
The surgical approaches for treating radiocarpal dislocations and fracture-dislocations are variable, dependent on the specific injury pattern. It is not unusual for these injuries to require multiple surgical approaches to address all the fracture fragments and achieve ligamentous stability. In…
Introduction Radiocarpal dislocations are rare injuries that occur as a result of a high-energy mechanism. The initial descriptions of this injury were prior to the advent of radiographs, at which time the clinical deformity of a distal radius fracture was…
Indications Persistent distal radioulnar joint (DRUJ) instability or an irreducible DRUJ after anatomic fixation of a radial shaft fracture requires further evaluation and management. The following scenarios are typically encountered after radial shaft fixation: 1. Reduced and stable DRUJ 2.…
Indications The decision between surgical and nonsurgical management is largely guided by patient age. In children, closed reduction and casting is the mainstay of treatment if an adequate reduction of both the radius fracture and the distal radioulnar joint (DRUJ)…
Introduction The Galeazzi fracture-dislocation is a fracture of the distal one-third of the radial shaft with an associated distal radioulnar joint (DRUJ) dislocation. This injury was described first by Astley Cooper in 1826 and later named after Riccardo Galeazzi who…