Relevant anatomy and etiology Dr. Robert Kienböck was a Viennese radiologist who described a series of patients presenting with radiographic signs of a collapsed lunate and attributed it to a traumatic disruption of the bone’s blood supply. Although more than…
Pathophysiology Inflammatory arthritis is the most common situation where a synovectomy or biopsy may be indicated. Some causes of osteoarthritis may, however, also benefit from a synovectomy. A radiographic association between calcium pyrophosphate dihydrate crystal deposition disease (CPPD) and chronic…
Pathomechanics Arthrofibrosis is due to an excessive fibrotic response following a prolonged inflammatory condition or a traumatic wrist injury or surgery, and it can lead to a progressive loss of joint motion. Wrist contractures can occur following any type of…
Relevant anatomy and biomechanics A pure perilunate injury involves a dislocation of the carpus from the lunate, and constitutes a purely ligamentous injury to the wrist. Pure perilunate dislocations are considered lesser arc injuries because the traumatic force results in…
Relevant biomechanics and natural history The development of osteoarthritis (OA) following displaced intraarticular fractures has been attributed to a variety of factors, including the initial trauma to cartilage, elevated contact stresses, and joint instability. Early cadaveric studies of simulated intraarticular…
Distal radius fractures (DRF) occur as a consequence of trauma and they are one of the most common types of fractures. There is a bimodal distribution with high-energy fractures occurring in younger people, mostly males, and low-energy fractures occurring in…
Relevant anatomy and biomechanics The scaphoid bone is the only carpal bone that bridges both the proximal and distal rows. As a result it is subjected to continuous shearing and bending forces. The scaphoid is tilted in 40 ± 3…
Relevant anatomy and biomechanics Many investigators have contributed to the understanding of midcarpal instability (MCI), which Lichtman consolidated into classifications ( Table 9.1 ). MCI represents several distinct clinical entities differing in the cause and direction of subluxation but sharing…
Various authors have cast light on the importance of the dorsal radiocarpal ligament (DRCL) in maintaining carpal stability. Tears of the DRCL have been linked to the development of both volar and dorsal intercalated segmental instabilities and may be implicated…
Relevant anatomy and biomechanics The lunotriquetral interosseous ligament (LTIL) is C -shaped, similar to the scapholunate interosseous ligament (SLIL), and consists of true ligamentous dorsal and palmar subregions and an intervening fibrocartilaginous membranous portion. The palmar region is the thickest…