By Marc Garcia-Elias, Christophe Mathoulin
Hand and wrist accidents account for hundreds of thousands of emergency room visits every year. even though the main common kind of articular wrist damage contains the distal radius, there are lots of different fractures that require skillful intervention to acquire greatest, long term functionality. This publication specializes in these advanced intra-articular wrist accidents that experience now not been commonly coated some time past, supplying an entire photo in their medical, radiographic and healing positive aspects. it's crucial for all experts who're frequently faced with those difficult injuries.
- every one bankruptcy written by means of a popular foreign expert who has pioneered major advances within the box within the final 5 years
- offers an in depth overview of surgical techniques to acute intra-articular wrist accidents, starting from partial ligament tears to the main advanced dislocations
- presents an outline of uncomplicated wrist anatomy, biomechanics, damage class, scientific presentation, evaluate and prognosis, and remedy recommendations
- comprises discussions of the main promising minimally invasive remedies, in particular arthroscopically guided fracture aid
- Highlights all options in approximately 500 instructive, fantastically drawn surgical diagrams, radiographs and intraoperative pictures
Packed with useful therapy directions, Articular harm of the Wrist is precious for all hand surgeons in addition to for orthopedic and plastic surgeons and fellows. it's going to speedy elevate their wisdom of these tough wrist accidents that experience no longer been good documented formerly, yet aren't any much less devastating by way of early joint degeneration and disorder if now not taken care of properly.
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Additional info for Articular Injury of the Wrist: FESSH 2014 Instructional Course Book
8). Simple complete transverse fractures of the hamate may be visible on plain radiographs, in particular in the Moneim projection. As in scaphoid fractures, a CT scan is almost always indicated, either to visualize the degree of dislocation and fragmentation or to detect or exclude a fracture in ambiguous cases. Transverse fractures of the hamate body are treated by closed reduction and percutaneous insertion of a cannulated headless double-threaded screw, or by an open technique. In grossly comminuted fractures, the hamate will not be the major problem of the high-impact carpal injury, but a proper outlining of the hamate should be achieved as part of the complex therapy of these injuries.
4 The ulnar nerve passes over the tip of the hamate hook. The motor branch (deep branch) of the ulnar nerve spirals ulnarly around the hamate hook into the deep branch and is at risk in any hamate hook surgery. 5 So even if they are diagnosed early, surgery will be the preferred option for hamate hook fractures. Surgery is always indicated in late cases (> 3 weeks after trauma) and in painful pseudarthroses. Any surgery of the hamate hook puts the ulnar nerve at risk, in particular the deep (motor) branch of the ulnar nerve.
They result from ulnar styloid impaction or shear mechanisms and can be diagnosed in most cases by plain radiography. Treatment is preferentially nonsurgical with wrist immobilization for up to 3 weeks. Although these chip fractures often remain ununited, prognosis is generally good and surgical measures are seldom required. 3 Fractures of the Body of the Triquetrum Fractures of the body represent the other main bony injury to the triquetrum but are less frequent. Of 231 triquetrum fractures that were analyzed by Höcker and Menschik7 only 3% were fractures of the body.
Articular Injury of the Wrist: FESSH 2014 Instructional Course Book by Marc Garcia-Elias, Christophe Mathoulin