Physical Medicine Rehabilitation

Articular Injury of the Wrist: FESSH 2014 Instructional by Marc Garcia-Elias, Christophe Mathoulin

By Marc Garcia-Elias, Christophe Mathoulin

Hand and wrist accidents account for thousands of emergency room visits every year. even supposing the main common form of articular wrist harm comprises the distal radius, there are various different fractures that require skillful intervention to procure greatest, long term functionality. This booklet makes a speciality of these complicated intra-articular wrist accidents that experience now not been broadly lined long ago, supplying a whole photograph in their scientific, radiographic and healing positive factors. it really is crucial for all experts who're usually faced with those tough injuries.

Special Features:

  • every one bankruptcy written by means of a popular foreign professional who has pioneered major advances within the box within the final 5 years
  • provides a close assessment of surgical techniques to acute intra-articular wrist accidents, starting from partial ligament tears to the main advanced dislocations
  • presents an outline of easy wrist anatomy, biomechanics, harm type, scientific presentation, overview and analysis, and remedy recommendations
  • comprises discussions of the main promising minimally invasive remedies, specifically arthroscopically guided fracture aid
  • Highlights all innovations in approximately 500 instructive, fantastically drawn surgical diagrams, radiographs and intraoperative images

Packed with functional remedy instructions, Articular harm of the Wrist is helpful 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 are not any much less devastating by way of early joint degeneration and disorder if now not handled properly.

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Additional info for Articular Injury of the Wrist: FESSH 2014 Instructional Course Book

Example text

J Hand Surg Am 2012; 37: 1405–1410 [8] Buijze GA, Jørgsholm P, Thomsen NO, Bjorkman A, Besjakov J, Ring D. Diagnostic performance of radiographs and computed tomography for displacement and instability of acute scaphoid wrist fractures. J Bone Joint Surg Am 2012; 94: 1967–1974 [9] Gilula LA, Destouet JM, Weeks PM, Young LV, Wray RC. Roentgenographic diagnosis of the painful wrist. Clin Orthop Relat Res 1984; 187: 52–64 [10] Schädel-Höpfner M, Böhringer G, Gotzen L, Celik I. Traction radiography for the diagnosis of scapholunate ligament tears.

3,5 Clinical signs are tenderness and swelling at the ulnar base of the palm. The hook of the hamate pull test6 has proved valuable: With the hand in ulnar deviation, the patient pulls his or her flexed ring and little fingers against resistance, thus eliciting pain in the fractured hamate hook (▶ Fig. 2). Plain radiographs are taken to exclude adjacent injury, but they are not sufficient to diagnose or exclude hamate hook fractures, which are best diagnosed by CT (or newer MRT) scans (▶ Fig. 3).

MRI may be diagnostic in acute injury (▶ Fig. 13 If no pathology is found and a sufficiently severe trauma is part of the history, the next line of investigation is MRI. MRI is very sensitive in finding occult fractures3,4 and often visualizes ligament and soft tissue edema, and sometimes ligament avulsions. To distinguish fracture from bone bruising, an intramedullary hyperintensity on the STIR (short T1 inversion recovery) images (white line) as well as intramedullary hypointensity on T1 W images (black line) extending to the cortices should be present (▶ Fig.

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