Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
Mais filtros








Base de dados
Intervalo de ano de publicação
1.
J Hand Microsurg ; 16(4): 100129, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39234371

RESUMO

Objectives: Proximal row carpectomy is a well-accepted surgical procedure for the management of traumatic and degenerative wrist pathologies. It is routinely performed through a dorsal approach; a volar surgical access was presented in order to enable concomitant carpal tunnel release and avoid flexion limitation or disabilities caused by adhesions of the dorsal capsule and extensor tendons. We propose a modification to the volar approach, with detailed description of skin incision (reproducing the standard palmar access to the scaphoid), capsular section (beginning with a longitudinal cut radial to flexor carpi radialis tendon and prolonged transversally along the radio-lunate joint) and sequence of carpal bone removal (starting with the scaphoid rather than the lunate). Materials and methods: The patients who underwent surgical treatment with modified volar proximal row carpectomy between 1992 and 2015 were enrolled in a retrospective analysis. Results: We report postoperative improvement in both the Mayo Wrist score and total active range of motion in 38 patients, in line with the outcomes of dorsal proximal row carpectomy. Conclusions: The modified volar approach is highly recommended when better visualization and access to proximal carpal bones are needed (particularly useful for inveterate perilunate dislocations), moreover if concomitant carpal tunnel syndrome or extensor tendon pathologies are present.

2.
J Hand Surg Eur Vol ; 49(4): 403-411, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38296251

RESUMO

Distal fingertip replantation is associated with being a technically demanding procedure and dubious outcomes, although it is now performed more frequently across the world. However, the technique and outcomes remain controversial with disagreement among replantation surgeons due to lack of consensus about the indications, intraoperative strategy and postoperative regimes. In this article, we asked six experienced hand surgeons several pertinent questions that every replantation surgeon performing distal fingertip replantation would face in their clinical practice. The article summarizes their responses, which might provide valuable insight to every replantation surgeon in different parts of their career while managing these injuries.


Assuntos
Amputação Traumática , Traumatismos dos Dedos , Humanos , Amputação Traumática/cirurgia , Traumatismos dos Dedos/cirurgia , Reimplante/métodos , Dedos/cirurgia , Microcirurgia/métodos
3.
J Ultrasound ; 25(3): 579-584, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35092602

RESUMO

PURPOSE: The dorsal component of the scapholunate ligament, is the strongest component, in fact it has a maximum tensile strength of 300 N and mainly controls flexion and extension. In a recent study, the thickness and length of the dorsal component of SLIL was measured using ultrasound image, the length of the dorsal scapholunate ligament was 7.5 mm ± 1.4 mm and the thickness of 1.8 mm ± 0.4 mm. We evaluate 60 wrists of 30 young athletic volunteers with ultra-sound image, comparing the thickness variations of the dorsal component of SLIL between the dominant and non-dominant wrist, to confirm our hypothesis that the dorsal component SLIL has proprioceptive activity and therefore the thickness of the ligament increases in following wrist activity. METHODS: With a high-frequency ultrasound probe > 15 MHz (Sonoscape X3 Pro) we evaluated 60 wrists of 30 young men (16 males and 14 females, 20-38 years old) manual sports volunteers (10 tennis players, 8 padel players, 7 swimmers, 5 weight lifters) with no recent ligament injuries of the hand or wrist to participate in the study, we compared the dorsal component of SLIL between the dominant and non-dominant wrist. RESULTS: Dorsal SLIL was visualized in all 60 volunteers wrists. We measured an average scapholunate dorsal ligament length 7.7 mm and average thickness of 2.3 mm in the dominant wrist and average 7.2 mm in length and average 1.9 mm thickness in the non dominant wrist. The mean dorsal scapholunate interval was average 4.9 mm and the mean central interval was average 2.1 mm in the dominant wrist and 4.7 mm and 1.8 mm in the non dominant wrist, so that meas-urements remained unchanged with those reported by previous authors. CONCLUSIONS: In our study we ultrasonographically measured an average scapholunate dorsal ligament length 7.7 mm and average thickness of 2.3 mm in the dominant wrist and average 7.2 mm in length and average 1.9 mm thickness in the non dominant wrist. This confirms our hypothesis that there is a direct stimulus on the ligamentous component of the dor-sal SLIL in the dominant wrist following repeated uses and activities such as to cause an increase in thickness of the dorsal ligament to highlight the possibility of a proprioceptivity of the ligament if subjected to continuous training. LEVEL OF EVIDENCE: IV.


Assuntos
Osso Semilunar , Osso Escafoide , Esportes , Adulto , Feminino , Humanos , Ligamentos Articulares/diagnóstico por imagem , Masculino , Osso Escafoide/diagnóstico por imagem , Punho , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA