RESUMO
Purpose To review the results of shortening osteotomies of the radius in our stage IIIB Kienbock's disease patients. Materials and Methods In the past 30 years, we treated 52 cases of Kienbock's disease by a shortening osteotomy of the radius, of which 21 already had carpal collapse. All patient charts and X-rays were reviewed, but only the cases already with carpal collapse (stage IIIB) are presented here. Results All patients improved after surgery. Pain, on a scale of 0 to 3, generally 2 or 3 before surgery (median: 2.3), was normally 1 or 0 afterward (median: 0.9); median flexion-extension of the wrist improved from 77 to 99 degrees; and grip strength of the other hand improved from 26 to 76%. The last clinical and radiological review was performed 1 to 23 years after surgery (median: 8 years). Conclusion Advanced Kienbock's disease with carpal collapse is not a contraindication for carpal-sparing surgery radial shortening osteotomy.
RESUMO
Seventeen cases of instability of the trapeziometacarpal joint were treated surgically using either the original Brunelli technique or one of two modifications. Six patients achieved very good, nine achieved good and two achieved poor results. The results of the three surgical techniques were similar and we recommend the use of the palmaris longus tendon for the ligament reconstruction, as it is the easiest to perform.
Assuntos
Instabilidade Articular/cirurgia , Ligamentos Articulares/cirurgia , Procedimentos Ortopédicos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Three cases of 6- to 8-week-old transcapho-peri-lunate dislocation of the carpus were treated with pre-operative progressive distraction, using an external fixation apparatus for 1 week. Surgical reduction and osteosynthesis of the scaphoid was then easily performed.
Assuntos
Luxações Articulares/terapia , Osso Semilunar/lesões , Traumatismos do Punho/terapia , Adulto , Terapia Combinada , Fixadores Externos , Humanos , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/cirurgia , Osso Semilunar/diagnóstico por imagem , Masculino , Cuidados Pré-Operatórios , Radiografia , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/cirurgiaRESUMO
Overlapping of fingers on flexion of the hand caused by malunion of a phalanx was corrected in two patients by a rotational osteotomy of the base of the corresponding metacarpal, avoiding a more delicate operation on the phalanx, with good results.