Abraham Colles: fracture of the carpal extremity of the radius.

Colles' fracture of the wrist is among the most common bony injuries encountered in emergency practice, and accounts for 10% to 20% of all fractures. Described in an excellent clinical treatise some 8 decades before the advent of radiographs, this fracture of the distal radius continues to pose a source of some disability to large numbers of patients. Complications include residual deformity, loss of mobility, median and ulnar nerve injury, shoulder-hand syndrome, and rupture of the extensor pollicis longus tendon. Although encountered in patients of either sex and in all age groups, this injury classically affects postmenopausal women, who are predisposed to it as a consequence of osteoporosis. The technique of immobilization appears not to be as important in influencing final outcome as does the precision of reduction.

A short history of the wrist joint.

From the standpoint of descriptive anatomy and function, the wrist has been somewhat neglected when compared to other joints. This article tries to describe the major contributions to this subject, many of which were overlooked before the recent era of markedly increased interest.

Trapeziometacarpal joint injuries.

This article begins with discussions of anatomy and thumb movement. Palmar (anterior) ligament reconstruction is then discussed. Peritrapezial arthritis is also discussed.

On the history and definition of Preiser's disease.

In 1910, Georg Preiser (1876-1913) described five cases of rarifying osteitis. Based on his imaging studies, he diagnosed post-traumatic avascular necrosis (AVN) of the scaphoid without any sign of primary fracture. This was followed by an article in 1911 in which Preiser related his findings to Kienböck's disease and Köhler's disease of the tarsal navicular. Upon searching the literature, we found descriptions and discussions of Preiser's imaging; however, the original images have never been published. We reproduce Preiser's original imaging in this current review. All of these appear to show a fracture and no signs of AVN, suggesting that Georg Preiser misinterpreted his findings. There is no apparent uniformity in the literature regarding the definition, description, or aetiology of Preiser's disease, and it is for this reason that we find the use of eponyms to be confusing.

The history of fracture fixation of the hand and wrist.

UNLABELLED: The treatment of fractures of the hand and wrist has evolved over the centuries from one of rest and immobilization to internal fixation and early motion. Although today's technology (anesthesia, antibiotics, metal implants) has allowed us more freedom in treating these injuries, a number of our patients continue to experience stiffness, nonunion, malunion, and chronic pain. We explore the techniques used to treat hand and wrist fractures throughout the centuries and determine what beneficial aspects of fracture care have been maintained and those that have changed as a result of new technology. We are now realizing that rigid immobilization of fractures at the expense of the soft tissues can be just as damaging as the ancient physician's techniques of prolonged immobilization with frequent dressing changes. New implants and lighter cast materials have allowed improved digital motion and early functional use of the extremity. This has become especially important in the treatment of the aging population, which demands improved function and a quicker return to activities. The optimal treatment of these fractures for each patient remains elusive, however, and there remains a tendency to rely on technology at the expense of sound clinical care. We must not loose sight of the goals of fracture treatment and should heed the lessons learned throughout centuries of treating these injuries. LEVEL OF EVIDENCE: Level V (expert opinion).

Fractures of the distal end of the radius. An historical account.

From the time of Hippocrates to the beginning of the nineteenth century, fractures of the distal end of the radius were mistaken for dislocations of the wrist. Clinical observations, anatomic dissections, and experiments on cadavers dispelled this error. It was not, however, until after the discovery of roentgenograms that the variety and complexity of these common injuries could be appreciated. From the large group of fractures of the distal end of the radius, three distinct varieties can be distinguished rather easily, and to them the eponyms of Colles (Pouteau-Colles), Smith, and Barton have been applied. The remainder, which consist of a substantial number, do not fit into any specific category and must be described individually.

[Bilateral SLAC (scapholunate advanced collapse) wrist: an unusual entity. Apropos of a 7000-year-old prehistoric case]. / SLAC wrist bilatéral: une entité à part. A propos d'un cas préhistorique de 7,000 ans.

SLAC (Scapho-Lunate Advanced Collapse) wrist is the most common form of osteoarthritis of the wrist. The main aetiology is ligamentous rotary subluxation of the scaphoid. The authors report on a case of bilateral SLAC wrist, identified on a prehistoric skeleton derived from the Hassi-el-Abiod site in the malian Sahara (Dutour, 1989). The paleopathological study consisted of macroscopic examination and radiological examination. Radiocarbon dating situated this human occupation to 7 thousand years ago. The diseases observed included bilateral radiocarpal lesions in an adult male individual. The degree of preservation of the carpal skeleton was 90%. Lesions were bilateral, but predominantly affected the right side. The radial styloid processes presented a lateral osteophytic cuff, giving a tapered "pen-nib" appearance. The scaphoid has a normal shape, but presented posterior and lateral osteophytes. The scaphoid surfaces of the two distal extremities of the radius and the corresponding parts of the scaphoid showed characteristic polishing. X-rays showed a band of condensation corresponding to the ivory region on the articular surfaces. In this case, the bilateral nature and the absence of any obvious macrotraumatic aetiology suggest that the only aetiology was progressive and bilateral ligamentous distension, due to repeated microtrauma analogous to that observed in sports disease (volley-ball) or in occupational diseases (jackhammer). The manufacture of stone tools (carved or polished) can be incriminated in the pathogenesis of these lesions. These lesions are therefore useful markers of repeated microtraumatic activities or "activity markers". The is the first paleopathological description and the oldest known case of bilateral SLAC wrist.