Multiple operations have been proposed to slow the progression of osteonecrosis and secondary carpal damage in Kienböck's disease. To assess the biomechanical changes after capitate shorting, we inserted pressure-testing devices into the carpal and radiocarpal joints in an anatomical study. Pressure sensors were placed into eight thawed non-fixated human cadaver arms to measure the forces trans...

Computer assisted surgical interventions and research in joint kinematics rely heavily on the accurate registration of three-dimensional bone surface models reconstructed from various imaging technologies. Anomalous results were seen in a kinematic study of carpal bones using a principal axes alignment approach for the registration. The study was repeated using an iterative closest point algori...

BACKGROUND Delays in diagnosis and inadequate treatment of acute scaphoid fractures can lead to non-unions, presenting surgeons with unique challenges regarding optimal management. OBJECTIVES To evaluate the clinical and radiographic outcome of scaphoid non-unions treated with percutaneous screw fixation. METHODS The study group comprised 12 patients with scaphoid non-unions of an average d...

UNLABELLED Wrist stabilization is ensured by the complex of stabilizers, both static (intrinsic and extrinsic ligaments) and dynamic ones (flexor and extensor sinews of the wrist). Extrinsic carpal ligaments link both carpal rows with forearm, while the intrinsic ones connect individual carpal bones. From among intrinsic ligaments, the most significant from clinical point of view is scapholunat...

The carpal tunnel is a channel with fibroosseous walls leading from the deep flexor space of the forearm into the palm of the hand. Superficially it is bounded by the flexor retinaculum which stretches from the trapezium and scaphoid laterally to the pisiform and hamate medially. This tough sheet blends proximally with the deep fascia of the forearm and distally with the palmar aponeurosis. The...

A 32 year old man, right-handed soldier, was admitted to Emergency Department two hours after undergoing right wrist injury following a 2 meter fall onto the hand, in hyperextension. Clinical examination revealed a deformity of the wrist with an obvious open lunate enucleation (A). The neurovascular status was intact. Standard radiograph of the wrist demonstrated a completely enucleated lunate,...

Figure 1. Radiograph demonstration of a perilunate dislocation: The lunate maintains its normal articulation with the radius, whereas the capitated articular surface is dislocated from the lunate dorsally. Figure 2. Diagrammatic representation of the 3 carpal arcs of Gilula's lines. The first arc is a smooth curve outlining the proximal convexities of the scaphoid, lunate, and triquetrum. The s...

BACKGROUND Poor reduction or neglect of an unstable carpal scaphoid fracture may lead to scaphoid nonunion or avascular necrosis. When pre-operative suggestion of avascular necrosis of the proximal pole is confirmed by intra-operative evaluation, conventional bone graft is not enough and a vascularized bone graft is strongly recommended. METHODS Five patients with nonunion of scaphoid fractur...

Twenty eight patients with advanced carpal collapse (20 with scapho-lunate advanced collapse [SLAC] and 8 with scaphoid-nonunion advanced collapse [SNAC]) who were treated with a four-corner arthrodesis were reviewed; 23 had a good or excellent outcome. The mean DASH score was 41. The flexion/extension arc decreased from 72 degrees to 52 degrees. Gripping force increased from 46% to 72%. The ra...