Injury to the carpometacarpal joints is rare. The strong ligamentous attachments and carpal bone alignment readily resist displacement. To the authors' knowledge, there are no studies evaluating postoperative recovery regimens of carpometacarpal fracture dislocations. The present study describes a postoperative hand therapy regimen that used a novel carpometacarpal brace permitting early mobili...

During the last two decades, increased knowledge of functional anatomy and pathophysiology of the triangular fibrocartilage complex (TFCC) have contributed to a change in surgeons' perspective toward it. The earlier concept of the TFCC as the "hammock" structure of the ulnar carpus has updated to the "iceberg" concept, whereby the much larger "submerged" part represents the foveal insertions of...

In his treatise on joint injuries Astley Cooper (1832) included only one example of carpal dislocation. Speed (1950) estimated that carpal fractures and dislocations comprised oneeighth of injuries about the wrist. Although they are so common carpal dislocations are often unrecognised or mismanaged (Watson-Jones 1946, Cave 1958, McLaughlin 1959, Wade 1960). There is still disagreement about the...

a radiological department, such was my belief too; but it was not long before I had changed my views on the subject, and I hope that no apology is needed therefore for the publication on my part of a few notes on this interesting and common type of fracture. Our lack of knowledge on this subject is no doubt due to the fact that radiological examinations of ' sprained wrists' were very seldom do...

Immobilisation of the thumb is widely believed to be important in the management of fractures of the carpal scaphoid. To assess the need for this, we randomly allocated 392 fresh fractures for treatment by either a forearm gauntlet (Colles') cast, leaving the thumb free, or by a conventional 'scaphoid' plaster incorporating the thumb as far as its interphalangeal joint. In the 292 fractures whi...

Fractures of the carpal scaphoid in children show some quite remarkable differences with respect to fractures of the carpal scaphoid in adults. A review of the literature shows that fractures in children are more often located in the distal third, are more often incomplete and are usually not displaced. Our experience with 23 fresh fractures of the carpal scaphoid in children confirms these fin...

Carpal bone fractures make up a significant proportion of injuries to the wrist. The complex bone shape and articulations make diagnosis more difficult and missed injuries more common. This article reviews carpal bone fractures excluding the scaphoid.

The fracture most commonly treated by orthopaedic surgeons is that of the distal radius. However, as yet there is no consensus on what constitutes an 'acceptable' radiological position before or after treatment. This should be defined as the position that will predict good function in the majority of cases. In this paper we review the radiological indices that can be measured in fractures of th...

In the past ten to fifteen years, investigators have demonstrated conclusively that some injuries about the wrist have profound long-term consequences relative to function of the wrist. Problem fractures and non-unions of the scaphoid have been associated, in particular~ with major alterations in the kinematics of the wrist8’64. Considering its vulnerable blood supply~-4, irregular shape, pecul...

Injuries to the wrist often present problems of accurate diagnosis and effective treatment (MacAusland 1944, B#{246}hler1956, Cave 1958, Aitken and Nalebuff 1960). Those associated with fractures are usually demonstrated by proper radiographs, but even these injuries may be missed (Soto-Hall and Haldeman 1941, Speed 1950). Dislocation of the scaphoid bone may occur after apparently successful r...