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The Bone & Joint Journal
Vol. 103-B, Issue 5 | Pages 939 - 945
1 May 2021
Kakar S Logli AL Ramazanian T Gaston RG Fowler JR

Aims

The purpose was to evaluate early clinical, patient-reported, and radiological outcomes of the scapholunate ligament 360° tenodesis (SL 360) technique for treatment of scapholunate (SL) instability.

Methods

We studied the results of nine patients (eight males and one female with a mean age of 44.7 years (26 to 55)) who underwent the SL 360 procedure for reducible SL instability between January 2016 and June 2019, and who were identified from retrospective review of electronic medical records. Final follow-up of any kind was a mean of 33.7 months (12.0 to 51.3). Clinical, radiological, and patient-reported outcome data included visual analogue scale (VAS) for pain, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Mayo Wrist Score (MWS), and Patient-Rated Wrist Examination (PRWE). Means were analyzed using paired t-test.


The Bone & Joint Journal
Vol. 102-B, Issue 1 | Pages 137 - 143
1 Jan 2020
Dias R Johnson NA Dias JJ

Aims

Carpal malalignment after a distal radial fracture occurs due to loss of volar tilt. Several studies have shown that this has an adverse influence on function. We aimed to investigate the magnitude of dorsal tilt that leads to carpal malalignment, whether reduction of dorsal tilt will correct carpal malalignment, and which measure of carpal malalignment is the most useful.

Methods

Radiographs of patients with a distal radial fracture were prospectively collected and reviewed. Measurements of carpal malalignment were recorded on the initial radiograph, the radiograph following reduction of the fracture, and after a further interval. Linear regression modelling was used to assess the relationship between dorsal tilt and carpal malalignment. Receiver operating characteristic (ROC) analysis was used to identify which values of dorsal tilt led to carpal malalignment.


The Bone & Joint Journal
Vol. 100-B, Issue 2 | Pages 197 - 204
1 Feb 2018
Gaspar MP Pham PP Pankiw CD Jacoby SM Shin EK Osterman AL Kane PM

Aims

The aims of this study were to compare the mid-term outcomes of patients with late-stage arthritis of the wrist treated with proximal row carpectomy (PRC) and dorsal capsular interposition (DCI) arthroplasty with a matched cohort treated with routine PRC alone.

Patients and Methods

A total of 25 arthritic wrists (24 patients) with pre-existing degenerative changes of the proximal capitate and/or the lunate fossa of the radius were treated with PRC + DCI over a ten-year period. This group of patients were matched 1:2 with a group of 50 wrists (48 patients) without degenerative changes in the capitate or lunate fossa that were treated with a routine PRC alone during the same period. The mean age of the patients at the time of surgery was 56.8 years (25 to 81), and the demographics and baseline range of movement of the wrist, grip strength, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and Patient-Rated Wrist Evaluation (PRWE) score were similar in both groups.


The Bone & Joint Journal
Vol. 99-B, Issue 11 | Pages 1508 - 1514
1 Nov 2017
Park JH Jang WY Kwak DH Park JW

Aims

Positive ulnar variance is an established risk factor for idiopathic ulnar impaction syndrome (UIS). However, not all patients with positive ulnar variance develop symptomatic UIS and other factors, including the morphology of the lunate, may be involved. The aim of this study was to clarify the relationship between lunate morphology and idiopathic UIS.

Patients and Methods

A cohort of 95 patients with idiopathic UIS (UIS group) was compared with 95 asymptomatic controls with positive ulnar variance. The shape of the lunate was measured using the capitate-triquetrum distance (CTD), ulnar coverage ratio (UCR), radiolunate distance and radiolunate angle. The association of radiographic parameters and lunate types with the development of UIS was investigated in univariable and multivariable analyses. Receiver operating characteristic curves were used to estimate a cutoff for any statistically significant variables.


The Bone & Joint Journal
Vol. 97-B, Issue 6 | Pages 818 - 823
1 Jun 2015
Plant CE Hickson C Hedley H Parsons NR Costa ML

We conducted an observational radiographic study to determine the inter- and intra-observer reliability of the AO classification of fractures of the distal radius. Plain posteroanterior and lateral radiographs of 456 patients with an acute fracture of the distal radius were classified by a consultant orthopaedic hand specialist and two specialist trainees, and the k coefficient for the inter- and intra-observer reliability of the type, group and subgroup classification was calculated.

Only the type of fracture (A, B or C) was found to provide substantial intra-observer reliability (k type 0.65). The inclusion of ‘group’ and ‘subgroup’ into the classification reduced the inter-observer reliability to fair (kgroup 0.29, ksubgroup = 0.28) and the intra-observer reliability to moderate (kgroup 0.53, ksubgroup 0.49). Disagreement was found to arise between specific subgroups, which may be amenable to clarification.

Cite this article: Bone Joint J 2015; 97-B:818–23.