No abstract available.
Carpal Bones/*injuries ; Female ; Fractures, Bone/*complications ; Hand Injuries/*complications ; Humans ; Male ; Radius Fractures/*complications

OBJECTIVE: The purpose of this study is to investigate the anatomic relationship between the neurovasular structures and transverse carpal ligment(TCL) to avoid complications during endoscopic carpal tunnel release. METHODS: Sixteen fresh cadaver hands from 3 men and 5 women(age range, 58~74 years) were used. Neurovascular structures around the TCL were meticulously dissected under a loupe magnification and several morphometric indices were calculated. RESULTS: We found an average length of TCL is 41mm and average distance between the TCL distal margin and superficial palmar arch along the flexor tendon of the ring finger is 9.2mm. In 3 hands, the looped ulnar artery, coursed 1 to 4mm radial to hook of hamate, continuing to the superficial palmar arch. During radial-to-ulnar flexion of the wrist, the looped ulnar artery beyond the hook of hamate shifts more radially (2 to 7mm) with proximal carpal bone. We also noted a Berretini branch located adjacent to the edge of the distal TCL. CONCLUSION: It is appropriate to transect the ligament at least 4mm radial from the radial margin of the hook of hamate or transect the proximal ligament in the radially deviated hand position to protect ulnar neurovascular structure. The proximal portal could be made just ulnar to the palmaris longus tendon to avoid the vascular injury in the proximal portion of the TCL.
Cadaver* ; Carpal Bones ; Carpal Tunnel Syndrome ; Fingers ; Hand ; Humans ; Ligaments ; Male ; Tendons ; Ulnar Artery ; Vascular System Injuries ; Wrist

The author reviewed 148 cases of phalangeal and metacarpal fractures of the hand, excluding distal phalangeal and carpal bones, in 75 patients treated at the Department of Orthopaedic Surgery, Dong-Kang Hospital, from January, 1984 to December, 1987. We obtained the following results ; 1. Better results were obtained in younger patients, transveres or spiral fractures, and cases immobilized in MP joint flexion. 2. Factors that led to worse results included older age, comminuted fracture, wide displacement, intra articular fracture, associated tendon injury, intraarticular pin placement. 3.In case of K-wire fixation, dorsal placement of the wire revealed better result than volar one.
Carpal Bones ; Clinical Study ; Fractures, Comminuted ; Hand ; Humans ; Joints ; Tendon Injuries

The scaphoid is the most commonly fractured carpal bone and the nonunion of the scaphoid has continued to represent a challenge to the surgeon who treats hand injuries. The are many treatment modalities and the technique of bone grafting described by Otto Russe in 1960, which is quite appropriately called the Matti-Russe procedure, has become a well-accepted method of treating nonunion of the scaphoid. And the results of this method has been presented by several authors. At the Department of Orthopedic Surgery, Seoul National University Hospital, From May 1985 to September 1988, ten cases of the scaphoid nonunion had been treated by Matti-Russe procedure and followed up more than 1 year. Fracture healing was observed in all ten cases. Seven patients were totally free of pain both at rest and at excercise and three patients noted moderate pain at excercise. All patient were satisfied with the results of operation and none felt worse.
Bone Transplantation ; Carpal Bones ; Fracture Healing ; Hand Injuries ; Humans ; Methods ; Orthopedics ; Seoul

Adult ; Carpal Bones ; injuries ; External Fixators ; Female ; Humans ; Joint Dislocations ; therapy ; Lunate Bone ; injuries ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Scaphoid Bone ; injuries ; Wrist Injuries ; therapy

OBJECTIVETo investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury.

METHODSFrom May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method.

RESULTSAll incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case.

CONCLUSIONThe application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

Adolescent ; Adult ; Carpal Joints ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Hamate Bone ; injuries ; surgery ; Humans ; Male ; Metacarpal Bones ; injuries ; surgery ; Metacarpophalangeal Joint ; injuries ; surgery ; Middle Aged ; Sutures ; utilization ; Young Adult

BACKGROUND: The purpose of this study was to investigate the frequency and distribution of associated carpal bone fractures (CBFs) in distal radial fractures (DRFs). METHODS: Three hundred and thirteen patients who underwent surgical treatment for DRFs between March 2007 and January 2010 were reviewed retrospectively. In this study, 223 patients who had preoperative computed tomography (CT) were included. We investigated the frequency and distribution of associated CBFs on CT scans. The relationship between the frequency of associated CBFs and patient factors such as age, gender, body mass index, and the mechanism of injury was assessed. RESULTS: CBFs were complicated in 46 of 223 DRFs (20.9%). The distribution of CBFs was 23 cases in the triquetrum, 16 in the lunate, 12 in the scaphoid, five in the hamate, and four in the pisiform. Among the 46 cases, a fracture of one carpal bone occurred in 36 cases, two in seven cases, three in two cases, and four in one case. In 10 of the 46 cases, associated CBFs occurred in more than two carpal bones. No significant differences were observed for age, sex, body mass index, or the mechanism of injury between patients with DRFs and CBFs and those without CBFs. CONCLUSIONS: Because CBFs that mainly occur in the proximal carpal row are complicated in DRFs at a relatively high frequency, assessment of carpal bones using CT scans is beneficial.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carpal Bones/*injuries/radiography ; Female ; Fractures, Bone/*complications/radiography ; Hand Injuries/*complications/radiography ; Humans ; Male ; Middle Aged ; Radius Fractures/*complications/radiography ; Retrospective Studies ; Tomography, X-Ray Computed