PURPOSE: The purpose of this study was to analyze the characteristics and severity of wrist injuries in snowboarding. METHODS: December 2005 to February 2008, Snowboarders who experienced wrist injures were included in this study. On the basis of the medical records and radiographic evaluation, the severity of distal radius fracture was classified according to the Arbeitsgemeinschaft fur Osteosynthesefragen/Association for the Study of Internal Fixation (AO/ASIF) classification. RESULTS: Most of the injured snowboarders were a either of the beginner (35 cases, 46.1%) or the intermediate (27 cases, 35.5%) level. The most common cause of injury in snowboarding was a slip down (60 cases, 78.9%). Comminuted and articular fractures classified as AO types A3, B, and C, which required surgical reduction, made up 42.3% of the distal radial fractures in snowboarders. When we analyzed the differences in severity between the educated and the non-educated groups, an A2 type injury in the AO classification was the most common type of injury in the educated group (20 cases, 38.5%), it means less severe fractures ocurred in the educated group (p=0.045). The most frequent injury mechanism of fractures was slip down (48 cases, 63.2%), and a slip down backwards was the dominant type of slip down (36 cases, 75.0%) (p=0.031). CONCLUSION: Among the snowboarders in this study who suffered self-down injury to the wrist, more fractures were associated with a backwards slip down than with a forward slip down due to over extension. For educated snowboarders the severity of fracture was lower than it was for uneducated snowboarders.
Medical Records ; Radius Fractures ; Skiing ; Wrist ; Wrist Injuries

Humans ; Joint Dislocations ; Lunate Bone ; Wrist Injuries

OBJECTIVE: To explore the key points of injury mechanism of scaphoid fracture in forensic expertise and to provide the references for forensic practices. METHODS: Forty-three cases of injury mechanism identification of scaphoid fracture were selected from 2007 to 2011 in Institute of Forensic Evidence, Chinese Criminal Police Academy. Following aspects were analyzed: missed diagnosis and misdiagnosis at first visit, fracture classifications, accompanying injuries and mechanism of injury. RESULTS: The rates of missed diagnosis and misdiagnosis were high in the cases of scaphoid fractures, most common in the fracture of the waist. The disagreement on mechanism of injury was whether it was due to direct impact or indirect effect by falling. CONCLUSION Wrist hyperextension due to fall with palm impact on the ground was the main cause of scaphoid fracture.
Diagnostic Errors ; Forensic Pathology ; Fractures, Bone ; Humans ; Scaphoid Bone/injuries* ; Wrist Injuries ; Wrist Joint

OBJECTIVETo provide anatomical basis for the internal fixation of scaphoid fractures.

METHODSThe shape and vascular lake of 48 dry scaphoids and 36 wet scaphoids were observed.

RESULTSThe data of dry bone group and wet bone group were as follows: the height of scaphoid tubercle were (11.28+/-0.94) mm and (10.35+/-1.54) mm; the thickness of scapoid waist were (12.02+/-1.90) mm and (11.21+/-1.20) mm; the width of scapoid waist were (10.59+/-1.11) mm and (11.34+/-1.47) mm; the minimal thickness of the body of scapoid were (6.51+/-1.22) mm and (8.54+/-1.07) mm; the axis length of scapoid were (25.68+/-2.21) mm and (26.50+/-2.56) mm; the width of epicondyle of scaphoid of distal portion, waist and proximal portion were (6.50+/-1.06) mm, (5.14+/-1.01) mm, (4.42+/-1.16) mm and (6.64+/-1.18) mm, (6.01+/-0.75) mm and (5.71+/-0.78) mm, respestively. The main blood vessels came from the dorsal and the radial of wrist and passed through the whole scaphoid along the crest of scaphoid.

CONCLUSIONThe internal fixation of scaphoid can be designed according to the anatomical data without damaging the articular surface and blood supply.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Wrist ; anatomy & histology ; blood supply ; Wrist Injuries ; surgery

PURPOSE: We conduct a comprehensive review of demography, vector and cause of injury and results of zone 5 volar wrist lacerations. MATERIALS AND METHODS: From July 2001 and June 2010, a total of 170 patients with zone 5 wrist lacerations were reviewed retrospectively. Sex, age, vector and cause of injury, injured structures and results were investigated. The correlations between the wound length, vector, cause of injury and number of injured structures were analyzed statistically. RESULTS: The most common cause of injury is self-inflicted wrist injury followed by incidental accident, industrial accident, and the glass is the most common vector. Thirty six patients underwent primary repair only and 134 patients explored then underwent teno-neuro-arteriorraphy. Error rate between the preoperative and intraoperative evaluations was 30.6%, particularly greater than 50% in cases of flexor digitorum profundus and radial artery injuries. The most common injured structure was palmaris longus followed by flexor carpi radialis, flexor carpi ulnaris and median nerve. The cause and vector of injury did not correlate with the number of injured structures. Relationship between the mean length of wounds and the number of injured structures showed weak positive correlation. CONCLUSION: In zone 5 wrist lacerations, exploration should be performed if the laceration involved over dermis layer. In addition to the surgical treatment, psychological care of these injuries is necessary.
Accidents, Occupational ; Demography ; Dermis ; Glass ; Humans ; Lacerations ; Median Nerve ; Radial Artery ; Retrospective Studies ; Wrist ; Wrist Injuries

OBJECTIVEFracture of either radius or ulna with a dislocation either at the proximal or distal radioulnar joint (DRUJ) is not a common injury and is inherently unstable. Here we report a case series, with both-bone forearm fractures associated with dislocation of DRUJ, as a Galeazzi-variant type fracture-dislocation, and try to analyze this injury pattern.

METHODSThe study was based on 6 patients having Galeazzi-variant type fracture-dislocation of different age (20 to 45 years). All fractures were closed type. Two fractures involved the same level and three fractures were at different levels of radius and ulna shaft. After thorough examination and investigations they were treated with limited contact dynamic compression plate without additional fixation for DRUJ.

RESULTSAll cases were followed up for 24 weeks. The maximum incidence occurred in age group between 31 and 40 years. All the fractures of both radius and ulna were united in average time of 12 weeks. Range of motion of wrist and elbow, supination and pronation at final follow-up were normal. There was no subsequent re-subluxation or dislocation of the DRUJ in any of the cases.

CONCLUSIONGaleazzi variant in adult is a new undescribed pattern of forearm with wrist injury. Stable open reduction and internal fixation of both-bone forearm fractures is mandatory, followed by 3 to 4 weeks of immobilization in a cast for the healing of disrupted DRUJ.

Adult ; Fracture Fixation, Internal ; Humans ; Joint Dislocations ; surgery ; Radius Fractures ; Wrist Injuries ; surgery ; Wrist Joint

Distal radius fractures are commonly associated with intra-articular injuries such as carpal ligament injuries and triangular fibrocartilage complex (TFCC) injuries. Such injuries occurring in elderly patients with a low-energy distal radius fracture can be treated successfully with cast immobilization and do not usually lead to clinical problems. However, despite healing of the fracture, some intra-articular injuries, especially in active patients with a high-energy fracture, can result in persistent pain and disability. In addition, the current trend of internal fixation and early use of the wrist may actually increase instability due to inadequate healing of the ligament injuries. Due to a lack of typical symptoms and physical findings in acute fracture settings, detection of these injuries is not easy. Arthroscopic examination, as well as radiographs and intraoperative fluoroscopic findings, are useful in detection of carpal ligament injuries. Complete ruptures of intercarpal interosseous ligaments warrant temporary interosseous fixation using K-wires. In TFCC injuries, distal radioulnar joint (DRUJ) instability should be assessed after anatomical reduction and fixation of a distal radius fracture. Operative treatments such as open or arthroscopic repair of TFCC to the fovea can guarantee greater stability of the DRUJ. For optimal results, early detection and appropriate treatment of intra-articular injuries associated with distal radius fractures is critical.
Aged ; Carpal Joints ; Humans ; Immobilization ; Joints ; Ligaments ; Radius ; Radius Fractures ; Rupture ; Triangular Fibrocartilage ; Wrist ; Wrist Injuries

The wrist joint is exposed to trauma easily which is a small portion of human body. Because there are many structures(tendons, vessels and nerves) in the wrist, it is necessary to examine carefully and treat properly when it is damaged. We have treated 230 cases of soft tissue injuries around the wrist and the result can be summarized as follows; 1. Among the 230 cases, the male ratio was 85% and the highest incidence was in the third decade. 2. Right side injuries were more than left and flexor surface injuries were more than extensor surface. 3, The main cause of injury was glass, 149 cases(64.8%) and the next on was knife, 37 cases(16%). 4. Injuries in the night were more than daytime. 5. Injuries in the summer were more than winter.
Glass ; Human Body ; Humans ; Incidence ; Male ; Soft Tissue Injuries ; Tendons ; Wrist Joint ; Wrist

PURPOSE: To avoid prolonged recovery time and scar tenderness in open carpal tunnel release and possible nerve or tendon injuries by bulky instruments in endoscopic techniques, we tried to percutaneously release the transverse carpal ligament using simple, thin instruments. MATERIALS AND METHODS: We performed carpal tunnel release percutaneously through a single small incision on the wrist with curved mosquito and meniscectomy hook knife under general or regional anesthesia in 41 wrists of 27 patients during the last 5 years and followed up for at least one year. Before and after release, endoscopic examinations were done to rule out space occupying lesions or other anormalies and to confirm complete release. RESULTS: According to the Cseuz's criteria, 38 cases (93%) showed excellent or good results, which was compatible to open or endoscopic technique with special instruments and there was no major neurovascular injury except one superficial palmar arch laceration associated with the second palmar incision in complicated case. CONCLUSIONS: From earlier experience, we learned that this simple technique may be used successfully with low cost without any fear of complication.
Anesthesia, Conduction ; Cicatrix ; Culicidae ; Humans ; Lacerations ; Ligaments ; Tendon Injuries ; Wrist

Fracture Fixation ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Scaphoid Bone ; injuries ; surgery ; Wrist Injuries ; surgery ; Wrist Joint ; surgery