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[PMID]:26188693
[Au] Autor:van de Grift TC; Ritt MJ
[Ad] Endereço:Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
[Ti] Título:Management of lunotriquetral instability: a review of the literature.
[So] Source:J Hand Surg Eur Vol;41(1):72-85, 2016 Jan.
[Is] ISSN:2043-6289
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:UNLABELLED: Lunotriquetral ligament injury is a relatively common cause of ulnar-sided wrist pain. Injury ranges from partial stable ligament tears to extensive perilunate instability. Clinical decision-making largely depends on the chronicity, instability and cause of the ligament injury. Conservative treatment is generally regarded as first choice of treatment of mild lunotriquetral instability; however, outcome studies on conservative treatment are lacking. Temporary arthroscopic pinning and/or debridement are minimally invasive procedures of preference. In the case of more dissociative injury, surgical interventions may be performed. The literature suggests that soft tissue reconstruction is an effective procedure in this group. Arthrodesis of the lunotriquetral joint is associated with high rates of non-union (up to 57%) and the indications for surgery should therefore be very clear. Methodological issues make it hard to draw firm conclusions from the data. Studies on the effectiveness of conservative management and prospective comparative studies will further improve clinical decision-making in lunotriquetral instability. LEVEL OF EVIDENCE: N/A.
[Mh] Termos MeSH primário: Articulações do Carpo/cirurgia
Instabilidade Articular/cirurgia
Ligamentos Articulares/cirurgia
Osso Semilunar/cirurgia
Piramidal/cirurgia
[Mh] Termos MeSH secundário: Artrodese
Artroscopia
Articulações do Carpo/lesões
Força da Mão
Seres Humanos
Instabilidade Articular/diagnóstico
Ligamentos Articulares/anatomia & histologia
Ligamentos Articulares/lesões
Osso Semilunar/anatomia & histologia
Osso Semilunar/lesões
Satisfação do Paciente
Amplitude de Movimento Articular
Piramidal/anatomia & histologia
Piramidal/lesões
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1609
[Cu] Atualização por classe:151219
[Lr] Data última revisão:
151219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150720
[St] Status:MEDLINE
[do] DOI:10.1177/1753193415595167


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[PMID]:26409577
[Au] Autor:Delattre O; Goulon G; Vogels J; Wavreille G; Lasnier A
[Ad] Endereço:Service de Chirurgie Orthopédique et Traumatologique du membre supérieur, Centre Hospitalier Universitaire Pierre Zobda Quitman, Fort-de-France, Martinique, France.
[Ti] Título:Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis.
[So] Source:J Hand Surg Am;40(11):2176-82, 2015 Nov.
[Is] ISSN:1531-6564
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To report the clinical and radiographic results of a consecutive series of patients who underwent the 3-corner arthrodesis (3CA) (arthrodesis of capitate, hamate, and lunate with scaphoid and triquetrum excision) procedure for wrist arthritis. METHODS: This was a retrospective study of 30 consecutive patients who underwent a 3CA between 1994 and 2008. The indications were painful wrist osteoarthritis due to stage 2 or 3 scapholunate advanced collapse, scaphoid nonunion advanced collapse, or scaphoid chondrocalcinosis advanced collapse wrists. The clinical assessment consisted of range of motion, grip strength, and the Disabilities of the Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation scores. The radiographic assessment parameters consisted of bone fusion, carpal height and translation, lunate tilt, and appearance of the radiolunate joint space. RESULTS: The average follow-up was 6 years (± 4 years). The arthrodesis was performed with staples, 2 screws, or a plate and screws. Grip strength was 72% of the contralateral side. The mean range of motion in flexion-extension arc and ulnar-radial deviation arc was 70° and 36°, respectively. The mean Disabilities of the Arm, Shoulder, and Hand and the Patient-Rated Wrist Evaluation scores were 17 (± 11) and 22 (± 24), respectively. The fusion incidence was 90% (27 of 30). The mean difference of radiolunate angle on preoperative and postoperative radiographs was 8° (16°-8° in dorsal direction). The radiolunate joint space had narrowed in 1 patient. Six surgical revisions (20%) were necessary owing to dorsal pain in patients operated using plates, staples, or excessively long screws. CONCLUSIONS: Three-corner arthrodesis results are comparable with 4-corner arthrodesis and proximal row carpectomy. We feel that it is simpler technically than 4-corner arthrodesis. Although 3CA is more complex than proximal row carpectomy, it preserves the native radiolunate joint. Complications that can be attributed to the dorsal fixation hardware (particularly staples and plates) were noteworthy. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
[Mh] Termos MeSH primário: Artrodese/métodos
Osteoartrite/cirurgia
Osso Escafoide/cirurgia
Piramidal/cirurgia
Articulação do Punho/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Parafusos Ósseos
Avaliação da Deficiência
Feminino
Força da Mão
Seres Humanos
Masculino
Meia-Idade
Osteoartrite/diagnóstico por imagem
Medição da Dor
Radiografia
Amplitude de Movimento Articular
Estudos Retrospectivos
Osso Escafoide/diagnóstico por imagem
Resultado do Tratamento
Piramidal/diagnóstico por imagem
Articulação do Punho/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1609
[Cu] Atualização por classe:161126
[Lr] Data última revisão:
161126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150928
[St] Status:MEDLINE


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[PMID]:26392453
[Au] Autor:Noordman BJ; Hartholt KA; Halm JA
[Ad] Endereço:Department of Surgery, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands Department of Surgery-Traumatology, Reinier de Graaf Group, Delft, Zuid-Holland, The Netherlands.
[Ti] Título:Simultaneous, bilateral fracture of the triquetral bone.
[So] Source:BMJ Case Rep;2015, 2015 Sep 21.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Fraturas Ósseas/diagnóstico por imagem
Piramidal/diagnóstico por imagem
[Mh] Termos MeSH secundário: Acidentes por Quedas
Seres Humanos
Masculino
Meia-Idade
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1606
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150923
[St] Status:MEDLINE


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[PMID]:26314223
[Au] Autor:ten Berg PW; Foumani M; Strackee SD
[Ad] Endereço:Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
[Ti] Título:A Rare Case of Bilateral Lunotriquetral Coalition and Bilateral Scaphoid Nonunion.
[So] Source:J Hand Surg Am;40(9):1921, 2015 Sep.
[Is] ISSN:1531-6564
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Fixação Interna de Fraturas/métodos
Fraturas não Consolidadas/cirurgia
Osso Semilunar/anormalidades
Osso Escafoide/lesões
Piramidal/anormalidades
[Mh] Termos MeSH secundário: Adolescente
Parafusos Ósseos
Diagnóstico Diferencial
Futebol Americano/lesões
Fixação Interna de Fraturas/instrumentação
Fraturas não Consolidadas/diagnóstico por imagem
Fraturas não Consolidadas/etiologia
Seres Humanos
Achados Incidentais
Osso Semilunar/diagnóstico por imagem
Masculino
Tomografia Computadorizada por Raios X
Piramidal/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Em] Mês de entrada:1605
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150829
[St] Status:MEDLINE


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[PMID]:26296417
[Au] Autor:Pillukat T; Fuhrmann RA; Windolf J; van Schoonhoven J
[Ad] Endereço:Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland. t.pillukat@handchirurgie.de.
[Ti] Título:[Ligament reconstruction for lunotriquetral instability using a distally based strip of the extensor carpi ulnaris tendon].
[Ti] Título:Die Bandersatzplastik bei lunotriquetraler Instabilität mit einem distal gestielten Streifen der Extensor-carpi-ulnaris-Sehne..
[So] Source:Oper Orthop Traumatol;27(5):404-13, 2015 Oct.
[Is] ISSN:1439-0981
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:OBJECTIVE: Stabilization of the lunotriquetral junction. INDICATIONS: Dynamic and static chronic instability without fixed dislocation of the carpals. CONTRAINDICATIONS: Chronically fixed dislocation of the carpals, ulnar impaction syndrome, osteoarthritis of the joint between hamate and triquetrum and other parts of the wrist joint, rheumatoid arthritis, chondrocalcinosis. SURGICAL TECHNIQUE: Restoration of the palmar portion of the lunotriquetral ligament using a distally based strip of the extensor carpi ulnaris tendon with temporary fixation of the lunotriquetral junction with K-wires. POSTOPERATIVE MANAGEMENT: Immobilization for 8 weeks with a radial cast that includes the first metacarpophalangeal joint. Removal of the K-wires after 8 weeks and exercise. RESULTS: The procedure with rare complications reliably restores stability of the lunotriquetral junction. Reduction of grip strength, pain during exercise, and a reduced range of motion persist. Overall, the results are predominantly good and excellent.
[Mh] Termos MeSH primário: Traumatismos da Mão/cirurgia
Instabilidade Articular/cirurgia
Ligamentos Articulares/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Técnicas de Sutura/instrumentação
Tendões/transplante
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Osso Semilunar/cirurgia
Masculino
Procedimentos Cirúrgicos Reconstrutivos/instrumentação
Transferência Tendinosa/métodos
Resultado do Tratamento
Piramidal/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1612
[Cu] Atualização por classe:170915
[Lr] Data última revisão:
170915
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150823
[St] Status:MEDLINE
[do] DOI:10.1007/s00064-015-0415-7


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[PMID]:26280852
[Au] Autor:Dimitriadis A; Paraskevas G; Kanavaros P; Barbouti A; Vrettakos A; Kitsoulis P
[Ti] Título:Association between the capitate-triquetrum distance and carpal collapse in scaphoid nonunion.
[So] Source:Acta Orthop Belg;81(1):36-40, 2015 Mar.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:The effect of the lunate type on carpal collapse in cases of scaphoid nonunion has not been thoroughly investigated. The purpose of the present study was to determine whether any association exists or not between the capitate-triquetrum distance and occurrence of carpal collapse in cases of scaphoid nonunion. In a retrospective study, 76 patients with scaphoid nonunion formed two groups based on the capitate-triquetrum distance: forty-three patients with distance of less than 5 mm and 33 patients with distance of 5 mm or more. The two groups were comparable with respect to sex distribution, age, dominant hand involvement, manual labor, nonunion location and time from injury to final x-rays. Six patients (13.9%) in the capitate-triquetrum<5 mm group and 13 patients (39.4%) in the capitate-triquetrum≥5 mm group had no signs of collapse, with significant difference (p<0.05). Capitate-triquetrum distance could contribute in the decision making process for cases of scaphoid nonunion without straightforward indication for surgical intervention.
[Mh] Termos MeSH primário: Capitato/patologia
Articulações do Carpo/diagnóstico por imagem
Articulações do Carpo/patologia
Piramidal/patologia
[Mh] Termos MeSH secundário: Capitato/diagnóstico por imagem
Seres Humanos
Radiografia
Estudos Retrospectivos
Piramidal/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1511
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150818
[St] Status:MEDLINE


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[PMID]:26205709
[Au] Autor:Wagner ER; Elhassan BT; Rizzo M
[Ad] Endereço:Department of Orthopedic Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
[Ti] Título:Diagnosis and Treatment of Chronic Lunotriquetral Ligament Injuries.
[So] Source:Hand Clin;31(3):477-86, 2015 Aug.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Chronic lunotriquetral (LT) injuries are less common than scapholunate ligament injuries and difficult to diagnose. They may be associated with positive ulnar variance. Clinical diagnostic tests elicit pain at the LT interval. Although radiographs are typically normal, MRI and wrist arthroscopy can help confirm the diagnosis. When conservative treatments fail, surgical options include LT ligament reconstruction, LT arthrodesis, and ulnar-shortening osteotomy (in patients with positive ulnar variance).
[Mh] Termos MeSH primário: Ligamentos Articulares/lesões
Osso Semilunar/lesões
Piramidal/lesões
Traumatismos do Punho/diagnóstico
Traumatismos do Punho/terapia
[Mh] Termos MeSH secundário: Artrodese
Artroscopia
Diagnóstico por Imagem
Seres Humanos
Osteotomia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1605
[Cu] Atualização por classe:150724
[Lr] Data última revisão:
150724
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150725
[St] Status:MEDLINE


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[PMID]:26205708
[Au] Autor:Nicoson MC; Moran SL
[Ad] Endereço:Hand and Wrist of Louisville, 2400 Eastpoint Parkway, Suite 570, Louisville, KY 40223, USA.
[Ti] Título:Diagnosis and Treatment of Acute Lunotriquetral Ligament Injuries.
[So] Source:Hand Clin;31(3):467-76, 2015 Aug.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Isolated acute lunotriquetral (LT) injuries are an uncommon diagnosis in hand surgery. Diagnosis is aided by a high index of suspicion when pain is localized over the LT joint. Standard radiographs show typically normal findings, leading to advanced diagnostic investigations, including MRI and wrist arthroscopy. Standard treatment options for acute LT injuries include immobilization, arthroscopy, and direct open LT repair.
[Mh] Termos MeSH primário: Ligamentos Articulares/lesões
Osso Semilunar/lesões
Piramidal/lesões
Traumatismos do Punho/diagnóstico
Traumatismos do Punho/terapia
[Mh] Termos MeSH secundário: Artroscopia
Desbridamento
Seres Humanos
Imobilização
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1605
[Cu] Atualização por classe:150724
[Lr] Data última revisão:
150724
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150725
[St] Status:MEDLINE


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[PMID]:26095820
[Au] Autor:Andersson JK; Andernord D; Karlsson J; Fridén J
[Ad] Endereço:Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: jonny_a@telia.com.
[Ti] Título:Efficacy of Magnetic Resonance Imaging and Clinical Tests in Diagnostics of Wrist Ligament Injuries: A Systematic Review.
[So] Source:Arthroscopy;31(10):2014-20.e2, 2015 Oct.
[Is] ISSN:1526-3231
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate the diagnostic performance of magnetic resonance imaging (MRI) and clinical provocative tests on injuries to the triangular fibrocartilage complex (TFCC), the scapholunate (SL) ligament, and the lunotriquetral (LT) ligament. METHODS: An electronic literature search of articles published between January 1, 2000, and February 28, 2014, in PubMed, Embase, and the Cochrane Library was carried out in April 2014. Only studies of the diagnostic performance of MRI and clinical provocation tests using wrist arthroscopy as the gold standard were eligible for inclusion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guided the extraction and reporting of data. The methodologic quality of the included articles was assessed with the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The primary outcome measure was the negative predictive value (NPV) of wrist MRI and provocative wrist tests, which was defined as the probability of an intact wrist ligament given a negative investigation. The question was whether negative results of MRI or provocative tests were enough to safely discontinue further investigation with arthroscopy. A minimum NPV of 95% was considered a clinically relevant cutoff value. The secondary outcome measures were the positive predictive value (PPV), sensitivity, and specificity. RESULTS: A total of 7 articles (327 patients with MRI and 105 patients with clinical tests) were included in this systematic review. The included articles displayed heterogeneity regarding participants, diagnostic methods, and study design. Seven articles investigated the diagnostic performance of MRI, whereas 1 article investigated clinical testing. The NPVs of MRI were as follows: TFCC, 37% to 90%; SL ligament, 72% to 94%; and LT ligament, 74% to 95%. The NPVs of clinical tests were 55%, 74%, and 94% for the TFCC, SL ligament, and LT ligament, respectively. Only 1 study reached the predetermined cutoff value for the primary outcome measure (NPV ≥95%) but only for MRI of the LT ligament; this study also reached a borderline-cutoff NPV of 94% for MRI of the SL ligament. Another study reached borderline-cutoff NPVs of 94% both for MRI and for clinical tests of the LT ligament. CONCLUSIONS: A negative result from MRI is unable to rule out the possibility of a clinically relevant injury to the TFCC, SL ligament, or LT ligament of the wrist. Clinical provocation wrist tests were of limited diagnostic value. The current gold standard--wrist arthroscopy--remains the preferred diagnostic technique with sufficient conclusive properties when it comes to wrist ligament injuries. LEVEL OF EVIDENCE: Level II, systematic review of Level II diagnostic studies.
[Mh] Termos MeSH primário: Ligamentos Articulares/lesões
Imagem por Ressonância Magnética/métodos
Fibrocartilagem Triangular/lesões
Traumatismos do Punho/diagnóstico
[Mh] Termos MeSH secundário: Artroscopia/métodos
Artroscopia/normas
Seres Humanos
Osso Semilunar
Osso Escafoide
Sensibilidade e Especificidade
Piramidal
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1605
[Cu] Atualização por classe:151005
[Lr] Data última revisão:
151005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150623
[St] Status:MEDLINE


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[PMID]:25748586
[Au] Autor:Dunet B; Vargas M; Pallaro J; Tournier C; Fabre T
[Ad] Endereço:Orthopedic and Traumatologic Unit, Hôpital Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux cedex, France. Electronic address: bertrand.dunet@wanadoo.fr.
[Ti] Título:A rare coronal fracture of the medial carpal column: Case report.
[So] Source:Chir Main;34(2):94-7, 2015 Apr.
[Is] ISSN:1769-6666
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:Carpal coronal fractures are rare. We report the case of a 15 year-old male who fell from a balcony and suffered a displaced coronal fracture of the capitate, hamate and triquetrum. The diagnosis, which was initially made based on the X-rays, was confirmed by CT scan. Open reduction and internal fixation using Herbert screws was performed. To the best of our knowledge, this is the first published case of a coronal fracture of these three bones. The patient returned to normal activities after six months.
[Mh] Termos MeSH primário: Capitato/lesões
Fraturas Ósseas
Hamato/lesões
Traumatismo Múltiplo
Piramidal/lesões
[Mh] Termos MeSH secundário: Adolescente
Capitato/diagnóstico por imagem
Capitato/cirurgia
Fraturas Ósseas/diagnóstico por imagem
Fraturas Ósseas/cirurgia
Hamato/diagnóstico por imagem
Hamato/cirurgia
Seres Humanos
Masculino
Traumatismo Múltiplo/diagnóstico por imagem
Traumatismo Múltiplo/cirurgia
Radiografia
Piramidal/diagnóstico por imagem
Piramidal/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1602
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150310
[St] Status:MEDLINE



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