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Innovations in Intercarpal Ligament Repair and Reconstruction, E-Book

Innovations in Intercarpal Ligament Repair and Reconstruction, E-Book

Marco Rizzo

(2015)

Abstract

This exciting issue will cover everything from Ligament anatomy and biomechanics of the Carpus, Diagnosis and Treatment of Perilunate and lunate fracture/dislocations, Acute Scapholunate ligament injuries – arthroscopic treatment, Acute scapholunate ligament injuries – open treatment, Diagnosis and treatment of acute lunotriquetral ligament injuries to Management of intercarpal ligament injuries associated with distal radius fractures, Chronic scapholunate ligament injuries - soft-tissue ligament reconstruction , Midcarpal instability, Salvage procedures in the management of carpal instability, and many more.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Innovations in Intercarpal Ligament Repair and Reconstruction\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents v
Preface: Innovations in Intercarpal Ligament Repair and Reconstruction\r v
Carpal Ligament Anatomy and Biomechanics\r v
Carpal Ligament Injuries, Pathomechanics, and Classification\r v
Perilunate Dislocations and Fracture Dislocations\r v
Management of Intercarpal Ligament Injuries Associated with Distal Radius Fractures\r v
Acute Scapholunate Ligament Injuries: Arthroscopic Treatment\r vi
Open Treatment of Acute Scapholunate Instability\r vi
Chronic Scapholunate Ligament Injury: Techniques in Repair and Reconstruction\r vi
Bone-Retinaculum-Bone Autografts for Scapholunate Interosseous Ligament Reconstruction\r vi
Chronic Scapholunate Ligament Injuries: Treatment with Supplemental Fixation\r vii
Diagnosis and Treatment of Acute Lunotriquetral Ligament Injuries\r vii
Diagnosis and Treatment of Chronic Lunotriquetral Ligament Injuries\r vii
Midcarpal Instability: A Comprehensive Review and Update\r vii
Salvage Operations for Wrist Ligament Injuries with Secondary Arthrosis\r viii
HAND CLINICS\r ix
FORTHCOMING ISSUES ix
November 2015 ix
February 2016 ix
May 2016 ix
August 2016 ix
November 2016 ix
RECENT ISSUES ix
May 2015 ix
February 2015 ix
November 2014 ix
August 2014 ix
May 2014 ix
Preface: Innovations in \rIntercarpal Ligament Repair and Reconstruction xi
Carpal Ligament Anatomy and Biomechanics 381
Key points 381
INTRODUCTION: LIGAMENTOUS ANATOMY 381
EXTRINSIC CARPAL LIGAMENTS 382
Palmar Radiocarpal Ligaments 382
Palmar Ulnocarpal Ligaments 383
Dorsal Radiocarpal Ligament 383
INTRINSIC CARPAL LIGAMENTS 383
Scapholunate Interosseous Ligaments 384
Lunotriquetral Interosseous Ligaments 385
Midcarpal Ligaments 385
Distal Carpal Row Interosseous Ligaments 386
SUMMARY 386
REFERENCES 386
Carpal Ligament Injuries, Pathomechanics, and Classification 389
Key points 389
INTRODUCTION 389
CLASSIFICATION 390
Carpal Instability Dissociative 391
Scapholunate dissociation 391
Lunotriquetral dissociation 393
Scaphoid fracture 393
Carpal Instability Nondissociative 394
Carpal instability nondissociative–volar intercalated segment instability 394
Carpal instability nondissociative–dorsal intercalated segment instability 394
Combined carpal instability nondissociative 395
Carpal Instability Adaptive 395
Carpal Instability Complex 395
Dorsal perilunate dislocations and dorsal perilunate fracture-dislocations 396
Palmar perilunate dislocations 396
Axial dislocations 396
SUMMARY 397
REFERENCES 398
Perilunate Dislocations and Fracture Dislocations 399
Key points 399
INTRODUCTION 399
Nature of the Problem 399
Mechanism of Injury 399
Classification 399
Presentation 400
Closed Reduction 400
TREATMENT OPTIONS 401
SURGICAL TECHNIQUE 402
Preparation and Patient Positioning 402
SURGICAL APPROACH AND PROCEDURE 402
Volar Approach 402
Dorsal Approach 403
Immediate Postoperative Care 404
Rehabilitation and Recovery 404
OPERATIVE PEARLS 404
Difficulty Restoring Carpal Alignment 404
Irreparable Scapholunate Interosseous Ligament 405
Transscaphoid Perilunate Dislocation 406
PITFALLS 406
Delayed Diagnosis 406
Pin Track Infection and Septic Arthritis 407
SUMMARY 407
REFERENCES 407
Management of Intercarpal Ligament Injuries Associated with Distal Radius Fractures 409
Key points 409
INTRODUCTION 409
SURGICAL TECHNIQUE 410
Preoperative Planning 410
Preparation and Patient Positioning 411
Surgical Approach 412
Surgical Procedure 412
IMMEDIATE AFTERCARE 412
REHABILITATION AND RECOVERY 413
CLINICAL RESULTS 413
SUMMARY 415
REFERENCES 415
Acute Scapholunate Ligament Injuries 417
Key points 417
INTRODUCTION 417
SURGICAL TECHNIQUE 419
COMMON SCAPHOLUNATE INTEROSSEOUS LIGAMENT INJURY PATTERNS AND ARTHROSCOPIC TREATMENT 419
Tear of the Proximal Scapholunate Interosseous Ligament 419
Partial Tear of the Dorsal Scapholunate Interosseous Ligament 419
Partial Tear of the Volar Scapholunate Interosseous Ligament 419
Complete Tear of the Dorsal Scapholunate Interosseous Ligament 419
Complete Tear of the Scapholunate Interosseous Ligament 420
REHABILITATION AND RECOVERY 421
CLINICAL RESULTS IN THE LITERATURE 422
Arthroscopic Debridement 422
Arthroscopic Debridement and Thermal Shrinkage 422
Arthroscopic Reduction and Fixation 422
Arthroscopic Ligamentoplasty 422
SUMMARY 423
SUPPLEMENTARY DATA 423
REFERENCES 423
Open Treatment of Acute Scapholunate Instability 425
Key points 425
INTRODUCTION 425
Nature of the Problem 425
Relevant Anatomy 425
Evaluation of Acute Injury 425
Natural History 426
SURGICAL TECHNIQUE 426
Preoperative Planning 426
Preparation and Patient Positioning 426
Surgical Approach 426
SURGICAL PROCEDURE 428
Reduction and Ligament Repair 428
Final Steps 429
Immediate Postoperative Care 429
REHABILITATION AND RECOVERY 429
CLINICAL RESULTS IN THE LITERATURE 430
SPECIAL CASE SCENARIO: OPEN TREATMENT OF ACUTE SCAPHOLUNATE INSTABILITY IN DISTAL RADIUS FRACTURES 431
SUMMARY 434
ACKNOWLEDGMENTS 434
REFERENCES 434
Chronic Scapholunate Ligament Injury 437
Key points 437
INTRODUCTION 437
ANATOMY AND CARPAL KINEMATICS 438
CLASSIFICATION OF SCAPHOLUNATE LIGAMENT INJURY 440
DIAGNOSIS 440
TREATMENT 442
Predynamic Instability 442
Dynamic Instability, Direct Repair Possible 442
OPERATIVE TECHNIQUE (DIRECT REPAIR WITH DORSAL INTERCARPAL LIGAMENT CAPSULODESIS) 442
Dynamic Instability, Direct Repair Not Possible 443
Static-Reducible Instability 445
OPERATIVE TECHNIQUE (MODIFIED-BRUNELLI TENODESIS) 447
IMMOBILIZATION AND REHABILITATION 447
SUMMARY 447
REFERENCES 447
Bone-Retinaculum-Bone Autografts for Scapholunate Interosseous Ligament Reconstruction 451
Key points 451
INTRODUCTION: NATURE OF THE PROBLEM 451
SURGICAL TECHNIQUE 452
Preoperative Planning 452
Prep and Patient Positioning 452
Surgical Approach 452
Surgical Procedure (as Described by Weiss4) 452
Immediate Postoperative Care 453
REHABILITATION AND RECOVERY 454
CLINICAL RESULTS IN THE LITERATURE 454
Dynamic Instability 454
Static Instability 454
SUMMARY 455
REFERENCES 456
Chronic Scapholunate Ligament Injuries 457
Key points 457
INTRODUCTION 457
PREOPERATIVE PLANNING 458
Radiographic Imaging 458
Indications 458
Contraindications 458
SURGICAL APPROACH 458
SCREW FIXATION OF THE SCAPHOLUNATE JOINT 458
POSTOPERATIVE CARE AND REHABILITATION 460
CLINICAL RESULTS IN THE LITERATURE 460
SCAPHOLUNATE AXIS METHOD 461
Open-hinge Scapholunate Axis Method 462
Postoperative Care, Rehabilitation, and Recovery 463
CLINICAL RESULTS IN THE LITERATURE 463
SUMMARY 465
REFERENCES 465
Diagnosis and Treatment of Acute Lunotriquetral Ligament Injuries 467
Key points 467
INTRODUCTION 467
PATHOMECHANICS 467
MECHANISM OF INJURY 468
Dorsally Applied Force 468
Perilunate Injury 468
Reverse Perilunate Injury 469
Other Causes 469
EVALUATION OF LUNOTRIQUETRAL INJURIES 469
IMAGING STUDIES 470
CLASSIFICATION 472
TREATMENT 472
COMPLICATIONS 474
REHABILITATION 474
SUMMARY 474
REFERENCES 475
Diagnosis and Treatment of Chronic Lunotriquetral Ligament Injuries 477
Key points 477
INTRODUCTION 477
LUNOTRIQUETRAL DISSOCIATIVE INSTABILITY 477
EXAMINATION AND IMAGING 478
NONOPERATIVE TREATMENT OF CHRONIC LUNOTRIQUETRAL INJURIES 479
SURGICAL TREATMENT OF CHRONIC LUNOTRIQUETRAL INJURIES 479
TECHNIQUE: DIAGNOSTIC ARTHROSCOPY, NEURECTOMY, AND LUNOTRIQUETRAL REPAIR (IF POSSIBLE) 481
TECHNIQUE: LUNOTRIQUETRAL RECONSTRUCTION 481
LUNOTRIQUETRAL ARTHRODESIS 483
ULNAR-SHORTENING OSTEOTOMY 483
SUMMARY 485
REFERENCES 485
Midcarpal Instability 487
Key points 487
INTRODUCTION 487
WRIST BIOMECHANICS 487
CLASSIFICATION OF CARPAL INSTABILITIES 488
DORSAL MIDCARPAL INSTABILITY 489
EXTRINSIC MIDCARPAL INSTABILITY 489
PALMAR MIDCARPAL INSTABILITY 489
DISCUSSION AND FUTURE DIRECTIONS 491
SUMMARY 493
REFERENCES 493
Salvage Operations for Wrist Ligament Injuries with Secondary Arthrosis 495
Key points 495
INTRODUCTION 495
WRIST DENERVATION PROCEDURES 496
Surgical Technique: Partial Wrist Denervation 497
FOUR-CORNER ARTHRODESIS VERSUS PROXIMAL ROW CARPECTOMY 497
Surgical Technique: Proximal Row Carpectomy 498
Surgical Technique: Scaphoidectomy with 4-Corner Arthrodesis 499
OTHER ALTERNATIVES TO PROXIMAL ROW CARPECTOMY AND SCAPHOIDECTOMY WITH 4-CORNER FUSION 500
Radial Styloidectomy 500
Scaphocapitolunate Arthrodesis with Radial Styloidectomy 500
Capitolunate Arthrodesis with and Without Triquetrum Excision 501
Bicolumnar Arthrodesis 501
Proximal Row Carpectomy with Osteochondral Resurfacing 501
Proximal Row Carpectomy with Capsular Interposition 502
SUMMARY 502
REFERENCES 502
Index 505