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Ulnar impaction syndrome
Ulno-carpal impaction syndrome is often secondary to the sequels of a fracture of the distal radius.
The inversion of the distal radio-ulnar index with a positive ulnar variance by shortening relative to the radius eventually leads to an abutment between the head of the ulna and the proximal articular face of the lunate. This contact leads to the alteration of the cartilaginous carpal surfaces. There are numerous treatments for the distal radio-ulnar component of malunion of distal radius fracture and the choice of therapy is based on specific evaluation of this joint through a clinical and radiological analysis.
Arthroscopy remains the best diagnostic element in evaluating the seriousness of the ulno-carpal abutment with a direct visualization of the cartilaginous lesions and allowing a precise assessment of the associated lesions, in particular on TFCC or LT ligament. When the inversion of the distal radio-ulnar index is less than or equal to 5mm, the surgical treatment can also be carried out by arthroscopy.
JR Haugstvedt
Lecture
9 years ago
385 views
6 likes
0 comments
10:08
Ulnar impaction syndrome
Ulno-carpal impaction syndrome is often secondary to the sequels of a fracture of the distal radius.
The inversion of the distal radio-ulnar index with a positive ulnar variance by shortening relative to the radius eventually leads to an abutment between the head of the ulna and the proximal articular face of the lunate. This contact leads to the alteration of the cartilaginous carpal surfaces. There are numerous treatments for the distal radio-ulnar component of malunion of distal radius fracture and the choice of therapy is based on specific evaluation of this joint through a clinical and radiological analysis.
Arthroscopy remains the best diagnostic element in evaluating the seriousness of the ulno-carpal abutment with a direct visualization of the cartilaginous lesions and allowing a precise assessment of the associated lesions, in particular on TFCC or LT ligament. When the inversion of the distal radio-ulnar index is less than or equal to 5mm, the surgical treatment can also be carried out by arthroscopy.
Tips 'n Tricks for wrist arthroscopy: installation, portals and exploration
Wrist arthroscopy allows a thorough exploration of the radiocarpal and midcarpal joints simply by carrying out small portals. This video shows how to achieve them and what can be seen in the wrist.
The purpose of this video is to understand the principle of wrist arthroscopy and how to perform the portals in the least invasive way. We can draw tendon-bone elements on the skin in order to create anatomical landmarks. Before using the knife, using a single needle is essential to identify the exact position of portals. We always start the exploration of the wrist with the radiocarpal joint, and the 3-4 portal. To find it, there are several simple ways. Once the scope is entered in the radiocarpal joint, it is possible only by this portal to explore all the articulation from radial styloid to ulnar styloid. Instrumental 6R portal will be performed. The midcarpal joint is narrower than the radiocarpal joint. We start with the ulnar midcarpal portal, the easiest to find, then an instrumental radiocarpal portal will be used. Placing the scope in a radial midcarpal position allows to explore the scapho-trapezoid-trapezium joint distally as well as the dorsal surface of the capitate bone.
C Mathoulin, P Liverneaux
Surgical intervention
9 years ago
1152 views
30 likes
0 comments
21:38
Tips 'n Tricks for wrist arthroscopy: installation, portals and exploration
Wrist arthroscopy allows a thorough exploration of the radiocarpal and midcarpal joints simply by carrying out small portals. This video shows how to achieve them and what can be seen in the wrist.
The purpose of this video is to understand the principle of wrist arthroscopy and how to perform the portals in the least invasive way. We can draw tendon-bone elements on the skin in order to create anatomical landmarks. Before using the knife, using a single needle is essential to identify the exact position of portals. We always start the exploration of the wrist with the radiocarpal joint, and the 3-4 portal. To find it, there are several simple ways. Once the scope is entered in the radiocarpal joint, it is possible only by this portal to explore all the articulation from radial styloid to ulnar styloid. Instrumental 6R portal will be performed. The midcarpal joint is narrower than the radiocarpal joint. We start with the ulnar midcarpal portal, the easiest to find, then an instrumental radiocarpal portal will be used. Placing the scope in a radial midcarpal position allows to explore the scapho-trapezoid-trapezium joint distally as well as the dorsal surface of the capitate bone.