Geometric and Mechanical Characterization of Human Carpal Bones – a Preliminary Study
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Fractures Long Bones, Upper Limb (Includes Hand)
Ministry of Defence Synopsis of Causation Fractures Long Bones, Upper Limb (includes hand) Author: Mr John A Dent, Ninewells Hospital and Medical School, Dundee Validator: Mr Sheo Tibrewal, Queen Elizabeth Hospital, London September 2008 Disclaimer This synopsis has been completed by medical practitioners. It is based on a literature search at the standard of a textbook of medicine and generalist review articles. It is not intended to be a meta-analysis of the literature on the condition specified. Every effort has been taken to ensure that the information contained in the synopsis is accurate and consistent with current knowledge and practice and to do this the synopsis has been subject to an external validation process by consultants in a relevant specialty nominated by the Royal Society of Medicine. The Ministry of Defence accepts full responsibility for the contents of this synopsis, and for any claims for loss, damage or injury arising from the use of this synopsis by the Ministry of Defence. 2 1. Definition 1.1. A bone breaks as a result of a variety of injuring forces. The fracture produced in a long bone may be of its shaft or diaphysis; towards one of its ends where the bone widens (metaphysis); or of the end of the bone, where it forms a joint with the next bone (Figure 1). Fractures near a joint may involve the joint surface causing intra-articular fractures. 1.2. It must always be remembered that the soft tissues surrounding the bone will also be damaged to a varying extent by the injuring force. -
What Is a Scaphoid Fracture?
Sussex Hand CONDITION Surgery Scaphoid Fractures CONDITION The scaphoid is one of the small What is a bones that make up your wrist. It is the commonest wrist bone Scaphoid Fracture? to break. Normal Wrist Xray Sometimes the diagnosis is delayed, Sometimes an operation is often by months or years. In this recommended. The exact situation xrays, MRI and CT scans approach will depend on the type might all be required to make a full of injury. Commonly a screw is Rest of the Thumb assessment of what is needed. placed down the centre of the metacarpal wrist bones scaphoid to keep the fragments (8 small bones lined up and still whilst the bone in total) The scaphoid What treatment is heals. This can sometimes be bone needed for a scaphoid done in a minimally invasive way fracture? with very small incisions (see Distal ulna This depends on a great many ‘Percutaneous screw fixation of Distal radius things. Some important factors are: Scaphoid Fractures’). Later on 1. How old is the injury? Fresh bigger operations might be A fracture of the scaphoid fractures have better healing necessary to re-align a bent potential scaphoid and put new bone into 2. Which part of the scaphoid is the old fracture (see ‘ORIF of broken? The nearer the fracture is Scaphoid Fractures +/-bone to end of the scaphoid next to the grafting’). radius (proximal pole) the more Very obvious chance there is of problems with What is the outcome fracture in the healing. This is to do with the blood following a scaphoid middle (waist) supply to the scaphoid bone which fracture? of the scaphoid is not good in the proximal pole. -
Table 9-10 Ligaments of the Wrist and Their Function
Function and Movement of the Hand 283 Table 9-10 Ligaments of the Wrist and Their Function Extrinsic Ligaments Function Palmar radiocarpal Volarly stabilizes radius to carpal bones; limits excessive wrist extension Dorsal radiocarpal Dorsally stabilizes radius to carpal bones; limits excessive wrist flexion Ulnar collateral Provides lateral stability of ulnar side of wrist between ulna and carpals Radial collateral Provides lateral stability of radial side of wrist between radius and carpals Ulnocarpal complex and articular Stabilizes and helps glide the ulnar side of wrist; stabilizes distal disk (or triangular fibrocartilage radioulnar joint complex) Intrinsic Ligaments Palmar midcarpal Forms and stabilizes the proximal and distal rows of carpal bones Dorsal midcarpal Forms and stabilizes the proximal and distal rows of carpal bones Interosseous Intervenes between each carpal bone contained within its proximal or distal row Accessory Ligament Transverse carpal Stabilizes carpal arch and contents of the carpal tunnel Adapted from Hertling, D., & Kessler, R. (2006). Management of common musculoskeletal disorders: Physical therapy principles and methods. Philadelphia, PA: Lippincott, Williams & Wilkins.; Oatis, C. A. (2004). Kinesiology: The mechanics and pathomechanics of human movement. Philadelphia, PA: Lippincott, Williams & Wilkins.; Weiss, S., & Falkenstein, N. (2005). Hand rehabilitation: A quick reference guide and review. St. Louis, MO: Mosby Elsevier. The radial and ulnar collateral ligaments provide lateral and medial support, respectively, to the wrist joint. The ulnocarpal complex is more likely to be referred to as the triangular fibro- cartilage complex (TFCC) and includes the articular disk of the wrist. The TFCC is the major stabilizer of the distal radioulnar joint (DRUJ) and can tear after direct compressive force such as a fall on an outstretched hand. -
Carpals and Tarsals of Mule Deer, Black Bear and Human: an Osteology Guide for the Archaeologist
Western Washington University Western CEDAR WWU Graduate School Collection WWU Graduate and Undergraduate Scholarship 2009 Carpals and tarsals of mule deer, black bear and human: an osteology guide for the archaeologist Tamela S. Smart Western Washington University Follow this and additional works at: https://cedar.wwu.edu/wwuet Part of the Anthropology Commons Recommended Citation Smart, Tamela S., "Carpals and tarsals of mule deer, black bear and human: an osteology guide for the archaeologist" (2009). WWU Graduate School Collection. 19. https://cedar.wwu.edu/wwuet/19 This Masters Thesis is brought to you for free and open access by the WWU Graduate and Undergraduate Scholarship at Western CEDAR. It has been accepted for inclusion in WWU Graduate School Collection by an authorized administrator of Western CEDAR. For more information, please contact [email protected]. MASTER'S THESIS In presenting this thesis in partial fulfillment of the requirements for a master's degree at Western Washington University, I grant to Western Washington University the non-exclusive royalty-free right to archive, reproduce, distribute, and display the thesis in any and all forms, including electronic format, via any digital library mechanisms maintained by WWu. I represent and warrant this is my original work, and does not infringe or violate any rights of others. I warrant that I have obtained written permissions from the owner of any third party copyrighted material included in these files. I acknowledge that I retain ownership rights to the copyright of this work, including but not limited to the right to use all or part of this work in future works, such as articles or books. -
Bone Limb Upper
Shoulder Pectoral girdle (shoulder girdle) Scapula Acromioclavicular joint proximal end of Humerus Clavicle Sternoclavicular joint Bone: Upper limb - 1 Scapula Coracoid proc. 3 angles Superior Inferior Lateral 3 borders Lateral angle Medial Lateral Superior 2 surfaces 3 processes Posterior view: Acromion Right Scapula Spine Coracoid Bone: Upper limb - 2 Scapula 2 surfaces: Costal (Anterior), Posterior Posterior view: Costal (Anterior) view: Right Scapula Right Scapula Bone: Upper limb - 3 Scapula Glenoid cavity: Glenohumeral joint Lateral view: Infraglenoid tubercle Right Scapula Supraglenoid tubercle posterior anterior Bone: Upper limb - 4 Scapula Supraglenoid tubercle: long head of biceps Anterior view: brachii Right Scapula Bone: Upper limb - 5 Scapula Infraglenoid tubercle: long head of triceps brachii Anterior view: Right Scapula (with biceps brachii removed) Bone: Upper limb - 6 Posterior surface of Scapula, Right Acromion; Spine; Spinoglenoid notch Suprspinatous fossa, Infraspinatous fossa Bone: Upper limb - 7 Costal (Anterior) surface of Scapula, Right Subscapular fossa: Shallow concave surface for subscapularis Bone: Upper limb - 8 Superior border Coracoid process Suprascapular notch Suprascapular nerve Posterior view: Right Scapula Bone: Upper limb - 9 Acromial Clavicle end Sternal end S-shaped Acromial end: smaller, oval facet Sternal end: larger,quadrangular facet, with manubrium, 1st rib Conoid tubercle Trapezoid line Right Clavicle Bone: Upper limb - 10 Clavicle Conoid tubercle: inferior -
The Differential Diagnosis of Bone Marrow Edema on Wrist MRI
Skeletal Radiology (2019) 48:1525–1539 https://doi.org/10.1007/s00256-019-03204-1 REVIEW ARTICLE Review article: the differential diagnosis of bone marrow edema on wrist MRI WanYin Lim1,2 & Asif Saifuddin3,4 Received: 5 December 2018 /Revised: 1 February 2019 /Accepted: 5 March 2019 /Published online: 22 March 2019 # ISS 2019 Abstract There is a large variety of conditions that can result in ‘bone marrow edema’ or ‘bone marrow lesions’ (BML) in the wrist on magnetic resonance imaging (MRI). The combination of clinical history and the distribution of the BML can serve as a valuable clue to a specific diagnosis. This article illustrates the different patterns of BML in the wrist to serve as a useful guide when reviewing wrist MRI studies. Imaging artefacts will also be briefly covered. Keywords MRI . Wrist . Marrow edema . Bone marrow lesion Introduction The etiology of BMLs can also be confusing due to the non-specific appearance, MRI demonstrating poorly defined Bone marrow lesions (BML), or marrow signal reduced T1-weighted spin echo (T1W SE) marrow signal in- hyperintensity on fluid-sensitive magnetic resonance im- tensity (SI) (Fig. 1a) with corresponding hyperintensity on aging (MRI) sequences, are observed in up to 36% of short tau inversion recovery (STIR), fat-suppressed T2W fast patients undergoing wrist MRI [1]. With regard to def- spin echo (FS T2W FSE), and fat-suppressed proton density- inition, the term ‘bone marrow lesion’ (BML) used in weighted fast spin echo (FS PDW FSE) sequences (Fig. 1b). this manuscript is synonymous with ‘edema-like marrow There may also be overlapping patterns between different en- signal’, ‘marrow edema-like signal’ or ‘bone marrow tities, but the combination of clinical history and lesion loca- edema pattern’ [2]. -
The Appendicular Skeleton the Appendicular Skeleton
The Appendicular Skeleton Figure 8–1 The Appendicular Skeleton • Allows us to move and manipulate objects • Includes all bones besides axial skeleton: – the limbs – the supportive girdles 1 The Pectoral Girdle Figure 8–2a The Pectoral Girdle • Also called the shoulder girdle • Connects the arms to the body • Positions the shoulders • Provides a base for arm movement 2 The Clavicles Figure 8–2b, c The Clavicles • Also called collarbones • Long, S-shaped bones • Originate at the manubrium (sternal end) • Articulate with the scapulae (acromial end) The Scapulae Also called shoulder blades Broad, flat triangles Articulate with arm and collarbone 3 The Scapula • Anterior surface: the subscapular fossa Body has 3 sides: – superior border – medial border (vertebral border) – lateral border (axillary border) Figure 8–3a Structures of the Scapula Figure 8–3b 4 Processes of the Glenoid Cavity • Coracoid process: – anterior, smaller •Acromion: – posterior, larger – articulates with clavicle – at the acromioclavicular joint Structures of the Scapula • Posterior surface Figure 8–3c 5 Posterior Features of the Scapula • Scapular spine: – ridge across posterior surface of body • Separates 2 regions: – supraspinous fossa – infraspinous fossa The Humerus Figure 8–4 6 Humerus • Separated by the intertubercular groove: – greater tubercle: • lateral • forms tip of shoulder – lesser tubercle: • anterior, medial •Head: – rounded, articulating surface – contained within joint capsule • Anatomical neck: – margin of joint capsule • Surgical neck: – the narrow -
17 Radial Styloidectomy David M
17 Radial Styloidectomy David M. Kalainov, Mark S. Cohen, and Stephanie Sweet xcision of the radial styloid gained recognition osteotomy removed 92% of the radioscaphocapitate in 1948 when Barnard and Stubbins1 reported on and 21% of the long radiolunate ligament origins. The Eten scaphoid fracture nonunions treated with transverse osteotomy was the most invasive, detach- bone grafting and radial styloidectomy. The procedure ing 95% of the radioscaphocapitate and 46% of the has since been advocated to address radioscaphoid long radiolunate ligament origins. arthritis developing from a variety of injuries, includ- In another cadaveric model, Nakamura et al19 ex- ing previous fractures of the radial styloid and scaphoid, amined the effects of increasingly larger oblique sty- and arthritis related to posttraumatic scapholunate loidectomies on carpal stability. They concluded that instability.2–8 the procedure should be limited to a 3- to 4-mm bony Resection of the radial styloid has also been a use- resection. With axial loading, significantly increased ful adjunct to other procedures where there is poten- radial, ulnar, and palmar displacements of the carpus tial for impingement between the styloid process and were detected after removing 6-mm and 10-mm sty- distal scaphoid or trapezium.9–15 Authors have in- loid segments. The 6-mm cut violated the radio- cluded discussion of successful radial styloidectomy scaphocapitate ligament origin, whereas the 10-mm in descriptions of proximal row carpectomy, mid- cut removed the radioscaphocapitate and a portion of carpal arthrodesis, and triscaphe fusion procedures. the long radiolunate ligament origins. Only an in- On occasion, an individual may be too physically un- significant change in carpal translation was detected fit or unwilling to undergo an extensive operation to after a 3-mm osteotomy. -
Treatment of Scaphoid Nonunion with Olecranon Bone Graft and Compression Screw
DOI: http://dx.doi.org/10.1590/1413-785220162403155935 ORIGINAL ARTICLE TREATMENT OF SCAPHOID NONUNION WITH OLECRANON BONE GRAFT AND COMPRESSION SCREW ANTONIO TUFI NEDER FILHO1, EDUARDO TRALDI FRANCESCHINI2, ARLINDO GOMES PARDINI JÚNIOR2, MARCELO RIBERTO3, NILTON MAZZER3 1. Hospital Lifecenter, Belo Horizonte, MG, Brazil. 2. Hospital Ortopédico, Belo Horizonte, MG, Brazil. 3. Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto, SP, Brazil. ABSTRACT of the handgrip strength of the non-affected side, which was Objective: To evaluate the outcome of olecranon bone graft 37 kgf. The DASH score averaged 5 points. Conclusion: We and compression screw for the treatment of nonunion of believe that the use of bone graft obtained from the olecranon the Lichtman type I scaphoid. Method: We evaluated 15 pa- and secured with cannulated screw is a resolute technique for tients of 32 who underwent surgical treatment for nonunion cases of linear nonunion of the Lichtmann type I scaphoid. It of the Lichtman type I scaphoid with olecranon bone graft has the advantages of a new anesthesia for removal of the and screw compression. Results: We obtained 100% con- graft and the access is easy, providing a good exposure for solidation in our sample. The mean flexion of the wrist on removal and good aesthetic results. Level of evidence IV. the affected side was 68° and 75° on the non-affected side. Case series. The average extension was 63° and 72°, respectively. The average grip strength was 35 kgf. This corresponds to 98% Keywords: Scaphoid bone. Pseudarthrosis. Bone transplantation. Citation: Neder Filho AT, Franceschini ET, Pardini Junior AG, Riberto M, Mazzer N. -
What Is the Scaphoid View ?
Journal of Indonesian Orthopaedic, Volume 40, Number 3, December 2012 7 What is The Scaphoid view ? Djunifer Hasudungan Sagala, Henry Yurianto, M. Ruksal Saleh, Idrus A. Paturusi Department of Orthopaedic and Traumatology Faculty of Medicine, Hasanuddin University, Wahidin Sudirohusodo General Hospital Makassar, Indonesia ABSTRACT Introduction. More than 60% of wrist injuries are associated with scaphoid bone fractures in young active people. Scaphoid fracture dif›cult to diagnose on initial radiography due to unique and complex structures of scaphoid bone, its overlapping position between other carpals bone and still no general consensus about how and which radiographic view should be taken for better expose. This let scaphoid fracture into potential complication such as non-union, delayed union, decrease of wrist joint motion, osteoarthritis of radiocarpal joint and avascular necrosis. Materials and Methods. Serial initial projection of radiograph was investigated to get the better view of scaphoid bone. Postero-anterior projection within wrist joint in extension 10°, 15°, and 20° with maximum ulnar deviation using wrist joint frame was found making the scaphoid clearer. The database was compared to get the ideal view of scaphoid. Extension and ulnar deviation were performed due to fiexed position of scaphoid anatomically in neutral wrist joint position. Results. Good exposure of scaphoid is got from performing radiographic examination of wrist joint 10° extended with maximum ulnar deviation position, in a total of 60 right and left wrist joint samples of young active men and women. Conclusions. Ten degrees extension with ulnar deviation wrist joint position can be proposed to be one of standard scaphoid view on plain radiography. -
Hand Bone Age: a Digital Atlas of Skeletal Maturity
V. Gilsanz/O. Ratib · Hand Bone Age Vicente Gilsanz · Osman Ratib Hand Bone Age A Digital Atlas of Skeletal Maturity With 88 Figures Vicente Gilsanz, M.D., Ph.D. Department of Radiology Childrens Hospital Los Angeles 4650 Sunset Blvd., MS#81 Los Angeles, CA 90027 Osman Ratib, M.D., Ph.D. Department of Radiology David Geffen School of Medicine at UCLA 100 Medical Plaza Los Angeles, CA 90095 This eBook does not include ancillary media that was packaged with the printed version of the book. ISBN 3-540-20951-4 Springer-Verlag Berlin Heidelberg New York Library of Congress Control Number: 2004114078 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable to prosecution under the German Copyright Law. Springer-Verlag Berlin Heidelberg New York Springer is a part of Springer Science+Business Media http://www.springeronline.com A Springer-Verlag Berlin Heidelberg 2005 Printed in Germany The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from therelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. Product liability: The publishers cannot guarantee the accuracy of any information about the application of operative techniques and medications contained in this book. -
Early Management of Upper Limb Fractures in General Practice
Bones • THEME Early management of upper limb fractures in general practice eneral practitioners are frequently confronted with BACKGROUND Upper limb injuries are very G injuries to the upper limb, most commonly from falls. David Spain, common and patients frequently present to general practitioners for treatment. Circumstances This article focusses on upper limb fractures and the MBBS, FRACGP, important issues relevant to correct early management. FACEM, is Director, of the injury and varied patient factors are critical Allamanda 24 Hour to assessment. Outcome of these injuries involves History of injury Emergency Care short term pain control and diagnosis; fracture Centre, Allamanda immobilisation, comfort and function in the A careful history should consider in detail the circum- Private Hospital, Senior Staff Specialist, treatment device medium term; and longer term, stances of the accident or fall (Table 1). This helps predict Emergency the best functional outcome. likely injury and is essential to distinguish simple slip falls Department, Gold OBJECTIVE This article aims to guide GPs from medical causes of collapse. Isolated injury must be Coast Hospital, and Clinical Senior Lecturer, through the initial assessment and early distinguished from an injury as a part of actual or potential the University of management of fractures and provides a logical, multiple trauma. Patients with a severe dramatic and Queensland. simple structure for this process. Understanding painful injury can be distracted, often resulting in other of different injury patterns and patient injuries of significance being initially overlooked. Simple characteristics to assist correct overall enquiry about other possible injury often unearths management is emphasised and the correct unusual replies.