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Isolated Trapezoid Fractures a Case Report with Compilation of the Literature
Bulletin of the NYU Hospital for Joint Diseases 2008;66(1):57-60 57 Isolated Trapezoid Fractures A Case Report with Compilation of the Literature Konrad I. Gruson, M.D., Kevin M. Kaplan, M.D., and Nader Paksima, D.O., M.P.H. Abstract as an axial load5,6 or bending stress7 transmitted indirectly Isolated fractures of the trapezoid bone have been rarely to the trapezoid through the second metacarpal. We present reported in the literature, the mechanism of injury being a case of an acute, isolated trapezoid fracture that resulted an axial or bending load transmitted through the second from direct trauma to the distal carpus and that was treated metacarpal. We report a case of an isolated, nondisplaced nonoperatively. Additionally, strategies for diagnosis and trapezoid fracture that was sustained by direct trauma treatment, as well as a synthesis of the published results and subsequently treated successfully in a short-arm cast. for both isolated and concomitant trapezoid fractures, are Diagnostic and treatment strategies for isolated fractures presented. of the trapezoid bone are reviewed as well as the results of operative and nonoperative treatment. Case Report A 25-year-old right-hand dominant male presented to the ractures of the carpus most commonly involve the emergency room (ER) complaining of isolated right-wrist scaphoid,1 with typical physical examination findings pain and swelling of 1 day’s duration. The patient stated Fof “snuffbox” tenderness. This presentation is fre- that a heavy metal door at work had closed onto the back quently the result of the patient falling onto an outstretched of his wrist causing an immediate onset of swelling and hand. -
Capitate Metastases in Adenocarcinoma Lung: a Rare
Case Report Capitate Metastases in Adenocarcinoma PROVISIONAL PDF Lung: A Rare Occurrence Jaspreet KAUR1, Renu MADAN1, Maneesh Kumar VIJAY2, Pramod Kumar JULKA1, Goura Kishore RATH1 Submitted: 21 May 2014 1 Department of Radiation Oncology, DR BRA Institute Rotary Cancer Accepted: 19 Nov 2014 Hospital, All India Institute of Medical Sciences, New Delhi 110029, India 2 Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India Abstract Metastatic carcinoma is the most common malignancy of the bone. Metastases to the upper limbs of the skeleton are extremely uncommon, with only 10–15% occurring in this region. Metastases to the hand and wrist comprise about 0.15% of all hand tumours, and only 0.1% of all metastases. Carpal bone metastases are much rarer than those to the metacarpal and phalangeal bones. They usually masquerade as more common hand pathology such as arthritis or osteomyelitis. Given the bleak prognosis of carpal metastatic disease in lung cancer, treatment of a metastasis to the hand is usually palliative. Contrary to earlier beliefs, palliative radiotherapy plays a significant role in pain relief and improving hand mobility in patients diagnosed with metastatic disease of the hand. We report a case of adenocarcinoma of the lung with metastases to the capitate bone of the carpus treated with palliative radiotherapy. Keywords: carpal bone, metastases, lung cancer, palliative, radiotherapy Introduction Case report Metastatic carcinoma is the most common A 52-year-old male presented with fever, left- malignancy of the bone. The skeleton is the sided chest pain and pain in the right wrist for two third most common site of metastases after months. -
Osteoid Osteoma of the Trapezoid Bone
'-DIDUL)1DMG0D]KDU Case Report Osteoid Osteoma of the Trapezoid Bone Dawood Jafari MD1)DULG1DMG0D]KDU0'1 Abstract Osteoid osteoma is a benign, bone-forming tumor that rarely involves the carpal bones. We report a case of osteoid osteoma of the trap- H]RLGFDUSDOERQHZLWKH[WHQVLRQWRWKHDGMDFHQWVHFRQGPHWDFDUSDOERQH&KURQLFZULVWSDLQDQGORFDOWHQGHUQHVVZHUHWKHPDMRUFOLQLFDO signs and symptoms. In chronic wrist pain osteoid osteoma and the possibility of extension to the adjacent bones should be considered. Keywords: &DUSDOERQHPHWDFDUSDORVWHRLGRVWHRPDWUDSH]RLG Cite the article as: Jafari D, Najd Mazhar F. Osteoid Osteoma of the Trapezoid Bone. Arch Iran Med. 2012; 15(12): 777 – 779. Introduction RSV\WKURXJKDGRUVDODSSURDFK:HXVHGDVPDOOGULOOELWDQG¿QH osteotome to remove the involved area, which included the adjacent steoid osteoma is a benign bone tumor that rarely localizes articular surface of the trapezoid. The biopsy specimen had a highly to the carpal bones.1,2 Wrist pain usually is the main com- vascular reddish nidus embedded in normal bone (Figure 5). We no- O plaint and because it rarely involves the carpal bone, diag- ticed that the articular surface of the second metacarpal was eroded nosis is often delayed. It has been reported in the scaphoid and lu- and softened (Figure 6). Following curettage, we sent the specimen nate areas; however, the trapezoid is an exceedingly rare location from the base of the second metacarpal in a separate container for for osteoid osteoma. Bifocal involvement of adjacent carpal bones pathologic analysis. The results of the histologic examinations of has been reported previously but to the best of our knowledge ex- both biopsy specimens indicated osteoid osteoma (Figure 7). Since tension of osteoid osteoma through the joint to adjacent bone has we had only one nidus at the CT scan and involvement of both trap- not been mentioned in the literature. -
Osteoblastoma of the Trapezoid Bone and Triquetral Bone: Report of Two Cases
CASE REPORT Acta Orthop Traumatol Turc 2013;47(5):376-378 doi:10.3944/AOTT.2013.3081 Osteoblastoma of the trapezoid bone and triquetral bone: report of two cases ‹brahim KAYA1, Burak BOYNUK2, Caner GÜNERBÜYÜK3, Ak›n U⁄RAfi4 1Department of Orthopedics and Traumatology, Haseki Training and Research Hospital, ‹stanbul, Turkey; 2Department of Orthopedics and Traumatology, Bak›rköy Ac›badem Hospital, ‹stanbul, Turkey; 3Department of Orthopedics and Traumatology, 29 May›s Hospital, ‹stanbul, Turkey; 4Department of Orthopedics and Traumatology, ‹stanbul Medipol University, School of Medicine, ‹stanbul, Turkey Osteoblastoma is a benign local aggressive tumor mostly localized in the vertebra or long bones. Carpal location and recurrence are extremely rare. Treatment options include either curettage or wide en bloc resection which causes functional disability in the hand and wrist and should be reserved only for recurrence. We present a case of recurrent trapezoid osteoblastoma previously treated with curet- tage of the trapezoid bone and a case of primary triquetral osteoblastoma. Key words: Curettage; osteoblastoma; trapezoid bone; triquetral bone. Osteoblastoma is a benign primary bone tumor first pain increased at night and had a good response to non- described as “giant osteoid osteoma” by Dahlin and steroidal analgesic drugs. Radiographs, computerized Johnson in 1954.[1] Later, in 1956, Lichtenstein and Jaffe tomography and magnetic resonance imaging (MRI) named this tumor “osteoblastoma” in two different arti- revealed findings resembling avascular necrosis of the cles.[2] It is an uncommon benign but locally aggressive trapezoid bone, periosteal reaction at the second tumor, most commonly located in the vertebral column metacarpal and generalized edema in the dorsal com- or metaphysis of long bones. -
Carpal Fractures
CURRENT CONCEPTS Carpal Fractures Nina Suh, MD, Eugene T. Ek, MBBS, PhD, Scott W. Wolfe, MD CME INFORMATION AND DISCLOSURES The Review Section of JHS will contain at least 3 clinically relevant articles selected by the Provider Information can be found at http://www.assh.org/Pages/ContactUs.aspx. editor to be offered for CME in each issue. For CME credit, the participant must read the Technical Requirements for the Online Examination can be found at http://jhandsurg. articles in print or online and correctly answer all related questions through an online org/cme/home. examination. The questions on the test are designed to make the reader think and will occasionally require the reader to go back and scrutinize the article for details. Privacy Policy can be found at http://www.assh.org/pages/ASSHPrivacyPolicy.aspx. The JHS CME Activity fee of $30.00 includes the exam questions/answers only and does not ASSH Disclosure Policy: As a provider accredited by the ACCME, the ASSH must ensure fi include access to the JHS articles referenced. balance, independence, objectivity, and scienti c rigor in all its activities. Disclosures for this Article Statement of Need: This CME activity was developed by the JHS review section editors and review article authors as a convenient education tool to help increase or affirm Editors reader’s knowledge. The overall goal of the activity is for participants to evaluate the Ghazi M. Rayan, MD, has no relevant conflicts of interest to disclose. appropriateness of clinical data and apply it to their practice and the provision of patient Authors care. -
The Cobbler's Shoes: Techniques for the Wrist and Carpal Bones
The Cobbler’s Shoes: Techniques for the Wrist and Carpal Bones. © 2008 Til Luchau, AdvancedTrainings.com (This article originally appeared in Massage and Bodywork magazine.) Just like the cobbler’s shoeless rists are amazing structures. They mediate the children, as hands‐on body therapists W relationship between our stable larger‐boned arms, we can tend to neglect our own hand and the highly mobile, sensitive dexterity of our hands. and wrist mobility. Since we use our Additionally, key structures pass through the wrists from hands so much in our work, we are arms to hands: tendons, nerves, and vessels. In this issue’s particularly prone to loosing article, I’ll talk about two effective techniques for working adaptability in our own carpal joints. with the wrist, drawing on the myofascial work as taught in Advanced‐Trainings.com’s “Advanced Myofascial Receiving the kind of work described Techniques” workshop and DVD series. As always, you here is great preventative can see video related to these techniques by visiting maintenance, and it can even increase Massage and Bodywork’s digital edition, which features a the quality of your work. Although lost clip from Advanced‐Trainings.com’s “Advanced mobility may or may not cause overt Myofascial Techniques for the Arm, Wrist, and Shoulder” symptoms, it will cause your touch to DVD set. Link available on ABMP.com and feel harder, more rigid, and less Massageandbodywork.com comfortable to your clients. It can also take a toll on your sensitivity and The carpus is the name of the boney structure formed by dexterity. -
Aneurysmal Bone Cyst of the Capitate: a Rare Case Report
)1DMG0D]KDU=0RJKLPL+<DK\D]DGHKHWDO Case Report Aneurysmal Bone Cyst of the Capitate: A rare case report )DULG1DMG0D]KDU0'1, Zahra Moghimi MD2, HoomanYahyazadeh MD2, Sareh Shahverdi MD2 Abstract Primary aneurysmal bone cyst (ABC) in the hands is rare. It occurs more commonly in metacarpal bones and involvement of carpal bones is very uncommon. We report the third case of ABC in the capitate, its clinical presentation, LPDJLQJ¿QGLQJVDQGWUHDWPHQW Keywords: Aneurysmal bone cyst, capitate, carpal bone, hand Cite this article as: Najd Mazhar F, Moghimi Z, Yahyazadeh H, Shahverdi S. Aneurysmal Bone Cyst of the Capitate: A rare case report. Arch Iran Med. 2014; 17(3): 211 – 214. Introduction measuring 15x 8x 9 mm in the capitate, without soft tissue inva- sion. Signal of the lesion was high-intensity on T2-weighted and neurysmal bone cyst (ABC) known as a benign bony le- low- intensity on T1-weighted (Figure 4 a – b). VLRQ ZDV ¿UVW LQWURGXFHG E\ Jaffe and Lichtenstein in $FFRUGLQJWRWKHLPDJLQJ¿QGLQJVa cystic lesion like aneurys- A 1942.1 ABCs may affect any part of the skeleton, but most mal bone cyst was at the top of the differential diagnosis list. We commonly involve the metaphysis RIORQJERQHVÀDWERQHVDQG approached to the lesion through a dorsal longitudinal incision. vertebral column.2 The occurrence of ABC in the hand are not Dorsal cortex was very thin and the capitate was occupied by a common, accounting for nearly 3 % to 5 % of all ABCs and are EORRG¿OOHGcystic lesion (Figure 5). The lesion was completely often occurred in the metacarpal bones.3 ABC rarely involves car- evacuated by thorough curettage and specimen sent to the histo- pal bones and only 2 cases of this tumor have been reported in the logic examination (Figure :H¿OOHGDQGLPSDFWHGWKHYRLGDUHD capitate.3 We report the third case of this tumor in the capitate with cancellous bone graft which was harvested from the ipsilat- along with its FOLQLFDO SUHVHQWDWLRQ LPDJLQJ ¿QGLQJV DQG WUHDW- eral iliac crest. -
The Structure and Movement of Clarinet Playing D.M.A
The Structure and Movement of Clarinet Playing D.M.A. DOCUMENT Presented in Partial Fulfilment of the Requirements for the Degree Doctor of Musical Arts in the Graduate School of The Ohio State University By Sheri Lynn Rolf, M.D. Graduate Program in Music The Ohio State University 2018 D.M.A. Document Committee: Dr. Caroline A. Hartig, Chair Dr. David Hedgecoth Professor Katherine Borst Jones Dr. Scott McCoy Copyrighted by Sheri Lynn Rolf, M.D. 2018 Abstract The clarinet is a complex instrument that blends wood, metal, and air to create some of the world’s most beautiful sounds. Its most intricate component, however, is the human who is playing it. While the clarinet has 24 tone holes and 17 or 18 keys, the human body has 205 bones, around 700 muscles, and nearly 45 miles of nerves. A seemingly endless number of exercises and etudes are available to improve technique, but almost no one comments on how to best use the body in order to utilize these studies to maximum effect while preventing injury. The purpose of this study is to elucidate the interactions of the clarinet with the body of the person playing it. Emphasis will be placed upon the musculoskeletal system, recognizing that playing the clarinet is an activity that ultimately involves the entire body. Aspects of the skeletal system as they relate to playing the clarinet will be described, beginning with the axial skeleton. The extremities and their musculoskeletal relationships to the clarinet will then be discussed. The muscles responsible for the fine coordinated movements required for successful performance on the clarinet will be described. -
Capitate-Trapezoid Synostosis: Analysis of an Early Bronze Age Case and Review of the Literature P
Folia Morphol. Vol. 76, No. 2, pp. 149–156 DOI: 10.5603/FM.a2016.0068 R E V I E W A R T I C L E Copyright © 2017 Via Medica ISSN 0015–5659 www.fm.viamedica.pl Capitate-trapezoid synostosis: analysis of an Early Bronze Age case and review of the literature P. Saccheri1, G. Sabbadini2, E. Crivellato1, A. Canci3, F. Toso4, L. Travan1 1Department of Experimental and Clinical Medicine, Section of Anatomy, University of Udine, Italy 2Department of Medical, Surgical and Health Sciences, University of Trieste, Italy 3Department of History and Preservation of the Cultural Heritage, University of Udine, Italy 4Department of Diagnostic Imaging, University Hospital of Udine, Italy [Received: 22 July 2016; Accepted: 2 September 2016] Background: Carpal synostoses are congenital defects characterised by com- plete or incomplete coalition of two or more carpal bones. Although most of these defects are discovered only incidentally, sometimes they become clinically manifest. Among the different types of carpal coalition, the synostosis between capitate and trapezoid bones is quite rare, with only sparse data available in the literature. The aim of this report was to describe a case of capitate-trapezoid synostosis (CTS) observed in an ancient human skeleton, as well as to scrutinise the pertinent literature in order to assess for the characteristics of this type of defect, including its potential relevance to clinical practice. Materials and methods: We studied the skeletal remains of an Early Bronze Age male warrior affected by incomplete CTS. Macroscopic and radiological examina- tion of the defect was carried out. We also performed a comprehensive PubMed search in the Medline and other specialty literature databases to retrieve and analyse data relevant to the subject under consideration. -
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 -
Section 1 Upper Limb Anatomy 1) with Regard to the Pectoral Girdle
Section 1 Upper Limb Anatomy 1) With regard to the pectoral girdle: a) contains three joints, the sternoclavicular, the acromioclavicular and the glenohumeral b) serratus anterior, the rhomboids and subclavius attach the scapula to the axial skeleton c) pectoralis major and deltoid are the only muscular attachments between the clavicle and the upper limb d) teres major provides attachment between the axial skeleton and the girdle 2) Choose the odd muscle out as regards insertion/origin: a) supraspinatus b) subscapularis c) biceps d) teres minor e) deltoid 3) Which muscle does not insert in or next to the intertubecular groove of the upper humerus? a) pectoralis major b) pectoralis minor c) latissimus dorsi d) teres major 4) Identify the incorrect pairing for testing muscles: a) latissimus dorsi – abduct to 60° and adduct against resistance b) trapezius – shrug shoulders against resistance c) rhomboids – place hands on hips and draw elbows back and scapulae together d) serratus anterior – push with arms outstretched against a wall 5) Identify the incorrect innervation: a) subclavius – own nerve from the brachial plexus b) serratus anterior – long thoracic nerve c) clavicular head of pectoralis major – medial pectoral nerve d) latissimus dorsi – dorsal scapular nerve e) trapezius – accessory nerve 6) Which muscle does not extend from the posterior surface of the scapula to the greater tubercle of the humerus? a) teres major b) infraspinatus c) supraspinatus d) teres minor 7) With regard to action, which muscle is the odd one out? a) teres -
Carpal Boss in Chronic Wrist Pain and Its Association with Partial Osseous
MUSCULOSKELETAL RADIOLOGY Carpal boss in chronic wrist pain and its association with partial osseous coalition and osteoarthritis ‑ A case report with focus on MRI findings Feng Poh Department of Diagnostic Radiology, Singapore General Hospital, Singapore Address for correspondence: Dr. Feng Poh, Department of Diagnostic Radiology, Singapore General Hospital, Outram Road ‑ 168 751, Singapore. E‑mail: [email protected] ABSTRACT The carpal boss is a bony prominence at the dorsal aspect of the 2nd and/or 3rd carpometacarpal joint, which has been linked to various etiologies, including trauma, os styloideum, osteophyte formation, and partial osseous coalition. It may result in symptoms through secondary degeneration, ganglion formation, bursitis, or extensor tendon abnormalities by altered biomechanics of wrist motion. We present a case of symptomatic carpal boss with the finding of a partial osseous coalition at the 2nd carpometacarpal (metacarpal– trapezoid) joint and highlight the magnetic resonance imaging (MRI) findings of carpal boss impingement and secondary osteoarthritis. To the best of our knowledge, there is no report in the literature describing the imaging findings of partial osseous coalition and degenerative osteoarthritis in relation to carpal boss. Key words: Carpal boss; carpal coalition; chronic wrist pain; os styloideum; osteoarthritis Introduction A persistent os styloideum is the widely accepted theory behind the carpal boss and has been described as the ninth Carpal boss, also known as “carpe bossu,” is a bony carpal bone.[4,5] It represents an un‑united ossicle over prominence at the dorsal aspect of the 2nd and/or the dorsal aspect of the wrist at the base of the 2nd and 3rd carpometacarpal joint and was first described by Fiolle.[1] 3rd metacarpals.