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Related Concept Videos

Flail Chest-II01:26

Flail Chest-II

Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
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Muscles of the Forearm that Move the Hand and Fingers01:16

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The muscles of the forearm that move the wrist, hand, and digits are numerous and diverse. They can be classified into two groups based on their location and function — the anterior and posterior compartment muscles.
Anterior Compartment
The anterior compartment muscles originate from the humerus. They primarily function as flexors and are also known as flexor muscles. They typically insert on the carpals, metacarpals, and phalanges. The superficial layer includes the flexor carpi radialis,...

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Metacarpal Small Incision for Carpal Tunnel Syndrome
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Published on: April 5, 2024

Trapeziectomy and carpal collapse.

Brandon J Yuan1, Steven L Moran, Shian Chao Tay

  • 1Department of Orthopedics and the Division of Plastic Surgery, Mayo Clinic, Rochester, MN 55905, USA.

The Journal of Hand Surgery
|February 3, 2009
PubMed
Summary
This summary is machine-generated.

Trapeziectomy for trapeziometacarpal osteoarthritis can lead to carpal instability, specifically dorsal intercalated segment instability (DISI). Patients with DISI after surgery reported lower satisfaction and function, especially those with advanced disease.

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Radiology

Background:

  • Trapeziectomy is a surgical treatment for trapeziometacarpal osteoarthritis.
  • This procedure can disrupt the scaphotrapezium-trapezoidal ligament complex.
  • Carpal collapse, specifically nondissociative dorsal intercalated segment instability (DISI), may occur post-surgery.

Purpose of the Study:

  • To evaluate clinical and radiographic outcomes following trapeziectomy.
  • To determine the incidence of postoperative carpal collapse (DISI).
  • To identify correlations between preoperative radiographic findings and postoperative carpal instability.

Main Methods:

  • Retrospective review of 33 wrists undergoing trapeziectomy (1999-2006).
  • Patient surveys assessed pain, function, and satisfaction.
  • Radiographic analysis of carpal angles and DISI frequency before and after surgery.

Main Results:

  • 58% of wrists had Stage IV trapeziometacarpal osteoarthritis.
  • Postoperative dorsal tilt (radiolunate angle) increased by a mean of 4.4 degrees.
  • The frequency of DISI significantly increased from 27% to 50% post-surgery.
  • Patients with DISI reported significantly lower satisfaction.

Conclusions:

  • Trapeziectomy poses a risk for developing carpal instability (DISI).
  • Stage IV trapeziometacarpal osteoarthritis may increase the incidence of postoperative carpal instability.
  • Carpal instability correlates with increased pain and decreased function and satisfaction.