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Impact01:30

Impact

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Impact occurs when two bodies collide, leading to the application of impulsive forces between them. Analyzing impact mechanics involves considering two colliding particles moving along a line known as the line of impact, which passes through their centers and is perpendicular to the contact plane.
When particles with different initial velocities collide, they induce deformation by applying equal and opposite impulses. At the point of maximum deformation, the particles move together with...
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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...
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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
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Impacts can be classified in various forms, primarily under two subgroups: central impact and oblique impact. A central impact occurs when two objects collide head-on, possessing opposite velocities aligned along the line of impact. Conversely, an oblique impact occurs when two objects collide at an angle, resulting in a modification of both direction and velocity.
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Impaction Syndromes About the Wrist.

Eon K Shin1

  • 1Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia Hand to Shoulder Center, 1203 Langhorne-Newtown Road, Suite 335, Langhorne, PA, 19047, USA. ekshin@handcenters.com.

Current Reviews in Musculoskeletal Medicine
|November 26, 2022
PubMed
Summary

Ulnar-sided wrist pain from impaction syndromes can be challenging to diagnose. Early suspicion and appropriate non-operative or surgical treatment, such as ulnar shortening osteotomy, can provide curative results.

Keywords:
Hamate arthrosis lunotriquetral ligament syndromeTriquetrohamate impaction syndromeUlnar impaction syndromeUlnar-sided wrist painWrist arthroscopy

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Area of Science:

  • Orthopedics
  • Hand and Wrist Surgery
  • Musculoskeletal Disorders

Background:

  • Ulnar-sided wrist pain is often caused by impaction syndromes.
  • Clinical differentiation between these syndromes can be challenging due to overlapping symptoms.

Purpose of the Study:

  • This review focuses on the diagnosis and treatment of three distinct impaction syndromes.
  • The syndromes discussed are ulnar impaction syndrome, hamate arthrosis lunotriquetral ligament syndrome, and triquetrohamate impaction syndrome.

Main Methods:

  • Review of current literature on diagnosis and treatment of ulnar-sided wrist impaction syndromes.
  • Discussion of non-operative and operative management strategies.
  • Emphasis on diagnostic wrist arthroscopy for confirmation and surgical planning.

Main Results:

  • Non-operative treatment is the initial approach, though its duration is not well-defined.
  • Ulnar shortening osteotomy effectively treats ulnar impaction syndrome but carries risks like hardware issues and nonunion.
  • Hamate arthrosis lunotriquetral ligament syndrome is managed by hamate excision; triquetrohamate impaction syndrome requires debridement and partial excision.

Conclusions:

  • Impaction syndromes are significant, often underappreciated, causes of ulnar-sided wrist pain.
  • A high index of suspicion is crucial for timely diagnosis and treatment.
  • Surgical intervention, when necessary, frequently leads to a curative outcome.