Midcarpal fusion with the spider plate.
Summary of "Midcarpal fusion with the spider plate."
Pain relief while preserving wrist motion in advanced carpal collapse.
Advanced carpal collapse stage II/III due to scaphoid non-union, scapholunate ligament tear, idiopathic radiocarpal osteoarthritis, aseptic osteonecrosis of the scaphoid (Preisser's disease). A relative indication is chronic midcarpal instability.
Osteoarthrisis of the lunate. Radiocarpal instability with ulnar translation of the wrist. SURGICAL
Dorsal curved incision between the 3rd and 4th dorsal extensor compartment. Partial wrist denervation (posterior interosseous nerve). Raising of a radial pedicled capsule flap. Complete extirpation of the scaphoid without fragmentation. Cartilage removal of all the joint facets for arthrodesis. Reduction of the lunate and temporary fixation with K wires between the triquetrum and capitate and the triquetrum and lunate. Milling the plate hole exactly in central position of the four carpal bones. The plate should not protrude from the bone to avoid impingement with the dorsal limb of the radius. Transferring of spongiosa harvested from the removed scaphoid into the arthrodesis gap. Fixation of the 8-hole plate with 2 screws in each of the four carpal bones. Fluoroscopy of the screw fitting. Control of the correct wrist articulation (motion test). Lavage of the wrist. Suture of the capsule flap. Redon drain, wound closure, dorsal splinting. POSTOPERATIVE
Dorsal splint for 3 weeks; finger mobilization up to complete fist closure starting on postoperative day 1. From week 4-6, active wrist motion, from week 7-10 with increasing load. Return to work after 11-12 weeks. CT scan in cases of delayed union, abnormal function, or persistence of pain.
Between 2002 and 2008, 36 four-corner fusions (32 male, 4 female) with the spider plate were performed in 24 right and 12 left wrists. The mean age of the patients at surgery was 48 years (range 32-71 years). Follow-up examinations were performed in 11 patients. The Krimmer and Rudolf scores were determined: 1 excellent, 7 good, 2 satisfactory, and 1 poor result were found. The mean grip strength was 51% relative to the opposite wrist. The mean range of motion (ROM) for wrist extension/flexion was 56% of the opposite side. Wrist extension/flexion averaged 24/0/32° and ulnar/radial deviation was on average 20/0/19°. Pain during activity was on average 2.2 based on the visual analogue scale (0-10). One delayed bony union due to a screw breakage, which required total wrist fusion, was observed.
Klinik für Unfall -, Hand - und Wiederherstellungschirurgie, Universitätsklinikum Jena, Erlanger Alle 101, 07740, Jena, Deutschland, Reinhard.Friedel@med.uni-jena.de.
This article was published in the following journal.
Name: Operative Orthopadie und Traumatologie
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21528434
- DOI: http://dx.doi.org/10.1007/s00064-011-0020-3
The author has designed a custom-made titanium plate for total wrist fusion for small-handed persons or patients with failed partial wrist fusions. From May 2011 to April 2013, this plate was used on ...
Radioscapholunate (RSL) fusion has been utilized for treatment of radiocarpal arthritis for patients with an intact midcarpal joint. This preserves midcarpal joint motion while alleviating pain. Dart ...
To evaluate radiologic result of anterior cervical discectomy and fusion with allobone graft and plate augmentation, and the change of radiologic outcome between screw type and insertion angle.
Plant cytokinesis requires intense membrane trafficking and remodeling to form a specific membrane structure, the cell plate that will ultimately separate the daughter cells. The nature and the role o...
Various fusion techniques have been used to treat lumbar spine isthmic spondylolisthesis (IS) in adults, including anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), tr...
The purpose of this study is to compare the fusion rates between the EBI, LLC C-Tek™ Anterior Cervical Plate, Slotted Hole Design versus the Fixed Hole Design.
To prospectively collect radiographic and outcome data on patients who are having cervical spine fusion surgery with the VueLock™ Anterior Cervical Plate System
Trinica Anterior Lumbar Plate (ALP) System is a commercially available, supplemental fusion device for use in the lumbar or sacral spine (L1-S1) to treat instability. The system provides ...
The Zero-P PEEK is a stand-alone device intended for use in cervical interbody fusion. The device consists of a plate and a spacer with four rigid screws to provide similar stability to a ...
The purpose of this study is to evaluate the safety and preliminary efficacy of NeoFuse in subjects with a diagnosis of degenerative disc disease (DDD) at 2 or more adjacent cervical verte...
Medical and Biotech [MESH] Definitions
A venomous New World spider with an hourglass-shaped red mark on the abdomen.
The region in the dorsal ECTODERM of a chordate embryo that gives rise to the future CENTRAL NERVOUS SYSTEM. Tissue in the neural plate is called the neuroectoderm, often used as a synonym of neural plate.
A subfamily in the family ATELIDAE, comprising three genera: woolly monkeys (Lagothrix), spider monkeys (Ateles), and woolly spider monkeys (Bracyteles).
The GENETIC RECOMBINATION of the parts of two or more GENES resulting in a gene with different or additional regulatory regions, or a new chimeric gene product. ONCOGENE FUSION includes an ONCOGENE as at least one of the fusion partners and such gene fusions are often detected in neoplastic cells and are transcribed into ONCOGENE FUSION PROTEINS. ARTIFICIAL GENE FUSION is carried out in vitro by RECOMBINANT DNA technology.
The GENETIC RECOMBINATION of the parts of two or more GENES, including an ONCOGENE as at least one of the fusion partners. Such gene fusions are often detected in neoplastic cells and are transcribed into ONCOGENE FUSION PROTEINS.