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Background: The purpose of this study is to audit the clinical and functional outcomes of arthroscopic ganglionectomy (AG) in our centre. Methods: A retrospective study was conducted on all 29 patients who underwent AG from 2007 to 2012 with a mean clinic and telephone follow-up duration of 6 months and 32 months respectively. Results: A total of 29 patients (17 women and 12 men) with a mean age of 38 years underwent AG. 15 patients (52%) had associated pain with the lump, 24 out of 29 patients (83%) had preoperative ultrasound to confirm the diagnosis. All patients had preoperative wrist radiographs that showed no chronic carpal instability and bony pathology. 26 out of 29 patients (90%) had dorsal wrist ganglions and 3 patients (10%) had volar wrist ganglions. 15 out of 24 ganglions (62.5%) were multiloculated. Mean ganglion size clinically and through wrist ultrasound was 2.5 cm and 1.8 cm respectively. During arthroscopy, ganglion stalk was identified in 14 patients (48%). Average operating time was 69.5 minutes. Intraoperatively, 24 out of 29 patients (83%) had wrist synovitis and 26 patients (90%) had associated carpal ligament laxity. 97% of cases were successfully resected arthroscopically. Recurrence rate was 10% (3 cases). There was no significant difference between preoperative and postoperative range of motion of wrists - the mean wrist flexion ranged from 63 to 59 degrees pre and postoperatively, and the mean wrist extension ranged from 66 to 64 degrees pre and postoperatively. Overall grip strength improved from 27 kg to 32 kg (), and there was also a significant improvement in pain scores pre and post-operatively from visual analogue scale (VAS) score of 0.8 to 0.3 (). No major intra or post-operative complications occurred. All patients were satisfied in terms of cosmesis. Conclusions: AG is a safe and reliable alternative to open resection of wrist ganglions. In addition, it can be used as a diagnostic and therapeutic tool for other wrist conditions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify a clinical radiographic features containing the measurements of carpal alignment, configuration, and joint space width of the wrist without osteoarthritis (OA) in Japanese. We also aimed to analyse age-related correlations in these parameters with reference to the difference between men and women. A total of 184 cases were analysed to establish the following relations: (1) Sex-related differences in the morphology and joint space width of the wrist without OA; (2) correlation coefficient between these parameters and age according to sex. This study suggests that carpal height ratio (CHR) was higher in men than in women. Also the ulnar variance (UV) increased and the radial inclination (RI) decreased with age in both men and women, and the volar tilt (VT) decreased with age in women. [ABSTRACT FROM AUTHOR]

We present here two cases wherein we performed radiolunate fusion using vascularized radius graft with the vascular pedicle of the fourth extensor compartment artery (fourth ECA) for the treatment of Bain's grade 2A Kienböck disease with incongruity of the radiolunate joint. The dorsodistal radius graft was levered out and mobilized on the pedicle of the fourth ECA; then the vascularized dorsodistal radius was shifted 1 cm distally and bridges were created between the radius and the lunate. The radiolunate joint was completely fused in both cases at three months after surgery. The capitolunate joint maintained congruity after surgery. The Mayo wrist score was 75 points, and the DASH (JSSH version) score for the two cases was 2.5 and 4.2 points, respectively. Radiolunate fusion using the vascularized radius bridging procedure is one of the satisfactory methods for treating advanced Kienböck disease, especially in Bain's grade 2A cases. [ABSTRACT FROM AUTHOR]

As the distal radius fracture is one of the most commonly encountered upper limb injuries, the aim of this study was to provide a quick and easy method to aid in the assessment of fractured wrists, both pre- and post-fixation, by utilising the relationship of the radial shaft and the lunate. A retrospective analysis on 100 consecutive patients with normal wrist radiographs was performed. The results demonstrated that the variations of radiolunate anatomy followed a normal distribution. The normal anatomical relationship was then described. A second part to the study consisted of reviewing our method of radiocarpal analysis on a cohort of patients who had sustained a distal radius fracture. Carpal alignment pre- and post-fixation was measured, with the results demonstrating that by using this assessment method, it was possible with a quick glance of the radiograph, to determine whether satisfactory correction of the fracture had been achieved. [ABSTRACT FROM AUTHOR]

Flexor tendon rupture following distal radius fracture is rare. We described a case of flexor pollicis longus rupture, presented five years after volar plating of distal radius fracture. [ABSTRACT FROM AUTHOR]

The pain of distal radioulnar arthrosis in rheumatoid patients is often due to disease largely confined to the radioulnar rather than the ulnocarpal articulation. This is a retrospective study of 14 patients (14 wrists) who underwent selective shaving of the radial articulation of the ulnar head leaving the ulnocarpal articulation intact. The ulnar head is reduced to the circumference of its shaft and a dorsal retinacular flap is interposed between it and the distal radius. Average age of the patients and follow-up were 63.5 years and 31 months, respectively. All patients had rheumatoid arthritis. Pain improved in 14 out of 15 wrists. Overall results were 67% good to excellent and 33% fair based on the modified Mayo's wrist score. This novel procedure for DRUJ arthrosis produces predictable pain relief in low demand rheumatoid patient. [ABSTRACT FROM AUTHOR]

Wrist arthrodesis is indicated for the rheumatoid hand especially in cases with severe destruction of the carpal bones. In the arthrodesis procedure for the rheumatoid wrist, autogenous iliac bone grafting is required in most cases. However, autogenous iliac bone graft necessitates the additional surgical intervention, and can be associated with the problem of inadequate bony quality or quantity. It is thought that use of the artificial bone substitute in the procedure can lessen the surgical morbidity while supplying the consistent material without shortage of graft quantity. We have performed arthrodesis of the rheumatoid wrist using beta-TCP for four patients. Clinical results of these patients were satisfactory both in pain relief and functional improvement with complete bony healing. Therefore, this procedure seems to be an effective option for the rheumatoid wrist with severe destructive changes. [ABSTRACT FROM AUTHOR]

An unusual case of compression of median nerve at the wrist is described due to a foreign body. In unusual presentation of carpal tunnel syndrome, ultrasonography of the wrist is recommended to rule out a foreign body in the region. [ABSTRACT FROM AUTHOR]