Search

Abstract: The carpal collapse is defined as a loss of carpal height. It corresponds to a disorganization of carpal bone pieces that switch between them against each other resulting in dysfunction of the dynamics of carp responsible for progressive cartilage wear. Osteoarthritis causes pain and stiffness of the wrist with a “bloated” pattern. We distinguish two main groups of carpal collapse : those resulting from an anomaly starting intracarpal whether malunion, a nonunion, a microcrystalline arthritis or a ligament injury and those resulting from disorientation radiocarpal following a malunion of the radius is called “adaptive carpal collapse”. The latter changes the orientation of the articular surface of the radius at which the carp adapts by shifting with a loss of height. Once the stage of collapse is present, it is important to identify its cause to best adapt the therapeutic management and prognosis assessment. This retrospective diagnosis requires knowing some anatomical features of bone structure carpal ligaments and method of analysis of radiological guidance and carpal height. Outcome of osteoarthritis secondary to carpal collapse is so predictable and stereotyped according to their causes and different treatments are possible depending on staging. Initial treatment of the lesion causing collapse remains the most likely to avoid the use of palliative treatment usually only possible with advanced stages. [Copyright &y& Elsevier]

Abstract: Objectives: The purpose of this study was to evaluate the results and complications of locked palmar plating in patients with articular fracture of the distal radius. Methods: Twenty-two patients were reviewed retrospectively. The average age was 68 years. All fractures were classified as Type C according to the AO classification. Clinical and functional examination including range of motion, grip strength, pain and return to previous activities were assessed. Loss of radial height, radial inclination, palmar tilt and ulnar variance were evaluated with preoperative and postoperative radiographs. Results: At an average follow-up of 10 months, the range of motion was 124° in flexion and extension and 178° in pronation and supination. Grip strength was 80% of the opposite side. Fifteen patients were free of pain. Three patients suffered tenosynovitis of the extensor tendons. Radiographic measurements averaged 11mm radial height, 21° radial inclination, 4° palmar tilt and 1mm ulnar variance. Conclusions: The result of this study showed that locked palmar plating of articular distal radius fractures is effective even in cases of metaphyseal comminution with a low rate of complications. [Copyright &y& Elsevier]