Kienbock's disease, or osteonecrosis of the lunate, can lead to chronic, debilitating wrist pain. Etiologic factors include vascular and skeletal variations combined with trauma or repetitive loading. In stage I Kienbock's disease, plain radiographs appear normal, and bone scintigraphy or magnetic resonance imaging is required for diagnosis. Initial treatment is nonoperative. In stage II, scler...

A 32 year old man, right-handed soldier, was admitted to Emergency Department two hours after undergoing right wrist injury following a 2 meter fall onto the hand, in hyperextension. Clinical examination revealed a deformity of the wrist with an obvious open lunate enucleation (A). The neurovascular status was intact. Standard radiograph of the wrist demonstrated a completely enucleated lunate,...

INTRODUCTION Perilunate and lunate dislocations are uncommon high energy injuries and have extensive soft tissue, cartilaginous and bony damage. The most common pattern is trans-scaphoid perilunate fracture dislocation which constitutes approximately 50% of these injuries. Unusual injury pattern like Scaphocapitate syndrome can occur with fracture through scaphoid waist and capitate that rotate...

PURPOSE To compare 5 different Kirschner wire fixation techniques in terms of the failure loads seen as scapholunate (SL) dissociation in a cadaveric, biomechanical study. METHODS 10 fresh-frozen, finger-amputated wrists with sectioned SL ligaments from 3 male and 2 female cadavers were tested. The change of SL angle, SL dissociation, and the load to failure of the 5 different Kirschner wire ...

We studied retrospectively the radiographs of 33 patients with late symptoms after scaphoid nonunion in an attempt to relate the incidence of scaphoid nonunion advanced collapse (SNAC) to the level of the original fracture. We found differing patterns for nonunion at the proximal, middle and distal thirds. The mean intervals between fracture and complaint were 20.9, 6.7 and 12.6 years and obvio...

PURPOSE Midcarpal degeneration is well documented after radioscapholunate fusion. This study tested the hypothesis that radioscapholunate fusion alters the kinematic behavior of the remaining lunotriquetral and midcarpal joints, with specific focus on the dart-thrower's motion. METHODS Simulated radioscapholunate fusions were performed on 6 cadaveric wrists in an anatomically neutral posture....