Surgical treatment in wrist instabilities
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IACUBIȚCHII, Vitalie, URSU, Sergiu, MAFTEI, Dumitru. Surgical treatment in wrist instabilities. In: MedEspera: International Medical Congress for Students and Young Doctors, Ed. 7th edition, 3-5 mai 2018, Chişinău. Chisinau, Republic of Moldova: 2018, 7, p. 148.
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MedEspera
7, 2018
Congresul "International Medical Congress for Students and Young Doctors"
7th edition, Chişinău, Moldova, 3-5 mai 2018

Surgical treatment in wrist instabilities


Pag. 148-148

Iacubițchii Vitalie1, Ursu Sergiu12, Maftei Dumitru2
 
1 ”Nicolae Testemițanu” State University of Medicine and Pharmacy,
2 Republican Clinical Hospital of Traumatology and Orthopedics
 
 
Disponibil în IBN: 18 noiembrie 2020


Rezumat

Introduction. Wrist joint instabilities are ligament injuries associated with subluxations, luxations, fractures, nonunions or osteoarticular diseases of carpal bones. There are type of surgery to resolve these problems. Materials and methods. Our experience is based on the treatment of 129 patients with wrist instabilities of different etiology aged between 17 and 68 years who underwent various selective arthrodesis. The average duration of disease was 3 years and 2 months. Kienbock disease was diagnosed in 41 patients, in various stages, pseudoarthrosis of the scaphoid complicated by deforming osteoarthritis in 71 cases, rotational subluxation of the scaphoid in 9 cases, trapezium trapezoid scaphoid o steoarthritis in 4 patients and malunion of the distal radius fracture in 4 cases. Results. Arthrodesis directed to obtain an ankylosis of the carpal bones by losing the amplitude of movements, but allows to achieve a stable joint, without pain and to restore gripping power. In 71 patients with scaphoid pseudoarthrosis, complicated with deforming osteoarthritis, arthrodesis of 4 carpal bones with scaphoidectomy in different variants was performed in 49 cases, total wrist arthrodesis in 8 cases, scaphoc apitate arthrodesis in 4 cases, removing the first row of carpal bones in 3 cases, scaphoidectomy in 5 cases, radial scaphoid arthrodesis in 1 case, and 1 other in scapho trapezium trapezoid arthrodesis. In 41 patients with Kienbock disease, Graner opera tion was performed in 16 cases, arthrodesis of 3 carpal bones in 10 cases, capitate scaphoid arthrodesis in 8 cases, radial semilunar in 4 cases, radial scaphoid arthrodesis in 1 case, removing the first row of carpal bones in 2 cases. Arthrodesis of 3 carpal bones (scapho trapezium trapezoid), was performed in 4 cases of deforming arthritis. Also triple scaphoid arthrodesis was done successfully in 9 patients with rotational subluxation of the scaphoid. Total wrist arthrodesis was performed in 4 ca ses of the intraarticular radial fracture malunion. Long term results were followed up in 46 patients: good (18), satisfactory (23). Unsatisfactory outcomes were in 5 cases because of absence of the ankylosis and presence of the pain. Conclusions. Selectiv e wrist arthrodesis is indicated in deforming arthritis grade II or III of diverse etiology, when outstanding amplitude movements are up to 50% of normal range. Each case of selective wrist arthrodesis is chosen individually according to disease, the sprea ding grade of deforming osteoarthritis and patient profession.

Cuvinte-cheie
wrist instabilities, pseudoarthrosis of the scaphoid, Kienbock disease, selective arthrodesis