Bookedited by Emmanuel Camus, Luc Van Overstraeten.
Summary: Nowadays, it is established that carpal ligamentary lesions may lead to instability and then to carpal arthritis. However, the variety of anatomopathological classifications and the multiplicity of surgical repair techniques reflect the difficulty of conceiving this ligamentary pathology. The clinical analysis and traditional investigation techniques face the complexity of the wrist. Its mechanical complexity is due to the number of synchronized bones in every movement of the hand. The clinical analysis of the wrist is insufficient to precisely measure the mobility of each carpal bone. Paraclinical examinations are also significant for clinical diagnosis. The tools available today range from X-rays to arthroscopy, including arthroCTscan and soon MRI. As concerns repair techniques, their diversity must not hide the fact that a biomechanical and physiological principle is involved and must be identified. This book is the result of a reflection of an expert group in the field of wrist pathology. It attempts to analyze, understand, explain and make comprehensible, if not obvious, the reflections that each practitioner should employ during the diagnosis and treatment of carpal ligamentary lesions. The focus is consciously not on degenerative carpal pathology, which usually enjoys more visibility. We hope that readers will benefit from the fact that fragmented pieces of knowledge are gathered in a single work, that they will find in this beginning synthesis inspiring to rethink a difficult and sometimes thankless surgery and to further the surgical advances of the 21st century.
Contents:
Part I: Fundamentals
Anatomy of the Carpal Ligaments
Carpal Biomechanics: Application to Ligamentous Injuries
Clinical Examination of Wrist Ligaments
Imaging of Traumatic Carpal Instability
MRI of Normal Anatomy and Injuries of Extrinsic Ligaments
Definition and Classification of Carpal Instability
Normal Wrist Arthroscopy
Application of Wrist Arthroscopy to the Study of the Intrinsic Ligaments
Arthroscopic Anatomy and Lesions of the Extrinsic Ligaments
Dynamic Arthroscopic Testing: False Positives and False Negatives
Arthroscopic Criteria to Date Traumas
Part II: Treatment of Ligament Lesions
Management of Wrist Sprain by the General Practitioner
Role of the Specialist to Sensitize First-Line Therapists
Management of Painful Constitutional Laxities
Rotatory Radiocarpal Instability
Vertical Instability of the Carpus - Axial Dislocation and Fracture-Dislocation: Review of the Literature
Arthroscopic Debridement Pinning: Management of Recent and Unstable Perilunate Injuries
Technique of Open Scapholunate Ligament Repair
Management of Scapholunate Instabilities Resorting to Blatt's Capsulodesis
Management of Chronic Scapholunate Ligament Tears Before Arthritis Occurrence or to Prevent Arthritis
Berger's Capsulodesis with Dorsal Intercarpal Ligament in Chronic Scapholunate Instability
Dorsal Scapholunate Capsulodesis: Viegas' Technique
The Capsulo-Fibrodesis: Horizontal Proximal Carpal Row Retightening Capsulodesis with Scapholunate 'Fibrodesis' - A New Surgical Option
The Brunelli's Tenodesis Chronic Lunotriquetral Ligament Injuries: Arthrodesis or Capsulodesis
Scapholunate Ligament Reconstruction Using a Bone-Ligament-Bone Autograft
Reduction and Association of the Scaphoid and Lunate (RASL)
Results of the Modified Brunelli Technique for Chronic Static Scapholunate Instability
Scaphocapitate Arthrodesis
Medicolegal Aspects of Traumatic Wrist Ligament Injuries
Socioeconomic Aspects of Traumatic Wrist Ligament Injuries.