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J Taleisnik

Publications and source records attributed to J Taleisnik.

35 records · Page 2Linked to original sources
PubMed1984

Triquetrohamate and triquetrolunate instabilities (medial carpal instability).

Anatomic and kinematic information needed for the understanding of radiocarpal instability is reviewed. Based on this, and on the concept of the columnar carpus, medial carpal instabilities are defined as those taking place between the triquetrum (medial column) and the hamate and lunate (central column). Therefore, two types of medial instability are recognized: triquetrohamate, across the mid-carpal joint, with loss of stability of the central column present only during ulnar or radial deviation (dynamic DISI and VISI), and triquetrolunate, producing the loss of the dorsiflexion influence of the triquetrum on the lunate and, consequently, a static type of VISI collapse. Treatment aimed at restoration of mid-carpal (triquetrohamate) and triquetrolunate dissociation is discussed, and illustrative cases presented.

Adult↗
PubMed1984

Classification of carpal instability.

A classification of carpal instability is presented based on anatomic and kinematic characteristics of the wrist. Three main types of instability are recognized. Lateral carpal instability may occur between the scaphoid and the trapezium-trapezoid, the scaphoid and the capitate, and the scaphoid and the lunate. Scapholunate dissociation or rotatory subluxation of the scaphoid is the most frequent representative of this type. Medical carpal instability may take place between the triquetrum and the lunate, or the triquetrum and the hamate. Dissociation between lunate and triquetrum results in static forms of instability, while disruption of triquetrohamate support leads to dynamic forms of instability. Proximal carpal instability may lead to disruption at the level of the radiocarpal joint or at the level of the midcarpal joint.

Aged↗
PubMed1983

Rotatory subluxation of the scaphoid after excision of dorsal carpal ganglion and wrist manipulation--a case report.

Surgical excision of a ganglion on the dorsum of the wrist is usually a benign procedure. The most frequent complications are transient postoperative stiffness and recurrence of the ganglion. This paper reports the development of a rotatory subluxation of the scaphoid after the manipulation of the wrist of a patient who had developed postoperative stiffness after the surgical excision of a dorsal wrist ganglion. This unusual complication was successfully treated by closed pinning under radiographic control followed by immobilization in palmar flexion. Manipulation of the wrist for the management of postoperative stiffness is rarely, if ever, indicated. Limitation of motion of a wrist without underlying structural changes is best managed by gentle, gradual splinting, both static and dynamic. It is suggested that preoperative x-rays should be obtained as part of the routine workup for a dorsal wrist ganglion.

Adult↗
PubMed1983

The arterial anatomy of the human carpus. Part I: The extraosseous vascularity.

The vascular anatomy of the wrist was studied in 25 fresh cadaver limbs by injection and chemical debridement techniques. The extraosseous arterial pattern was formed by an anastomotic network of three dorsal and three palmar arches connected longitudinally at their medial and lateral borders by the ulnar and radial arteries. Additional longitudinal anastomoses were provided by the dorsal and palmar branches of the anterior interosseous artery. The most distal of the palmar arches was the deep palmar arch, formed by the anastomosis of the radial artery and the deep palmar branch of the ulnar artery. Two recurrent arteries, one radial and one ulnar, were consistently seen arising from the concavity of this arch, traversing proximally to frequently anastomose with the terminal branches of the anterior division of the anterior interosseous artery. This anastomosis provided the major collateral circulation about the wrist.

Arteries↗
PubMed1983

The arterial anatomy of the human carpus. Part II: The intraosseous vascularity.

The intraosseous vascular anatomy of the carpal bones of 25 fresh cadaver limbs was studied by injection and Spalteholz clearing techniques. The carpal bones were classified into three general groups based on the size and location of nutrient vessels, the presence or absence of intraosseous anastomoses, and the dependence of large areas of bone on a single intraosseous vessel. Group I included the scaphoid, capitate, and 20% of the lunates in this series. Each had large areas of bone dependent on a single intraosseous vessel and was considered at greater risk to develop avascular necrosis following fracture. Group II included the trapezoid and hamate, both of which have two areas of vessel entry but lack intraosseous anastomoses. Group III included the trapezium, triquetrum, pisiform, and 80% of the lunates in this series, which receive nutrient arteries through two nonarticular surfaces, have consistent intraosseous anastomoses, and have no large areas of bone dependent upon a single vessel. The clinical incidence of avascular necrosis in groups II and III is low.

Arteries↗
PubMed1982

Palmar carpal instability secondary to dislocation of scaphoid and lunate: report of case and review of the literature.

An isolated dislocation of scaphoid and lunate is presented. We believe that this injury was responsible for the later development of a palmar carpal instability pattern. Carpal kinematics and pertinent literature are reviewed to support this belief. In our patient, the scaphoid relationship to the trapezium and trapezoid had remained largely undisturbed. The separation of lunate and capitate, a frequent form of carpal dislocation, could be explained on an anatomical basis. The lunate remained attached to the scaphoid, but completely dissociated from the triquetrum. This provided a rare clinical model for the evaluation of the effects of triquetrolunate dissociations on carpal alignment.

Adult↗
PubMed1980

Post-traumatic carpal instability.

A classification of the subtle patterns of carpal instability, exclusive of major carpal fractures, dislocations and fracture dislocations is proposed. This classification is based on a modification of Navarro's concept of the carpus; it is composed of 3 vertical longitudinal columns: lateral (scaphoid); central (lunate and distal carpal row); medial (triquetrum). Carpal dissociations may occur between the lateral and central columns (lateral instability), within the central column (central instability), between the central column and the triquetrum (medial instability), and between the entire carpus and the distal radioulnar articular surface (proximal instability). Lateral carpal instabilities are further subdivided according to the different components of the central column that articulate with the scaphoid. Therefore, 3 main lateral patterns may be identified: scaphoid-trapezium-trapezoid subluxation; scaphoid-capitate diastasis; scaphoid-lunate dissociation. An example of central instability is presented to illustrate this particular type of carpal dissociation. Medial, or lunate-triquetrum instability, is believed responsible for the volar-flexed intercalated segment instability pattern, in which the lunate collapses into a volar-flexed position and there is longitudinal "crumpling" of the radiocarpal link. Proximal carpal or radiocarpal instability may occur in an ulnar (ulnar translocation), dorsal (dorsal subluxation), or volar direction (volar subluxation). It is usually associated with loss of the anatomic alignment of the distal radius.

Adult↗
PubMed1979

Rheumatoid synovitis of the volar compartment of the wrist joint: its radiological signs and its contribution to wrist and hand deformity.

The radiological signs that suggest involvement of the volar compartments of the wrist include grooving of the scaphoid, pseudocysts of the distal radius, and scaphoid-lunate dissociation. These indicate involvement of the radiocarpal ligamentous support. This leads to loss of stability of the scaphoid, which then goes into a volar-flexed position, contributing to shortening the radial carpal height and favoring rotation of the carpus into supination, radial deviation of the metacarpals, and ulnar drift of the fingers.

Arthritis, Rheumatoid↗
PubMed1976

The ligaments of the wrist.

The ligaments of the wrist were studied by dissecting ten fixed and seven fresh frozen wrists. In three other specimens multiple cross-sections were prepared. These studies show that the wrist ligaments can be classified into two groups: extrinsic and intrinsic. In the extrinsic group, the deep volar radiocarpal ligaments are three strong and very important structures connecting the radius to the capitate, the radius to the lunate, and, in a deeper layer, the radius to both the scaphoid and the lunate. A ligamentous deficiency was noted frequently between the capitate and the lunate. There also are very strong volar connections between the radius and the medial or ulnar carpus. These studies suggest that certain patients with a generalized ligamentous laxity and weakness will develop a pathological disruption of the volar ligaments with trauma. These torn volar ligaments should be repaired or reconstructed, for repair of only the dorsal ligaments seldom will provide good stability to such wrists.

Humans↗
PubMedDate not supplied

Computed tomography of the normal radioulnar joints.

Computed tomography followed by sectional radiography and photography as performed on eight cadaveric specimens in order to define the anatomy and normal motion of both the proximal and the distal radioulnar articulations. Osseous landmarks were defined that allowed measurement of rotation at the glenohumeral, proximal radioulnar and distal radioulnar joints as well as rotation between humerus and radius and between humerus and ulna. Findings included the absence of independent ulnar rotation and the presence of normal translatory motion at the distal radioulnar articulation that may be misinterpreted as evidence of subluxation of the distal ulna.

Elbow Joint↗
PubMedDate not supplied

Computed tomography of the normal soft tissues of the wrist.

Computed tomography and sectional radiography and photography were performed on eight cadaveric wrist specimens in order to define the soft tissue structures of the normal wrist. Three specific levels were analyzed in detail: the levels of the distal radioulnar joint, of the pisotriquetral joint, and of the hook of the hamate. All soft tissues, with the exception of arteries and veins, were well demonstrated with computed tomography. In particular, the contents of both Guyon's canal and the carpal tunnel could be delineated. The position of the extensor carpi ulnaris tendon and sheath could also be evaluated. Contrast opacification of the flexor tendon sheaths and palmar synovial sacs did not contribute to the analysis. Computed tomography appears to be an important imaging modality in the evaluation of significant clinical problems, including the carpal tunnel and ulnar tunnel syndromes and subluxation of the extensor carpi ulnaris tendon.

Humans↗
PubMedDate not supplied

Nonunion of metacarpal extraarticular fractures in children: report of two cases and review of the literature.

Extraarticular metacarpal fractures are common during childhood, and osseous healing is the rule. We have treated two patients with delayed and nonunion of three metacarpal shafts. One patient sustained closed second and third metacarpal fractures, and the other sustained an open second metacarpal fracture. Both injuries were crush-type of significant force. Although initial treatment seemed appropriate, delayed union was not appreciated. The children were referred for cosmetic deformity. One of our patients required open reduction/internal fixation with bone grafting, whereas the other was observed. All metacarpal fractures healed. Thorough clinical examination, radiographic views, reduction, and proper immobilization are factors that may help prevent this previously unreported complication in children.

Bone Wires↗
PubMedDate not supplied

Subtotal arthrodeses of the wrist joint.

The goal of subtotal arthrodesis of the wrist is to provide a stable and pain-free joint, with preservation of a limited but useful range of motion. Experience indicates that the available mobility of the joints that are left unfused tends to increase with time and use of the extremity, and that accelerated wear of these joints has not been a problem. Subtotal arthrodeses of the wrist are indicated for: painful arthritis involving one or two radiocarpal or intracarpal joint surfaces, stabilization of carpal collapse deformities, failed ligament reconstructions or repairs, bone tumors with partial carpal involvement, and supplementation of carpal implants, when their insertion alone could precipitate or increase potential carpal instability.

Arthrodesis↗