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At least 73 records · Page 4Linked to original sources
PubMed2000

Trapeziometacarpal joint instability affects the moment arms of thumb motor tendons.

This study measured the changes in moment arm length of thumb motor tendons after simulated ligamentous instability and subsequent reconstruction of the trapeziometacarpal joint. Excursions of thumb motor tendons were measured simultaneously with the trapeziometacarpal joint angulation during flexion to extension and abduction to adduction motion. Tendon moment arms were calculated based on joint and tendon displacement techniques in the intact joint, after sequential sectionings of the capsuloligamentous restraints, and after the reconstruction procedure of Eaton and Littler. The results showed that moment arms of the abductor pollicis longus and extensor pollicis brevis tendons increased significantly as compared with those for normal joints during flexion to extension motion after sectioning the palmar capsuloligamentous components. After the ulnopalmar structures were cut, the moment arm of the extensor pollicis longus tendon had a statistically significant increase during abduction to adduction motion, and those of the extensor and flexor pollicis longus tendons decreased significantly during flexion to extension motion. Changed moment arms were restored to a normal level after the ligamentous reconstruction. These results indicate that ligamentous disruptions alter the mechanical balance of thumb motor tendons, which may contribute to joint deformities observed in trapeziometacarpal joint arthritis. Restoring joint stability is important to correct mechanical imbalance of the tendons.

Aged↗
PubMed1995

Treatment of acute injuries of the triangular fibrocartilage complex associated with distal radioulnar joint instability.

One hundred thirty patients who had an injury of the triangular fibrocartilage complex (TFCC) with distal radioulnar joint (DRU) instability were treated operatively. The TFCC injury with DRUJ instability occurred as an isolated lesion in 20. After appropriate fracture stabilization, 86 patients were treated with closed reduction of the DRUJ and radioulnar transfixation with one to two Kirschner wires with the forearm in neutral rotation. In 19 patients the avulsed ulnar styloid was internally fixed, and the DRUJ supplemented with radioulnar transfixation. In 13 patients the ulnar styloid was internally fixed. In 12 patients with radial avulsion fractures the displaced bony fragment was percutaneously fixed with a Kirschner-wire. Postoperatively all the patients were immobilized in a long arm cast in neutral rotation for 6 weeks. The results were excellent in 95%, fair in 30, and poor in 5.

Accidental Falls↗
PubMed2005

Functional results post-triangular fibrocartilage complex reconstruction with extensor carpi ulnaris with or without ulnar shortening in chronic distal radioulnar joint instability.

From September 1996 to September 2001, 37 adult patients were diagnosed with chronic triangular fibrocartilage complex (TFCC) tears with distal radioulnar joint (DRUJ) instability in our clinic. They had all received the procedure of TFCC reconstruction with partial extensor carpi ulnaris (ECU) combined with or without ulnar shortening. There were 36 males and one female in the study with a mean age of 22.4 years. The follow-up period ranged from 25 to 48 months with a mean of 36.2 months. All patients received the rehabilitation programme and were re-examined at our outpatient department. The results were graded according to the Mayo Modified Wrist Score. Eleven of the 37 patients rated their wrists "excellent", 22 rated "good", and four rated "fair". Overall, a total of 33 patients (89%) rated satisfactorily and returned to work or sport activities. Therefore, TFCC reconstruction with partial ECU tendon combined with or without ulnar shortening procedure is an effective method for post-traumatic chronic TFCC tears with DRUJ instability suggested by this study.

Adult↗
PubMed1998

[Management of old neglected posttraumatic acromioclavicular joint instability and arthrosis].

UNLABELLED: Resection arthroplasty of the AC joint was performed in 42 cases of osteoarthrosis and residual instability of traumatic origin including 26 shoulders with horizontal instability of more than half of the width of the clavicula and lesions of the deltotrapezoid fascial complex (Rockwood type II: 7; type III: 9; type IV: 17; type V: 9). 23 cases were treated with a sole Weaver-Dunn procedure. 26 cases with horizontal instability and lesions of the deltotrapezoid fascia (Rockwood IV and V type) were treated in 7 cases with the standard Weaver-Dunn procedure and in 19 cases with a modified Weaver-Dunn procedure in combination with a coracoclavicular (3 x 1) and acromio-clavicular (1 x 1) 1 mm PDS string augmentation and double breasting fascioplasty of the deltotrapezoid complex. RESULTS: Successful results (in Patte-Score) after a minimum follow-up of 2 years (mean: 32 months) were reached in 88.4% of cases with only Weaver/Dunn procedure with a significant difference of good and excellent results in the horizontally stable group (93.8%) versus the horizontally unstable group (57.2%). In the group with horizontal instability and Weaver-Dunn procedure and complex additional stabilization with fascioplasty and PDS augmentation, 89.5% excellent and good results were found. CONCLUSION: Cases with horizontal instability (type Rockwood IV and V) seem to be over-represented among patients with failed conservative treatment. Resection arthroplasty with ligament transposition after Weaver/Dunn gives excellent results in posttraumatic osteoarthrosis with mainly vertical and moderate horizontal instability. In cases with advanced horizontal instability after Rockwood IV and V injuries, almost equal results can be reached by an additional coracoclavicular and acriomioclavicular PDS augmentation with deltotapezoid fascioplasty.

Acromioclavicular Joint↗
PubMed1987

Transposition of coracoacromial ligament to humerus in treatment of vertical shoulder joint instability. Clinical applicability of experimental technique.

Treatment of experimental distal subluxation in the shoulder joint was achieved by transposition of the coracoacromial ligament and its bony attachment from the acromion to the lesser tuberosity of the humerus. This transposition also reduced external rotation in the first 40 degrees of abduction. The method, which was applied in two clinical cases of distal subluxation, proves reasonable from a biomechanical point of view and yields satisfactory primary clinical results.

Acromion↗
PubMed2004

Reports of joint instability in knee osteoarthritis: its prevalence and relationship to physical function.

OBJECTIVE: To report the prevalence and relationship of self-reported knee instability to physical function in a sample of subjects with knee osteoarthritis (OA), and to discuss the implications of these observations for rehabilitation. METHODS: Subjects were 105 individuals (80 females) with knee OA who rated their knee instability severity on a 6-point numeric scale in response to the query "To what degree does giving way, buckling, or shifting of the knee affect your level of daily activity?" A principal component analysis was used to combine The Western Ontario and McMaster Universities pain, stiffness, and physical function subscale scores, and the Timed Get Up and Go Test score into a principal component score for physical function (PCPF). Other variables that could affect the PCPF such as age, sex, years with knee OA, radiographic severity of knee OA, knee pain, knee motion, and quadriceps strength were also recorded. The prevalence of self-reported knee instability was determined by calculating the proportion of subjects who reported each severity level of knee instability. Hierarchical regression analysis was performed to determine if the level of self-reported knee instability could predict the PCPF, even after accounting for the effects of the other variables. RESULTS: Sixty-three percent of the subjects reported knee instability during activities of daily living, and 44% reported that instability affects their ability to function. The severity of self-reported knee instability was associated with the PCPF (eta2=0.40, P <0.001), and after controlling for all other independent variables, significantly increased the prediction of the PCPF (r2=0.56, r2 change=0.05; P <0.001). CONCLUSION: The results indicate that a substantial proportion of individuals with knee OA report episodes of knee instability during activities of daily living, and instability affects physical function beyond that which can be explained by contributions from other impairments such as knee pain, range of motion, and quadriceps strength. Knee instability is a problem that should be specifically addressed in rehabilitation programs and may require interventions beyond those that address pain, joint motion, and muscular strength, to maximize the effectiveness of rehabilitation for individuals with knee OA.

Activities of Daily Living↗
PubMed1993

[Malleolar fractures with ankle joint instability--experience with the positioning screw].

UNLABELLED: Malleolar fractures with an unstable ankle joint require additional stabilization. Different implants exist: We present the results of 135/155 patients treated with the so-called positioning screw. In 123 patients the positioning screw showed a spontaneous loosening with functional treatment and was therefore removed with the rest of the implants after eight to twelve months. In twelve cases the screw was broken. In 3/21 patients with the old 3.5 mm cortical screw with a core diameter of 1.9 mm in a correct position and in 9/113 patients with the new 3.5 mm cortical screw with inner core of 2.4 mm in an incorrect position. CONCLUSION: Positioning screws require early removal only if they fail to loosen or if a persistent limitation of dorsiflexion is still present after three months.

Adult↗