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Hypothesis An open volar surgical approach with suture anchor repair of the foveal ligament and temporary pinning of the distal radioulnar joint (DRUJ) is an effective way to treat DRUJ instability associated with chronic foveal tears of the triangular fibrocartilage complex (TFCC). Methods We retrospectively reviewed nine patients with foveal ligament tears of the TFCC and DRUJ instability who underwent open repair of the TFCC using a volar surgical approach, combined with temporary pinning of the DRUJ for 8 weeks. Pain, instability, arc of motion, and functional outcomes scores were evaluated. Results Mean patient age was 40.5 years (range 16.3-56.2). Average time from injury to surgery was 8.4 months (range 2.9-23.3 months). Average final follow-up was 18.9 months from injury (range 12.0-29.3 months), 10.5 months from surgery (range 3.9-18.6 months), and 8.7 months from pin removal (range 1.7-17.2 months). At final follow-up, all patients demonstrated clinically stable DRUJ. Pain scores diminished signierapeutic study.Background Distal radius fracture is one of the most common lesions in adults. Surgical techniques have evolved considerably with a clear tendency toward mini-invasive techniques. Objective Our aim is to push the limits to a 12 mm approach and evaluate its clinical and radiological results. Patients and Methods Ten fractures in nine patients were operated by a double incision with mean size 11.50 ± 3.41 mm (range 8.00-1.00) and using a specially designed volar distal locking plate. Results At the latest follow-up, visual analogue scale score for pain (0.20 ± 0.63 during rest and 0.60 ± 1.07 while making efforts) and quick DASH (quick Disabilities of the Arm, Shoulder and Hand) score (6.14 ± 7.43) were extremely low. All the range of motion parameters and grip strength were above the 95% barrier of the contralateral side, with exception of ulnar deviation. Radiological parameters obtained were located within the normal ranges. Time to return to independent daily tasks and work was 6.67 ± 5.15 and 10.14 ± 14.24 days, respectively. One case of transient carpal tunnel syndrome was solved with watchful waiting and one case of extensor tendons impingement was improved after plate removal. All patients were completely satisfied at the end of the treatment. Conclusion In conclusion, mini-invasive volar technique for distal radius fractures with special designed plates in carefully selected patients allowed us to obtain good clinical and radiological results, minimal complications, fast recovery, and high-satisfactory rates. STM2457 cost Level of Evidence This is a Level IV, case series study.Background Distal forearm fracture is the most common pediatric fracture. As studies have indicated time trends in fracture incidence, we wanted to update the epidemiology and estimate time trends between 1950 and 2016 in Malmö, Sweden. Methods The city of Malmö, Sweden, had 318,107 inhabitants (58,585 of the population was aged less then 16 years) in 2014 and one hospital. We, therefore, used the hospital diagnosis registry and hospital medical records to identify and classify distal forearm fractures 2014 to 2016 in children aged 0 to 15 years. For long-term trend calculations, we also included published data from 1950 to 2006 (resulting in 17 evaluated years) and used joinpoint regression to estimate annual percent changes (APC). To describe differences in incidence between two periods, we calculated incident rate ratios (IRR) with 95% confidence intervals (95% CI) to describe uncertainty. Results Childhood distal forearm fracture incidence in 2014 to 2016 was 546/100,000 person-years (660 in boys and 427 in girls). The age-adjusted incidence in 2014 to 2016 and in 2005 to 2006 was similar (boys IRR 1.0, 95% CI 0.9-1.2 and girls IRR 1.1, 95% CI 0.9-1.3). Time-trend analyses from 1950 to 2016 revealed increasing age-adjusted incidence in both boys (APC +0.9%, 95% CI 0.7-1.2) and girls (APC +0.6%, 95% CI 0.3-0.9). Conclusion Distal forearm fracture incidence was similar in 2014 to 2016 and in 2005 to 2006. Age-adjusted incidence had increased in both sexes from 1950 to 2016. Level of Evidence This is a Level III b study.Backgound The scaphoid is the most commonly fractured carpal bone and often presents as a diagnostic challenge. Fractures can often go unnoticed on initial radiographic evaluation and clinical presentation can vary significantly among patients. Awareness of high-risk cohorts assists practitioners in making the appropriate clinical diagnosis of acute scaphoid fracture. Materials and Methods The National Trauma Data Bank is the world's largest trauma data repository. Utilizing the 2016 public use file, we isolated scaphoid fractures by anatomic fracture location by utilizing International Classification of Diseases, 10th revision coding. Reported cases of distal pole (S62.01), waist (S62.02), and proximal pole (S62.03) were included. This data was then queried to determine trends in mechanism of injury, demographic information, and associated injuries. Results There were a total of 968,665 patients with 2,769 cases of reported scaphoid fractures resulting in 286 scaphoid fractures per 100,000 person-years. Males were more likely to sustain a scaphoid fracture than females. The most commonly encountered associated injuries were distal radius fractures, distal ulnar fractures, and nonscaphoid carpal bone fractures, respectively. Conclusions Scaphoid fractures presenting to trauma centers are more commonly reported among males and those involved in motor vehicle accidents or falls. Appropriate scaphoid-specific radiographic imaging should be obtained as well as wrist and elbow images to evaluate for concomitant injuries, especially distal radius fractures.Objective The purpose of this study was to evaluate the short-term outcomes of patients undergoing proximal row carpectomy (PRC) with interposition arthroplasty using a decellularized dermal allograft. Methods Patients with a minimum of 1-year follow-up after undergoing a PRC using decellularized dermal allograft were contacted for clinical evaluation, radiographs, and postoperative outcome questionnaires, including the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire as well as the modified Likert scale for patient satisfaction. Nine of ten (90%) consecutive patients who were treated using this surgical technique were available for follow-up. Results At a mean follow-up of 18 months, a total of nine patients achieved a mean flexion-extension arc of 113 degrees, pronosupination of 170.5 degrees, grip strength of 68 Ibs and pinch strength of 17 Ibs. Relative to the contralateral side, these values were 95, 100, 84 and 82%, respectively. There was significant improvement in the mean DASH score from 63.
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