Background: Kienböck’s disease is the avascular necrosis of the lunate bone. There is no consensus on the treatment strategy to avoid joint deterioration. This trial is conducted to compare the functional and radiological outcomes of radial shortening and capitate shortening techniques, in patients with avascular necrosis of lunate. Methods: Patients with a confirmed diagnosis of Kienböck’s disease who met the inclusion criteria were randomly divided into radial shortening and capitate shortening groups and treated by allocated technique. Physical examination and radiologic evaluations were performed before and 6 and 12 months after the operation. Results: A total of 52 patients (52 wrists) of stage II or III Kienböck’s disease were assessed for eligibility, 12 patients in the radial shortening group, and 17 patients remained until the end of the study. Patients in both groups achieved a satisfactory outcome, with no report of postoperative complications. None of the outcome measures, ranges of motion, grip, and pinch strengths were significantly different between the groups. The outcome was not considerably different in patients with positive or negative ulnar variances who were treated by capitate shortening technique. Conclusions: The capitate shortening technique which is performed through a smaller incision, and takes less time as compared with radial shortening can be advantageous for patients with stage II or III Kienböck’s disease regardless of the ulnar variance. This method can be as effective as classical methods such as radial shortening in improving clinical and functional symptoms after surgery while causing fewer complications.
Background: Trigger wrist is a relatively rare hand disorder that refers to the painful snapping and clicking or triggering at the wrist level during finger or wrist movements. Objectives: In this study, we aimed at reporting a series of trigger wrist and discussing their etiology, as well as their clinical manifestation and outcomes. Methods: In this retrospective study, the patients with the definitive diagnosis of trigger wrist were reviewed. Their demographics and clinical symptoms were extracted from their medical records. The symptoms of median neuropathy, including weakness or atrophy of the thenar muscles, persistent numbness, and paresthesia were recorded to investigate the association with Carpal Tunnel Syndrome (CTS). Results: A total of seven patients with the Mean±SD age of 35.5±10.3 years were included in the study. A benign mass was the etiology of trigger wrist in all cases, with giant cell tumor of flexor tendon sheet as the most common etiology (57.1%). Trigger wrist was associated with CTS in three cases (42.8%), in all of whom the tumor size was larger than the average. Pain and snapping with or without palpable mass were the main clinical symptoms of the patients that completely disappeared by surgical removal of the lesion. A mean 40.3 months follow-up of the patients was uneventful. Conclusion: Benign neoplasms could be considered as the most common etiology of trigger wrist. Since many patients with trigger wrist might have CTS, too, the careful differentiation of these entities is necessary. Once accurately diagnosed, surgical intervention is entirely curative.
Introduction: Post-traumatic Pseudoaneurysm (PTP) is a rare condition. Because of its clinical course and presentation like a tumor lesion, its early diagnosis and appropriate treatment is necessary. Case Presentation: In this study, we present a case of PTP in the left peroneal artery two years after trauma that presented with calf mass. Conclousion: Magnetic resonance imaging and magnetic resonance angiography were used for the diagnosis, and the patient was successfully managed with endovascular stenting.
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