Twenty-two patients with a diagnosis of scapholunate instability underwent a modified Brunelli procedure. The overall results of this short follow-up study showed that a majority of patients (17 out of 22) had relief of pain. Grip strength recovered well. Postoperative range of motion was reduced in extension and flexion, remained unchanged for radial deviation and improved for ulnar deviation. The radiological appearance of dynamic or static scapholunate instability did not change after the procedure. Most patients (17 out of 22) felt subjective improvement and would have the operation again. A significantly poorer result was seen in those patients with an unresolved medicolegal claim. Although short-term results are encouraging for some patients, the authors feel that more long-term follow-up is needed before recommending the procedure.

From the Centre tfr Hand Twenty-three wrists in 22 patients (mean age, 37 years) with ulnar impaction syndrome were treated by ulnar shortening. The mean ulnar shortening was 2 mm (range, 1-4 mm). At a mean follow-up time of 33 months, 17 patients had obtained good subjective pain relief and 16 were shown to have a good overall outcome using the Wrightington Hospital Wrist Function Evaluation.

No abstract

We describe four women and two men who had persistent wrist pain and reduced function after minor operations on the dorsum, usually for ganglia. They had diffuse pain and paraesthesia over the dorsum of the wrist, thumb, index and middle fingers, which was worse and different from that before operation. They all had temporary relief of symptoms after block of the posterior interosseous nerve with bupivacaine. Later, excision of the terminal branches of the nerve at the wrist cured three patients completely and gave marked improvement in the other three, with no complications. Great care is required at operations on the dorsum of the wrist, but pain from a neuroma can be relieved by local excision.