Sports injuries of the wrist

Fufa, Duretti T.; Goldfarb, Charles A.

doi:10.1007/s12178-012-9145-8

Cited by 19 publications

(11 citation statements)

References 32 publications

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“…39 Although research has long been directed at elucidating noncontact ACL injury mechanisms, the role of repetitive loading has received little attention. 33 Many joints in the human body are susceptible to repetitive loading injuries, including the wrist, 11 shoulder, 3 elbow, 10 intervertebral disc, 38 and hip. 5 In fact, failures due to tissue fatigue have been reported in the leporine medial collateral ligament 41 and the human extensor digitorum longus tendon.…”

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confidence: 99%

Risk of Anterior Cruciate Ligament Fatigue Failure Is Increased by Limited Internal Femoral Rotation During In Vitro Repeated Pivot Landings

2015

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Background A reduced range of hip internal rotation is associated with increased peak anterior cruciate ligament (ACL) strain and risk for injury. It is unknown, however, whether limiting the available range of internal femoral rotation increases the susceptibility of the ACL to fatigue failure. Hypothesis Risk of ACL failure is significantly greater in female knee specimens with a limited range of internal femoral rotation, smaller femoral-ACL attachment angle, and smaller tibial eminence volume during repeated in vitro simulated single-leg pivot landings. Study Design Controlled laboratory study. Methods A custom-built testing apparatus was used to simulate repeated single-leg pivot landings with a 4×-body weight impulsive load that induces knee compression, knee flexion, and internal tibial torque in 32 paired human knee specimens from 8 male and 8 female donors. These test loads were applied to each pair of specimens, in one knee with limited internal femoral rotation and in the contralateral knee with femoral rotation resisted by 2 springs to simulate the active hip rotator muscles’ resistance to stretch. The landings were repeated until ACL failure occurred or until a minimum of 100 trials were executed. The angle at which the ACL originates from the femur and the tibial eminence volume were measured on magnetic resonance images. Results The final Cox regression model (P = .024) revealed that range of internal femoral rotation and sex of donor were significant factors in determining risk of ACL fatigue failure. The specimens with limited range of internal femoral rotation had a failure risk 17.1 times higher than did the specimens with free rotation (P = .016). The female knee specimens had a risk of ACL failure 26.9 times higher than the male specimens (P = .055). Conclusion Limiting the range of internal femoral rotation during repetitive pivot landings increases the risk of an ACL fatigue failure in comparison with free rotation in a cadaveric model. Clinical Relevance Screening for restricted internal rotation at the hip in ACL injury prevention programs as well as in individuals with ACL injuries and/or reconstructions is warranted.

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confidence: 99%

Risk of Anterior Cruciate Ligament Fatigue Failure Is Increased by Limited Internal Femoral Rotation During In Vitro Repeated Pivot Landings

2015

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“…[282930] In our study, we carried out the direct MRAr in one specimen, and in the sagittal plane, we could find the UT, UL ligaments, and the volar and dorsal capsules more clearly than conventional MRI.…”

Section: Discussionmentioning

confidence: 99%

High-resolution 3T Magnetic Resonance Imaging of the Triangular Fibrocartilage Complex in Chinese Wrists

Zhan

Renju

et al. 2017

Chinese Medical Journal

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Background:The injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) could demonstrate the detailed complex anatomy of TFCC in Chinese.Methods:Fourteen Chinese cadaveric wrists (from four men and three women; age range at death from 30 to 60 years; mean age at 46 years) and forty healthy Chinese wrists (from 20 healthy volunteers, male/female: 10/10; age range from 21 to 53 years with a mean age of 32 years) in Beijing Jishuitan Hospital from March 2014 to March 2016 were included in this study. All cadavers and volunteers had magnetic resonance (MR) examination of the wrist with coronal T1-weighted and proton density-weighted imaging with fat suppression in three planes, respectively. MR arthrography (MRAr) was performed on one of the cadaveric wrists. Subsequently, all 14 cadaveric wrists were sliced into 2 mm thick slab with band saw (six in coronal plane, four in sagittal plane, and four in axial plane). The MRI features of normal TFCC were analyzed in these specimens and forty healthy wrists.Results:Triangular fibrocartilage, the ulnar collateral ligament, and the meniscal homolog could be best observed on images in coronal plane. The palmar and dorsal radioulnar ligaments were best evaluated in transverse plane. The ulnotriquetral and ulnolunate ligaments were best visualized in sagittal plane. The latter two structures and the volar and dorsal capsules were better demonstrated on MRAr.Conclusion:High-resolution 3T MRI is capable to show the detailed complex anatomy of the TFCC and can provide valuable information for the clinical diagnosis in Chinese.

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“…Studies have suggested it as critically important for practitioners to show greater awareness towards use of physical examination and false positives for corroborating the diagnostic imaging [10,11]. Previous studies demonstrate a difference in the accuracy of MRI in diagnosing these injuries [9]. Multiple factors can play a major role in MRI accuracy in detecting TFCC lesions; the magnetic field strength is one of these factors as it was shown by Anderson et al who suggested that imaging with 3.0 T offers higher quality at a given spatial resolution [10].…”

Section: Discussionmentioning

confidence: 99%

“…MRI is applied when there is persistence of pain which prevents athletes from their performance. Due to the fact that MRI show higher sensitivity towards detection of TFCC abnormalities and lesions, the MRI arthrogram has been found to be specifically significant for precisely detecting the clinically relevant TFCC tears through the overflow of contrasting leakage directed from the ulnocarpal joint into the DRUJ [9]. Using radiography for evaluating purely soft tissue TFCC injury may not possible lead to demonstrate pathognomonic abnormalities, but rather may result in demonstrating secondary findings such as fracture in the ulnar styloid or positive ulnar variance.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Triangular Fibrocartilage Complex Abnormalities among Asymptomatic Young Individuals Using Magnetic Resonance Imaging in A Tertiary Center in Saudi Arabia: A Cross-Sectional Study

Fairag¹,

Alshareef²,

Alharbi³

et al. 2017

Med Case Rep

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This study aims to detect and evaluate abnormalities and injuries of triangular fibrocartilage complex (TFCC) using 3.0 T high-resolution MRI. It also determines its efficacy among young asymptomatic individuals. This is a cross sectional exploratory study with a sample size of 30 (21 women and 9 men). None of the volunteers showed signs for previous wrist injuries. Details of TFCC morphology were determined using MRI images for dominant wrist. Analysis of locations for tear or degeneration or any characteristics was also performed. An incomplete or partial tear was presented by 5 volunteers (all women) whereas degeneration or complete tear was absent. Besides, 25 volunteers showed an intact ligament including all men. Prevalence of incidental TFCC is found to be less insignificant. The fact that participants showed less prevalence of asymptomatic abnormalities can be related to their young age. Close correlation of the findings with physical examination and history of individuals is required. Level of Evidence:Diagnostic, Level III.

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Sports injuries of the wrist

Cited by 19 publications

References 32 publications

Risk of Anterior Cruciate Ligament Fatigue Failure Is Increased by Limited Internal Femoral Rotation During In Vitro Repeated Pivot Landings

Risk of Anterior Cruciate Ligament Fatigue Failure Is Increased by Limited Internal Femoral Rotation During In Vitro Repeated Pivot Landings

High-resolution 3T Magnetic Resonance Imaging of the Triangular Fibrocartilage Complex in Chinese Wrists

Prevalence of Triangular Fibrocartilage Complex Abnormalities among Asymptomatic Young Individuals Using Magnetic Resonance Imaging in A Tertiary Center in Saudi Arabia: A Cross-Sectional Study

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