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Lars Adolfsson - One of the best experts on this subject based on the ideXlab platform.
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incidence of distal Ulna fractures in a swedish county 74 100 000 person years most of them treated non operatively
Acta Orthopaedica, 2020Co-Authors: Maria Moloney, Simon Farnebo, Lars AdolfssonAbstract:Background and purpose - Fractures of the distal Ulna can occur in isolation or in conjunction with a distal radius fracture. They may result in incongruence and instability of the distal radioUlnar joint. We investigated the incidence of distal Ulna fractures, whether any fracture types were more common, and the methods of treatment used.Patients and methods - Data were collected from patients 18 years or older, treated for a fracture of the distal Ulna in Ostergotland, Sweden, during 2010-2012. Patients were identified in the patient registry. The fractures were classified according to the AO comprehensive classification of fractures.Results - The incidence of distal Ulna fractures was 74/100,000 person-years. The most common fracture type was that of the Ulnar styloid Q1 (79%), followed by the Ulnar neck Q2 (11%). Rarest was Ulna head fracture, type Q4 (1%). Incidental findings were a mean age of 63 years (SD 18), a concomitant distal radius fracture in 92% of the patients and that 79% were caused by falling from standing height. Internal fixation was performed in 30% of the Q2-Q6 fractures. This indicates that most were considered stable without internal fixation or stable after fixation of a concomitant radius fracture.Interpretation - Our results show that fractures of the distal Ulna are not very common, and some fracture types are even rare. There seem to be no consensus on treatment.
Naotoshi Mitsukawa - One of the best experts on this subject based on the ideXlab platform.
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association between forearm muscle thickness and age related loss of skeletal muscle mass handgrip and knee extension strength and walking performance in old men and women a pilot study
Ultrasound in Medicine and Biology, 2014Co-Authors: Robert S. Thiebaud, Jeremy P Loenneke, Madoka Ogawa, Naotoshi MitsukawaAbstract:Very little information is available concerning the relationship between handgrip strength and muscle size in the upper and lower extremities, especially the forearm muscle itself. To investigate the relationships among ultrasound-measured forearm muscle thickness from the radius and Ulna bone interface with handgrip strength, knee extension strength, walking speed and absolute/relative total skeletal muscle mass (TMM), 32 Japanese men and 21 Japanese women ages 70-83 years had muscle thickness (MT) measured by ultrasound. In the forearm, two MTs (forearm-radius and forearm-Ulna MT) were measured. TMM was estimated from an ultrasound-derived prediction equation. Handgrip-strength was significantly correlated with forearm-Ulna MT in both men and women. There were no significant correlations between forearm MT and walking speed in either sex. In men, both forearm-radius and forearm-Ulna MT were significantly correlated with TMM and TMM index. In women, a significant correlation was only observed between forearm-Ulna MT and TMM index. Our results suggest that forearm-Ulna MT may be a useful parameter for evaluating handgrip strength and TMM index in older Japanese men and women. Language: en
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association between forearm muscle thickness and age related loss of skeletal muscle mass handgrip and knee extension strength and walking performance in old men and women a pilot study
Ultrasound in Medicine and Biology, 2014Co-Authors: Jeremy P Loenneke, Madoka Ogawa, Robert S. Thiebaud, Takashi Abe, Naotoshi MitsukawaAbstract:Abstract Very little information is available concerning the relationship between handgrip strength and muscle size in the upper and lower extremities, especially the forearm muscle itself. To investigate the relationships among ultrasound-measured forearm muscle thickness from the radius and Ulna bone interface with handgrip strength, knee extension strength, walking speed and absolute/relative total skeletal muscle mass (TMM), 32 Japanese men and 21 Japanese women ages 70–83 years had muscle thickness (MT) measured by ultrasound. In the forearm, two MTs (forearm-radius and forearm-Ulna MT) were measured. TMM was estimated from an ultrasound-derived prediction equation. Handgrip-strength was significantly correlated with forearm-Ulna MT in both men and women. There were no significant correlations between forearm MT and walking speed in either sex. In men, both forearm-radius and forearm-Ulna MT were significantly correlated with TMM and TMM index. In women, a significant correlation was only observed between forearm-Ulna MT and TMM index. Our results suggest that forearm-Ulna MT may be a useful parameter for evaluating handgrip strength and TMM index in older Japanese men and women.
Won Sik Choy - One of the best experts on this subject based on the ideXlab platform.
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locking compression plate distal Ulna hook plate as alternative fixation for fifth metatarsal base fracture
Journal of Foot & Ankle Surgery, 2014Co-Authors: Ju Sang Park, Won Sik ChoyAbstract:Abstract Intramedullary screw fixation has been the most common treatment for fifth metatarsal base fractures. However, screw application will not achieve accurate reduction in fractures with small fragments, osteoporotic bone, or Lawrence zone 1 fractures. Because of the similar anatomic architecture between the distal Ulna and the fifth metatarsal base, the purpose of the present study was to assess the results of a locking compression plate distal Ulna hook plate in stabilizing displaced zone 1 or 2 fifth metatarsal base fractures. A total of 19 patients with Lawrence zone 1 (n = 12) or 2 (n = 7) fractures of the fifth metatarsal base were treated surgically with a locking compression plate distal Ulna hook plate. The patients were evaluated clinically and radiographically, and the functional outcomes were graded using the American Orthopaedic Foot and Ankle Society midfoot scoring system. Radiographic bony union was obtained in all patients, at an average of 7.4 weeks. The mean American Orthopaedic Foot and Ankle Society midfoot score improved from 26 (range 0 to 45) points preoperatively to 94 (range 72 to 100) points at the final follow-up visit. Three patients developed post-traumatic cubometatarsal arthrosis, and 1 patient developed sural nerve neurapraxia. In our experience, the distal Ulna hook plate achieved a high rate of bony consolidation and anatomically suitable fixation in zone 1 or 2 fifth metatarsal base fractures. We suggest that the locking compression plate distal Ulna hook plate should be considered as an alternative treatment of multifragmentary, osteoporotic, and tuberosity avulsion (zone 1) fifth metatarsal base fractures.
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lcp distal Ulna hook plate as alternative fixation for fifth metatarsal base fracture
European Journal of Orthopaedic Surgery and Traumatology, 2013Co-Authors: Ju Sang Park, Won Sik ChoyAbstract:Intramedullary screw fixation is the most common treatment for fifth metatarsal base fractures. Screw application does not achieve accurate reduction in fracture with small fragments, osteoporotic bone, or Lawrence zone 1 fractures, however. On the basis of similar anatomical architectures between the distal Ulna and the fifth metatarsal base, the purpose of this study was to assess the results of a locking compression plate (LCP) distal Ulna hook plate in stabilizing displaced zone 1 or 2 fifth metatarsal base fractures. Nineteen patients with Lawrence zone 1 (n = 12) or 2 (n = 7) fractures of the fifth metatarsal base were treated surgically with an LCP distal Ulna hook plate. The patients were evaluated clinically and radiographically, and functional outcomes were graded by using the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scoring system. Radiographic bony union was obtained in all patients, at an average of 7.4 weeks. The mean AOFAS midfoot score improved from 26 (range, 0–45) preoperatively to 94 (range, 72–100) points at the final follow-up. There were three patients with post-traumatic cubometatarsal arthrosis and one patient with sural nerve neuropraxia. In our experience, the distal Ulna hook plate achieves a high rate of bony consolidation and anatomically suitable fixation in zone 1 or 2 fifth metatarsal base fractures. We also suggest that the LCP distal Ulna hook plate should be considered as an alternative treatment in multifragmentary, osteoporotic, and tuberosity avulsion (zone 1) fifth metatarsal base fractures.
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distal Ulna hook plate fixation for unstable distal Ulna fracture associated with distal radius fracture
Orthopedics, 2012Co-Authors: Sang Ki Lee, Kap Jung Kim, Ju Sang Park, Won Sik ChoyAbstract:The significance of distal Ulna fractures is often undermined, which can result in inadequate treatment compared with fractures of the radius, the Ulna's larger counterpart. However, little guidance exists in the current literature on how to manage distal Ulna head or neck fractures and intra-articular Ulna head fractures. Therefore, the purpose of this retrospective study was to evaluate the outcomes of distal Ulna hook plate fixation for the treatment of an unstable distal Ulna fracture associated with a distal radius fracture. Twenty-five patients with unstable distal Ulna fractures who underwent stable fixation for an associated distal radius fracture were included in the study. All patients achieved satisfactory reduction and bony union. Average final motion was as follows: wrist flexion, 72° (range, 60°-85°); extension, 69° (range, 65°-80°); pronation, 77° (range, 55°-95°); supination, 82° (range, 65°-90°); Ulnar deviation, 35° (range, 15°-50°); and radial deviation, 24° (range, 10°-40°). Average postoperative grip strength was 28 kg (range, 22-30 kg) and was 91% (range, 71%-100%) in the cases in which the dominant hand was injured and 80% (range, 65%-100%) in the cases in which the nondominant hand was injured. Average postoperative modified Mayo wrist score and Disabilities of the Arm, Shoulder and Hand score was 87 points (range, 65-100 points) and 14 points (range, 0-54 points), respectively. Chronic instability of the distal radioUlnar joint was not encountered in any patient. Thus, the study demonstrated that distal Ulna hook plate fixation for the treatment of unstable distal Ulna fractures can achieve healing with good alignment, satisfactory function, and minimal transient morbidity.
Graham J W King - One of the best experts on this subject based on the ideXlab platform.
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Rotational Anatomy of the Radius and Ulna: Surgical Implications
Henry Ford Health System Scholarly Commons, 2020Co-Authors: Daneshvar Parham, Willing Ryan, Lapner Michael, Pahuta, Markian A., Graham J W KingAbstract:PURPOSE: The rotational anatomy of the forearm bones is not well defined. This study aims to further the understanding of the torsion of the radius and Ulna to better guide treatment. METHODS: Computed tomography images of 98 cadaveric forearms were obtained and 3-dimensional models of the radius and Ulna were generated and analyzed. The rotation of the radius was evaluated by comparing the orientation of the distal radius central axis (DRCA) with the volar cortex of the distal radius (DR) and biceps tuberosity (BT). The rotation of the Ulna was evaluated by assessing the orientation of the Ulnar head with respect to the proximal Ulna. RESULTS: The DR volar cortex pronates from distal to proximal. The BT was 43.8° ± 16.9° supinated from the DRCA (range, 2.7°-86.5°). The mean difference in rotation between contralateral biceps tuberosities was 7.0° ± 7.1°. The volar cortex of the DR was 12.6° ± 5.4° supinated compared with the DRCA. The Ulnar head was pronated 8.4° ± 14.9° with respect to the greater sigmoid notch (range, 50.3° pronation-22.0° supination). CONCLUSIONS: The BT has a variable orientation relative to the DR, but it is generally located anteromedially in a supinated arm or 136° opposite the radial styloid. Understanding the rotational anatomy of the radius and Ulna can play an important role in surgical planning and implant design. The rotational anatomy of the radius and Ulna varies significantly between individuals, but is similar in contralateral limbs. CLINICAL RELEVANCE: Distal radius volar cortex rotational anatomy can help guide treatment of DR fractures and malunions as well as assist in positioning of wrist arthroplasty implants, particularly in the presence of bone loss. The side-to-side similarities demonstrated in this study should be helpful in managing patients with segmental bone loss or fracture malunion and those requiring joint reconstruction
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load transfer at the distal Ulna following simulated distal radius fracture malalignment
Journal of Hand Surgery (European Volume), 2015Co-Authors: Louis M Ferreira, Gillia S Greeley, James A Johnso, Graham J W KingAbstract:Purpose To measure the effects of distal radius malalignment on loading at the distal Ulna. Methods Using an adjustable mechanism to simulate angulated and translated malalignments, clinically relevant distal radius deformities were simulated in a cadaveric model. A custom-built load cell was inserted just proximal to the native Ulna head to measure the resultant force and torque in the distal Ulna. Loads were measured before and after transecting the triangular fibrocartilage complex (TFCC). Results There was an increase in distal Ulna load and torque with increasing dorsal translation and angulation. Combined conditions of angulation and translation increased force and torque in the distal Ulna to a greater extent than with either condition in isolation. Transecting the TFCC resulted in a reduction in distal Ulna load and torque. Conclusions A progressive increase in load at the distal Ulna was observed with increasing severity of malalignment, which may be an important contributor to residual Ulnar wrist pain and dysfunction. However, no clear-cut threshold of malalignment of a dorsally angulated and translated distal radius fracture was identified. These observations suggest that radius deformities cause articular incongruity, which increases TFCC tension and distal radioUlnar joint load. Cutting of the TFCC decreased distal Ulna loading, likely by releasing the articular constraining effect of the TFCC on the distal radioUlnar joint, allowing the radius to rotate more freely with respect to the Ulna. Clinical relevance Anatomical reduction of a distal radius fracture minimizes the forces in the distal Ulna and may reduce residual Ulnar wrist pain and dysfunction.
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distal radioUlnar joint kinematics in simulated dorsally angulated distal radius fractures
Journal of Hand Surgery (European Volume), 2014Co-Authors: Masao Nishiwaki, Louis M Ferreira, Mark Welsh, Braden Gammon, James A Johnson, Graham J W KingAbstract:Purpose To examine the effects of dorsal angulation deformities of the distal radius with and without triangular fibrocartilage complex (TFCC) rupture on the 3-dimensional kinematics of the distal radioUlnar joint (DRUJ) during simulated active motion. Methods Nine fresh-frozen cadaveric specimens were tested in a forearm simulator that produced active forearm rotation. Dorsal angulation deformities of the distal radius with 10°, 20°, and 30° angulation were created. Changes in the position of the Ulna relative to the radius at the DRUJ as a consequence of each dorsal angulation deformity were quantified during simulated active supination in terms of volar, Ulnar, and distal displacement of the Ulna. Testing was performed initially with the TFCC intact and repeated after complete sectioning of the TFCC at its Ulnar insertion. Results Increasing dorsal angulation deformities of the distal radius significantly increased volar, Ulnar, and distal displacement of the Ulna when the TFCC was intact. Sectioning of the TFCC significantly increased volar displacement of the Ulna in dorsal angulation deformities. As little as 10° of dorsal angulation significantly increased distal displacement of the Ulna with the TFCC intact and resulted in a significant increase in volar, Ulnar, and distal displacement of the Ulna with sectioned TFCC. Conclusions Dorsal angulation deformities of the distal radius affect the 3-dimensional kinematics of the DRUJ, especially with the TFCC sectioned. Clinical relevance The progressive change in DRUJ kinematics with increasing dorsal angulation may partially explain the relationship between the magnitude of dorsal angulation of distal radius fractures and functional outcomes in younger patients. The status of the TFCC should be evaluated carefully, as well as the magnitude of osseous deformity in patients with distal radius fractures and malunions, because changes in DRUJ kinematics caused by dorsal angulation are greater when the TFCC is ruptured.
Jeremy P Loenneke - One of the best experts on this subject based on the ideXlab platform.
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associations between handgrip strength and ultrasound measured muscle thickness of the hand and forearm in young men and women
Ultrasound in Medicine and Biology, 2015Co-Authors: Brittany R Counts, Brian E Barnett, Scott J. Dankel, Jeremy P LoennekeAbstract:It is unknown whether muscle size of intrinsic hand muscles is associated with handgrip strength. To investigate the relationships between handgrip strength and flexor muscle size of the hand and forearm, muscle thickness (MT) of 86 young adults (43 men and 43 women) between the ages of 18 and 34 y was measured by ultrasound. Two MTs (forearm radius and forearm Ulna MT) in the anterior forearm, two MTs (lumbrical and dorsal interosseous MT) in the anterior hand and handgrip strength were measured on the right side. Linear regression with part (also referred to as semipartial) correlation coefficients revealed that forearm Ulna MT positively correlated with handgrip strength in both men (part = 0.379, p = 0.001) and women (part = 0.268, p = 0.002). Dorsal interosseous MT correlated with handgrip strength in women only (part = 0.289, p = 0.001). Our results suggest that the forearm Ulna and dorsal interosseous MTs for women and forearm Ulna MTs for men are factors contributing to prediction of handgrip strength in young adults.
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association between forearm muscle thickness and age related loss of skeletal muscle mass handgrip and knee extension strength and walking performance in old men and women a pilot study
Ultrasound in Medicine and Biology, 2014Co-Authors: Robert S. Thiebaud, Jeremy P Loenneke, Madoka Ogawa, Naotoshi MitsukawaAbstract:Very little information is available concerning the relationship between handgrip strength and muscle size in the upper and lower extremities, especially the forearm muscle itself. To investigate the relationships among ultrasound-measured forearm muscle thickness from the radius and Ulna bone interface with handgrip strength, knee extension strength, walking speed and absolute/relative total skeletal muscle mass (TMM), 32 Japanese men and 21 Japanese women ages 70-83 years had muscle thickness (MT) measured by ultrasound. In the forearm, two MTs (forearm-radius and forearm-Ulna MT) were measured. TMM was estimated from an ultrasound-derived prediction equation. Handgrip-strength was significantly correlated with forearm-Ulna MT in both men and women. There were no significant correlations between forearm MT and walking speed in either sex. In men, both forearm-radius and forearm-Ulna MT were significantly correlated with TMM and TMM index. In women, a significant correlation was only observed between forearm-Ulna MT and TMM index. Our results suggest that forearm-Ulna MT may be a useful parameter for evaluating handgrip strength and TMM index in older Japanese men and women. Language: en
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association between forearm muscle thickness and age related loss of skeletal muscle mass handgrip and knee extension strength and walking performance in old men and women a pilot study
Ultrasound in Medicine and Biology, 2014Co-Authors: Jeremy P Loenneke, Madoka Ogawa, Robert S. Thiebaud, Takashi Abe, Naotoshi MitsukawaAbstract:Abstract Very little information is available concerning the relationship between handgrip strength and muscle size in the upper and lower extremities, especially the forearm muscle itself. To investigate the relationships among ultrasound-measured forearm muscle thickness from the radius and Ulna bone interface with handgrip strength, knee extension strength, walking speed and absolute/relative total skeletal muscle mass (TMM), 32 Japanese men and 21 Japanese women ages 70–83 years had muscle thickness (MT) measured by ultrasound. In the forearm, two MTs (forearm-radius and forearm-Ulna MT) were measured. TMM was estimated from an ultrasound-derived prediction equation. Handgrip-strength was significantly correlated with forearm-Ulna MT in both men and women. There were no significant correlations between forearm MT and walking speed in either sex. In men, both forearm-radius and forearm-Ulna MT were significantly correlated with TMM and TMM index. In women, a significant correlation was only observed between forearm-Ulna MT and TMM index. Our results suggest that forearm-Ulna MT may be a useful parameter for evaluating handgrip strength and TMM index in older Japanese men and women.
