FRACTURE DU SCAPHOIDE PDF

Anatomical snuff box People with scaphoid fractures generally have snuff box tenderness. Vascular supply of the scaphoid comes from two different vascular pedicles. Avascular necrosis AVN is a common complication of a scaphoid fracture. Since the scaphoid blood supply comes from two different vascular branches of the radial artery, fractures can limit access to blood supply.

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Benjamin Dallaudiere: moc. Abstract The keys to successful ultrasonography US of the wrist include knowledge of the relevant anatomy and understanding the biomechanical aspects. A wide spectrum of pathological findings including bone fractures scaphoid, triquetrum and ligament lesions dorsal intercarpal and radiocarpal ligaments, scapholunate ligament can be caused by an identical traumatic mechanism determined on the basis of the position of wrist at the time of injury.

In the setting of wrist trauma, an early diagnosis can minimize the potential for inappropriate or delayed treatment. We describe a practical radiological approach by using a standardized imaging protocol: standard radiographs four views associated with an US examination focused on seven landmarks. If there is discordance between clinical and radiological features or if the diagnosis of a disruption of the scapholunate ligament remains uncertain, additional cross-sectional imaging MRI or CT arthrogaphy should be performed.

Keywords: Wrist, Trauma, Ultrasonography, Scaphoid, Ligaments Introduction Wrist injuries are common occurrences in sports and others traumatic conditions. However, this nonspecific term is frequently used as diagnosis in wrist injuries without taking their true underlying pathology into account.

Indeed, the wrist joint is an articulation consisting of many bones and ligamentous structures which, during normal function, allows complex motions while maintaining stability. In the coronal plane, the carp tends to dislocate towards its ulnar aspect with clenching of the fist, due to the ulnar orientation of the distal radial surface.

In the sagittal plane, emphasis should be placed on the role of the scapholunar complex. When a compressive load is applied to the wrist, scaphoid flexion occurs due to the ascent of the trapezium [ 2 ]. In contrast, the lunatum extends during compression because of the larger size of its anterior horn. This biomechanical concept explains the predisposition to instability of the wrist. The interosseous scapholunate ligament SLL especially the dorsal band which is the thickest and functionally most important part links the bones of this complex and maintains the lunate in a state of balance between the opposing forces, allowing synchronous motion [ 3 , 4 ].

The injury mechanism most commonly involves a combination of hyperextension and radial deviation stresses with an impact on the thenar eminence. This leads to a dorsiflexion of the scapholunar complex with a sudden horizontalization of the scaphoid.

The commonly seen injury patterns can be caused by a similar mechanism depending on the position of the wrist on impact: a scaphoid fracture, a scapholunate disruption exacerbated by the ascent of the capitatum , or a dorsal sling tear due to the translating movement of the carpal bones beneath the inferior margin of the radius Figure 1A—C [ 5 , 6 , 7 , 8 ].

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Benjamin Dallaudiere: moc. Abstract The keys to successful ultrasonography US of the wrist include knowledge of the relevant anatomy and understanding the biomechanical aspects. A wide spectrum of pathological findings including bone fractures scaphoid, triquetrum and ligament lesions dorsal intercarpal and radiocarpal ligaments, scapholunate ligament can be caused by an identical traumatic mechanism determined on the basis of the position of wrist at the time of injury. In the setting of wrist trauma, an early diagnosis can minimize the potential for inappropriate or delayed treatment. We describe a practical radiological approach by using a standardized imaging protocol: standard radiographs four views associated with an US examination focused on seven landmarks. If there is discordance between clinical and radiological features or if the diagnosis of a disruption of the scapholunate ligament remains uncertain, additional cross-sectional imaging MRI or CT arthrogaphy should be performed. Keywords: Wrist, Trauma, Ultrasonography, Scaphoid, Ligaments Introduction Wrist injuries are common occurrences in sports and others traumatic conditions.

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