Ulnar Styloid Process Research Articles

Effects of Elastic Wrist Taping on Maximum Grip Strength

In this study, we examined the effects of elastic wrist taping with different pressure levels on the maximum grip strength. The subjects were 20 healthy male university students. The tape was wrapped three times around the wrist at the radial and ulnar styloid process. Taping pressure was measured using a pressure measuring system for stockings and bandages. A pressure sensor was placed over the palmaris longus muscle tendon, 1.5 cm proximal to the palmar crease of the subject’s wrist on the dominant upper limb. The following experimental conditions were assessed: control condition (CC), without attachments; sensor condition (SC), with an attached sensor and a cover tape with minimum pressure application (1–5 hPa); and four pressure conditions (PCs), with pressure applications of 30, 60, 90, and 120 hPa using elastic tapes. Grip strength was significantly greater for CC than for PCs. However, the overall decrease in grip strength was still relatively small. No differences were observed in the grip strengths among the four PC groups. Our results showed that grip strength exertion decreased on the application of higher pressures of elastic tape wrapping and that the degree of decrease was similar for all PCs above 30 hPa.

Comparison between Distractor Application on Both Radial & Ulnar Side and Radial Side Only for Fracture Distal Radius with Ulnar Styloid Fracture

Background: Fracture of distal radius with involvement of the ulnar styloid process is a common clinical problem. It can be treated conservatively, usually involving wrist immobilization in plaster cast or surgically. A key method of surgical fixation is external fixation by distractor. Distractor can be applied either only on the radial side or on both ulnar and radial sides. Materials and Methods: A prospective randomized and comparative study of 1 year duration was conducted on 32 patients admitted in the Department of Orthopaedics of BSMC & H in the age group of 20 to 75 years old with AO types B and C distal radius fracture along with involvement of the ulnar styloid process. The parameters studied were restoration of radial length, restoration of radial angle, intracarpal step-off and palmar tilt which were statistically evaluated and Fisher’s exact test was performed. The two tailed P-value was calculated and both the groups were statistically compared. Results: In our study, 37.5% patients in Group A and 81.25% in Group B had a radial difference <3 mm which was statistically significant (Table 1, Chart 1). 43.75% patients in Group A and 87.5% in Group B had radial angle <5’ which was significant (Table 2, Chart 2). 31.25% in Group A and 75% had intra carpal step off <2 mm which was again statistically significant (Table 3, Chart 3). 62.5% had an abnormal palmar tilt in Group A while only 6.25% had an abnormal palmar tilt in Group B which is extremely statistically significant. On an average, 2 mm of distraction was required in 75% patients of Group A while only 30% patients in Group B required distraction (Table 4, Chart 4). Conclusion: In our study, the radial difference, radial angle, intra carpal step off and palmar tilt returned significantly to normal in the patients treated with distractor on radial side only when compared with distractor application on both radial and ulnar sides for distal radius fracture with ulnar styloid process involvement. Also post-operative distraction required under image intensifier was higher in the group treated with distractor on either side than those with distractor only on radial side.

The effect of a supervised exercise program on arm girth measurements in breast cancer survivors.

9115 Background: There is minimal research examining the effect of cardiovascular and resistance exercise after surgery and/or radiation treatment to the breast and axillary area. Currently there are no guidelines for activity restrictions; however, medical providers historically have recommended limiting activity of the affected arm in an attempt to prevent the development of lymphedema. This could potentially affect future quality of life and other medical issues in breast cancer survivors. Methods: Female breast cancer survivors (n=79) completed an 8-week group exercise program meeting two days per week for cardiovascular and resistance training. Participants were also encouraged to exercise independently in addition to their group sessions. Bilateral arm girth measurements were performed on all participants upon program entry and exit. Measurements were taken distal to the ulnar styloid process (wrist) and three inches above (upper arm) and below (elbow) the lateral epicondyle of the elbow. All participants included in this analysis attended ≥ 70% of the group exercise sessions and had complete entry and exit measurements. Results: Participants attended an average of 15.94 ± 3.75 exercise sessions during the 8 week program. Changes in arm girth measurement were compared for the surgical side and non-surgical sides of the body using paired t-tests. Arm girth changes in the surgical side of the body were compared to the non-surgical side of the body using the Wilcoxon Ranked Sum test. The surgical and the non-surgical arm girths did not significantly increase at the wrist (p=0.55 and p=0.76), elbow (p=0.31 and p=0.24) or upper arm (p=0.18 and p=0.42). The changes in arm girth observed on the surgical body side were not significantly different from the changes observed on the non-surgical side (wrist (p=0.67), elbow (p=0.44), and upper arm (p=0.36). Conclusions: A structured, group-based exercise program involving both cardiovascular and resistance training did not significantly increase arm girth measurements in breast cancer survivors.

Comment on the Analysis of Two Skeletons from Terqa, Syria

ABSTRACTRecently, a report on two human skeletons from an Early Bronze Age tomb excavated at Tell Ashara, Syria has been published in International Journal of Osteoarchaeology. One individual was identified as a warrior following these criteria: (i) size and robustness of bones, (ii) cut marks on the humerus, (iii) reduction of the ulnar styloid process, both interpreted as healed weapon‐related trauma, (iv) well‐developed muscle insertions, and (v) degenerative joint disease. Actually, none of these five criteria support the conclusion because of the following reasons: (i) not necessarily all tall and robust men become warriors, (ii) the post mortem origin of cut marks on the humerus is more likely than sharp force trauma, (iii) there are several possible causes of the unusual ulnar styloid shape other than weapon‐related trauma, (iv) the interpretation of musculoskeletal stress markers and (v) degenerative joint disease lacked control for age, sex and body size. Copyright © 2012 John Wiley &amp; Sons, Ltd.

Distale Radiusschaftfraktur beim Cyr Wheel-Turnen – eine ungewöhnliche Rhönradverletzung

The cyr wheel is a modified gymnastic wheel with only one ring that can lead to extreme forces on the gymnast. We report on a distal radius shaft fracture (AO 22 A2.1) and a fracture of the styloid process of the ulna that occurred after holding on to a slipping Cyr wheel and exposition to high pressure on the lower arm. The fracture was fixed by screws and a plate.

Oblique Ulnar Styloid Osteotomy—A Treatment for Ulnar Styloid Impaction Syndrome

We report a series of 5 patients (mean age, 41 y) presenting with ulnar styloid impingement syndrome (USIS) and treated by an oblique ulnar styloid osteotomy. The purpose of the study was to determine whether the osteotomy is an effective method for treating USIS. The diagnosis of USIS was made based on a history of ulnar-sided wrist pain supported by clinical and radiological findings. Clinical assessment included provocative tests to differentiate USIS from pain associated with ulnocarpal impaction syndrome. The ulnar styloid length was assessed with a posteroanterior X-ray using the methods of Garcia-Elias and Biyani. The ulnar styloid was deemed excessively long if the ulnar styloid process index was greater than 0.21 or if the overall styloid length was greater than 6 mm. Ulnar variance was recorded. All wrists were assessed by computed tomography arthrography and magnetic resonance imaging studies to rule out any associated soft tissue abnormalities, including ligamentous injuries. Preoperative and postoperative pain levels were recorded using a pain scoring system. Patients were followed up for a mean of 46 months. Before surgery, the mean styloid length was 10 mm, and the ulnar styloid process index was 0.32. The reported pain score was significantly reduced following surgery and all patients, except one, returned to premorbid levels of activity. Oblique ulnar styloid osteotomy is an effective means of relieving impaction of the ulnar styloid while preserving the integrity of the intrinsic ulnar styloid ligaments. Therapeutic IV.

Ablation par radiofréquence d’un ostéome ostéoïde du poignet : à propos de deux cas

Two cases of osteoid osteomas of the lunate and ulnar styloid process are described, treated by thermocoagulation. Follow-up was done clinically and by computed tomography (scanner) at one year, and clinically at three years. A quick and complete resolution of pain occurred in both cases, with bony sclerosis around the treated lesion on computed tomography, with no evidence of recurrence. A mild reduction in grip strength without functional impairment was noted in both cases, possibly due to a stronger controlateral dominant hand, and to a previous failed surgical excision in one case. No damage to neurovascular, musculotendinous or cutaneous structures occurred. Thermocoagulation of osteoid osteomas seems to be an efficient and safe technique even in critical and superficial anatomical regions such as the wrist.

Effects of arm bracing posture on respiratory muscle strength and pulmonary function in patients with chronic obstructive pulmonary disease

ObjectiveTo analyze the effect of arm bracing posture on respiratory muscle strength and pulmonary function in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods20 patients with COPD (11 male; 67±8 years; BMI 24±3 kg · m−2) were submitted to assessments of Maximal Inspiratory and Expiratory Pressures (MIP and MEP, respectively) and spirometry with and without arm bracing in a random order. The assessment with arm bracing was done on standing position and the height of the support was adjusted at the level of the ulnar styloid process with elbow flexion and trunk anterior inclination of 30 degrees promoting weight discharge in the upper limbs. Assessment without arm bracing was also performed on standing position, however with the arms relaxed alongside the body. The time interval between assessments was one week. ResultsMIP, MEP and maximal voluntary ventilation (MVV) were higher with arm bracing than without arm bracing (MIP 64±22 cmH2O versus 54±24 cmH2O, P=,00001; MEP 104±37 cmH2O versus 92±37 cmH2O, P=.00001, and MVV 42±20 L/min versus 38±20 L/min, P=.003). Other variables did not show statistical significant difference. ConclusionThe arm bracing posture resulted in higher capacity to generate force and endurance of the respiratory muscles in patients with COPD.

Efeitos do apoio dos membros superiores sobre a força muscular respiratória e função pulmonar de doentes com doença pulmonar obstrutiva crónica

ObjectiveTo analyze the effect of arm bracing posture on respiratory muscle strength and pulmonary function in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods20 patients with COPD (11 male; 67 ± 8 years; BMI 24 ± 3 Kg · m−2) were submitted to assessments of Maximal Inspiratory and Expiratory Pressures (MIP and MEP, respectively) and spirometry with and without arm bracing in a random order. The assessment with arm bracing was done on standing position and the height of the support was adjusted at the level of the ulnar styloid process with elbow flexion and trunk anterior inclination of 30 degrees promoting weight discharge in the upper limbs. Assessment without arm bracing was also performed on standing position, however with the arms relaxed alongside the body. The time interval between assessments was one week. ResultsMIP, MEP and maximal voluntary ventilation (MVV) were higher with arm bracing than without arm bracing (MIP 64 ± 22 cmH2O versus 54 ± 24 cmH2O, p = 0,00001; MEP 104 ± 37 cmH2O versus 92 ± 37 cmH2O, p = 0,00001 and MVV 42 ± 20 L/min versus 38 ± 20 L/min, p = 0,003). Other variables did not show statistical signifi cant difference. ConclusionThe arm bracing posture resulted in higher capacity to generate force and endurance of the respiratory muscles in patients with COPD.

Wrist arthroscopic treatment for fractures of the ulna styloid process

Objective To discuss the treatment methods of wrist arthroscopic management for fractures of the ulna styloid process to achieve better clinical outcomes. Methods Fifteen cases of fractures of the ulna styloid process were first treated with reduction of combined fracture of the distal radius under C-arm fluoroscope and wrist arthroscope monitoring using percutaneous pinning fixation or open reduction and internal fixation with plate and screws. The triangular fibrocartilage complex (TFCC) was examined under wrist arthroscope and debridement or repair was done accordingly. The fractured ulna styloid process was reduced and fixed with steel tension band under wrist arthroscope monitoring. Results Eleven cases had concomitant TFCC injury. The patients were follow-up for an average of 15.4 months and the X-ray showed bone union of all the ulna styloid process fractures. The mean healing time was 5.2 months. According to the Green-O' Brien functional evaluation criteria the excellent and good rate of wrist function was 93.3%. There were no complications such as ulnar side pain and wrist instability. Conclusion Wrist arthroscopic treatment of fractures of ulna styloid process is not only effective to reduce and fix the fracture and beneficial for fracture heeling, but also able to detect TFCC injury for early management to avoid chronic wrist pain or wrist instability. Key words: Ulna fractures; Arthroscopy; Treatment outcome

The anatomy of the dorsal cutaneous branch of the ulnar nerve

We investigated the anatomy of the dorsal cutaneous branch of the ulnar nerve in 32 upper limbs in cadavers. The dorsal cutaneous branch of the ulnar nerve originated on average 5.1 cm proximal to the ulnar styloid process and 1.9 cm palmar and radial to the subcutaneous border of the ulna. It crossed the subcutaneous border 0.2 cm proximal to the ulnar styloid process. In all cases it displaced further away in full pronation. We recommend cautious dissection when approaching within 2.5 cm of the ulnar styloid process. We also recommend making the initial incision in full pronation and just along the dorsal aspect of the subcutaneous border of the ulna.

Kinematic Features of Wheelchair Propulsion of Elite Chinese National Wheelchair Racers

PURPOSE: This study was to investigate kinematic features of wheelchair propulsion among elite Chinese wheelchair racers during Training Camp of the 2008 Paralympic Games. METHODS: Seven wheelchair racers in Chinese National Paralympic Team (2 females, 5 males, age 25±4.4, body mass 60.3±4.6kg, training year 9.1±2.4) were filmed from the sagittal and front views by a MaxTraq motion analysis system at 60 Hz while they propelled their own racing wheelchairs at maximal speeds on a training roller. Seven reflective markers were placed on the right ear, acromion, lateral epicondyle of humerus, styloid process of Ulna, 3rd metacarpophalangeal joint, wheel axis and pushim. Film data were digitized and smoothed before the joint angles, and angular and linear velocities of the upper extremity were calculated. RESULTS: The results showed the drive phase time (DT), recovery time (RT) and cycle time (CT) were 0.095±0.013, 0.252±0.103 and 0.347±0.114 seconds, respectively. The hand contact angle, release angle and range on the pushrim were 44.2°±2.9, 207.8°±20.2 and 163.6° ±21.8, respectively. The maximal shoulder, elbow and wrist joint angles were 24.1°±25.2, 142.4°±32.2 and 158.7°±14.2, respectively in the drive phase and 66.6° ±27.1, 157.1° ±27.2 and 194.2°±15.3 in the recovery phase. The maximal angular velocities at the shoulder, elbow and wrist joints were 189.5°/s±98.2, 255°/s±165.4 and 573.6°/s±262.4 in the drive phase and 506.3±210.5, 465.6±210.1 and 590.8±273.6°/s in the recovery phase. The pattern recognition demonstrated that the Chinese wheelchair racers used the circular pattern with high upper arm elevation in the recovery phase. CONCLUSION: The Chinese national wheelchair racers had faster CT (0.347s) with comparison to other national wheelchair racers (approximately 0.500s). With the circular stroke pattern, the Chinese wheelchair racers sequentially increased their angular velocities from the shoulder to elbow, then to wrist in the drive phase. The greater upper arm elevation at the end of recovery phase may facilitate the racing speed production in the drive phase.

Application of the reversed posterior interosseous artery flap in the contractures of the first web space

Objective To assess and review the methods of the reversed posterior interosseous artery flap for treating the contracture of the first web space. Methods Forty-two cases of the first web space severe contracture were cured by the reversed posterior interosseous artery flap rotate at 1.5-2.0 cm proximal ulnar styloid process after release the adhesion. After operation curative effects were evaluated by measuring the first web space with Gu's method. Results The flap of 42 cases obtain success, however 3 cases was partly necrosis of epidermis. Follow-up examination was obtained in 31 cases for average 18 months after operative.The width of the first web space was augmented an average of 37.9 mm. Rehabilitation training after operation can enhance the effect of the therapy with 8.6 mm more expanded. Conclusion The flap is an ideal choice for treatment on the defect of the contracture of the first web space and rehabilitation training after operation is important. Key words: First web space; Posterior interosseous artery; Island flap; Microsurgical technigue

A 65-year-old man presents with pelvic pain

Tophaceous gout of the symphysis pubis is an exceedingly rare event, with only four other cases reported in the literature [1–4]. Gout is the oldest recognized arthropathy and results from the deposition of monosodium urate crystals [5]. Gouty tophi are a consequence of prolonged hyperuricemia and can be found in soft tissues, tendon sheaths, joints, and bony prominences [3]. Calcium may precipitate with the urate crystals to varying degrees, making tophi more apparent on radiographs. Gout most often afflicts the feet, ankles, knees, hands, and elbows, in decreasing order of frequency [5]. This case is exceptional because it demonstrates the hallmark imaging characteristics of tophaceous gout in spite of its uncharacteristic location. The symphyseal joint space is preserved. The erosions on either side of the joint are well-demarcated with sclerotic margins. These erosions have been described as “punched-out,” resembling “mousebites,” with overhanging edges that are typical of gout. The association of these erosions with the hyperdense calcified tophus is a reflection of the indolence of this arthropathy [5]. This case diagnosis may be achieved from the images and information provided. Following the patient’s initial presentation, a skeletal survey and laboratory workup were performed. The serum uric acid level was elevated, in keeping with the suspected diagnosis. Skeletal survey was notable in that the first tarsometatarsal (TMT) joint was unaffected. However, other sites, including the ulnar styloid process, displayed erosions with sclerotic margins and overhanging edges (Fig. 1). The combination of imaging findings, history and laboratory evaluation led to this patient’s diagnosis of tophaceous gout involving the symphysis pubis. Synovial fluid analysis of this joint was deferred. Other conditions that may afflict the symphysis pubis include metastasis, plasmacytoma, primary osseous neoplasm such as chondrosarcoma, septic arthritis, osteoarthritis in isolation or in association with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, and amyloidosis. Neoplasms, both primary and secondary, and infection are much less likely given the well-defined pattern of osteolysis with sclerotic margins. Preservation of the joint space and lack of periosteal elevation further mitigate against these diagnoses on imaging alone. Septic joint is unlikely in an afebrile patient with normal white blood cell count. This patient had no systemic symptoms such as weight loss and generalized malaise to suspect malignancy. Erosions are typical of osteoarthritis involving the symphysis pubis, as in the temporomandibular, acromioThe case presentation can be found at doi:10.1007/s00256-010-0898-0

Bilateral dorsal perilunate dislocation of wrist

We present a case of simultaneous dorsal perilunate dislocation of both wrists, without a history of fall on outstretched hands. In contrast, it appeared that the mechanism was reverse. His hands were held in radial deviation with wrists in full palmar flexion. The forearms were in neutral position and elbows in mid-flexion. The wrists were suddenly and forcibly pronated. The radiographs of both wrists showed dorsal perilunate dislocation with avulsion fracture of the tip of ulnar styloid process and avulsion fracture of posterior horn of lunate. Radial translation of the carpal bones was also noted. The mechanism is proposed and discussed.

The 'β-wire Technique' for the Fixation of Ulnar Styloid Process Fracture - Surgical Technique -

The 'β-wire Technique' for the Fixation of Ulnar Styloid Process Fracture - Surgical Technique -

THE DORSAL CUTANEOUS BRANCH OF THE ULNAR NERVE: AN ANATOMICAL STUDY

There are significant variations in the anatomy of the dorsal cutaneous branch of the ulnar nerve. The dorsal cutaneous branch is at a risk of injury during a therapy for the ulnar side of the wrist. The purpose of this study is to measure the variations of the dorsal cutaneous branch. We studied 30 embalmed cadaver specimens. In its course, two division patterns of the dorsal cutaneous branch were identified, namely proximal and distal types. The proximal type went around the ulna proximal to the ulnar styloid process, and directed toward the ulnodorsal aspect. The distal type went around to the ulnodorsal aspect, distal to the styloid process. The proximal type was found in 21 of 30 cadavers, and the distal type was found in nine of 30 cadavers.

Treatment of ulnar styloid process fractures using K-wire and ten,on band

Objective To discuss the techniques and clinical results of treatment of ulnar styloid process fractures. Methods From August 2001 to June 2006, 58 fractures of ulnar styloid process in 56 patients were treated with K-wire fixation combined with tension band. Results Postoperatively patients were followed for 1.5 to 18 months, with an average of 7 months. X-ray showed bone union in all cases. There was no chronic pain and impairment of wrist motion in 55 cases. One case experienced chronic wrist pain. Conclusion Fixation of ulnar styloid process fractures using K-wire and tension band is an ideal treatment option. It is especially effective in preventing distal ulnar pain. Key words: Fractures,bone; Treatment outcome; Styloid process of ulna

Brachydactyly type A1 associated with unusual radiological findings and a novel Arg158Cys mutation in the Indian hedgehog ( IHH) gene

Brachydactyly type A1 (BDA1; MIM 112500) is characterized by shortness or absence of the middle phalanx of the hands and feet. The condition is caused by heterozygous mutations in the Indian hedgehog ( IHH) gene or a yet unidentified gene on chromosome 5p13. We investigated six affected members of a large Swedish family segregating autosomal dominant brachymesophalangia. Affected individuals show hypoplasia of the ulnar styloid processes, ulna minus, osteoarthritis, normal length of all distal phalanges and shortening or absence of the middle phalanges. Stationary ossicles or sesamoid bones were observed at the metacarpal heads in all patients. Genetic analysis of the family showed that the IHH-gene was linked to the disease ( Z max 3.42 at theta 0.00) and sequence analysis of IHH revealed a novel c.472C > T transition in all affected family members. The mutation results in a p.158Arg > Cys substitution located in the highly conserved amino-terminal domain of IHH. This domain is of importance for the interaction between IHH and the Patched receptor. Our combined findings add radiological findings to the BDA1 phenotype and confirm a critical functional domain of IHH.

Arthroskopische Refixation von traumatischen 1B-Läsionen des Discus ulnocarpalis – eine retrospektive Studie

The aim of the study was to investigate the postoperative outcome of the arthroscopic sutures of traumatic 1B-lesions of triangular fibrocartilage complex (TFCC) tears. Thirty-six patients who underwent an arthroscopic repair of traumatic 1B-lesions of the TFCC without a dislocation of the ulnar styloid process were included in this study. The average age of the 18 male and 18 female patients was 43.8 (range: 22-70) years. In 16 cases, we operated the left and in 20 cases the right TFCC. On average, the follow-up examination was performed after 7.9 years (range: 3.2-14.3) years. Patients with revision operations or neurovascular pathology were excluded. The Mayo modified wrist score and the disability of arm, shoulder and hand (DASH) score were used to identify the outcome. The Mayo modified wrist score was preoperatively 49.74+/-20.99 and postoperatively 82.43+/-15.89 (p<0.001). The DASH score was preoperatively 48.68+/-21.47 and postoperatively 24.1+/-19.81 (p<0.001). Only five patients demonstrated an isolated 1B-lesion of the TFCC and showed, likewise, significant improvements both regarding the DASH score and the Mayo modified wrist score (p<0.05). However, there was no significant difference to the patients with further wrist injuries (p>0.05). The results of the current study suggest that 1B-lesions of the TFCC can be successfully repaired by arthroscopically assisted suture techniques. An isolated 1B-lesion of the TFCC is rather unusual.