Orthopaedic Articles - Articles for Orthopaedic Practice

Orthopaedic articles on current trends, tips & tricks and best evidence from top orthopaedic specialists.

Perilunate Injuries

David Sauder


Perilunate Injuries

David Sauder, M.D., FRCSC
Assistant Professor, University of Saskatchewan
Saskatoon, SK

Introduction
Perilunate injuries are uncommon, severe disruptions of carpal anatomy. Their defining feature is dislocation of the capitate head from the concavity of the distal lunate. There are two common patterns: 1) the perilunate dislocation and 2) the transscaphoid perilunate dislocation1. The perilunate injury is a high energy disruption of carpal anatomy and it is crucial that a search for associated injuries be undertaken.




Scapholunate Ligament (SL) Tears

Neil White


Scapholunate Ligament (SL) Tears

Neil J. White, M.D., FRCSC
Orthopaedic Hand & Trauma Surgeon 
University of Calgary
Calgary, AB

In 1972, Linscheid and colleagues observed a pattern of wrist injury implicating a starting point for the simple 'wrist sprain.' It was theorized that an unrecognized injury to the Scapholunate (SL) ligament could lead to a predictable collapse deformity and, ultimately, severe arthritis of the wrist. They postulated that early recognition and treatment of this injury could prevent long-term morbidity1. Some 40 years later SL ligament dissociation is far better understood, but we still struggle when it comes to early identification.




Acute Scaphoid Fractures

Brent Graham


Acute Scaphoid Fractures

Brent Graham, M.D., MSc, FRCSC
University Health Network/University of Toronto Hand Program
Toronto, ON

The key to treating acute scaphoid fractures is accurate diagnosis. Despite the conventional wisdom on this topic, an informed observer, such as an orthopaedic surgeon, will identify a scaphoid fracture, even when it is completely undisplaced on the initial X-ray. Obviously, diagnosis requires alertness to the possibility of a scaphoid fracture plus a consistent history combined with physical examination findings of tenderness to palpation over the scaphoid itself. The physical examination should include palpation of the scaphoid not only in the anatomic snuffbox but also dorsally and over the scaphoid tubercle. Tenderness in any one of these locations may be an indication of a scaphoid fracture. The overwhelming majority of scaphoid fractures occur between the ages of 15 and 40. Acute scaphoid fractures are rare outside this age range.



Common Carpal Injuries - Identification and Early Management

Tod Clark


Common Carpal Injuries - Identification and Early Management

Tod Clark, M.D., FRCSC
Winnipeg, MB

Stephen Kennedy, M.D., FRCSC
Seattle, WA

Introduction
Wrist movement occurs through the complex, yet balanced, movement of carpal bones and their capsuloligamentous attachments. When disrupted, instability, pain, articular shear, and arthrosis may result, and such injuries may occur more often than we realize1. Many of these injuries are missed in the acute setting. Seven percent of distal radius fractures have an associated carpal fracture, 18-64% have a scapholunate ligament tear, and 12-16% have a lunotriquetral ligament tear2-6. Accurate diagnosis and early treatment lead to the most favorable outcomes1,7. The purpose of this COA Bulletin Themes section is to review the evaluation and treatment of acute carpal injuries. The most common injuries will be reviewed while diagnostic and treatment pearls will be offered to minimize both misdiagnosis and delayed treatment.




The Case Against Anterior Approach for Primary Total Hip Arthroplasty

Donald Garbuz


The Case Against Anterior Approach for Primary Total Hip Arthroplasty

Donald S. Garbuz M.D., MHSc, FRCSC
Professor and Head
Division of Lower Limb Reconstruction and Oncology
Department of Orthopaedics
University of British Columbia
Vancouver, BC 

Over the last ten years several "new" surgical approaches have been introduced for use in total hip arthroplasty. These started with the MIS movement. According to their advocates, all these approaches will speed recovery and improve patient outcomes. These improvements were based on the theory that these approaches will be superior due to minimal damage to the muscles and soft tissues around the hip. Two of the more widely "touted" approaches were the 2-incision approach and the mini Watson-Jones. 






Articles on basic science topics from members of the Orthogate Community.

Articles on bone metabolism and osteoporosis topics from members of the Orthogate Community.

Articles about career planning for orthopaedic surgery residents and orthopaedic surgeons.

Articles about education.
Articles on foot and ankle topics from members of the Orthogate Community.
Articles on hand and wrist topics from members of the Orthogate Community.
Articles on hip and knee topics from members of the Orthogate Community.
Articles about medical informatics.
Articles about orthopedic informatics.
Articles on pediatric orthopaedic topics from members of the Orthogate Community.
Articles on shoulder and elbow topics from members of the Orthogate Community.
Articles on spine topics from members of the Orthogate Community.
Articles on sports medicine topics from members of the Orthogate Community.
Articles on trauma topics from members of the Orthogate Community.
Articles on musculoskeletal tumor topics from members of the Orthogate Community.

Submit Community Content

If you have orthopedic information that you would like to share with the Orthogate Community, please register/login and submit your news, event, job, article, case or workshop from the Submit Content menu under the My Account area. Learn more!