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A-1081 Arthroscopic classification of scapho-lunate and luno-triquetral tear
Jane C. Messina, Nicolas Dreant, Riccardo Luchetti, Christophe Mathoulin, Jane C. Messina, Nicolas Dreant, Riccardo Luchetti, Christophe Mathoulin 1 Hand Surgery Unit Gaetano Pini Orthopaedic Institute, Milano, Italy, 2 Nice Hospital, France*, 3 Hand Surgery Unit, Rimini,Italy, 4 Derby Hospital, UK, 5 Institut de la Main, Paris,
Thursday, June 14, 2018 · 3:45 p.m. · 07m 36s
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so um why uh into couple ligament tear are important
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because the patient as an unexplained paid for
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reasons we don't know why the read reduction of
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great trying examination are very frequently completed negative
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the lesions can developing several steps and then can lead to assert track this treatment of decision on not
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always that it's actually it specially in chronic is is with a great number different technique existing
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and the mechanism of trauma is the fall on the ostrich hand as described by makes eleven years ago
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begins on the right side in extension on a deviation in that happens to be
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nation and starts with a vowel a part of us scuffling the ligament already
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cover kept it in all the i rest of the ligament needing to appear in eighty stability
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and then you see the mechanism the scuffle donate injury the fall on the palm aside
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and the then department fraction of the loon eight then we have the lunatic waiter
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dissociation and then the uh do a complete dislocation but that not always happens
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uh these out all the old person who's i've described this megan is this is that
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there is also another mechanism is a on a side it very neatly stability
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describe the initially baby a guest and then bashing guess the
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ideas for honest arch hand compression extension and pro nation
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so we haven't a spectrum of injuries of multiple ligaments ligaments uh
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the lesser arteries involves sometimes there are associated bone and
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human injury with the great urge are you make any is the capital of the congress it can be maintained
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and is is uh and they have to ask up yellows has
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to identify does closest definitely gonna injury is see the that
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yeah it's the stage for you see how with the from the mid couple joint on the right
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just catherine is is open top and then there is also the remote to flick troll
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injury we have described but this classification of these they come into enough
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a paper ever publish with the look one of us that in a few years ago
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and uh uh we have done with him a a study
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anatomy custody on cadavers basement in order to section
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the disorderly gonna and dainty phi which she coming is involved in each stage you can read the paper
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if you are interested this is the classification in a stage one is a simple sprite
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in the stage to there is a minimal passage of the parole
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board discover nature by without any widening in this stage three
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a you wave alvin anterior widening of discoveries based from the make up a joint as you can see in the picture
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in this stage three b. you have it also them edge of the most important part
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of the discovery ligament a so you have this posterior laxity uh with the problem
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they're also the the the c. s. s. a. e. injury that also stephanie sept enjoying the stage three beep
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the three c. easy completed a legion of the anterior and posterior part that there is a gap
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that can be a is dynamic and can be able get it with the problem then closes out in
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this stage for there is a a madman much wider get with the passage of the ascot
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and the the stage fright you have uh also the radiological abnormalities so we do the cleaning 'cause that
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is on the scaffold in a ligament an eighty patients i go quickly because of the time
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and uh and when you see the different type of
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trauma and the staging of the the stage three
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is the main group you as you see here say fifty six patient in the stage three the stage trees subdivided in
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h. b. n. c. and the main group are the see the main group is the c. but also the beep
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and uh uh then we'd either lila also the lunatic
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which are the uh tear classification we had
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of twenty four to ten forty fifty six or a fifty four chronic seventy eight patients on
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type which karma is indicated there we had also yeah the the subdivision in stages just
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to the stage be understood you see are still the most frequent cases of
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and this is a case the manual worker which it as a tool
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marks and uh uh you see the scaffold an eight get and
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also the a lunatic widget injury you see on the right to
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the every pair artist cup agree peer of that also part
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and you see the closure of the get an a and also the lunatic with a fixation
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with this temporary fixation list through this is uh for the for up to six months
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without a return of the greenpeace to amanda work uh he's a record where
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the these work yes it or done is doing is work again
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this is a a twenty two a lunatic which are injuries stage three b. we did they
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repay and then in the the with the with the system up to those apart
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uh these uh uh the um now some papers which are
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uh and i've been batteries but it was group too
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uh develop the doctors copy can also meaning many open technique as the
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atlanta snake and uh also the canal katie and that does
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classification is evolving animals a better analysis of the ligament is then age
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yeah it does copycat is specification can be using all into capital gonna
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injury acute or chronic you know just to define the stage
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and the aim is the improvement or the treatment at the early stages in the different stages with
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me many in basic technique unless the mobile edition time thank you very much for your attention
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just a question of fall
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i have a one question uh as you that uh you uh fit
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so practically need joint so we for the uh we first rule
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uh yeah so a usual procedure uh oh it so was acute to oh
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production or chronically nationwide is the it in acute and chronic injury but uh
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in and then i remove those two of the six months usually
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yes
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yes i did uh i that the scaffold in it and the lunatic which are artist copy a stabilisation yes
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is the same technique as exactly the same technique at the stuff for the native
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in the uh one of trick watch or a joint of the volley going to spare strong
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ligament you think that door sort kept basis is not stable actually with a screw
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he uh that i usually do the artist coptic doors ask a
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silly pair when there is a dorsal injury to three b.
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when it's a complete stranger you can also do adore suck up so this is but i fix it with this crude just to have more
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uh and you do some are also some shaving in between so you can do another few bills this kind of
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okay it's otherwise in very severe cases that you can do a which were not these cases
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you can do also the alert to quit a fusion or uh
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or in chronic very uh uh unstable stage four five
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uh it can it depends also the patient work if the man will work or
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not you can that you cannot how other solution these are actual injuries
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so you can in the pension tessa benefit with a minimally invasive technique
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that you can i more severe cases treated with that opened techniques
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any more questions
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