Baratz_FM.qxd 2/28/06 12:03 AM Page i Wrist Surgery Tricks of the Trade Baratz_FM.qxd 2/28/06 12:03 AM Page ii Baratz_FM.qxd 2/28/06 12:03 AM Page iii Wrist Surgery Tricks of the Trade Mark E. Baratz, M.D. Professor and Vice Chairman Department of Orthopaedic Surgery Director, Division of Upper Extremity Surgery Residency and Fellowship Program Director Drexel University College of Medicine Allegheny General Hospital Pittsburgh, Pennsylvania Melvin P. Rosenwasser, M.D. Professor Department of Orthopaedic Surgery Columbia University College of Physicians and Surgeons Director, Orthopaedic Hand Trauma Service New York–Presbyterian Hospital New York, New York Brian D. Adams, M.D. Professor Director, Hand Surgery Fellowship Department of Orthopaedics University of Iowa College of Medicine University of Iowa Hospitals and Clinics Iowa City, Iowa Scott H. Kozin, M.D. Associate Professor Department of Orthopaedic Surgery Temple University School of Medicine Director, Upper Extremity Surgery Philadelphia Shriners Hospital Philadelphia, Pennsylvania Thieme New York • Stuttgart Baratz_FM.qxd 2/28/06 12:03 AM Page iv Thieme Medical Publishers, Inc. 333 Seventh Ave. New York, NY 10001 Executive Editor: Esther Gumpert Associate Editor: Owen Zurhellen IV Vice President, Production and Electronic Publishing: Anne T. Vinnicombe Production Editor: Print Matters, Inc. Sales Manager: Ross Lumpkin Chief Financial Officer: Peter van Woerden President: Brian D. Scanlan Compositor: Thomson Digital Printer: Maple-Vail Library of Congress Cataloging-in-Publication Data Wrist surgery : tricks of the trade / Mark E. Baratz ... [et al.]. p. ; cm. Includes bibliographical references and index. ISBN 1-58890-217-X (US-HC) – ISBN 3-13-139011-5 (GTV) 1. Wrist–Surgery. 2. Wrist–Wounds and injuries–Surgery. I. Baratz, Mark. [DNLM: 1. Wrist Injuries–surgery. 2. Wrist Joint–surgery. 3. Orthopedic Procedures–methods. WE 830 W9559 2006] RD559.W755 2006 617.5(cid:2)74–dc22 2005055992 Copyright ©2006 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher’s consent is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating, preparation of microfilms, and electronic data processing and storage. Important note:Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their efforts to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors, editors, or publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such information.Readers are encouraged to confirm the information contained herein with other sources. For example, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain. Printed in the United States 5 4 3 2 1 TMP ISBN 1-58890-217-X GTV ISBN 3 13 139011 5 Baratz_FM.qxd 2/28/06 12:03 AM Page v I dedicate this book to my wife, Arlene, and my children, Katie, Chris, and Chelsea. ——Mark E. Baratz I dedicate this book to my wonderful wife, Phoebe, and our children, Ted, Chuck, Kate, and Allie, who make my days happy. ——Melvin P. Rosenwasser My contribution to this book is dedicated to the memory of Jayasankar “Jay” Menon, M.D., who was instrumental in developing new ideas to make total wrist replacement a real possibility for many of our patients. ——Brian D. Adams I dedicate this book to our children, Bryan and Samantha, for their everlasting supply of joy and wonder; to my wife, Louise, for her ongoing support, partnership, and love; and to my parents, William and Roni, for their countless lessons of life and family. ——Scott H. Kozin Baratz_FM.qxd 2/28/06 12:03 AM Page vi Baratz_FM.qxd 2/28/06 12:03 AM Page vii Contents Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi Peter J. Stern, M.D. Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xv Section I Overview of Distal Radius Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Chapter 1 Closed Reduction and Percutaneous Pin Fixation of Distal Radius Fractures . . . . . . . . . . . . . . . . . . . . .2 Chapter 2 Limited-Open Reduction and Percutaneous Pin Fixation with External Fixation of Distal Radius Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Chapter 3 Intra-articular Fractures of the Distal Radius Treated with Dorsal Plate . . . . . . . . . . . . . . . . . . . . . . . . .8 Chapter 4 Palmar Fracture/Subluxation of the Distal Radius . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Chapter 5 Open Treatment of a Distal Radius Fracture with a Fixed Angle Palmar Plate . . . . . . . . . . . . . . . . . . .12 Chapter 6 Open Treatment of Galeazzi Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 Section II Distal Radius Malunions and Nonunions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 Chapter 7 Extension Osteotomy for the Malunited Distal Radius . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 Chapter 8 Dorsal and Palmar Osteotomy for Malunion of Distal Radius with Iliac Crest Bone Graft . . . . . . . . . .23 Chapter 9 Malunion of the Distal Radius with Palmar Translation of the Articular Surface . . . . . . . . . . . . . . . . .25 Chapter 10 Nonunion of Distal Radius Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 Section III Distal Ulna Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 Chapter 11 Open Reduction and Internal Fixation of an Ulnar Styloid Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Chapter 12 Fractures of the Ulnar Head . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 Chapter 13 Fractures of the Ulnar Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 Section IV Distal Ulna Nonunions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37 Chapter 14 Resect Ulnar Styloid Fracture with Repair of Triangular Fibrocartilage Complex . . . . . . . . . . . . . . . .38 Chapter 15 Nonunion of an Ulnar Neck Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 (cid:2) vii Baratz_FM.qxd 2/28/06 12:03 AM Page viii Section V.1 The Distal Radioulnar Joint: Unstable Distal Ulna, Head Intact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45 Chapter 16 Open Repair of an Ulnar-Sided Triangular Fibrocartilage Complex Tear . . . . . . . . . . . . . . . . . . . . . . . .46 Chapter 17 Peripheral Tear of the Triangular Fibrocartilage Complex from the Ulna: Arthroscopic Repair . . . . . .49 Chapter 18 Reconstruction of Distal Radioulnar Ligaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53 Section V.2 The Distal Radioulnar Joint: Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55 Chapter 19 Sauve-Kapandji Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56 Chapter 20 Hemiresection Arthroplasty of the Distal Ulna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58 Chapter 21 Darrach Procedure (Distal Ulna Resection) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60 Section V.3 The Distal Radioulnar Joint: Unstable Distal Ulna, Post-Darrach . . . . . . . . . . . . . . . . . . . . . . . . . . . .63 Chapter 22 Flexor Carpi Ulnaris Tenodesis Stabilization of the Resected Distal Ulna . . . . . . . . . . . . . . . . . . . . . . .64 Chapter 23 Extensor Carpi Ulnaris–Flexor Carpi Ulnaris Tenodesis Stabilization of the Resected Distal Ulna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67 Chapter 24 Distal Ulna Implant Arthroplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69 Section V.4 The Distal Radioulnar Joint: Ulnocarpal Abutment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 Chapter 25 Arthroscopic “Wafer” Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74 Chapter 26 Open “Wafer” Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77 Chapter 27 Ulnar Shaft Shortening Osteotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79 Section VI.1 The Wrist Joint: Scaphoid Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83 Chapter 28 Percutaneous Screw Fixation of Scaphoid Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84 Chapter 29 Open Reduction and Internal Fixation of Displaced Scaphoid Fractures via Dorsal Approach . . . . . .87 Section VI.2 The Wrist Joint: Scaphoid Nonunions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89 Chapter 30 Open Reduction and Internal Fixation of Scaphoid Nonunion via Palmar Approach with Distal Radial Bone Graft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Chapter 31 Open Reduction and Internal Fixation of Scaphoid Nonunion with Vascularized Bone Graft . . . . . .93 Section VI.3 The Wrist Joint: Nonunion Hook of Hamate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95 Chapter 32 Excision Hook of Hamate for Nonunion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96 Section VI.4 The Wrist Joint: Scapholunate Ligament Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99 Chapter 33 Arthroscopy and Percutaneous Pin Fixation of Scapholunate Ligament Injuries . . . . . . . . . . . . . . . .100 Chapter 34 Open Scapholunate Ligament Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102 Chapter 35 Scapholunate Reconstruction with Dorsal Capsular Flap (Blatt Procedure) . . . . . . . . . . . . . . . . . . . .104 Chapter 36 Flexor Carpi Radialis Tendon Stabilization of the Scapholunate Joint (Brunelli Procedure) . . . . . . .106 Chapter 37 Bone Graft–Bone Autograft Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108 Chapter 38 Screw Fixation: Reduction and Association of the Scapholunate (RASL) Procedure . . . . . . . . . . . . .110 Section VI.5 The Wrist Joint: Carpal Fracture-Dislocations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113 Chapter 39 Open Reduction and Internal Fixation Perilunate Dislocation via Dorsal Approach . . . . . . . . . . . . .114 Chapter 40 Open Reduction and Internal Fixation Lunate Dislocation via Combined Dorsal–Palmar Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116 (cid:2) viii CONTENTS Baratz_FM.qxd 2/28/06 12:03 AM Page ix Chapter 41 Open Reduction and Internal Fixation of Trans-scaphoid Perilunate Fracture Dislocation . . . . . . . .119 Chapter 42 Open Reduction and Internal Fixation of Scaphocapitate Syndrome . . . . . . . . . . . . . . . . . . . . . . . . .122 Section VI.6 The Wrist Joint: Arthritis Due to Scapholunate Advanced Collapse and Scaphoid Nonunion Advanced Collapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125 Chapter 43 Wrist Denervation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126 Chapter 44 Radial Styloidectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .128 Chapter 45 Proximal Row Carpectomy with Capsular Resurfacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .130 Chapter 46 Scaphoid Excision with Capitolunate Triquetrohamate Arthrodesis . . . . . . . . . . . . . . . . . . . . . . . . . .133 Chapter 47 Excision Distal Pole of the Scaphoid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 Section VI.7 The Wrist Joint: Scaphotrapeziotrapezoid Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137 Chapter 48 Scaphotrapeziotrapezoid Joint Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .138 Chapter 49 Scaphotrapeziotrapezoid Joint Arthroplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141 Section VI.8 The Wrist Joint: Rheumatoid and Post-traumatic Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143 Chapter 50 Arthroscopic Synovectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .144 Chapter 51 Extensor Carpi Radialis Longus to Extensor Carpi Ulnaris Tendon Transfer . . . . . . . . . . . . . . . . . . . .146 Chapter 52 Radiocarpal Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .148 Chapter 53 Total Wrist Arthrodesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150 Chapter 54 Total Wrist Arthroplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153 Section VI.9 The Wrist Joint: Kienböck Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157 Chapter 55 Radial Shortening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158 Chapter 56 Vascularized Bone Grafting for Kienböck Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161 Chapter 57 Capitate Shortening with Capitohamate Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164 Chapter 58 Scaphocapitate Fusion with Lunate Excision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167 Section VI.10 The Wrist Joint: The Pediatric Wrist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171 Chapter 59 Fractional Lengthening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172 Chapter 60 Closing Wedge Osteotomy of Carpus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175 Chapter 61 Tendon Transfer for Wrist Extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .178 Chapter 62 Madelung’s Deformity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .182 Section VI.11 The Wrist Joint: Ganglions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185 Chapter 63 Excision of Dorsal Wrist Ganglion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .186 Chapter 64 Excision of Palmar Wrist Ganglion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188 Section VII.1 The Carpometacarpal Joint: Thumb Carpometacarpal Joint Injuries . . . . . . . . . . . . . . . . . . . . . . . . .191 Chapter 65 Ligament Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .192 Chapter 66 Closed Reduction and Internal Fixation of Bennett’s or Rolando’s Fractures . . . . . . . . . . . . . . . . . . .195 Section VII.2 The Carpometacarpal Joint: Thumb Carpometacarpal Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . .199 Chapter 67 Metacarpal Osteotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200 Chapter 68 Thumb Carpometacarpal Joint Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .203 Chapter 69 Ligament Reconstruction with Tendon Interposition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .206 (cid:2) CONTENTS ix