Brunelli Procedure
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Brunelli Procedure
The Brunelli ProcedureA new surgical technique for carpal instability with scapho-lunar dislocation, G A Brunelli, G R Brunelli. https://pubmed.ncbi.nlm.nih.gov/8519586/ is a surgical procedure that can be used to correct instability in the wrist. Instability in the wrist can be caused by a torn Scapholunate ligament. The Brunelli Procedure does not fix the torn ligament. A hole is drilled through the Scaphoid bone and a part of a tendon taken from the patient is put through this hole and attached to the nearby bones. The procedure usually results in reduced movement of the wrist. Instability in the wrist can, over time, lead to wrist osteoarthritis Wrist osteoarthritis is a group of mechanical abnormalities resulting in joint destruction, which can occur in the wrist. These abnormalities include degeneration of cartilage and hypertrophic bone changes, which can lead to pain, swelling and loss .... Video showing the surgical procedure performed on a human hand is founhere Refe ...
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Wrist
In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known as the carpal bones." (2) the wrist joint or radiocarpal joint, the joint between the radius and the carpus and; (3) the anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as ''wrist joints''. "With the large number of bones composing the wrist (ulna, radius, eight carpas, and five metacarpals), it makes sense that there are many, many joints that make up the structure known as the wrist." This region also includes the carpal tunnel, the anatomical snuff box, bracelet lines, the flexor retinaculum, and the extensor retinaculum. As a consequence of these various definitions, ...
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Scapholunate
The scapholunate ligament is a ligament of the wrist. Rupture of the scapholunate ligament causes scapholunate instability, which, if untreated, will eventually cause a predictable pattern of wrist osteoarthritis called scapholunate advanced collapse (SLAC). Anatomy The scapholunate ligament is an intraarticular ligament binding the scaphoid and lunate bones of the wrist together. It is divided into three areas, dorsal, proximal and palmar, with the dorsal segment being the strongest part. It is the main stabilizer of the scaphoid. In contrast to the scapholunate ligament, the lunotriquetral ligament is more prominent on the palmar side. Instability Complete rupture of this ligament leads to wrist instability. The main type of such instability is dorsal intercalated segment instability (DISI) deformity, where the lunate angulates to the posterior side of the hand. A ''dynamic scapholunate instability'' is where the scapholunate ligament is completely ruptured, but secondary ...
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Ligament
A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the: * Peritoneal ligament: a fold of peritoneum or other membranes. * Fetal remnant ligament: the remnants of a fetal tubular structure. * Periodontal ligament: a group of fibers that attach the cementum of teeth to the surrounding alveolar bone. Ligaments are similar to tendons and fasciae as they are all made of connective tissue. The differences among them are in the connections that they make: ligaments connect one bone to another bone, tendons connect muscle to bone, and fasciae connect muscles to other muscles. These are all found in the skeletal system of the human body. Ligaments cannot usually be regenerated naturally; however, there are periodontal ligament stem cells located near the periodontal ligament which are involved in the adult reg ...
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Scaphoid
The scaphoid bone is one of the carpal bones of the wrist. It is situated between the hand and forearm on the thumb side of the wrist (also called the lateral or radial side). It forms the radial border of the carpal tunnel. The scaphoid bone is the largest bone of the proximal row of wrist bones, its long axis being from above downward, lateralward, and forward. It is approximately the size and shape of a medium cashew. Structure The scaphoid is situated between the proximal and distal rows of carpal bones. It is located on the radial side of the wrist, and articulates with the radius, lunate, trapezoid, trapezium, and capitate. Over 80% of the bone is covered in articular cartilage. Bone The palmar surface of the scaphoid is concave, and forming a distal tubercle, giving attachment to the transverse carpal ligament. The proximal surface is triangular, smooth and convex. The lateral surface is narrow and gives attachment to the radial collateral ligament. The medial sur ...
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Wrist Osteoarthritis
Wrist osteoarthritis is a group of mechanical abnormalities resulting in joint destruction, which can occur in the wrist. These abnormalities include degeneration of cartilage and hypertrophic bone changes, which can lead to pain, swelling and loss of function. Osteoarthritis of the wrist is one of the most common conditions seen by hand surgeons. Osteoarthritis of the wrist can be idiopathic, but it is mostly seen as a post-traumatic condition. There are different types of post-traumatic osteoarthritis. Scapholunate advanced collapse (SLAC) is the most common form, followed by scaphoid non-union advanced collapse (SNAC). Other post-traumatic causes such as intra-articular fractures of the distal radius or ulna can also lead to wrist osteoarthritis, but are less common. Types SLAC and SNAC are two patterns of wrist osteoarthritis, following predictable patterns depending on the type of underlying injury. SLAC is caused by scapholunate ligament rupture, and SNAC is caused by a ...
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