Clinical trial NCT01258166: Traumatic Ulnar Translocation of the Carpus
Official title: Traumatic Ulnar Translocation of the Carpus: Early Diagnosis and Treatment
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Traumatic Ulnar Translocation of the Carpus
Lead sponsor: Northwestern University
Sponsor class: OTHER
First posted: 2010-12-10
Enrollment: 10
Sex: ALL
Minimum age (years): 17
Maximum age (years): 80
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients who suffered traumatic ulnar translocation of the carpus

Brief summary: Ulnar translocation of the carpus is a form of wrist instability where the small bones of the wrist shift out of position. It is well recognized in patients with rheumatoid arthritis, but can also occur after a traumatic event, such as a violent football tackle or a fall from a height. The treatment options vary considerably, and there is no consensus of how to best address this injury pattern.

Because traumatic ulnar translocation is relatively rare, the diagnosis may be missed or delayed, causing problems for the patient such as persistent pain and loss of function. The investigators present 11 cases of this injury, discuss how to recognize it, and report our results after different treatment methods.

Detailed description: Ulnar translocation of the carpus is a form of wrist instability where the entire carpus translates medially along the inclined plane of the distal radius. This pattern of instability has been well recognized in patients with rheumatoid arthritis as a result of articular erosions and attenuation of wrist ligaments. In contrast, ulnar translocation of the carpus following trauma is seemingly rare, with published accounts limited to case reports and small case series.

The radiographic features of traumatic ulnocarpal translocation have been described and the instability pattern has been reproduced in cadaveric models. However, the recognition of radiocarpal malalignment may be unintentionally missed or delayed owing due to the uncommon nature of the this injury. The investigators present 11 cases of posttraumatic ulnar translocation of the carpus and review criteria for early recognition of the injury and the results following varying treatment methods.

Eligibility criteria: Inclusion Criteria:

Patient who suffered traumatic ulnar translocation of the carpus Willing to sign the consent

Exclusion Criteria:

Patients with collagen vascular disease

Primary outcomes:
Secondary outcomes:
Other outcomes:
Locations:
city: Chicago
country: United States
facility: Chicago Center for Surgery of the Hand
state: Illinois
Study officials:
References:
citation: Rayhack JM, Linscheid RL, Dobyns JH, Smith JH. Posttraumatic ulnar translation of the carpus. J Hand Surg Am. 1987 Mar;12(2):180-9. doi: 10.1016/s0363-5023(87)80268-x.
citation: Wollstein R, Wei C, Bilonick RA, Gilula LA. The radiographic measurement of ulnar translation. J Hand Surg Eur Vol. 2009 Jun;34(3):384-7. doi: 10.1177/1753193408101465. Epub 2009 Mar 25.
citation: Yang Z, Mann FA, Gilula LA, Haerr C, Larsen CF. Scaphopisocapitate alignment: criterion to establish a neutral lateral view of the wrist. Radiology. 1997 Dec;205(3):865-9. doi: 10.1148/radiology.205.3.9393549.
citation: Bellinghausen HW, Gilula LA, Young LV, Weeks PM. Post-traumatic palmar carpal subluxation. Report of two cases. J Bone Joint Surg Am. 1983 Sep;65(7):998-1006.
citation: Mulier T, Reynders P, Broos P, Fabry G. Posttraumatic ulnar translation of the carpus. A case report. Acta Orthop Scand. 1992 Feb;63(1):102-3. doi: 10.3109/17453679209154862.
citation: McMurtry RY, Youm Y, Flatt AE, Gillespie TE. Kinematics of the wrist. II. Clinical applications. J Bone Joint Surg Am. 1978 Oct;60(7):955-61.