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The Brunelli Procedure [1] is a surgical procedure that can be used to correct instability in the wrist. [2] Instability in the wrist can be caused by a torn Scapholunate ligament . The Brunelli Procedure does not fix the torn ligament.
X-ray images indicate scapholunate ligament instability when the scapholunate distance is more than 3 mm, which is called scapholunate dissociation. [7] A static scapholunate instability is generally readily visible, but a dynamic scapholunate instability can only be seen radiographically in certain wrist positions or under certain loading conditions, such as when clenching the wrist, or ...
Scapholunate advanced collapse (also known as SLAC wrist) is a type of wrist osteoarthritis. SLAC wrist is the most common type of post-traumatic wrist osteoarthritis [ 1 ] and is often the result of an undiagnosed or untreated scapholunate ligament rupture. [ 2 ]
The examiner will feel a significant 'clunk' and the patient will experience pain if the test is positive. For completeness, the test must be performed on both wrists for comparison. If the scapholunate ligament is disrupted, the scaphoid will subluxate over the dorsal lip of the distal radius. Original Description by Watson:
Because SLAC results from scapholunate ligament rupture, there is a larger space between the two bones, also known as the Terry Thomas sign. [10] Scaphoid instability due to the ligament rupture can be stactic or dynamic. [11] When the X-ray is diagnostic and there is a convincing Terry Thomas sign it is a static scaphoid instability.
In radiology, the Terry-Thomas sign is a scapholunate ligament dissociation on an anteroposterior view of the wrist. [1] [2] Most commonly a result of a fall on the outstretched hand , the scapholunate ligament ruptures resulting in separation of the lunate and scaphoid bones. This burst causes the scaphoid bone to dorsally rotate. [3]
A. Acromioplasty; Adhesive capsulitis of the shoulder; Akin osteotomy; Ankle fusion; Ankle replacement; Anterior cervical discectomy and fusion; Anterior cruciate ligament reconstruction
Bone graft procedures consist of more than just the surgery itself. The complete three-month total cost of a complex posterolateral lumbar spine fusion bone graft supplemented with graft extenders ranges from a mean of approximately US$33,860 to US$37,227. [33] This price includes all visits in and out of the hospital for three months.