The American Journal of Orthopedics

June 2007 Volume XXXVI No. 6 pISSN:1078-4519 eISSN:1934-3418

E-PUBLISHING

87 Guest Editorial—E-Focus on the Hand
Matthew M. Tomaino, MD
Matthew M. Tomaino, MD, Professor of Orthopaedics, University of Rochester Medical Center, Rochester, New York (www.drtomaino.com).
Abstract not available.
Am J Orthop. 2007;36(6):E87

88
Asymptomatic Pisiform—Hamate Coalition: A Case Report
Adam T. Silverman, MD, MS, Steven S. Shin, MD, MS, and Nader Paksima, DO, MPH
Nader Paksima, DO, MPH, Department of Orthopaedic Surgery, New York University–Hospital for Joint Diseases, 530 First Ave, Suite 8U, New York, NY 10016 (tel, 718-
206-6923; fax, 718-206-8675; e-mail, npaksima@yahoo.com).
Abstract not available. Introduction provided instead.
Carpal coalition is a well-documented skeletal anomaly. Of the various coalitions that have been described, the lunatetriquetrum is the most prevalent. The pisiform—hamate coalition, originally reported in the West African Yoruba tribe, is rare. All 6 cases were incidental findings in asymptomatic patients. Recent reports document patients with tenderness on palpation of the coalition and ulnar neuropathy. Here we report the case of an asymptomatic pisiformhamate coalition and review the literature.
Am J Orthop. 2007;36(6):E88-E90

91
Madelung Deformity With Prior Distal Radius Fracture: A Case Report
Justin S. Field, MD, and Marco Rizzo, MD
Marco Rizzo, MD, The Mayo Clinic, Department of Orthopedic Surgery, 200 First Street, SW, Rochester, MN 55905 (tel, 507-284-3689; fax, 507-284-5539; e-mail, rizzo.marco@mayo.edu).
Abstract not available. Introduction provided instead.
Madelung¹ first described the wrist deformity bearing his name in 1878. Although previous authors had described lesions that we might now term Madelung deformity, Madelung was the first to accurately describe it clinically and to propose both an etiology and a treatment. The deformity results from epiphyseal arrest on the ulnar and volar half of the distal radius, which causes the articular surface to be directed ulnarly and volarly. In 1992, Vickers and Nielsen² further described the abnormal physeal and ligamentous anatomy on the volar aspect of the radiocarpal joint. They identified a thick fibrous band spanning the radial metaphysis to the proximal carpal row (Vickers ligament) seen in congenital Madelung deformity.
The etiologies of Madelung deformity have been thoroughly described in the literature. Although confusion continues as to the exact etiology of this condition, most reports show the deformity to be a condition inherited by an autosomal-dominant trait with variable expressivity. Common to congenital Madelung deformity is the presence of Vickers ligament, which tethers the volar-ulnar distal radial physis. Other reports have described an acquired or pseudo-Madelung deformity wherein injury to the immature physis produces a bony bridge with progression to a deformity that may mimic that of a true congenital Madelung deformity. In this report, we present the case of an acquired Madelung deformity secondary to trauma with the presence of a Vickers ligament and absence of a bony bridge affecting the volar-ulnar distal radial physis. In the literature, presence of Vickers ligament associated with posttraumatic Madelung deformity is unique; it has been described only in the congenital variant.
Am J Orthop. . 2007;36(6):E91-E93

94
Dorsoulnar Wrist Ganglion Associated With an Os Ulnostyloideum: A Case Report
Obi U. Osuji, MD, and Timothy R. McAdams, MD
Timothy R. McAdams, MD, Department of Orthopaedic Surgery, Stanford University Hospital, 1000 Welch Rd, Suite 100, Palo Alto, CA 94304 (tel, 650-725-5903; fax, 650- 723-6786; e-mail, tmcadams@stanford.edu).
Abstract not available. Introduction provided instead.
True accessory ossifications of the ulnar wrist, unrelated to prior trauma, are uncommon.¹ In a study of 800 asymptomatic wrists, Biyani and colleagues² found only 2 cases of an accessory os styloideum, or “os ulnostyloideum.” Accessory ossicles in the immediate area surrounding the distal ulna and its styloid process have been implicated in primary chronic polyarthritis and inflammation.^1,3
Wrist ganglions are typically found on the dorsal or volar aspect of the wrist. Ulnar-sided dorsal ganglions are less common and, when present, usually arise from the scapholunate joint and spread ulnarly. To our knowledge, ulnar-sided ganglion cysts have not been described in relation to accessory ossifications of the ulnar styloid.
Am J Orthop. 2007;36(6):E94-E96

97
An Isolated Perihamate, Transtriquetral Fracture-Dislocation: A Case Report
George A. Azar, MD, MPH, T. Shane Shaw, MD, Neofitos Stefanides, MD
John R. Denton, MD, Department of Orthopaedic Surgery, 152-11 89th Avenue, Jamaica, New York 11432-3730 (tel, 718-558-7239; fax, 718-558-6181; e-mail, johnrdenton@aol.com).
Abstract not available. Introduction provided instead.
Traumatic hamate dislocation with a triquetral fracture is a rare injury usually associated with significant carpal soft-tissue and bony injuries. Here we present the case of an isolated ulnar column fracture-dislocation and describe mechanism of injury, classification, and treatment.
Am J Orthop. 2007;36(5):E80-E82

PRINT PUBLISHING

292
Frank W. Jobe, MD —Mentor
Peter D. McCann, MD
Abstract not available.
Am J Orthop. 2007;36(6):292.

294 5 Points on Arthroscopic Double-Row and “Transosseous-Equivalent” Rotator Cuff Repair
Adam Yanke, MS, Matthew T. Provencher, MD, and Brian J. Cole, MD, MBA
Brian J. Cole, MD, MBA, Rush University, Department of Orthopaedic Surgery, 1725 W. Harrison, Suite 1063, Chicago, IL 60612 (email, bcole@rushortho.com).
Abstract not available.
Am J Orthop. 2007;36(6):294-297

298 The Process of Progress in Medicine, in Sports Medicine, and in Baseball Medicine
JFrank W. Jobe, MD, and Marilyn M. Pink, PhD, PT
JMarilyn M. Pink, PhD, PT, Centinela Freeman Regional Medical Center, Biomechanics Laboratory, 555 East Hardy Street, Inglewood, CA 90301-4011. (tel, 310-680-8070; fax, 310-671-5923; e-mail, Biomechanics@centinelafreeman.com).
Abstract not available.
Am J Orthop. 2007;36(6):298-302

308 Evaluation of Elbow and Shoulder Problems in Professional Baseball Pitchers
William A. Grana, MD, MPH, James B. Boscardin, MD, Herman J. Schneider, ATC/L, Scott H. Takao, MEd, ATC/L, Tomas Vera, ATC, and Scott G. Goin, MD
William A. Grana, MD, MPH, Department of Orthopaedic Surgery, Arizona Health Sciences Center, PO Box 245064, Tucson, AZ 85724-5024 (tel, 520-626-4024; fax, 520-626-2668; e-mail, clawrenc@email.arizona.edu).
When a professional athlete injures an elbow or shoulder, the uninjured joint must receive as much attention as the injured joint. Is there a relationship between injury of one joint and subsequent injury of the other joint? In the prospective study reported here, we created a database (a) to determine whether injury to one joint was more likely to result in a problem with the other joint and (b) to analyze for trends and correlations. A survey was administered to all pitchers on a professional baseball team to collect data about shoulder and elbow problems during their careers. Eighty-four pitchers (737 seasons of experience, 52 index injuries) were evaluated. Of the injured players, 27 were treated surgically. Risk for later injury was 4.6 times larger for players who had an index surgery than for those who had not. Of the players who had ulnar collateral ligament (UCL) reconstruction, 42% later sustained a shoulder injury. No player with rotator cuff surgery sustained a subsequent elbow or shoulder injury. There were significantly more upper extremity injuries with right-handed throwers. An elbow injury was more likely to result in shoulder problems, specifically after UCL reconstruction. Players who required surgery were almost 5 times more likely to have a later injury or surgery than players who did not require surgery.
Am J Orthop. 2007;36(6):308-313

317 Bilateral Discoid Medial Menisci of the Knee
Michael E. Marchetti, MD, Donald C. Jones, PhD, David A. Fischer, MD, Joel L. Boyd, MD, and Hollis M. Fritts, MD
David A. Fischer, MD, The Orthopaedic Center, 8100 Northland Dr., Minneapolis, MN 55431 (tel, 952-806-5322; fax, 952-831-1626; e-mail, d.fischermn@comcast.net).
Abstract not available.
Am J Orthop. 2007;36(6):317-321

325 Knee Pain and Leg-Length Discrepancy After Retrograde Femoral Nailing
Ricardo Reina, MD, Fernando E. Vilella, MD, Norman Ramírez, MD, Richard Valenzuela, MD, Gil Nieves, MD, and Christian A. Foy, MD
Norman Ramírez, MD, Department of Orthopaedic Surgery, School of Medicine, University of Puerto Rico, San Juan, PR 00936 (tel, 787-264-2066; fax, 787-264-4483; e-mail, normanpipe@aol.com).
We retrospectively studied postoperative knee function and leg-length discrepancy (LLD) in 31 patients with femoral diaphyseal fractures treated with retrograde intramedullary nailing (IMN) between October 1998 and April 2000. Mean follow-up was 25 months, mean knee range of motion was 126°, mean Hospital for Special Surgery knee scores were 89.2 (pain) and 78.3 (function), and mean LLD was 1.19 cm. Despite the theoretically higher knee pain and LLD rates associated with retrograde IMN, we believe it may offer a viable treatment option when the antegrade nailing technique is restricted.
Am J Orthop. 2007;36(6):325-328