Background In this study, we aimed to compare the stability of traditional tension band wiring (TBW) and screw combined TBW (SC‐TBW) fixation methods performed for a transverse olecranon osteotomy‐fracture during different degrees of elbow movement by using finite element analysis. Methods Three‐dimensional solid modeling of the olecranon was obtained by computed tomography images. Transverse olecranon fracture was created and fixed by TBW and SC‐TBW with respect to triceps muscle force. Opening angle, twisting angle and interplanar translation occurring on the fracture line were evaluated at 45° and 90° elbow flexion. Results Opening angle: 0.71°, 0.87° at 45° and 0.64°, 0.67° at 90° elbow flexion for TBW and SC‐TBW, respectively. Twisting angle: −0.01°, −0.19° at 45° flexion and 0.19°, 0.30° at 90° flexion for TBW and SC‐TBW, respectively. Interplanar translation: 1.93 mm, 4.65 mm at 45° flexion and 1.78 mm, 3.95 mm at 90° flexion for TBW and SC‐TBW, respectively. Conclusion TBW fixation provides more stability than SC‐TBW fixation model.

ObjectiveThe aim of this study was to report our results of lunate excision combined with capitohamate fusion in the treatment of Kienböck's stage IIIB/IIIC disease.MethodsA total of 7 patients with a mean age 35.2 (SD 11.5) years were enrolled in the study. Pain was the principal reason for surgery. All operations were carried out by the same senior surgeon. Patients were evaluated in terms of range of motion, DASH and VAS scores, satisfaction, and grip/tip/palmar/key pinch strength compared with contralateral sides. Preoperative carpal height indexes and findings of osteoarthritis were determined radiographically and compared with postoperative evaluations.ResultsMean duration of follow up was 15.2 months. Mean DASH and VAS scores were 13.8 2.7 and 2 1.1 respectively. The mean patient satisfaction score was 3.2 0.4 over 4 points. The mean grip strength in the operated hands was 66.4%, palmar pinch was 75.1%, tip pinch was 71.8% and key pinch was 70.4% when compared to the contralateral unaffected sides. The mean flexion range in the operated hands was 58.8%, extension range was 60.3%, radial deviation range was 65.2% and ulnar deviation range was 65.7% when compared to the contralateral sides. There was no significant difference between preoperative and postoperative carpal height ratios (p = 0.086).ConclusionsOur early term results indicate that lunate excision combined with capitohamate fusion may be an alternative treatment option in patients with stage IIIB and IIIC Kienböck's disease.Level of EvidenceLevel IV, Therapeutic study.

The aim of this study is to identify the prevalence and distribution patterns of sesamoid bones at the metacarpophalangeal (MCP) and interphalangeal (IP) joints and to determine if there is an association between the distribution patterns and age, gender, and hand side. Patients who had a direct radiograph of the hand obtained between 2019-2020 were retrospectively evaluated. All radiographs were evaluated in terms of the prevalence, coincidence, and distribution patterns of sesamoid bones. Presence of an association between distribution patterns and age, sex and side was also assessed. A total of 1501 hand radiographs were included into the study. There were 12 different patterns of sesamoid bone distribution. The most common distribution pattern was the presence of sesamoid bone at the first MCP joint only (25.8 %). There was a positive correlation between the second and third MCP, second and fifth MCP, second and first IP, third and fourth MCP and fifth MCP and first IP joints. The pattern with a sesamoid bone at the first MCP joint only was more prevalent among males, whereas the pattern involving coincidence of sesamoid bones at the first, second, fifth MCP and first IP joints was more prevalent among females (p<0.001, p=0.031). A positive correlation was observed between age and the number of MCP joints with sesamoid bones (p<0.001). The number of MCP joints with sesamoid bones was found to be higher in females (p<0.001).This study is important in that it provided anatomical data that can be guiding for clinicians in terms of diagnosis and management of hand disorders.

Introduction: Three different methods are described in the literature for the evaluation of carpal collapse. Measurements of carpal collapse by different people may affect the results. We aimed to investigate the inter and intraobserver reliability of three different methods used in carpal height measurement and to review the reference ranges for each method in healthy individuals. Methods: 179 wrist radiographs were evaluated by an orthopedist and a radiologist. Two observers made their evaluations independently of each other and unaware of each other's measurement results. They measured the carpal height ratio, the revised carpal height ratio, and the distance between the capitate-radius on each radiograph. One month later, all radiographs were reevaluated by two observers. Results: Results were analyzed by calculating the intraclass correlation coefficient. All methods had very high reproducibility. Interobserver reliability of the CH and RCH ratios were similar, and both had higher interobserver reliability scores than the CR index. In intraobserver reliability, the score of the CH ratio was higher in all measurements, and the lowest score was in the CR index. However, there was no statistical difference between the three methods in terms of inter- and intraobserver reliability. Conclusion: All three methods can be used in cases where the healthy extremity is desired to be used as a reference point in the evaluation of carpal height. Although the reliability scores of the CH ratio were found to be higher in this study, the practitioner can choose the desired method by evaluating the advantages and disadvantages of each method.