Radial Shortening Osteotomy Using Volar Locking Plate for Kienböck\u27s Disease

Purpose:The purpose of this study was to report the preliminary results for radial shortening osteotomyfollowed by volar locking plate fixation without post-operative immobilization for the treatment of Kienböck\u27sdisease.Methods:Ten consecutive patients with Kienböck\u27s disease of stages III were treated by radial shorteningosteotomy at the metaphysis using a volar locking plate system. Radial shortening osteotomy was performed for patients with negative or neutral ulnar variance, and combined shortening of radius and ulna for those with positive ulnar variance. The active motion of the digits, wrist, and forearm was encouraged immediately after surgery, and no splints were used.Results:The average follow-up was 26 months. In all the patients, the osteotomized bone united after an average of 11 weeks. Follow-up radiographs showed no further progression of the disease in carpal height,Ståhl\u27s index, or Lichtman\u27s stage classification. Moderate pain reported by all the patients preoperativelysignificantly improved by the final follow-up. Wrist extension, flexion, grip strength, and the Mayo wrist score were significantly improved compared with preoperative values.Conclusions:Volar locking plate fixation without immobilization is a safe and effective procedure for radial shortening osteotomy of Kienböck\u27s disease

Structural investigation of K-feldspar KAlSi3O8 crystals by XRD and Raman spectroscopy: an application to petrological study of Luc Yen Pegmatites, Yen Bai Province, Vietnam

K-feldspars in pegmatites from Luc Yen gem mining area, Yen Bai province, Vietnam were studied by X-ray fluorescence, X-ray powder diffraction and the Raman spectroscopy. Chemical analysis determined the K-feldspars in the form of (K0:8909Na0:0388Ca0:002Pb0:0042Cs0:0024Rb0:0338)(Al0:9975Fe0:0053Ti0:0004)Si2:988O8. Both X-ray powder diffraction and Raman spectroscopy indicated Luc Yen K-feldspars as orthoclase phase. Together with the values of Al content of the T1 tetrahedral sites in orthoclase, it is understood that Luc Yen pegmatites are of young ages (Cenozoic) and shallow intrusive types

The Effect of Radial and Ulnar Length Change on Distal Forearm Loading

The effect of distal radial and ulnar length change on forearm bone loading is not well understood during simulated dynamic wrist loading. This thesis presents two studies which investigate the effect of these length changes on distal forearm loading under simulated dynamic wrist motion. The first study investigates the effect of radial length change on axial loading at the distal radius and ulna and relationship between ulnar variance and distal forearm loading. The complex variation in axial loads in the distal radius and during length change and dynamic wrist motion were studied and discussed. There was no correlation between native variance and distal loads. The second study investigates the effect of ulnar change on axial loading at the distal radius and ulna and the effect of triangular fibrocartilage ligament complex (TFCC) on this relationship. Variation in axial loads during ulnar lengthening followed similar trends to radial shortening and vice versa

The Last Tasmanian

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Surgical treatment of the Kienbck's disease

The natural progression of lunate osteonecrosis is one of loss of vascularity, fragmentation, and later collapse with subsequent loss of carpal integrity. In the treatment of the Kienb ck's disease, reported that surgical treatment has been more effective than the conservative treatment, such as cast immobilization which cannot prevent the progress of the disease even if its initial stage. The ultimate goal of treatment is mechanical decompression and revascularization of the lunate. Many therapeutic guidelines were researched by several authors to the different stages, but not established absolute guideline yet. We have treated a total of 13 cases of Kienb ck's disease, their symptom duration was 40 months in average. All cases were followed for 39months in average. According to the Lichtman's classification, stage II in 3 cases, stage IIIa in 6 cases, stage IIIb in 4 cases were defined radiologically. The ulnar variance were negative in 8 cases, neutral in 4 cases, positive in a case. Operative treatments were performed with scaphoido-capitate fusion in 2 cases, triscaphe fusion in 8 cases, radial shortening in 3 cases, from Mar. 1991 to Dec. 1998. Their end results were analyzed with subjective pain, objective wrist motions clinically which based on Lichtman's criteria and with carpal height radiologically. Ten cases were satisfied and another 3 cases were unsatisfied according to the Lichtman's criteria. The pain was relieved in all cases but the range of motion was decreased mederately after scaphoidocapitate fusion. The carpal index was not changed from 0.50 preoperatively to 0.50 postoperatively in average in all cases. There were were a superficial wound infection and a paresthesia of the operative sites as postoperative complications.ope

Understanding the motivational characteristics of type 1 diabetes regime management during adolescence

Throughout the Stage 2 training a number of opportunities were negotiated to demonstrate the competencies required to achieve the Doctorate in Health Psychology. This has involved working across local authority and NHS organisations and holding workplace contracts within Children, Young People and Family Services, a Paediatric Diabetes Team and the Department of Rheumatology. This has provided a variety of experiences, which are reflected within this thesis, in order to demonstrate the expertise and skills required to achieve health psychologist status