Background  Scaphoid nonunion with humpback deformity and avascular necrosis (AVN) is a challenging problem. Correction of dorsal intercalated segment instability (DISI) requires grafting of a large and hard vascularized bone segment onto the volar side of the scaphoid. Purposes  We have been treating the patients with one-incision vascularized bone grafting technique for scaphoid nonunion to improve blood supply and correct humpback deformity. We evaluated these cases retrospectively to the surgical efficacy of our procedure. Methods  We harvested vascularized bone from the dorsal side of the radius using the method by Zaidemberg et al and inserted the cortical aspect into the scaphoid volar side using a direct lateral approach. Totally, 11 patients (nine males andtwo females) with a mean age of 40 years were recruited for this study. The mean time from fracture to treatment was 6 years and 3 months. The mean preoperative radiolunate angle was 25 degrees. All the patients showed AVN of the proximal scaphoid on T1-weighted images. An averaged follow-up period was 2 years and 3 months. Results  Postoperative computed tomography revealed bony union in 10 patients (91% of union rate) with a mean modified Mayo'swrist score of 88 points (range, 75-100 points) and a mean disabilities of arm, shoulder, and hand (DASH) score of 4 points (range, 0-20 points). The mean radiolunate angle was corrected from 25 to 5 degrees. No adverse events were observed, except temporary mild paresthesia of the radial nerve territory in two patients. Conclusion  This technique effectively corrected DISI in patients with scaphoid nonunion accompanied by humpback deformity and AVN.Background  Lunotriquetal coalition is the most common carpal coalition that can be symptomatic if trauma disrupts the syndesmosis or synchondrosis or if degenerative changes develop between the abnormal articulating surfaces. Case Description  A 15-year-old boy presented with a symptomatic lunotriquetral coalition after a fall 2 years prior. Following appropriate investigation, he was managed via arthroscopic debridement, bone grafting, and lunotriquetral arthrodesis. Literature Review  The majority of symptomatic lunotriquetral coalitions have been managed with open arthrodesis. There is only one prior report of arthroscopic arthrodesis of this articulation that did not utilize bone graft. Relevance  This report details the procedure to allow arthroscopic lunotriquetral arthrodesis with bone grafting, conveying osteogenic properties, and encouraging incorporation at the fusion site while maintaining the dorsal ligaments.Background  Pisotriquetral (PT) loose bodies have been described in the literature only a few times as case reports. While PT pathology remains the differential for ulnar-sided wrist pain, it can often be difficult to diagnose, as symptoms can be variable and radiographic imaging may be negative for any findings.  https://www.selleckchem.com/products/wnt-c59-c59.html  Case Description  A 24-year-old major league baseball player presented with pain and locking of his wrist during follow through of his bat swing. Plain radiographic imaging, as well as computed tomography (CT) imaging, was negative for any pathology. Dynamic magnetic resonance imaging (MRI) demonstrated a loose body which entered the PT joint when the wrist was moved into a flexed position. This caused entrapment of the loose body and locking of the wrist. Literature Review  A total of 17 reported patients in the literature have been diagnosed with a PT loose body. The clinical examination findings, radiographic findings, and surgical findings are reviewed. Case Relevance  PT loose bodies can present a challenging clinical picture to diagnose. The purpose of this case report is to review the appropriate clinical workup, including common examination findings and advanced imaging techniques, to help the clinician with the diagnosis.Objective  Pyrocardan trapeziometacarpal interposition implant is a free intra-articular spacer composed of pyrocarbon. This biconcave resurfacing implant, both ligament and bone-stock sparing, is indicated for use in early-to-moderate stage trapeziometacarpal osteoarthritis. It was hypothesized that the postoperative outcome measures of the Pyrocardan implant would be comparable to those seen with ligament reconstruction and tendon interposition (LRTI) surgeries and those reported by the designer of the implant, Phillipe Bellemère, but that strength would be greater than for LRTI. Methods  In this prospective case series, 40 Pyrocardan implants were performed in 37 patients. Average age was 58 years (range 46-71). Patients were assessed preoperatively, 3 months, 6 months, 1 year, 2 years, and beyond (long term) wherever possible. Results  There have been no major complications or revision surgeries for the series. Average follow-up was 29 months (range 12 months-7 years). Twenty-eight joints were assessed at over 2 years post index surgery. Outcome measure scores improved from preoperative assessment to the most recent follow-up equal or greater than 2 years. Average grip strength at 2 years was 30 kg, as compared with 19.6 kg in an age-matched cohort who underwent trapeziectomy and 25 kg in Bellemère's original series of Pyrocardan implants. Conclusions  Pyrocardan interposition arthroplasty appears to be a safe, effective treatment for trapeziometacarpal arthritis. Patient-reported clinical outcomes were at least equivalent to LRTI and are comparable to Bellemère's original series. Grip and pinch strength appear to be better than LRTI. Level of Evidence  This is a Level III, prospective observational cohort study.Background  Total wrist fusion can be elected to relieve pain in patients with osteoarthritis and rheumatoid arthritis. This study aimed to investigate the overall complications and the factors associated with reoperation and soft tissue complication after total wrist fusion. Methods  We retrospectively identified adult patients who underwent total wrist fusion using Current Procedural Terminology (CPT) codes, International Classification of Diseases, Ninth and Tenth Revision (ICD-9 and ICD-10) and verified these by medical chart review. We included patients ( n  = 215) who were treated at a single institutional system from January 1, 2002 to January 1, 2019. The mean age was 53.3 ± 15.0 years and the median follow-up was 6.1 years (interquartile range [IQR] =1.7-9.0). The most common indications for wrist fusion included inflammatory arthritis ( n  = 66, 31%), degenerative arthritis ( n  = 59, 27%), and posttraumatic arthritis ( n  = 47, 22%). All wrist fusions were performed using a dorsal fusion plate or dorsal spanning plate, either with a local autograft ( n  = 167, 78%), iliac crest autograft ( n  = 2, 1.