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Three-dimensional computed tomography evaluation of the ulnocarpal joint under stress loading 应力负荷下尺桡关节的三维计算机断层扫描评估
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241275470
Ho Youn Park, Dai-Soon Kwak, Il-Jung Park, Jin-Woo Lee, Seung Hyo Kim, Joo-Yup Lee
We investigated which stress position of the wrist would result in the most significant reduction in the ulnocarpal distance using three-dimensional computed tomography (3DCT) images. 3DCT scans of 10 normal individuals and 19 patients with ulnar impaction syndrome were taken in neutral, radial/ulnar deviation and weightbearing pronation/supination wrist positions, and the shortest ulnolunate and ulnotriquetral distances were evaluated separately in each position. Both the ulnolunate and the ulnotriquetral distances were shortest in the weightbearing supination position in all participants. The ulnolunate distance was significantly decreased ( p = 0.00) in the weightbearing supination position compared with the neutral position in the ulnar impaction syndrome (UIS) group. However, the change in ulnotriquetral distance did not differ between the normal group and the UIS group. This study demonstrated that supination may be more vulnerable than pronation to UIS.Level of evidence:IV
我们使用三维计算机断层扫描(3DCT)图像研究了哪种手腕受力姿势会导致尺桡骨距离最明显的缩短。我们在腕关节中立位、桡侧/尺侧偏离位和负重前倾/上举位对 10 名正常人和 19 名尺桡骨内陷综合征患者进行了三维计算机断层扫描,并分别评估了每个位置的最短尺桡骨距离和尺骨切迹距离。所有参与者在负重上举姿势下的尺骨距离和尺骨未端距离都是最短的。与中立位相比,尺骨撞击综合征(UIS)组患者在负重上举位时的尺骨间距明显减少(p = 0.00)。然而,正常组和 UIS 组的尺骨髁间距变化并无差异。这项研究表明,上举姿势可能比前倾姿势更容易患上 UIS。
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引用次数: 0
The reliability of clinical assessment of distal radioulnar joint instability among non-United Kingdom European surgeons 非英国籍欧洲外科医生对桡尺关节远端不稳定性进行临床评估的可靠性
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241275456
Grey Giddins, Thomas Knapper, Nicola Fine, Greg Pickering
Clinical assessment of distal radioulnar joint (DRUJ) instability has been shown to be unreliable among experienced hand surgeons in the United Kingdom (UK). The aim of this study was to test the reliability of assessing DRUJ stability in European surgeons outside the UK. Four participants (eight wrists) with four unstable and four stable DRUJs as measured with a proven jig were assessed by 34 surgeons (22 men and 12 women) with a mean age of 43 years (range 29–61). Clinical assessment of DRUJ instability had a sensitivity of 32%, specificity of 88%, a positive predictive value of 72% and a negative predictive value of 56%. Surgeons who had attended a 1-hour workshop on clinical assessment of DRUJ stability the day before the testing were no more reliable at assessing DRUJ instability when compared with those who did not. This further highlights the need for better training with feedback when assessing the DRUJ and the need for objective assessment of DRUJ instability when reported in scientific studies.Level of evidence: V
英国(UK)经验丰富的手外科医生对桡尺关节远端(DRUJ)不稳定性的临床评估结果显示并不可靠。本研究旨在测试英国以外的欧洲外科医生评估 DRUJ 稳定性的可靠性。34 名外科医生(22 名男性和 12 名女性)对四名参与者(八只手腕)进行了评估,他们的 DRUJ 分别为四只不稳定和四只稳定,并使用经过验证的夹具进行了测量,这些外科医生的平均年龄为 43 岁(29-61 岁不等)。临床评估 DRUJ 不稳定性的敏感性为 32%,特异性为 88%,阳性预测值为 72%,阴性预测值为 56%。在测试前一天参加过 1 小时 DRUJ 稳定性临床评估研讨会的外科医生与未参加者相比,在评估 DRUJ 不稳定性方面并不更可靠。这进一步强调了在评估DRUJ时需要更好的培训和反馈,以及在科学研究报告中对DRUJ不稳定性进行客观评估的必要性:V
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引用次数: 0
Amandys® versus four-corner fusion in patients aged over 50 years: long-term retrospective study in stage 3 wrist osteoarthritis Amandys® 与四角融合术在 50 岁以上患者中的应用:腕关节骨关节炎 3 期的长期回顾性研究
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241275480
Aude Lozano, Caroline Cointat, Yves Bouju, Yves Kerjean, Flore-Anne Lecoq, Philippe Bellemère
We compared the outcomes of the Amandys® implant and four-corner fusion in patients aged over 50 years with grade 3 wrist osteoarthritis and a mean follow-up of 5 years. Clinical assessments were of pain, mobility, strength, functional scores and satisfaction. Radiographs were taken. A total of 46 patients (mean age 63 years; 28 four-corner fusion and 21 Amandys®) were included. Pain relief, mobility and functional scores were not significantly different in the two groups at inclusion. At the last follow-up, wrist extension and grip were improved after Amandys® arthroplasty. Flexion decreased after four-corner fusion. One patient in the Amandys® group was not satisfied and one dislocation required repositioning of the implant. There were six nonunions, of which one required revision surgery in the four-corner fusion group. With the Amandys®, immobilization was shorter and mobility improved, making it a valid alternative to four-corner fusion especially in older patients.Level of evidence: IV
我们比较了 Amandys® 植入物和四角融合术对 50 岁以上、患有 3 级腕关节骨关节炎、平均随访 5 年的患者的治疗效果。临床评估包括疼痛、活动度、力量、功能评分和满意度。同时还拍摄了 X 光片。共纳入 46 名患者(平均年龄 63 岁;28 名四角融合术患者和 21 名 Amandys® 患者)。两组患者的疼痛缓解程度、活动度和功能评分在纳入时无明显差异。在最后一次随访中,Amandys®关节置换术后腕关节伸展和握力得到改善。四角融合术后,腕关节屈伸功能有所下降。Amandys®组中有一名患者不满意,有一个脱位患者需要重新定位植入物。在四角融合组中,有六名患者出现了骨不连,其中一名患者需要进行翻修手术。使用Amandys®后,固定时间缩短,活动能力提高,因此是四角融合术的有效替代方案,尤其适用于老年患者:证据等级:IV
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引用次数: 0
Combining double antegrade intramedullary pinning with proximal interphalangeal joint transfixation in a bicondylar proximal phalangeal fracture 在双髁近端指骨骨折中结合使用双前向髓内钉和近端指间关节经固定术
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241275448
Jui-Chien Wang, Yen-Chun Huang, Jung-Pan Wang
The combination of double antegrade intramedullary pinning with proximal interphalangeal joint transfixation offers an effective and minimally invasive approach to reduce the complications of joint stiffness and functional disability.Level of evidence: V
双前向髓内针联合近端指间关节经固定术是一种有效的微创方法,可减少关节僵硬和功能障碍等并发症:V
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引用次数: 0
Changes in hand function and health state utility after cubital tunnel release using the United Kingdom Hand Registry 利用英国手部登记册了解肘隧道松解术后手部功能和健康状况效用的变化
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241275487
Joris S. Teunissen, Timothy T. Griffiths, Brigitte E. P. A. van der Heijden, Ryckie G. Wade, Jennifer C. E. Lane, Steven E. R. Hovius, Grainne Bourke, Fadi Issa, Jeremy N. Rodrigues, Conrad J. Harrison
This study aimed to analyse and contrast changes in health-related quality of life (HR-QoL) and hand symptoms in the first 6 months after surgical treatment for primary cubital tunnel syndrome. Data originated from the United Kingdom Hand Registry. HR-QoL was assessed using the generic EuroQol five-dimensional assessment tool (EQ-5D-5L) and hand symptoms using the Patient Evaluation Measure (PEM). In total, 281 patients were included in the statistical analysis. Cubital tunnel release resulted in clinically relevant relief of hand symptoms. However, no improvement in HR-QoL was detected by the EQ-5D-5L. As a result, current health economic models, such as those used by the National Institute for Health Care Excellence (NICE) in the UK, might conclude that cubital tunnel release is not cost-effective. This discrepancy requires exploration, and hand-specific preference-based measures might be needed for value-based healthcare in hand surgery.Level of evidence: III
本研究旨在分析和对比原发性肘隧道综合征手术治疗后头 6 个月中与健康相关的生活质量(HR-QoL)和手部症状的变化。数据来源于英国手部登记处。健康相关生活质量(HR-QoL)使用通用的EuroQol五维评估工具(EQ-5D-5L)进行评估,手部症状则使用患者评估量表(PEM)进行评估。共有281名患者被纳入统计分析。眶管松解术在临床上缓解了手部症状。但是,EQ-5D-5L 并未发现手部症状有任何改善。因此,目前的健康经济模型(如英国国家健康护理卓越研究所(NICE)使用的模型)可能会得出结论:肘管松解术不具有成本效益。需要对这一差异进行探讨,手部手术中的价值导向型医疗保健可能需要基于手部特异性偏好的测量方法:证据等级:III
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引用次数: 0
Statistical questions FESSH 2024 workshop 统计问题 FESSH 2024 研讨会
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241278113
Miriam Marks, Ruud W. Selles, Dieuwke C. Broekstra
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引用次数: 0
Re: Koo KK-H, Morris J, Ansari SA, Younis F. Hand conditions as sequelae of infection with COVID-19: a literature review. J Hand Surg Eur. 2024, 49: 284–9 再Koo KK-H、Morris J、Ansari SA、Younis F.感染 COVID-19 后遗症引起的手部疾病:文献综述。J Hand Surg Eur.2024, 49: 284-9
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241256856
Rocco de Vitis
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引用次数: 0
Indocyanine green near infrared fluorescent imaging and its potential role in peripheral nerve repair 吲哚菁绿近红外荧光成像及其在周围神经修复中的潜在作用
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241277059
Rebecca Friedman, Chistopher Kubajak, Nikhil A. Agrawal, Jonathan L. Bass
This case series describes the successful use of indocyanine green dye and near infrared fluorescence imaging in primary peripheral nerve repair.
本系列病例介绍了吲哚菁绿染料和近红外荧光成像在原发性周围神经修复中的成功应用。
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引用次数: 0
Pain and instability ascribed to the distal radioulnar ligaments and central disc as part of the triangular fibrocartilage complex: a round table discussion 作为三角纤维软骨复合体一部分的桡侧远端韧带和中央椎间盘引起的疼痛和不稳定性:圆桌讨论
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241254705
Teun Teunis, Marion Burnier, Andrew Y. H. Chin, David Ring
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引用次数: 0
Results of spinal accessory nerve to suprascapular nerve transfers in children with brachial plexus birth injury 臂丛神经产伤患儿脊髓副神经与肩胛上神经转移的结果
IF 1.8 2区 医学 Q2 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1177/17531934241276372
Maria Hyttinen, Henrikki Rönkkö, Pasi Paavilainen, Mika Helminen, Jarkko Jokihaara
Shoulder external rotation after brachial plexus birth injury can be restored by transfer of the spinal accessory nerve to the suprascapular nerve, or more distally to its infraspinatus branch. We studied the outcome of these nerve transfers in 52 patients with a minimum postoperative follow-up of 12 months (mean 7.3 years). The median postoperative improvement in shoulder external rotation was 120° (interquartile range [IQR] 45–135) after anterior and 110° (IQR 83–120) after dorsal spinal accessory nerve transfer to the suprascapular nerve main trunk, and 110° (IQR 80–125) after transfer to the infraspinatus branch. Patients operated after 20 months obtained external rotation ≥90° less frequently. The results of this study suggest that a decision about distal nerve transfer for shoulder external rotation is recommended at 1.5 years of age.Level of evidence: III
臂丛神经产伤后的肩关节外旋可以通过将脊髓附属神经转移到肩胛上神经或更远的冈下神经分支来恢复。我们对 52 名术后随访至少 12 个月(平均 7.3 年)的患者进行了这些神经转移的结果研究。将背侧脊髓附属神经转移至肩胛上神经主干后,肩关节外旋的术后改善幅度中位数为120°(四分位数间距[IQR] 45-135);将背侧脊髓附属神经转移至肩胛下神经主干后,肩关节外旋的改善幅度中位数为110°(四分位数间距[IQR] 83-120);将背侧脊髓附属神经转移至冈下神经分支后,肩关节外旋的改善幅度中位数为110°(四分位数间距[IQR] 80-125)。20个月后手术的患者获得≥90°外旋的频率较低。该研究结果表明,建议在患者1.5岁时决定是否进行远端神经转移以治疗肩关节外旋:证据等级:III
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Journal of Hand Surgery-European Volume
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