Pub Date : 2024-09-14DOI: 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
{"title":"The reliability of clinical assessment of distal radioulnar joint instability among non-United Kingdom European surgeons","authors":"Grey Giddins, Thomas Knapper, Nicola Fine, Greg Pickering","doi":"10.1177/17531934241275456","DOIUrl":"https://doi.org/10.1177/17531934241275456","url":null,"abstract":"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","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"3 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 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
{"title":"Three-dimensional computed tomography evaluation of the ulnocarpal joint under stress loading","authors":"Ho Youn Park, Dai-Soon Kwak, Il-Jung Park, Jin-Woo Lee, Seung Hyo Kim, Joo-Yup Lee","doi":"10.1177/17531934241275470","DOIUrl":"https://doi.org/10.1177/17531934241275470","url":null,"abstract":"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","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"97 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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
{"title":"Amandys® versus four-corner fusion in patients aged over 50 years: long-term retrospective study in stage 3 wrist osteoarthritis","authors":"Aude Lozano, Caroline Cointat, Yves Bouju, Yves Kerjean, Flore-Anne Lecoq, Philippe Bellemère","doi":"10.1177/17531934241275480","DOIUrl":"https://doi.org/10.1177/17531934241275480","url":null,"abstract":"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","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"20 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 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
{"title":"Changes in hand function and health state utility after cubital tunnel release using the United Kingdom Hand Registry","authors":"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","doi":"10.1177/17531934241275487","DOIUrl":"https://doi.org/10.1177/17531934241275487","url":null,"abstract":"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","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"1 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 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
{"title":"Combining double antegrade intramedullary pinning with proximal interphalangeal joint transfixation in a bicondylar proximal phalangeal fracture","authors":"Jui-Chien Wang, Yen-Chun Huang, Jung-Pan Wang","doi":"10.1177/17531934241275448","DOIUrl":"https://doi.org/10.1177/17531934241275448","url":null,"abstract":"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","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"5 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1177/17531934241256856
Rocco de Vitis
{"title":"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","authors":"Rocco de Vitis","doi":"10.1177/17531934241256856","DOIUrl":"https://doi.org/10.1177/17531934241256856","url":null,"abstract":"","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"54 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1177/17531934241278113
Miriam Marks, Ruud W. Selles, Dieuwke C. Broekstra
{"title":"Statistical questions FESSH 2024 workshop","authors":"Miriam Marks, Ruud W. Selles, Dieuwke C. Broekstra","doi":"10.1177/17531934241278113","DOIUrl":"https://doi.org/10.1177/17531934241278113","url":null,"abstract":"","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"105 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 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。
{"title":"Indocyanine green near infrared fluorescent imaging and its potential role in peripheral nerve repair","authors":"Rebecca Friedman, Chistopher Kubajak, Nikhil A. Agrawal, Jonathan L. Bass","doi":"10.1177/17531934241277059","DOIUrl":"https://doi.org/10.1177/17531934241277059","url":null,"abstract":"This case series describes the successful use of indocyanine green dye and near infrared fluorescence imaging in primary peripheral nerve repair.","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"48 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1177/17531934241275462
Yongqiang Guo, Tao Li, Xiaofei Tian, Jun Xiao, Tianwu Li, Lin Qiu
We report our experience with correction of radially deviated Wassel type III thumb polydactyly. After comprehensive assessments from preoperative radiographs, physical examinations and intraoperative reports, we corrected the metacarpophalangeal joint in 34 cases of radially deviated Wassel type III thumb polydactyly. Opening-wedge osteotomies combining bone graft and soft tissue reconstruction were used in 28 cases and soft tissue reconstruction only in six cases. Absorbable sutures were used instead of traditional Kirschner (K)-wires to fix the bone grafts. Patients were followed up for 12–78 months (mean 47 months). According to the Tada scoring system, 25 patients achieved good results, seven fair results and two poor results. Our modified technique for correcting radially deviated Wassel type III thumb polydactyly yielded satisfactory results. Continued follow-up and further studies will contribute to a better understanding of the long-term efficacy and potential refinements of this technique.Level of evidence: IV
我们报告了对桡侧偏斜的 Wassel III 型拇指多指畸形进行矫正的经验。经过术前X光片、体格检查和术中报告的综合评估，我们对34例桡侧偏斜的Wassel III型拇指多指畸形患者的掌指关节进行了矫正。28例采用了结合植骨和软组织重建的开楔截骨术，6例仅采用了软组织重建。使用可吸收缝合线代替传统的 Kirschner (K) 线固定植骨。对患者进行了 12-78 个月（平均 47 个月）的随访。根据 Tada 评分系统，25 名患者效果良好，7 名效果一般，2 名效果不佳。我们采用改良技术矫正桡侧偏斜的 Wassel III 型拇指多指畸形取得了令人满意的效果。继续跟踪和进一步研究将有助于更好地了解该技术的长期疗效和可能的改进：证据等级：IV
{"title":"Surgical correction of radially deviated Wassel type III thumb polydactyly: a prospective case series","authors":"Yongqiang Guo, Tao Li, Xiaofei Tian, Jun Xiao, Tianwu Li, Lin Qiu","doi":"10.1177/17531934241275462","DOIUrl":"https://doi.org/10.1177/17531934241275462","url":null,"abstract":"We report our experience with correction of radially deviated Wassel type III thumb polydactyly. After comprehensive assessments from preoperative radiographs, physical examinations and intraoperative reports, we corrected the metacarpophalangeal joint in 34 cases of radially deviated Wassel type III thumb polydactyly. Opening-wedge osteotomies combining bone graft and soft tissue reconstruction were used in 28 cases and soft tissue reconstruction only in six cases. Absorbable sutures were used instead of traditional Kirschner (K)-wires to fix the bone grafts. Patients were followed up for 12–78 months (mean 47 months). According to the Tada scoring system, 25 patients achieved good results, seven fair results and two poor results. Our modified technique for correcting radially deviated Wassel type III thumb polydactyly yielded satisfactory results. Continued follow-up and further studies will contribute to a better understanding of the long-term efficacy and potential refinements of this technique.Level of evidence: IV","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"11 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 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
{"title":"Results of spinal accessory nerve to suprascapular nerve transfers in children with brachial plexus birth injury","authors":"Maria Hyttinen, Henrikki Rönkkö, Pasi Paavilainen, Mika Helminen, Jarkko Jokihaara","doi":"10.1177/17531934241276372","DOIUrl":"https://doi.org/10.1177/17531934241276372","url":null,"abstract":"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","PeriodicalId":54813,"journal":{"name":"Journal of Hand Surgery-European Volume","volume":"49 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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