Pub Date : 2019-12-10DOI: 10.1177/1753193419892561
J. Blackburn, D. Armstrong
A 23-year-old, right-hand-dominant man presented to our unit having sustained a fight bite injury to his ring finger metacarpophalangeal (MCP) joint. He was listed for exploration and washout of the injury under regional anaesthesia, as performed by the senior author. During exploration, the joint capsule was found to be breached and on further inspection a small, clear plastic ring was identified in the volar or palmar aspect of the joint, immediately above the volar plate. The ring looked like a dental brace band and as the patient was awake, he was questioned whether the recipient of the blow had been wearing dental braces, and this was confirmed to be so. The fixed dental brace is made of brackets attached to the teeth, an archwire linking them and held together with rubber ligatures or dental brace bands (Figure 1). These rubber bands are available in many colours, although they are often transparent to minimize the visual impact of the brace (Figure 1). Due to its small size and transparent nature, this was something that the senior author felt could have been easily missed during the surgery (Figure 2). It is well known that the metacarpal head can be damaged by an opponent’s teeth when assaulting someone with a clenched fist position. Plain radiographs are often used to detect tooth foreign bodies or osteochondral defects in the metacarpal head (Eyres and Allen, 1993), but
{"title":"Fixed dental brace band in a fight bite injury: a case report","authors":"J. Blackburn, D. Armstrong","doi":"10.1177/1753193419892561","DOIUrl":"https://doi.org/10.1177/1753193419892561","url":null,"abstract":"A 23-year-old, right-hand-dominant man presented to our unit having sustained a fight bite injury to his ring finger metacarpophalangeal (MCP) joint. He was listed for exploration and washout of the injury under regional anaesthesia, as performed by the senior author. During exploration, the joint capsule was found to be breached and on further inspection a small, clear plastic ring was identified in the volar or palmar aspect of the joint, immediately above the volar plate. The ring looked like a dental brace band and as the patient was awake, he was questioned whether the recipient of the blow had been wearing dental braces, and this was confirmed to be so. The fixed dental brace is made of brackets attached to the teeth, an archwire linking them and held together with rubber ligatures or dental brace bands (Figure 1). These rubber bands are available in many colours, although they are often transparent to minimize the visual impact of the brace (Figure 1). Due to its small size and transparent nature, this was something that the senior author felt could have been easily missed during the surgery (Figure 2). It is well known that the metacarpal head can be damaged by an opponent’s teeth when assaulting someone with a clenched fist position. Plain radiographs are often used to detect tooth foreign bodies or osteochondral defects in the metacarpal head (Eyres and Allen, 1993), but","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419892561","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47171392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-09DOI: 10.1177/1753193419892560
C. Buzea, T. Panazan, I. Boiangiu
compared with the contralateral side (seven wrists). This report has limitations: no preoperative patient-rated outcomes measures are available, so it is impossible to prove improvement of wrist function, however, patient satisfaction, grip strength and return to work were high. Second, the follow-up was short; and third, there was no control group. Because most patients were satisfied with the operation, we will continue to use this technique.
{"title":"A variant form of Laurin–Sandrow syndrome in an adult patient","authors":"C. Buzea, T. Panazan, I. Boiangiu","doi":"10.1177/1753193419892560","DOIUrl":"https://doi.org/10.1177/1753193419892560","url":null,"abstract":"compared with the contralateral side (seven wrists). This report has limitations: no preoperative patient-rated outcomes measures are available, so it is impossible to prove improvement of wrist function, however, patient satisfaction, grip strength and return to work were high. Second, the follow-up was short; and third, there was no control group. Because most patients were satisfied with the operation, we will continue to use this technique.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419892560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48772817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-09DOI: 10.1177/1753193419892523
Jae-Young Park, M. B. Kim, Hyuk-Soo Han
lent, one good, and one fair result (Figure 2(b)). Mean Disabilities of the Arm, Shoulder and Hand (DASH) score was 1. We acquired full active flexion of distal interphalangeal joint at final follow-up except for two patients. K-wire fixation with distal interphalangeal joint hyperextension was a useful, reliable, and simple treatment method for chronic tendinous mallet finger deformities, with correctable deformities regardless of previous failed surgery.
{"title":"Elastic pneumatic tourniquet cuff versus conventional polyurethane elastomer cuff for hand surgery: a randomized study","authors":"Jae-Young Park, M. B. Kim, Hyuk-Soo Han","doi":"10.1177/1753193419892523","DOIUrl":"https://doi.org/10.1177/1753193419892523","url":null,"abstract":"lent, one good, and one fair result (Figure 2(b)). Mean Disabilities of the Arm, Shoulder and Hand (DASH) score was 1. We acquired full active flexion of distal interphalangeal joint at final follow-up except for two patients. K-wire fixation with distal interphalangeal joint hyperextension was a useful, reliable, and simple treatment method for chronic tendinous mallet finger deformities, with correctable deformities regardless of previous failed surgery.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419892523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42416461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-09DOI: 10.1177/1753193419889806
A. Sayers
I was interested to read the recommendations of Boeckstyns et al. in their recent article. Unfortunately, they have made a number of important factual errors that need correcting. They have fallen into the trap of misinterpreting what competing risk models do, or do not do as the case may be. In the article ‘Are competing risks models appropriate to describe implant failure?’ (Sayers et al., 2018), we describe the differences between Kaplan–Meier curves and the cumulative incidence function as estimated by competing risk models. In the penultimate paragraph we state:
我很有兴趣阅读Boeckstyns等人在他们最近的文章中的建议。不幸的是，他们犯了一些重要的事实错误，需要纠正。他们已经落入了错误解读相互竞争的风险模型能做什么或不能做什么的陷阱。在文章“竞争风险模型是否适合描述种植体失败?”(Sayers et al.， 2018)，我们描述了Kaplan-Meier曲线和通过竞争风险模型估计的累积发生率函数之间的差异。在倒数第二段，我们声明:
{"title":"Re: Boeckstyns MEH, Merser S, Cool P. Reporting implant survival. J Hand Surg Eur. 2019, 44: 761–3","authors":"A. Sayers","doi":"10.1177/1753193419889806","DOIUrl":"https://doi.org/10.1177/1753193419889806","url":null,"abstract":"I was interested to read the recommendations of Boeckstyns et al. in their recent article. Unfortunately, they have made a number of important factual errors that need correcting. They have fallen into the trap of misinterpreting what competing risk models do, or do not do as the case may be. In the article ‘Are competing risks models appropriate to describe implant failure?’ (Sayers et al., 2018), we describe the differences between Kaplan–Meier curves and the cumulative incidence function as estimated by competing risk models. In the penultimate paragraph we state:","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419889806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42447043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-09DOI: 10.1177/1753193419891382
E. Bodmer, M. Marks, S. Hensler, S. Schindele, D. Herren
The objective was to compare outcomes of the volar, Chamay and tendon splitting approaches for proximal interphalangeal joint arthroplasty using a surface-replacing implant (CapFlex-PIP). One-hundred prospectively documented patients with a 2-year follow-up were included. Range of proximal interphalangeal joint motion, the brief Michigan Hand Outcomes Questionnaire and complications were analysed. Between baseline and follow-up, mean proximal interphalangeal joint motion increased for the volar (53° to 54°), Chamay (38° to 53°) and tendon splitting (40° to 61°) approaches. The volar approach yielded the greatest flexion and the highest extension deficit. The mean brief Michigan Hand Outcomes Questionnaire scores at baseline and 2 years were 45 and 74 (volar), 45 and 66 (Chamay) and 41 and 75 (tendon splitting). Seven patients in the Chamay group and two in the volar group required a reoperation consisting of teno-/arthrolysis. The tendon splitting approach tended to result in the best outcomes that were associated with fewer complications compared with the volar and Chamay approaches. Level of evidence: IV
{"title":"Comparison of outcomes of three surgical approaches for proximal interphalangeal joint arthroplasty using a surface-replacing implant","authors":"E. Bodmer, M. Marks, S. Hensler, S. Schindele, D. Herren","doi":"10.1177/1753193419891382","DOIUrl":"https://doi.org/10.1177/1753193419891382","url":null,"abstract":"The objective was to compare outcomes of the volar, Chamay and tendon splitting approaches for proximal interphalangeal joint arthroplasty using a surface-replacing implant (CapFlex-PIP). One-hundred prospectively documented patients with a 2-year follow-up were included. Range of proximal interphalangeal joint motion, the brief Michigan Hand Outcomes Questionnaire and complications were analysed. Between baseline and follow-up, mean proximal interphalangeal joint motion increased for the volar (53° to 54°), Chamay (38° to 53°) and tendon splitting (40° to 61°) approaches. The volar approach yielded the greatest flexion and the highest extension deficit. The mean brief Michigan Hand Outcomes Questionnaire scores at baseline and 2 years were 45 and 74 (volar), 45 and 66 (Chamay) and 41 and 75 (tendon splitting). Seven patients in the Chamay group and two in the volar group required a reoperation consisting of teno-/arthrolysis. The tendon splitting approach tended to result in the best outcomes that were associated with fewer complications compared with the volar and Chamay approaches. Level of evidence: IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419891382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48561198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-05DOI: 10.1177/1753193419890542
S. Sabapathy, Monusha Mohan, Dafang Zhang
Macrodactyly of the hand is a rare congenital disorder of three-dimensional overgrowth that accounts for less than 1% of all congenital hand differences (Cerrato et al., 2013; Waters and Gillespie, 2016). When severe, macrodactyly is functionally limiting and can cause functional impairment to the unaffected digits. No tissue involved in macrodactyly is normal. Osteochondral changes found near the interphalangeal joint render improvements in motion difficult, if not impossible. The digital artery is generally the same size as that of a normal digit, resulting in relative under-perfusion of the enlarged digit (DeValentine et al., 1981), and thus, potentially a higher risk for healing problems after surgery. The presence of syndactyly adds the challenge of digit separation and skin coverage. Early ray resection is often recommended (Waters and Gillespie, 2016) since reconstruction would entail multiple stages, each with the possibility of wound healing complications and ultimately unpredictable functional and aesthetic results. However, despite counselling, some parents may not accept amputation due to social, cultural, or personal reasons. Moreover, in cases of severe macrosyndactyly of the two central fingers, ray resection would either leave an aesthetically unpleasing cleft or, with cleft closure, would narrow the span of the palm and limit the ability to grasp large objects. We present the long-term functional outcomes of two cases of staged reconstruction of severe complex macrosyndactyly. Both patients initially presented before 1 year of age with complete syndactyly of the enlarged middle and ring fingers with synonychia (Figure 1). There were no remarkable prenatal or postnatal events. Plain radiographs showed fused distal phalanges. Treatment options were discussed, and both families declined ray resections. Therefore, staged reconstruction was performed. In the first stage, the syndactylized digits were shortened. A dorsal incision was used to excise the enlarged distal and middle phalanges to the level of the tips of the normal fingers, preserving a sufficient volar flap for coverage. Free nail bed grafts from the distal amputated part were placed on de-epithelialized dermis at the appropriate recipient position (Sabapathy et al., 1990). In the second stage, syndactyly separation was performed using a dorsal skin flap to reconstruct the web commissure, interdigitating flaps on the lateral aspects of the digits to avoid scar contractures, and fullthickness skin grafts over exposed fat. Subsequent stages focused on debulking the width of the digits, which involved cortical thinning of the phalanx, reduction of the width of the nail bed, and extraarticular wedge resections to correct angular deformities. No wound healing or flap complications occurred. At final follow-up, 11 and 7 years after reconstruction, Patient-Reported Outcomes Measurement Information System Upper Extremity score was 57 and 41, respectively. Paediatric Outcomes Data
{"title":"Complex macrosyndactyly: the long-term functional results of staged reconstruction in two cases","authors":"S. Sabapathy, Monusha Mohan, Dafang Zhang","doi":"10.1177/1753193419890542","DOIUrl":"https://doi.org/10.1177/1753193419890542","url":null,"abstract":"Macrodactyly of the hand is a rare congenital disorder of three-dimensional overgrowth that accounts for less than 1% of all congenital hand differences (Cerrato et al., 2013; Waters and Gillespie, 2016). When severe, macrodactyly is functionally limiting and can cause functional impairment to the unaffected digits. No tissue involved in macrodactyly is normal. Osteochondral changes found near the interphalangeal joint render improvements in motion difficult, if not impossible. The digital artery is generally the same size as that of a normal digit, resulting in relative under-perfusion of the enlarged digit (DeValentine et al., 1981), and thus, potentially a higher risk for healing problems after surgery. The presence of syndactyly adds the challenge of digit separation and skin coverage. Early ray resection is often recommended (Waters and Gillespie, 2016) since reconstruction would entail multiple stages, each with the possibility of wound healing complications and ultimately unpredictable functional and aesthetic results. However, despite counselling, some parents may not accept amputation due to social, cultural, or personal reasons. Moreover, in cases of severe macrosyndactyly of the two central fingers, ray resection would either leave an aesthetically unpleasing cleft or, with cleft closure, would narrow the span of the palm and limit the ability to grasp large objects. We present the long-term functional outcomes of two cases of staged reconstruction of severe complex macrosyndactyly. Both patients initially presented before 1 year of age with complete syndactyly of the enlarged middle and ring fingers with synonychia (Figure 1). There were no remarkable prenatal or postnatal events. Plain radiographs showed fused distal phalanges. Treatment options were discussed, and both families declined ray resections. Therefore, staged reconstruction was performed. In the first stage, the syndactylized digits were shortened. A dorsal incision was used to excise the enlarged distal and middle phalanges to the level of the tips of the normal fingers, preserving a sufficient volar flap for coverage. Free nail bed grafts from the distal amputated part were placed on de-epithelialized dermis at the appropriate recipient position (Sabapathy et al., 1990). In the second stage, syndactyly separation was performed using a dorsal skin flap to reconstruct the web commissure, interdigitating flaps on the lateral aspects of the digits to avoid scar contractures, and fullthickness skin grafts over exposed fat. Subsequent stages focused on debulking the width of the digits, which involved cortical thinning of the phalanx, reduction of the width of the nail bed, and extraarticular wedge resections to correct angular deformities. No wound healing or flap complications occurred. At final follow-up, 11 and 7 years after reconstruction, Patient-Reported Outcomes Measurement Information System Upper Extremity score was 57 and 41, respectively. Paediatric Outcomes Data ","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419890542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44963216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-03DOI: 10.1177/1753193419889299
A. Nicholls, I. Hargreaves, D. Wheen
SNAC arthritis, cases occurring on the dominant side and remaining factors of preoperative golf participation (typical score on par-72 course, rounds played and hours practiced per year) (p> 0.05). In conclusion, this study found similar return to golf results between PRC and FCA. Quite encouraging, is that a majority of patients who returned to golf felt they were performing better and no patients felt they were performing at a worse level than before surgery. However, while an approximately 80% rate of return to golf appears encouraging, it also means that up to 20% of previously avid golfers were unable to return postoperatively and therefore had worse golf participation, without major complications to explain their inability to return. Our post hoc analysis suggests that younger patients and those with established handicaps can be advised that they may have the highest likelihood of returning to golf. Surgeons can utilize this information to set appropriate patient expectations. Declaration of conflicting interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
{"title":"Vascularized medial femoral condyle flap harvest adjacent to total knee arthroplasty: a case report","authors":"A. Nicholls, I. Hargreaves, D. Wheen","doi":"10.1177/1753193419889299","DOIUrl":"https://doi.org/10.1177/1753193419889299","url":null,"abstract":"SNAC arthritis, cases occurring on the dominant side and remaining factors of preoperative golf participation (typical score on par-72 course, rounds played and hours practiced per year) (p> 0.05). In conclusion, this study found similar return to golf results between PRC and FCA. Quite encouraging, is that a majority of patients who returned to golf felt they were performing better and no patients felt they were performing at a worse level than before surgery. However, while an approximately 80% rate of return to golf appears encouraging, it also means that up to 20% of previously avid golfers were unable to return postoperatively and therefore had worse golf participation, without major complications to explain their inability to return. Our post hoc analysis suggests that younger patients and those with established handicaps can be advised that they may have the highest likelihood of returning to golf. Surgeons can utilize this information to set appropriate patient expectations. Declaration of conflicting interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419889299","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48112452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-02DOI: 10.1177/1753193419889297
M. Vanhees, Nicholas D Cardillo, M. Hile
Hodgkinson PD. The use of skeletal traction to correct the flexed PIP joint in Dupuytren’s disease. A pilot study to assess the use of the Pipster. J Hand Surg Br. 1994, 19: 534–7. Messina A, Messina J. The TEC treatment (continuous extension technique) for severe Dupuytren’s contracture of the fingers. Ann Hand Upper Limb Surg. 1991, 10: 247–50. Messina JC, Messina A. Indications of the continuous extension technique (TEC) for severe Dupuytren Disease and recurrences. In: Werker PMN, Dias J, Eaton C, Reichert B, Wach W (eds) Dupuytren Disease and Related Diseases – The Cutting Edge. Switzerland, Springer International Publishing, 2017: 311–6. Rajesh KR, Rex C, Mehdi H, Martin C, Fahmy NRM. Severe Dupuytren’s contracture of the proximal interphalangeal joint: treatment by two-stage technique. J Hand Surg Br. 2000, 25: 442–4.
{"title":"The effect of knot position in Adelaide flexor tendon repairs","authors":"M. Vanhees, Nicholas D Cardillo, M. Hile","doi":"10.1177/1753193419889297","DOIUrl":"https://doi.org/10.1177/1753193419889297","url":null,"abstract":"Hodgkinson PD. The use of skeletal traction to correct the flexed PIP joint in Dupuytren’s disease. A pilot study to assess the use of the Pipster. J Hand Surg Br. 1994, 19: 534–7. Messina A, Messina J. The TEC treatment (continuous extension technique) for severe Dupuytren’s contracture of the fingers. Ann Hand Upper Limb Surg. 1991, 10: 247–50. Messina JC, Messina A. Indications of the continuous extension technique (TEC) for severe Dupuytren Disease and recurrences. In: Werker PMN, Dias J, Eaton C, Reichert B, Wach W (eds) Dupuytren Disease and Related Diseases – The Cutting Edge. Switzerland, Springer International Publishing, 2017: 311–6. Rajesh KR, Rex C, Mehdi H, Martin C, Fahmy NRM. Severe Dupuytren’s contracture of the proximal interphalangeal joint: treatment by two-stage technique. J Hand Surg Br. 2000, 25: 442–4.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419889297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42231728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-02DOI: 10.1177/1753193419889504
M. Tonkin
The trapeziometacarpal (TMC) joint allows movement in extension/flexion (alternatively termed radial abduction/adduction) in the frontal plane; abduction/adduction (alternatively, antepulsion/retropulsion) in the sagittal plane; and supination/pronation (rotation around the longitudinal thumb axis) (Figure 1). The first two are angular movements and the third is an axial rotation. I prefer to use the terminology extension/flexion and abduction/adduction for movements in the frontal and sagittal planes, and not those in brackets. Nevertheless, both are used by different authors. Circumduction is the path followed by the thumb in movement from full supination of 30 (reposition); to neutral rotation of 0 when the thumbnail is at 90 to the frontal plane with 20 of extension and 30 of abduction (neutral position); to full pronation of 90 with the thumbnail parallel to the frontal plane of the palm (opposition) (Figure 1).
{"title":"Thumb opposition: its definition and my approach to its measurement","authors":"M. Tonkin","doi":"10.1177/1753193419889504","DOIUrl":"https://doi.org/10.1177/1753193419889504","url":null,"abstract":"The trapeziometacarpal (TMC) joint allows movement in extension/flexion (alternatively termed radial abduction/adduction) in the frontal plane; abduction/adduction (alternatively, antepulsion/retropulsion) in the sagittal plane; and supination/pronation (rotation around the longitudinal thumb axis) (Figure 1). The first two are angular movements and the third is an axial rotation. I prefer to use the terminology extension/flexion and abduction/adduction for movements in the frontal and sagittal planes, and not those in brackets. Nevertheless, both are used by different authors. Circumduction is the path followed by the thumb in movement from full supination of 30 (reposition); to neutral rotation of 0 when the thumbnail is at 90 to the frontal plane with 20 of extension and 30 of abduction (neutral position); to full pronation of 90 with the thumbnail parallel to the frontal plane of the palm (opposition) (Figure 1).","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419889504","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43986614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.1177/1753193419889307
Hero J. A. Zijlker, K. Harmsen, S. Strackee
demonstrated, however, that the knot outside the repair was stronger only early in the healing process; they found no difference between inside and outside knot repair strength 6 weeks after. Recently, a knotless, asymmetric repair was reported to be even stronger compared with the Lim/Tsai configuration, highlighting that the knot was the weakest link in flexor tendon repairs (Lim et al., 2018). There are several limitations to this study. First, we did not add an epitendinous suture to our repair configurations before testing. This was done on purpose to avoid extra variables when analysing the results, but might not truly reflect the flexor tendon repair configurations used in vivo. Second, this is a basic science study, and the ex vivo setup might not mimic the in vivo environment. The knot position outside of the repair zone might be more prone to adhesions compared with the inside position, whereas the inside position causes decreased tendon-to-tendon contact in vivo. Lastly, the repair constructs were loaded to failure and did not undergo cyclic testing.
{"title":"Partial flexor carpi radialis tendon transfer technique for midcarpal instability","authors":"Hero J. A. Zijlker, K. Harmsen, S. Strackee","doi":"10.1177/1753193419889307","DOIUrl":"https://doi.org/10.1177/1753193419889307","url":null,"abstract":"demonstrated, however, that the knot outside the repair was stronger only early in the healing process; they found no difference between inside and outside knot repair strength 6 weeks after. Recently, a knotless, asymmetric repair was reported to be even stronger compared with the Lim/Tsai configuration, highlighting that the knot was the weakest link in flexor tendon repairs (Lim et al., 2018). There are several limitations to this study. First, we did not add an epitendinous suture to our repair configurations before testing. This was done on purpose to avoid extra variables when analysing the results, but might not truly reflect the flexor tendon repair configurations used in vivo. Second, this is a basic science study, and the ex vivo setup might not mimic the in vivo environment. The knot position outside of the repair zone might be more prone to adhesions compared with the inside position, whereas the inside position causes decreased tendon-to-tendon contact in vivo. Lastly, the repair constructs were loaded to failure and did not undergo cyclic testing.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419889307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42147293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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