Pub Date : 2022-03-08DOI: 10.1177/17531934221078685
G. Georgiev
I read this article with interest. The authors described a case of an accessory muscle as a possible cause of ulnar nerve compression proximal to the cubital canal. However, I would like to make my modest comments about the reported accessory muscle. The authors correctly point out that this muscle does not have the anatomical features of the anconeus epitrochlearis muscle and was more proximal in location. However, I think that when the authors accept a variant muscle as a possible cause of nerve compression, they need to be clearer and should make a proposal about the possible name of the muscular variation or explain to which muscle it belongs. As pointed out by Georgiev et al. (2017), the lack of knowledge of the variant muscle discovered at surgical intervention could be (1) scarcely presented clinical reports, (2) rarity of the reported structure and (3) limited approach during decompression surgery. I would like to add another cause: a limited knowledge about anatomical variations. According to me, when accepting a variant muscle, three important things should be born in mind: (1) location, (2) insertions and (3) function. In the article of Wright et al. (2021) the approach is not limited and gives wide visualization of the muscular variant and the authors could clearly determine it. In my opinion, it could be speculated that the possible cause of ulnar nerve compression in the reported case is accessory slip from the triceps brachii muscle. Accessory slip from triceps brachii, although rare, is clearly described in the work of Swamy et al. (2013). Moreover, a clinical case of ulnar nerve compression by additional slips of the triceps brachii has also been described by Kim et al. (2016). In conclusion, I think that when considering variant muscle entrapment neuropathy, the authors should make a proposal about the muscle to which it belongs, rather than only report an accessory muscle. Anatomy is a very old science, and precise knowledge of different anatomical variations is mandatory for experienced surgeons.
{"title":"Re: Wright H, Fahmy M, Bourke G. An accessory muscle as the possible cause of ulnar nerve compression proximal to the cubital canal: a case report. J Hand Surg Eur. 2021, 46: 1114–5","authors":"G. Georgiev","doi":"10.1177/17531934221078685","DOIUrl":"https://doi.org/10.1177/17531934221078685","url":null,"abstract":"I read this article with interest. The authors described a case of an accessory muscle as a possible cause of ulnar nerve compression proximal to the cubital canal. However, I would like to make my modest comments about the reported accessory muscle. The authors correctly point out that this muscle does not have the anatomical features of the anconeus epitrochlearis muscle and was more proximal in location. However, I think that when the authors accept a variant muscle as a possible cause of nerve compression, they need to be clearer and should make a proposal about the possible name of the muscular variation or explain to which muscle it belongs. As pointed out by Georgiev et al. (2017), the lack of knowledge of the variant muscle discovered at surgical intervention could be (1) scarcely presented clinical reports, (2) rarity of the reported structure and (3) limited approach during decompression surgery. I would like to add another cause: a limited knowledge about anatomical variations. According to me, when accepting a variant muscle, three important things should be born in mind: (1) location, (2) insertions and (3) function. In the article of Wright et al. (2021) the approach is not limited and gives wide visualization of the muscular variant and the authors could clearly determine it. In my opinion, it could be speculated that the possible cause of ulnar nerve compression in the reported case is accessory slip from the triceps brachii muscle. Accessory slip from triceps brachii, although rare, is clearly described in the work of Swamy et al. (2013). Moreover, a clinical case of ulnar nerve compression by additional slips of the triceps brachii has also been described by Kim et al. (2016). In conclusion, I think that when considering variant muscle entrapment neuropathy, the authors should make a proposal about the muscle to which it belongs, rather than only report an accessory muscle. Anatomy is a very old science, and precise knowledge of different anatomical variations is mandatory for experienced surgeons.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48635950","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 : 2022-03-07DOI: 10.1177/17531934221083815
M. Villanueva, Á. Iborra, H. Fahandezh-Saddi, P. Sanz-Ruíz, Concepción Noriega
This study describes a new ultrasound-guided surgical technique for aponeurotomy and interphalangeal joint capsular release in patients with Dupuytren’s disease and analyses the clinical outcomes. We carried out a retrospective review of 70 digits in 35 patients who underwent ultrasound-guided aponeurotomy and interphalangeal joint capsular release, with a minimum follow-up of 2 years. The primary outcome was the correction of the deformity and the QuickDASH questionnaire score after surgery and at 1 and 2 years. The secondary outcome was the presence of residual contracture immediately after surgery. The mean QuickDASH score fell from 28 before surgery to 14 after surgery. A significant decrease of −63° was observed for the global contracture, −35° the metacarpophalangeal joint contracture and −28° for the proximal interphalangeal joint contracture. Ultrasound-guided aponeurotomy and interphalangeal joint capsular and palmar plate releases are highly accurate and safe. Level of evidence: IV
{"title":"Ultrasound-guided aponeurotomy and interphalangeal joint capsular release for treatment of Dupuytren’s disease","authors":"M. Villanueva, Á. Iborra, H. Fahandezh-Saddi, P. Sanz-Ruíz, Concepción Noriega","doi":"10.1177/17531934221083815","DOIUrl":"https://doi.org/10.1177/17531934221083815","url":null,"abstract":"This study describes a new ultrasound-guided surgical technique for aponeurotomy and interphalangeal joint capsular release in patients with Dupuytren’s disease and analyses the clinical outcomes. We carried out a retrospective review of 70 digits in 35 patients who underwent ultrasound-guided aponeurotomy and interphalangeal joint capsular release, with a minimum follow-up of 2 years. The primary outcome was the correction of the deformity and the QuickDASH questionnaire score after surgery and at 1 and 2 years. The secondary outcome was the presence of residual contracture immediately after surgery. The mean QuickDASH score fell from 28 before surgery to 14 after surgery. A significant decrease of −63° was observed for the global contracture, −35° the metacarpophalangeal joint contracture and −28° for the proximal interphalangeal joint contracture. Ultrasound-guided aponeurotomy and interphalangeal joint capsular and palmar plate releases are highly accurate and safe. Level of evidence: IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47853673","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 : 2022-03-07DOI: 10.1177/17531934221084628
Galip Gencay Üstün, Fethiye Damla Menkü Özdemir, A. Aksu
{"title":"Outcomes after flexor tendon injuries in children: the impact of parental education","authors":"Galip Gencay Üstün, Fethiye Damla Menkü Özdemir, A. Aksu","doi":"10.1177/17531934221084628","DOIUrl":"https://doi.org/10.1177/17531934221084628","url":null,"abstract":"","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46318692","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 : 2022-03-07DOI: 10.1177/17531934221084171
Rui Barbeiro Gonçalves, Joana Ovídio, P. Jordão
Isolated physeal fractures in the pediatric distal ulna are relatively uncommon. While the skeletally immature patient generally has higher remodeling potential than adults, special considerations should be given to the pediatric wrist. We report the case of a 15-year-old male with an isolated Salter-Harris (SH) type IV distal ulna fracture.
{"title":"Isolated Salter-Harris Type IV distal ulna fracture: a case report","authors":"Rui Barbeiro Gonçalves, Joana Ovídio, P. Jordão","doi":"10.1177/17531934221084171","DOIUrl":"https://doi.org/10.1177/17531934221084171","url":null,"abstract":"Isolated physeal fractures in the pediatric distal ulna are relatively uncommon. While the skeletally immature patient generally has higher remodeling potential than adults, special considerations should be given to the pediatric wrist. We report the case of a 15-year-old male with an isolated Salter-Harris (SH) type IV distal ulna fracture.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42601433","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 : 2022-03-02DOI: 10.1177/17531934221082412
B. Haddad, Solal Benhamou, E. David, C. Klein
Cannata G, de Maio F, Mancini F, Ippolito E. Physeal fractures of the distal radius and ulna: long-term prognosis. J Orthop Trauma. 2003, 17: 172–9. Kasis AG, Hekal WEA, Mubashir A. Isolated Salter-Harris Type IV fracture of the distal ulna in a 12-year-old boy. Eur J Trauma. 2004, 30: 127–9. Marrannes S, Lambrecht D, Decramer A. Reduction of an unusual Salter-Harris Type IV fracture of the ulna. Case Rep Orthop. 2020, 2020: 8498401. O’Hagan T, Hussain WG, Bielski RJ. A complex injury of the distal ulnar physis: a case report and brief review of the literature. Am J Orthop. 2012, 41: E1–E3.
canata G, de Maio F, Mancini F, Ippolito E.桡骨和尺骨远端骨折的远期预后。[J]中华骨科杂志，2003,17(7):391 - 391。Kasis AG, Hekal WEA, Mubashir a .一例12岁男孩尺骨远端孤立性Salter-Harris IV型骨折。中华创伤杂志，2004,30:127-9。Marrannes S, Lambrecht D, Decramer A.罕见的Salter-Harris型尺骨骨折复位。病例Rep骨科，2020,2020:8498401。刘建军，刘建军，刘建军，等。复杂损伤的远尺物理:一个病例报告和简要回顾的文献。[J]中华骨科杂志，2012,41(1):1 - 3。
{"title":"The value of preserving the full middle phalanx in distal long finger amputations: A series of 59 cases","authors":"B. Haddad, Solal Benhamou, E. David, C. Klein","doi":"10.1177/17531934221082412","DOIUrl":"https://doi.org/10.1177/17531934221082412","url":null,"abstract":"Cannata G, de Maio F, Mancini F, Ippolito E. Physeal fractures of the distal radius and ulna: long-term prognosis. J Orthop Trauma. 2003, 17: 172–9. Kasis AG, Hekal WEA, Mubashir A. Isolated Salter-Harris Type IV fracture of the distal ulna in a 12-year-old boy. Eur J Trauma. 2004, 30: 127–9. Marrannes S, Lambrecht D, Decramer A. Reduction of an unusual Salter-Harris Type IV fracture of the ulna. Case Rep Orthop. 2020, 2020: 8498401. O’Hagan T, Hussain WG, Bielski RJ. A complex injury of the distal ulnar physis: a case report and brief review of the literature. Am J Orthop. 2012, 41: E1–E3.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45209325","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 : 2022-02-28DOI: 10.1177/17531934221081803
C. Harrison, A. D. Clelland, T. Davis, B. Scammell, Weiya Zhang, P. Russell, S. Fullilove, I. Chakrabarti, D. Davidson, J. Rodrigues
The QuickDASH is a short-form version of the DASH questionnaire, the most widely used patient-reported outcome measure in hand surgery. Multidimensional computerized adaptive testing (MCAT) can produce shorter and more precise testing than static short forms, like QuickDASH. We used DASH responses from 507 patients with Dupuytren’s disease to develop a MCAT. The algorithm was evaluated in a Monte Carlo simulation, where the standard error of measurement (SEm) of scores obtained from the 11-item QuickDASH was compared with scores obtained from an MCAT that could administer up to 11 items from the full 30-item DASH. The MCAT asked a mean of 8.51 items (SD 2.93) and 265/1000 simulated respondents needed to complete ≤five items. Median SEms were better for DASH MCAT: 0.299 (hand function) and 0.256 (sensory symptoms) versus 0.320 and 0.290, respectively, for QuickDASH. Our study showed that the DASH MCAT can produce more precise DASH measurement than the QuickDASH, from fewer items.
{"title":"A comparative analysis of multidimensional computerized adaptive testing for the DASH and QuickDASH scores in Dupuytren’s disease","authors":"C. Harrison, A. D. Clelland, T. Davis, B. Scammell, Weiya Zhang, P. Russell, S. Fullilove, I. Chakrabarti, D. Davidson, J. Rodrigues","doi":"10.1177/17531934221081803","DOIUrl":"https://doi.org/10.1177/17531934221081803","url":null,"abstract":"The QuickDASH is a short-form version of the DASH questionnaire, the most widely used patient-reported outcome measure in hand surgery. Multidimensional computerized adaptive testing (MCAT) can produce shorter and more precise testing than static short forms, like QuickDASH. We used DASH responses from 507 patients with Dupuytren’s disease to develop a MCAT. The algorithm was evaluated in a Monte Carlo simulation, where the standard error of measurement (SEm) of scores obtained from the 11-item QuickDASH was compared with scores obtained from an MCAT that could administer up to 11 items from the full 30-item DASH. The MCAT asked a mean of 8.51 items (SD 2.93) and 265/1000 simulated respondents needed to complete ≤five items. Median SEms were better for DASH MCAT: 0.299 (hand function) and 0.256 (sensory symptoms) versus 0.320 and 0.290, respectively, for QuickDASH. Our study showed that the DASH MCAT can produce more precise DASH measurement than the QuickDASH, from fewer items.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41745319","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 : 2022-02-28DOI: 10.1177/17531934221080952
I. Quintero, E. Buitrago, L. Ballesteros
We describe the patterns of motor branches to the elbow flexors in 106 fresh-frozen cadaveric upper extremities from 53 donors of the Latin American mestizo race. We identified a 20% incidence of an accessory biceps head. The innervation patterns to this accessory head were specifically described and added to the Yang classification as Type IV for the biceps and Type III for the brachialis. The patterns arising from the musculocutaneous nerve to the biceps brachii were of Type I in 69%, Type II in 9%, Type III in 7% and Type IV in 11%, and to the brachialis of Type I in 77%, Type II in 11% and Type III in 9%. In 4%, the branches did not originate from the musculocutaneous nerve. We hypothesize that the branch to the accessory biceps head might be considered as a donor for nerve transfer in selected brachial plexus injuries.
{"title":"The innervation of the biceps brachii and brachialis muscles in specimens with a high incidence of an accessory biceps head","authors":"I. Quintero, E. Buitrago, L. Ballesteros","doi":"10.1177/17531934221080952","DOIUrl":"https://doi.org/10.1177/17531934221080952","url":null,"abstract":"We describe the patterns of motor branches to the elbow flexors in 106 fresh-frozen cadaveric upper extremities from 53 donors of the Latin American mestizo race. We identified a 20% incidence of an accessory biceps head. The innervation patterns to this accessory head were specifically described and added to the Yang classification as Type IV for the biceps and Type III for the brachialis. The patterns arising from the musculocutaneous nerve to the biceps brachii were of Type I in 69%, Type II in 9%, Type III in 7% and Type IV in 11%, and to the brachialis of Type I in 77%, Type II in 11% and Type III in 9%. In 4%, the branches did not originate from the musculocutaneous nerve. We hypothesize that the branch to the accessory biceps head might be considered as a donor for nerve transfer in selected brachial plexus injuries.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45581593","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 : 2021-06-01DOI: 10.1177/1753193420984924
{"title":"European Board of Hand Surgery Diploma Examination 2020 (14–15 November 2020, Online event)","authors":"","doi":"10.1177/1753193420984924","DOIUrl":"https://doi.org/10.1177/1753193420984924","url":null,"abstract":"","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193420984924","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41691123","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 : 2021-03-24DOI: 10.1177/17531934211003027
G. Giddins
When I started reading ‘Bones’, I thought I knew a lot about them; by the time I had finished I realized that my ignorance was vastly greater than my knowledge. This is a treasure trove of information written by an enthusiast who clearly loves his subject and has studied it over decades. It is a well-structured book divided into two main halves. The first entitled ‘Bone concealed’ and the second ‘Bone revealed’. Bone concealed has nine chapters looking at the biology of bone; how it fails, its treatments through time and orthopaedic innovations, both mechanical and biological, undertaken to address these. The majority is about bone biology, with particular reference to the bones and development in other animals and comparison with humans. It provides a very interesting and easily digestible update on bone structure and biology. The author starts at the cellular/molecular levels, up through Haversian canals and onto the cylindrical structure of many bones to build his argument about bone being the ‘world’s best building material’. This applies both to humans and all animals with an endoskeleton. He identifies many specific roles of bones in other animals and very clearly discusses the merits of chitin exoskeletons versus bony endoskeletons. The chapters on bone pathology and its treatment will be well known to surgeons, but fascinating for the lay reader. His choice of ‘Six orthopaedic giants’ for Chapter 6 is of course subjective, but well argued. I found the second half of the book about ‘Bone revealed’ more interesting, probably because I knew so much less about it. The author delves into anthropology, illustrating what can be learnt about humans from skeletal remains and how the story of our origins has changed repeatedly with new discoveries, including the deceit of the Piltdown Man. He also includes some of the complex story of the dinosaurs, as well as the unedifying bickering between the leading dinosaur palaeontologists, Othneil Marsh and Edward Cope, in the 19th Century; their mutual animosity seems to have been boundless. There are fascinating chapters on the historical use of bones in a domestic setting and for war, contrasted with bones as a medium for art in many cultures, even today. These chapters are particularly well supplemented by some fascinating photos. This was a book I enjoyed reading, re-reading for review and will enjoy dipping into in the future. I congratulate Roy Meals, Assistant Editor of this Journal, for a unique and fascinating book.
{"title":"BONES inside and out","authors":"G. Giddins","doi":"10.1177/17531934211003027","DOIUrl":"https://doi.org/10.1177/17531934211003027","url":null,"abstract":"When I started reading ‘Bones’, I thought I knew a lot about them; by the time I had finished I realized that my ignorance was vastly greater than my knowledge. This is a treasure trove of information written by an enthusiast who clearly loves his subject and has studied it over decades. It is a well-structured book divided into two main halves. The first entitled ‘Bone concealed’ and the second ‘Bone revealed’. Bone concealed has nine chapters looking at the biology of bone; how it fails, its treatments through time and orthopaedic innovations, both mechanical and biological, undertaken to address these. The majority is about bone biology, with particular reference to the bones and development in other animals and comparison with humans. It provides a very interesting and easily digestible update on bone structure and biology. The author starts at the cellular/molecular levels, up through Haversian canals and onto the cylindrical structure of many bones to build his argument about bone being the ‘world’s best building material’. This applies both to humans and all animals with an endoskeleton. He identifies many specific roles of bones in other animals and very clearly discusses the merits of chitin exoskeletons versus bony endoskeletons. The chapters on bone pathology and its treatment will be well known to surgeons, but fascinating for the lay reader. His choice of ‘Six orthopaedic giants’ for Chapter 6 is of course subjective, but well argued. I found the second half of the book about ‘Bone revealed’ more interesting, probably because I knew so much less about it. The author delves into anthropology, illustrating what can be learnt about humans from skeletal remains and how the story of our origins has changed repeatedly with new discoveries, including the deceit of the Piltdown Man. He also includes some of the complex story of the dinosaurs, as well as the unedifying bickering between the leading dinosaur palaeontologists, Othneil Marsh and Edward Cope, in the 19th Century; their mutual animosity seems to have been boundless. There are fascinating chapters on the historical use of bones in a domestic setting and for war, contrasted with bones as a medium for art in many cultures, even today. These chapters are particularly well supplemented by some fascinating photos. This was a book I enjoyed reading, re-reading for review and will enjoy dipping into in the future. I congratulate Roy Meals, Assistant Editor of this Journal, for a unique and fascinating book.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/17531934211003027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47076225","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 : 2020-12-01DOI: 10.1177/1753193420975675
M. Bamal, P. McArthur
Aims: 1) To evaluate the incidence of non-union, malunion, broken implants, peri-prosthetic fracture, loosening and implant removal. 2) To evaluate improvement in wrist position, hygiene and patient satisfaction. Methods: This is a retrospective review of our patients who underwent wrist fusion for spasticupper limbs secondary to cerebral palsy or stroke. The implant used was a variable angle locking distal radius plate with standard dorsal approach to wrist and carpometacarpal (CMC) joints were not bridged. Proximal row carpectomy (PRC) was performed in all cases and extensor pollicis (EPL) tendon was left subcutaneous. Patients were followed up for assessing complication rates, bony union and overall satisfaction. Visual analogue scale (VAS) was used to assess patient-reported outcomes. Results: Eight wrist arthrodesis were performed over a period of two years in seven patients. Mean age of patients was 26 years and mean follow up is 10 months. Indications for surgery were wrist position producing difficulties. Mean pre-operative wrist flexion, satisfaction scores across most domains on visual analogue scale showed significant improvement. All wrists demonstrated bony union. No implants had to be removed. There were no complaints of implant prominence, implant or tendon irritation, metacarpal prominence or increased extension. No report of implant loosening or periprosthetic fractures. Conclusions: Implant and surgical technique appear to be safe with a low complication rate. Implant can be considered superior to available standard fusion plates on account of profile and size. Commercial implants should be made available in better designs keeping the above factors in mind especially in view of demonstrable benefits in small size limbs. Base of thumb osteoarthritis (BTOA) in the interface – an analysis of management and service structure
{"title":"BSSH Autumn abstracts","authors":"M. Bamal, P. McArthur","doi":"10.1177/1753193420975675","DOIUrl":"https://doi.org/10.1177/1753193420975675","url":null,"abstract":"Aims: 1) To evaluate the incidence of non-union, malunion, broken implants, peri-prosthetic fracture, loosening and implant removal. 2) To evaluate improvement in wrist position, hygiene and patient satisfaction. Methods: This is a retrospective review of our patients who underwent wrist fusion for spasticupper limbs secondary to cerebral palsy or stroke. The implant used was a variable angle locking distal radius plate with standard dorsal approach to wrist and carpometacarpal (CMC) joints were not bridged. Proximal row carpectomy (PRC) was performed in all cases and extensor pollicis (EPL) tendon was left subcutaneous. Patients were followed up for assessing complication rates, bony union and overall satisfaction. Visual analogue scale (VAS) was used to assess patient-reported outcomes. Results: Eight wrist arthrodesis were performed over a period of two years in seven patients. Mean age of patients was 26 years and mean follow up is 10 months. Indications for surgery were wrist position producing difficulties. Mean pre-operative wrist flexion, satisfaction scores across most domains on visual analogue scale showed significant improvement. All wrists demonstrated bony union. No implants had to be removed. There were no complaints of implant prominence, implant or tendon irritation, metacarpal prominence or increased extension. No report of implant loosening or periprosthetic fractures. Conclusions: Implant and surgical technique appear to be safe with a low complication rate. Implant can be considered superior to available standard fusion plates on account of profile and size. Commercial implants should be made available in better designs keeping the above factors in mind especially in view of demonstrable benefits in small size limbs. Base of thumb osteoarthritis (BTOA) in the interface – an analysis of management and service structure","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193420975675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47580437","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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