Pub Date : 2020-10-01DOI: 10.1177/1753193420914762
Aim: To evaluate long-term outcomes of using Ligamentotaxor in treating complex fractures involving the PIP & D IP joints Methods: A retrospective study of all patients treated with Ligamentotaxor for unstable Intra-articular phalangeal fractures in our institution between 2009 and 2018. 29 patients were included and evaluated using both objective (range of motion, and regular X-rays) and subjective QuickDASH score for global function. Out of the 29 Patients, 68% were males and 7% were open injuries. Fractures were classified according to Pélissier’s classification based on the initial radiographs. The average time before surgery was 8–9 days. A gentle active motion was permitted on the day following surgery. Results: An average of 27.5 months (70-12) follow up; Radiological union was achieved in all patients at mean 33 days. The mean QuickDASH score was 8.7.85% of the patients had no limitation of their daily activities and 35 % experience pain on exertion. The mean flexion of the affected digit was 66 degrees and the mean extension deficit was six degrees. Neither secondary subluxation nor complex regional pain syndrome was reported in any of the cases. Only one case of superficial pin tract infection was reported and responded well to one week of oral antibiotics. Cold intolerance and persistent swelling were reported in four cases. Neither of the cases needed revision by fusion nor replacement. Conclusion: Ligamentotaxor is easy and quick to apply by surgeons and well tolerated by patients, and therefore this reliable technique could be relevant for the management of complex PIP and DIP joint fractures. The device allowed adequate fracture reduction, early mobilisation with minimal soft tissue complications.
{"title":"BSSH Spring Meeting Abstracts","authors":"","doi":"10.1177/1753193420914762","DOIUrl":"https://doi.org/10.1177/1753193420914762","url":null,"abstract":"Aim: To evaluate long-term outcomes of using Ligamentotaxor in treating complex fractures involving the PIP & D IP joints Methods: A retrospective study of all patients treated with Ligamentotaxor for unstable Intra-articular phalangeal fractures in our institution between 2009 and 2018. 29 patients were included and evaluated using both objective (range of motion, and regular X-rays) and subjective QuickDASH score for global function. Out of the 29 Patients, 68% were males and 7% were open injuries. Fractures were classified according to Pélissier’s classification based on the initial radiographs. The average time before surgery was 8–9 days. A gentle active motion was permitted on the day following surgery. Results: An average of 27.5 months (70-12) follow up; Radiological union was achieved in all patients at mean 33 days. The mean QuickDASH score was 8.7.85% of the patients had no limitation of their daily activities and 35 % experience pain on exertion. The mean flexion of the affected digit was 66 degrees and the mean extension deficit was six degrees. Neither secondary subluxation nor complex regional pain syndrome was reported in any of the cases. Only one case of superficial pin tract infection was reported and responded well to one week of oral antibiotics. Cold intolerance and persistent swelling were reported in four cases. Neither of the cases needed revision by fusion nor replacement. Conclusion: Ligamentotaxor is easy and quick to apply by surgeons and well tolerated by patients, and therefore this reliable technique could be relevant for the management of complex PIP and DIP joint fractures. The device allowed adequate fracture reduction, early mobilisation with minimal soft tissue complications.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193420914762","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43832802","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 : 2020-07-01DOI: 10.1177/1753193419875899
M. Boeckstyns
The little finger, more than other fingers, may display a tendency to ‘curl’ after trauma or operation with a contracted hyperextension of the MCP joint and flexion of the interphalangeal joints. Although in my country the teaching is that you should immobilize the finger in the intrinsic plus position to avoid this problem, I believe that this is over-advised and over-used. I have encountered very few cases with contracture after longstanding immobilization, and I challenge the dogma that casting the fingers in the intrinsic plus position is mandatory. I consider the concept of safe-position as one among many examples of theoretical biomechanical considerations that lack clinical verification (Tang, 2019). My experience is that if immobilization in extrinsic plus is attempted, the hand almost always spontaneously slides into a more comfortable position with less MCP joint flexion in the plaster cast. For me, the key point is mobilization of the fingers before fracture healing is achieved and ensuring that the exercises are properly executed. In treating hand disorders, I use immobilization in a near ‘safe’ position in only a few situations, for example moderate MCP joint flexion of 40 –60 after flexor tendon reconstruction in the fingers. However, again as far as possible, I start with immediate or at least very early mobilization.
{"title":"Questions about the treatment of the fractures around the fifth metacarpophalangeal joint","authors":"M. Boeckstyns","doi":"10.1177/1753193419875899","DOIUrl":"https://doi.org/10.1177/1753193419875899","url":null,"abstract":"The little finger, more than other fingers, may display a tendency to ‘curl’ after trauma or operation with a contracted hyperextension of the MCP joint and flexion of the interphalangeal joints. Although in my country the teaching is that you should immobilize the finger in the intrinsic plus position to avoid this problem, I believe that this is over-advised and over-used. I have encountered very few cases with contracture after longstanding immobilization, and I challenge the dogma that casting the fingers in the intrinsic plus position is mandatory. I consider the concept of safe-position as one among many examples of theoretical biomechanical considerations that lack clinical verification (Tang, 2019). My experience is that if immobilization in extrinsic plus is attempted, the hand almost always spontaneously slides into a more comfortable position with less MCP joint flexion in the plaster cast. For me, the key point is mobilization of the fingers before fracture healing is achieved and ensuring that the exercises are properly executed. In treating hand disorders, I use immobilization in a near ‘safe’ position in only a few situations, for example moderate MCP joint flexion of 40 –60 after flexor tendon reconstruction in the fingers. However, again as far as possible, I start with immediate or at least very early mobilization.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419875899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48047160","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 : 2020-06-01DOI: 10.1177/1753193419871660
M. Martin-Ferrero, C. Simón-Pérez, M. B. Coco-Martín, Aureliio Vega-Castrillo, H. Aguado-Hernández, A. Mayo-Íscar
We report outcomes of 228 consecutive patients with total joint arthroplasty using the Arpe® prosthesis, among which 216 trapeziometacarpal joints in 199 patients had a minimum of 10 years follow-up. The cumulative survival rate of the 216 implants at 10 years using the Kaplan–Meyer method was 93%. Two hundred joints were functional and painless. We found good integration and positioning of the components in 184 (93%) of the joints. Sixteen prostheses failed. We conclude that this implant has acceptable long-term survival rate and restores good hand function. We also report our methods to improve implant survival and to decrease the risk of component malpositioning, and failure rate. Level of evidence: II
{"title":"Trapeziometacarpal total joint arthroplasty for osteoarthritis: 199 patients with a minimum of 10 years follow-up","authors":"M. Martin-Ferrero, C. Simón-Pérez, M. B. Coco-Martín, Aureliio Vega-Castrillo, H. Aguado-Hernández, A. Mayo-Íscar","doi":"10.1177/1753193419871660","DOIUrl":"https://doi.org/10.1177/1753193419871660","url":null,"abstract":"We report outcomes of 228 consecutive patients with total joint arthroplasty using the Arpe® prosthesis, among which 216 trapeziometacarpal joints in 199 patients had a minimum of 10 years follow-up. The cumulative survival rate of the 216 implants at 10 years using the Kaplan–Meyer method was 93%. Two hundred joints were functional and painless. We found good integration and positioning of the components in 184 (93%) of the joints. Sixteen prostheses failed. We conclude that this implant has acceptable long-term survival rate and restores good hand function. We also report our methods to improve implant survival and to decrease the risk of component malpositioning, and failure rate. Level of evidence: II","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419871660","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41470903","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 : 2020-05-01DOI: 10.1177/1753193419879567
Uldis Krustiņš, J. Krustiņš, Diāna Bringina, Kristine Laurane, A. Jumtins
This article presents the results of a prospective cohort study that included 63 patients with intra-articular (AO Type C) distal radial fractures who were treated using an arthroscopically assisted approach with either volar locking plates or external fixator and K-wires. Postoperative analysis was carried out using X-ray assessment, clinical data, Patient-Rated Wrist Evaluation score, Gartland and Werley score, Modern Activity Subjective Survey of 2007 score, range of motion, grip, pinch and tripod pinch assessment at 1, 3, 6 and 12 months postoperatively. Despite the statistically significant differences found in a number of parameters during the period of observation, there were no clinically relevant differences determined between the two methods. There was a greater number of complications in the external fixator and K-wire treated patients. Level of evidence: II
{"title":"Comparison of volar locking plates with external fixation and K-wires in arthroscopically assisted intra-articular distal radial fracture fixation","authors":"Uldis Krustiņš, J. Krustiņš, Diāna Bringina, Kristine Laurane, A. Jumtins","doi":"10.1177/1753193419879567","DOIUrl":"https://doi.org/10.1177/1753193419879567","url":null,"abstract":"This article presents the results of a prospective cohort study that included 63 patients with intra-articular (AO Type C) distal radial fractures who were treated using an arthroscopically assisted approach with either volar locking plates or external fixator and K-wires. Postoperative analysis was carried out using X-ray assessment, clinical data, Patient-Rated Wrist Evaluation score, Gartland and Werley score, Modern Activity Subjective Survey of 2007 score, range of motion, grip, pinch and tripod pinch assessment at 1, 3, 6 and 12 months postoperatively. Despite the statistically significant differences found in a number of parameters during the period of observation, there were no clinically relevant differences determined between the two methods. There was a greater number of complications in the external fixator and K-wire treated patients. Level of evidence: II","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419879567","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49251012","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 : 2020-05-01DOI: 10.1177/1753193419866128
C. Selles, M. Mulders, J. Colaris, M. van Heijl, B. Cleffken, N. Schep
The aim of this study was to determine the difference in functional outcomes after open reduction and internal fixation (ORIF) with and without arthroscopic debridement in adults with displaced intra-articular distal radius fractures. In this multicentre trial, 50 patients were randomized between ORIF with or without arthroscopic debridement. The primary outcome measure was the Patient-Rated Wrist Evaluation (PRWE) score. Secondary outcome measures were Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, pain scores, range of wrist motion, grip strength, and complications. Median PRWE was worse for the intervention group at 3 months and was equal for both groups at 12 months. The secondary outcome measures did not show consistent patterns of differences at different time-points of follow-up. We conclude that patients treated with additional arthroscopy to remove intra-articular hematoma and debris did not have better outcomes than those treated with ORIF alone. We therefore do not recommend arthroscopy for removal of hematoma and debris when surgically fixing distal radius fractures. Level of evidence: I
{"title":"Arthroscopic debridement does not enhance surgical treatment of intra-articular distal radius fractures: a randomized controlled trial","authors":"C. Selles, M. Mulders, J. Colaris, M. van Heijl, B. Cleffken, N. Schep","doi":"10.1177/1753193419866128","DOIUrl":"https://doi.org/10.1177/1753193419866128","url":null,"abstract":"The aim of this study was to determine the difference in functional outcomes after open reduction and internal fixation (ORIF) with and without arthroscopic debridement in adults with displaced intra-articular distal radius fractures. In this multicentre trial, 50 patients were randomized between ORIF with or without arthroscopic debridement. The primary outcome measure was the Patient-Rated Wrist Evaluation (PRWE) score. Secondary outcome measures were Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, pain scores, range of wrist motion, grip strength, and complications. Median PRWE was worse for the intervention group at 3 months and was equal for both groups at 12 months. The secondary outcome measures did not show consistent patterns of differences at different time-points of follow-up. We conclude that patients treated with additional arthroscopy to remove intra-articular hematoma and debris did not have better outcomes than those treated with ORIF alone. We therefore do not recommend arthroscopy for removal of hematoma and debris when surgically fixing distal radius fractures. Level of evidence: I","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419866128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46972866","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 : 2020-05-01DOI: 10.1177/1753193419866382
P. Masouros, E. Apergis, A. Mavrogenis, G. Babis, Dendi K Artemi, V. Nikolaou
Reconstruction of the interosseous membrane has the potential to re-establish a normal loading pattern through the forearm and enhance stability after an Essex-Lopresti lesion. The aim of our study was to assess the capacity of three different techniques, which all use a regionally harvested autograft, to restore longitudinal stability. Simulation of the Essex-Lopresti lesion was done by excising the radial head and sectioning the interosseous membrane in seven cadaveric specimens. Each technique was used in each specimen consecutively, using the pronator teres, the brachioradialis and the flexor carpi radialis tendons, respectively. The specimens were submitted to mechanical testing by applying proximally migratory forces to the radius and radioulnar displacement was assessed fluroscopically at wrist level. The pronator teres tendon achieved the greatest reduction (94% correction with respect to the intact interosseous membrane/radial head out state, followed by brachioradialis (92%) and flexor carpi radialis (85%). However, no statistically significant differences in displacement data or strength were detected between the techniques.
{"title":"Reconstruction of the forearm interosseous membrane: a biomechanical study of three different techniques","authors":"P. Masouros, E. Apergis, A. Mavrogenis, G. Babis, Dendi K Artemi, V. Nikolaou","doi":"10.1177/1753193419866382","DOIUrl":"https://doi.org/10.1177/1753193419866382","url":null,"abstract":"Reconstruction of the interosseous membrane has the potential to re-establish a normal loading pattern through the forearm and enhance stability after an Essex-Lopresti lesion. The aim of our study was to assess the capacity of three different techniques, which all use a regionally harvested autograft, to restore longitudinal stability. Simulation of the Essex-Lopresti lesion was done by excising the radial head and sectioning the interosseous membrane in seven cadaveric specimens. Each technique was used in each specimen consecutively, using the pronator teres, the brachioradialis and the flexor carpi radialis tendons, respectively. The specimens were submitted to mechanical testing by applying proximally migratory forces to the radius and radioulnar displacement was assessed fluroscopically at wrist level. The pronator teres tendon achieved the greatest reduction (94% correction with respect to the intact interosseous membrane/radial head out state, followed by brachioradialis (92%) and flexor carpi radialis (85%). However, no statistically significant differences in displacement data or strength were detected between the techniques.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419866382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47072028","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 : 2020-03-01DOI: 10.1177/1753193419881081
Ö. Cesim, Ç. Öksüz
The aim of the study is to investigate the correlation between cold intolerance and sensory function after repair of nerve transection or decompression of peripheral neuropathy in the upper extremity. We included patients with abnormal cold sensitivity who had a score of 30 or more in the Cold Intolerance Symptom Severity Questionnaire. There were 30 individuals after surgery to repair nerve transection and 30 with compression neuropathy, aged between 18–65 years. We used the Cold Intolerance Symptom Severity Questionnaire to evaluate cold intolerance and the Rosen Score to evaluate sensory function. There was a significant negative correlation between cold intolerance and sensory function in both peripheral nerve transections and compression neuropathies. We conclude that greater cold intolerance is associated with worse sensory function in peripheral nerve injuries. Interventions for sensory function in cold intolerance treatment may reduce the severity of cold intolerance. Level of evidence: III
{"title":"More severe cold intolerance is associated with worse sensory function after peripheral nerve repair or decompression","authors":"Ö. Cesim, Ç. Öksüz","doi":"10.1177/1753193419881081","DOIUrl":"https://doi.org/10.1177/1753193419881081","url":null,"abstract":"The aim of the study is to investigate the correlation between cold intolerance and sensory function after repair of nerve transection or decompression of peripheral neuropathy in the upper extremity. We included patients with abnormal cold sensitivity who had a score of 30 or more in the Cold Intolerance Symptom Severity Questionnaire. There were 30 individuals after surgery to repair nerve transection and 30 with compression neuropathy, aged between 18–65 years. We used the Cold Intolerance Symptom Severity Questionnaire to evaluate cold intolerance and the Rosen Score to evaluate sensory function. There was a significant negative correlation between cold intolerance and sensory function in both peripheral nerve transections and compression neuropathies. We conclude that greater cold intolerance is associated with worse sensory function in peripheral nerve injuries. Interventions for sensory function in cold intolerance treatment may reduce the severity of cold intolerance. Level of evidence: III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419881081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48744252","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 : 2020-03-01DOI: 10.1177/1753193419866646
S. Mackenzie, O. Stone, P. Jenkins, N. Clement, I. Murray, A. Duckworth, J. McEachan
Some patients present with typical clinical features of carpal tunnel syndrome despite normal nerve conduction studies. This study compared the preoperative and 1-year postoperative QuickDASH scores in patients with normal and abnormal nerve conduction studies, who underwent carpal tunnel decompression. Of the 637 patients included in the study, 19 had clinical features of carpal tunnel syndrome but normal nerve conduction studies, and underwent decompression after failure of conservative management. Preoperative QuickDASH scores were comparable in both groups (58 vs 54.8). However, there were significant differences between the normal and abnormal nerve conduction study groups in the QuickDASH at 1 year (34.9 vs 21.5) and change in QuickDASH postoperatively (23.1 vs 33.4). Patients with normal nerve conduction studies had comparable preoperative disability scores compared with those with abnormal studies. Although they had a significant improvement in QuickDASH at 1 year, this was significantly less than those with abnormal nerve conduction studies. Level of evidence: III
尽管神经传导检查正常，一些患者仍表现出典型的腕管综合征的临床特征。本研究比较了行腕管减压术的正常和异常神经传导患者术前和术后1年的QuickDASH评分。在纳入研究的637例患者中，19例具有腕管综合征的临床特征，但神经传导研究正常，在保守治疗失败后接受了减压。两组术前QuickDASH评分具有可比性(58比54.8)。然而，正常和异常神经传导研究组在1年时的QuickDASH (34.9 vs 21.5)和术后QuickDASH的变化(23.1 vs 33.4)之间存在显著差异。神经传导研究正常的患者与研究异常的患者相比，术前残疾评分相当。尽管他们在1年后的QuickDASH有了显著的改善，但这明显低于神经传导异常的患者。证据水平:III
{"title":"Carpal tunnel decompression in patients with normal nerve conduction studies","authors":"S. Mackenzie, O. Stone, P. Jenkins, N. Clement, I. Murray, A. Duckworth, J. McEachan","doi":"10.1177/1753193419866646","DOIUrl":"https://doi.org/10.1177/1753193419866646","url":null,"abstract":"Some patients present with typical clinical features of carpal tunnel syndrome despite normal nerve conduction studies. This study compared the preoperative and 1-year postoperative QuickDASH scores in patients with normal and abnormal nerve conduction studies, who underwent carpal tunnel decompression. Of the 637 patients included in the study, 19 had clinical features of carpal tunnel syndrome but normal nerve conduction studies, and underwent decompression after failure of conservative management. Preoperative QuickDASH scores were comparable in both groups (58 vs 54.8). However, there were significant differences between the normal and abnormal nerve conduction study groups in the QuickDASH at 1 year (34.9 vs 21.5) and change in QuickDASH postoperatively (23.1 vs 33.4). Patients with normal nerve conduction studies had comparable preoperative disability scores compared with those with abnormal studies. Although they had a significant improvement in QuickDASH at 1 year, this was significantly less than those with abnormal nerve conduction studies. Level of evidence: III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419866646","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41907725","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 : 2020-03-01DOI: 10.1177/1753193419875945
P. Stirling, T. Yeoman, A. Duckworth, N. Clement, P. Jenkins, J. McEachan
This prospective single-centre study describes the functional outcomes, satisfaction and health-related quality of life after open revision carpal tunnel decompression for recurrent carpal tunnel syndrome. The QuickDASH, patient satisfaction and EuroQol-5 dimensions questionnaires were collected preoperatively and postoperatively over a 5-year period (2013–2018). The median time to revision was 13.3 years (range 3.9–35.4 years; interquartile range 7.2–15.9 years). Outcomes were available for 14 hands in 13 patients at a mean of 20 months after revision surgery. The mean preoperative and postoperative QuickDASH scores were 55 and 29, respectively, and the mean improvement in QuickDASH was 26. The mean improvement in EuroQol-5 dimensions score was 0.1, and 13 of the 14 patients were satisfied. The net promoter score was 85. This study confirms that patients undergoing revision open carpal tunnel decompression for recurrent carpal tunnel syndrome experience a significant improvement in function and health-related quality of life. Level of evidence: IV
{"title":"Decompression for recurrent carpal tunnel syndrome provides significant functional improvement and patient satisfaction","authors":"P. Stirling, T. Yeoman, A. Duckworth, N. Clement, P. Jenkins, J. McEachan","doi":"10.1177/1753193419875945","DOIUrl":"https://doi.org/10.1177/1753193419875945","url":null,"abstract":"This prospective single-centre study describes the functional outcomes, satisfaction and health-related quality of life after open revision carpal tunnel decompression for recurrent carpal tunnel syndrome. The QuickDASH, patient satisfaction and EuroQol-5 dimensions questionnaires were collected preoperatively and postoperatively over a 5-year period (2013–2018). The median time to revision was 13.3 years (range 3.9–35.4 years; interquartile range 7.2–15.9 years). Outcomes were available for 14 hands in 13 patients at a mean of 20 months after revision surgery. The mean preoperative and postoperative QuickDASH scores were 55 and 29, respectively, and the mean improvement in QuickDASH was 26. The mean improvement in EuroQol-5 dimensions score was 0.1, and 13 of the 14 patients were satisfied. The net promoter score was 85. This study confirms that patients undergoing revision open carpal tunnel decompression for recurrent carpal tunnel syndrome experience a significant improvement in function and health-related quality of life. Level of evidence: IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419875945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46644669","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 : 2020-03-01DOI: 10.1177/1753193419869205
S. Kwak, Seung-Jun Lee, J. Bae, H. Jeong, Sang Woo Kang, K. Suh
Osborne’s modified decompression involves repairing Osborne’s ligament beneath the ulnar nerve after simple decompression for idiopathic cubital tunnel syndrome. In this retrospective interrupted time series, 31 patients underwent modified simple decompression and 20 patients underwent conventional simple decompression. In the modified simple decompression group, the ulnar nerve length was measured at operation in full elbow flexion and extension before and after repair of Osborne’s ligament. Ulnar nerve instability during elbow motion was measured using ultrasonography before operation and at 12 months after operation. In patients treated by modified simple decompression, the ulnar nerve length in full elbow flexion reduced significantly after repair of Osborne’s ligament. At 12 months after surgery, the grade of ulnar nerve instability was lower in the modified simple decompression group than in the conventional simple decompression group. The clinical outcomes did not differ significantly between the groups at 24 months after operation. Level of evidence: III
{"title":"In idiopathic cubital tunnel syndrome, ulnar nerve excursion and instability can be reduced by repairing Osborne’s ligament after simple decompression","authors":"S. Kwak, Seung-Jun Lee, J. Bae, H. Jeong, Sang Woo Kang, K. Suh","doi":"10.1177/1753193419869205","DOIUrl":"https://doi.org/10.1177/1753193419869205","url":null,"abstract":"Osborne’s modified decompression involves repairing Osborne’s ligament beneath the ulnar nerve after simple decompression for idiopathic cubital tunnel syndrome. In this retrospective interrupted time series, 31 patients underwent modified simple decompression and 20 patients underwent conventional simple decompression. In the modified simple decompression group, the ulnar nerve length was measured at operation in full elbow flexion and extension before and after repair of Osborne’s ligament. Ulnar nerve instability during elbow motion was measured using ultrasonography before operation and at 12 months after operation. In patients treated by modified simple decompression, the ulnar nerve length in full elbow flexion reduced significantly after repair of Osborne’s ligament. At 12 months after surgery, the grade of ulnar nerve instability was lower in the modified simple decompression group than in the conventional simple decompression group. The clinical outcomes did not differ significantly between the groups at 24 months after operation. Level of evidence: III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419869205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49195797","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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