Pub Date : 2020-03-01DOI: 10.1177/1753193419865716
A. Zolotov
and Masashi Yamazaki in Department of Orthopaedic Surgery at the University of Tsukuba for advice on clinical materials and basic science. We thank Dr Toshikazu Tanaka in Kikkoman General Hospital for leadership in surgeries. We thank Dr Yoshio Nakata of the Faculty of Health and Sport Sciences at the University of Tsukuba for advice on statistical analysis and Drs Sho Kohyama and Akira Ikumi for MRI examinations.
{"title":"Two-stage treatment of severe Dupuytren’s contracture with an external fixator","authors":"A. Zolotov","doi":"10.1177/1753193419865716","DOIUrl":"https://doi.org/10.1177/1753193419865716","url":null,"abstract":"and Masashi Yamazaki in Department of Orthopaedic Surgery at the University of Tsukuba for advice on clinical materials and basic science. We thank Dr Toshikazu Tanaka in Kikkoman General Hospital for leadership in surgeries. We thank Dr Yoshio Nakata of the Faculty of Health and Sport Sciences at the University of Tsukuba for advice on statistical analysis and Drs Sho Kohyama and Akira Ikumi for MRI examinations.","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/10.1177/1753193419865716","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46326808","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: 10.1177/1753193419880119
J. Andersson, J. Karlsson
We read this article with great interest. Awareness in terms of which distal radial fractures that could be associated with concomitant scapholunate (SL) ligament injury is an important issue. Mudgal and Hastings (1993) have described that concomitant SL injury is very common in Chauffeuŕs fractures and Scheer and Adolfsson (2011) have proposed that injury to the triangular fibrocartilage complex (TFCC) can be expected when the dorsal angulation exceeds 32 . Otherwise, we have had no valid guidelines in terms of awareness of concomitant wrist ligament injuries in distal radius fractures, in spite of highenergy trauma and comminuted intra-articular fractures. Therefore, this article provides guidelines to clinical decision making, namely in which patients we should use arthroscopy-assisted surgery, when operating on the fractures. This is valuable, as the health care resources are not sufficient to cover arthroscopy-assisted surgery in all displaced distal radial fractures. Sun et al. have used axial computed tomography (CT) scans of acute two-part intra-articular radial fractures and have compared CT with normal radiographs. The authors showed significant increment in the SL distance in the following distal radial fracture subtypes: radial styloid oblique, dorsal ulnar column, sagittal ulnar column and volar coronal. CT is a static examination, and we are all aware that it often takes 3–12 months before a dynamic SL dissociation develops into a static deformity. Dynamic SL instability prior to the current trauma was not evaluated in the study by Sun et al., nor is the history of the patients in terms of possible prior wrist trauma clearly explained. We also miss a description of possible concomitant dorsal intercalated segment instability (DISI) on the CT scans, which could assume prior SL injury. The SL ligament varies from 2 to 5 mm in length and has some elasticity. Therefore, we think that a minor widening of the SL gap could be due to tension in the ligament according to displacement of the specific distal radial fracture fragments units, in some of the patients. It is also surprising that the authors did not find any bony avulsions in their cohort. Andersson and Garcia-Elias (2013) found 13% SL avulsion injuries with bony fragments in their surgical cohort of 45 patients. We believe that Sun et al. have significantly contributed to the pathomechanic understanding of distal radial fractures with concomitant SL injuries. They have provided a relevant guideline for higher threshold and awareness in which patients surgeons should aim for arthroscopy-assisted surgery at the same time as the distal radial fracture is operated on. But still, arthroscopy is the gold standard in terms of diagnostics of wrist ligament injuries and magnetic resonance imaging (MRI) or CT are unable to rule out the possibility of a clinically relevant injury to the wrist ligaments, including the SL ligament (Andersson et al., 2015).
{"title":"Re: Sun et al. Association of scapholunate dissociation and two-part articular fractures of the distal radius. J Hand Surg Eur. 2019, 44: 468–74","authors":"J. Andersson, J. Karlsson","doi":"10.1177/1753193419880119","DOIUrl":"https://doi.org/10.1177/1753193419880119","url":null,"abstract":"We read this article with great interest. Awareness in terms of which distal radial fractures that could be associated with concomitant scapholunate (SL) ligament injury is an important issue. Mudgal and Hastings (1993) have described that concomitant SL injury is very common in Chauffeuŕs fractures and Scheer and Adolfsson (2011) have proposed that injury to the triangular fibrocartilage complex (TFCC) can be expected when the dorsal angulation exceeds 32 . Otherwise, we have had no valid guidelines in terms of awareness of concomitant wrist ligament injuries in distal radius fractures, in spite of highenergy trauma and comminuted intra-articular fractures. Therefore, this article provides guidelines to clinical decision making, namely in which patients we should use arthroscopy-assisted surgery, when operating on the fractures. This is valuable, as the health care resources are not sufficient to cover arthroscopy-assisted surgery in all displaced distal radial fractures. Sun et al. have used axial computed tomography (CT) scans of acute two-part intra-articular radial fractures and have compared CT with normal radiographs. The authors showed significant increment in the SL distance in the following distal radial fracture subtypes: radial styloid oblique, dorsal ulnar column, sagittal ulnar column and volar coronal. CT is a static examination, and we are all aware that it often takes 3–12 months before a dynamic SL dissociation develops into a static deformity. Dynamic SL instability prior to the current trauma was not evaluated in the study by Sun et al., nor is the history of the patients in terms of possible prior wrist trauma clearly explained. We also miss a description of possible concomitant dorsal intercalated segment instability (DISI) on the CT scans, which could assume prior SL injury. The SL ligament varies from 2 to 5 mm in length and has some elasticity. Therefore, we think that a minor widening of the SL gap could be due to tension in the ligament according to displacement of the specific distal radial fracture fragments units, in some of the patients. It is also surprising that the authors did not find any bony avulsions in their cohort. Andersson and Garcia-Elias (2013) found 13% SL avulsion injuries with bony fragments in their surgical cohort of 45 patients. We believe that Sun et al. have significantly contributed to the pathomechanic understanding of distal radial fractures with concomitant SL injuries. They have provided a relevant guideline for higher threshold and awareness in which patients surgeons should aim for arthroscopy-assisted surgery at the same time as the distal radial fracture is operated on. But still, arthroscopy is the gold standard in terms of diagnostics of wrist ligament injuries and magnetic resonance imaging (MRI) or CT are unable to rule out the possibility of a clinically relevant injury to the wrist ligaments, including the SL ligament (Andersson et al., 2015).","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/10.1177/1753193419880119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41511110","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: 10.1177/1753193419880312
M. Kroeze, H. Rakhorst, P. Houpt
Arm sling elevation is widely used after hand surgery to prevent swelling and pain. This prospective cohort study investigated whether arm sling elevation has any value after carpal tunnel release surgery. Patients were assigned to one of two groups after carpal tunnel release: with or without arm sling elevation. The primary outcome was postoperative swelling. Secondary outcomes were pain and symptom relief and functional outcome. Volumetric analysis showed no significant difference between the sling and non-sling group. Pain scores and improvement of symptom severity and functional status scores were similar for both groups. Thirty-eight per cent found the sling uncomfortable. These results do not support routine use of arm sling elevation after carpal tunnel release. Level of evidence: III
{"title":"Arm sling after carpal tunnel surgery: myth or evidence based?","authors":"M. Kroeze, H. Rakhorst, P. Houpt","doi":"10.1177/1753193419880312","DOIUrl":"https://doi.org/10.1177/1753193419880312","url":null,"abstract":"Arm sling elevation is widely used after hand surgery to prevent swelling and pain. This prospective cohort study investigated whether arm sling elevation has any value after carpal tunnel release surgery. Patients were assigned to one of two groups after carpal tunnel release: with or without arm sling elevation. The primary outcome was postoperative swelling. Secondary outcomes were pain and symptom relief and functional outcome. Volumetric analysis showed no significant difference between the sling and non-sling group. Pain scores and improvement of symptom severity and functional status scores were similar for both groups. Thirty-eight per cent found the sling uncomfortable. These results do not support routine use of arm sling elevation after carpal tunnel release. 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/10.1177/1753193419880312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49075103","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 : 2020-02-01DOI: 10.1177/1753193419867049
G. Asmar, Tahar Mati, I. Pop, M. Falcone
This retrospective, single-centre study was carried out on patients with digital subungual glomus tumours. We describe a subperiosteal approach with a ‘shark mouth’ flap containing the nail plate and nail bed as a single unit, providing ideal exposure and easy access to the tumour. It combines the advantages of the transungual and lateral approaches, whether the subungual tumours are located centrally, peripherally or under the germinal matrix. The ‘shark mouth’ flap approach was used by the same surgeon in 24 patients with solitary glomus tumours of the fingers. Clinical outcomes at the early postoperative phase and at the last follow-up were satisfactory. Pain relief and wound healing were quickly achieved. No complications, such as fingertip numbness or nail deformities, were observed, and there was only one recurrence. This approach is reliable, nail-sparing and less time-consuming than other techniques. Level of evidence: IV
{"title":"The ‘shark mouth’ flap approach for digital glomus tumours in 24 patients: technique and clinical outcomes","authors":"G. Asmar, Tahar Mati, I. Pop, M. Falcone","doi":"10.1177/1753193419867049","DOIUrl":"https://doi.org/10.1177/1753193419867049","url":null,"abstract":"This retrospective, single-centre study was carried out on patients with digital subungual glomus tumours. We describe a subperiosteal approach with a ‘shark mouth’ flap containing the nail plate and nail bed as a single unit, providing ideal exposure and easy access to the tumour. It combines the advantages of the transungual and lateral approaches, whether the subungual tumours are located centrally, peripherally or under the germinal matrix. The ‘shark mouth’ flap approach was used by the same surgeon in 24 patients with solitary glomus tumours of the fingers. Clinical outcomes at the early postoperative phase and at the last follow-up were satisfactory. Pain relief and wound healing were quickly achieved. No complications, such as fingertip numbness or nail deformities, were observed, and there was only one recurrence. This approach is reliable, nail-sparing and less time-consuming than other techniques. Level of evidence: IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419867049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43063759","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 : 2020-02-01DOI: 10.1177/1753193419876475
C. Hellevuo, O. Leppänen, S. Kapanen, S. Vilkki
This study evaluates the long-term results of pollicization for a congenitally absent or severely hypoplastic thumb. Twenty-nine patients with 34 pollicizations were divided to two groups: those with simple thumb hypoplasia (22 pollicizations) and those with radial longitudinal dysplasia (12 pollicizations). The patients were followed from 1.3 to 32 years, with a mean follow-up time of 11 years. The patients were examined clinically and radiologically, and they completed a questionnaire concerning satisfaction with appearance, function, and social interaction. The Percival score was also calculated. In both groups, grip and pinch strengths of the operated hands were inferior to the normative age-related values. Radiologically, flattening of the original metacarpal head was found in 20 out of the 34 operated hands. We found better patient satisfaction in the simple hypoplasia group than in the radial longitudinal dysplasia group. The functional outcomes and patients’ satisfaction did not correlate with the age of patients at operation. Level of evidence: IV
{"title":"Long-term outcomes after pollicization: a mean 11-year follow-up study","authors":"C. Hellevuo, O. Leppänen, S. Kapanen, S. Vilkki","doi":"10.1177/1753193419876475","DOIUrl":"https://doi.org/10.1177/1753193419876475","url":null,"abstract":"This study evaluates the long-term results of pollicization for a congenitally absent or severely hypoplastic thumb. Twenty-nine patients with 34 pollicizations were divided to two groups: those with simple thumb hypoplasia (22 pollicizations) and those with radial longitudinal dysplasia (12 pollicizations). The patients were followed from 1.3 to 32 years, with a mean follow-up time of 11 years. The patients were examined clinically and radiologically, and they completed a questionnaire concerning satisfaction with appearance, function, and social interaction. The Percival score was also calculated. In both groups, grip and pinch strengths of the operated hands were inferior to the normative age-related values. Radiologically, flattening of the original metacarpal head was found in 20 out of the 34 operated hands. We found better patient satisfaction in the simple hypoplasia group than in the radial longitudinal dysplasia group. The functional outcomes and patients’ satisfaction did not correlate with the age of patients at operation. Level of evidence: IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419876475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41503924","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 : 2020-02-01DOI: 10.1177/1753193419864900
Sung-Jae Kim, Joo-Hyoung Ha, Chang-Hun Lee
{"title":"Minimal clinically important difference of patient-rated outcome measures in surgically treated distal radial fractures","authors":"Sung-Jae Kim, Joo-Hyoung Ha, Chang-Hun Lee","doi":"10.1177/1753193419864900","DOIUrl":"https://doi.org/10.1177/1753193419864900","url":null,"abstract":"","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419864900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42770673","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 : 2020-02-01DOI: 10.1177/1753193419864488
M. Al-Qattan
I read with interest this excellent review on the Oberg-Manske-Tonkin (OMT) classification of congenital upper limb anomalies. In the classification, congenital dislocation of the radial head is classified as an error in the radio–ulnar (anteroposterior) axis. I have reviewed the pathogenesis of congenital dislocation of the radial head (Al-Qattan et al., 2016) and identified five different primary insults. Four out of five insults lead to disturbed anteroposterior radio–ulnar growth axis. The fifth pathway of pathogenesis is related to collagen abnormality and not to the anteroposterior axis of development. The annular ligament (which is made of collagen type I) is attached to the margins of the radial notch of the ulna; and it supports the head of the radius in the correct place without having any attachments to the radius. Mutations that lead to collagen type I abnormalities will be associated with congenital dislocation of the radial (and these are reviewed in my paper). One example of these mutations is COL1A1/COL1A2 mutations that cause osteogenesis imperfecta types I to IV, and congenital dislocation of the radial head is a feature of all four types. If abnormal collagen is a primary cause of congenital dislocation of the radial head, the frequency of congenital dislocation of the radial head in these types of osteogenesis imperfecta should be proportionate to the severity of the collagen abnormality, which is mildest in type I followed by type IV, and is relatively severe in type III. The frequencies of congenital dislocation of the radial head in these three types of osteogenesis imperfecta are 2%, 13%, and 22%; respectively (Fassier et al., 2007). I think that congenital dislocation of the radial head is best categorized under two different categories in the OMT classification.
我饶有兴趣地阅读了这篇关于先天性上肢异常的oberg - mansk - tonkin (OMT)分类的优秀综述。在分类中，先天性桡骨头脱位被归类为桡尺(前后)轴的错误。我回顾了先天性桡骨头脱位的发病机制(al - qattan et al.， 2016)，并确定了五种不同的主要损伤。五分之四的损伤导致桡尺骨前后生长轴紊乱。第五种发病途径与胶原蛋白异常有关，而与前后轴发育无关。环状韧带(由I型胶原蛋白构成)附着于尺骨桡切迹边缘;它在正确的位置支撑着桡骨的头部而没有任何附着在桡骨上。导致I型胶原蛋白异常的突变将与先天性桡骨脱位相关(这些在我的论文中进行了回顾)。这些突变的一个例子是COL1A1/COL1A2突变导致I型至IV型成骨不全，而先天性桡骨头脱位是所有四种类型的特征。如果胶原异常是先天性桡骨头脱位的主要原因，那么在这些类型的成骨不全症中，先天性桡骨头脱位的发生频率应与胶原异常的严重程度成正比，I型最轻，其次是IV型，III型相对严重。在这三种类型的成骨不全症中，先天性桡骨头脱位的发生率分别为2%、13%和22%;(Fassier et al.， 2007)。我认为先天性桡骨头脱位最好在OMT分类中分为两个不同的类别。
{"title":"Re: Oberg KC. Classification of congenital upper limb anomalies: towards improved communication, diagnosis, and discovery. J Hand Surg Eur. 2019, 44: 4–14","authors":"M. Al-Qattan","doi":"10.1177/1753193419864488","DOIUrl":"https://doi.org/10.1177/1753193419864488","url":null,"abstract":"I read with interest this excellent review on the Oberg-Manske-Tonkin (OMT) classification of congenital upper limb anomalies. In the classification, congenital dislocation of the radial head is classified as an error in the radio–ulnar (anteroposterior) axis. I have reviewed the pathogenesis of congenital dislocation of the radial head (Al-Qattan et al., 2016) and identified five different primary insults. Four out of five insults lead to disturbed anteroposterior radio–ulnar growth axis. The fifth pathway of pathogenesis is related to collagen abnormality and not to the anteroposterior axis of development. The annular ligament (which is made of collagen type I) is attached to the margins of the radial notch of the ulna; and it supports the head of the radius in the correct place without having any attachments to the radius. Mutations that lead to collagen type I abnormalities will be associated with congenital dislocation of the radial (and these are reviewed in my paper). One example of these mutations is COL1A1/COL1A2 mutations that cause osteogenesis imperfecta types I to IV, and congenital dislocation of the radial head is a feature of all four types. If abnormal collagen is a primary cause of congenital dislocation of the radial head, the frequency of congenital dislocation of the radial head in these types of osteogenesis imperfecta should be proportionate to the severity of the collagen abnormality, which is mildest in type I followed by type IV, and is relatively severe in type III. The frequencies of congenital dislocation of the radial head in these three types of osteogenesis imperfecta are 2%, 13%, and 22%; respectively (Fassier et al., 2007). I think that congenital dislocation of the radial head is best categorized under two different categories in the OMT classification.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419864488","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47172462","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 : 2020-02-01DOI: 10.1177/1753193419881086
Brent Byrne, A. Jacques, R. Gurfinkel
We performed a prospective, observational study using a non-surgical, conservative protocol with immediate mobilization for the treatment of 101 isolated stable or initially unstable proximal phalangeal fractures. The patients were evaluated at the time of discharge from therapy treatment, mean 7 weeks (range 3–15) after conservative treatment. These patients achieved a median proximal interphalangeal joint extension of −4° (IQR 0, −8), a mean total active motion of 253° (SD 20) and minimal pain. We conclude that a non-surgical, conservative protocol can be used for patients with isolated proximal phalangeal fractures without uncorrectable finger rotation or fracture angulation exceeding 25° in the sagittal plane or 10° in the coronal plane following closed reduction. Our data supports that a conservative protocol can be the good option for isolated stable or initially unstable proximal phalangeal fractures. Level of evidence: IV
{"title":"Non-surgical management of isolated proximal phalangeal fractures with immediate mobilization","authors":"Brent Byrne, A. Jacques, R. Gurfinkel","doi":"10.1177/1753193419881086","DOIUrl":"https://doi.org/10.1177/1753193419881086","url":null,"abstract":"We performed a prospective, observational study using a non-surgical, conservative protocol with immediate mobilization for the treatment of 101 isolated stable or initially unstable proximal phalangeal fractures. The patients were evaluated at the time of discharge from therapy treatment, mean 7 weeks (range 3–15) after conservative treatment. These patients achieved a median proximal interphalangeal joint extension of −4° (IQR 0, −8), a mean total active motion of 253° (SD 20) and minimal pain. We conclude that a non-surgical, conservative protocol can be used for patients with isolated proximal phalangeal fractures without uncorrectable finger rotation or fracture angulation exceeding 25° in the sagittal plane or 10° in the coronal plane following closed reduction. Our data supports that a conservative protocol can be the good option for isolated stable or initially unstable proximal phalangeal fractures. Level of evidence: IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419881086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42657542","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 : 2020-02-01DOI: 10.1177/1753193419876900
Camilo Chaves, G. Asmar, M. Falcone
{"title":"Anterior rerouting of the 1,2 intercompartmental supraretinacular artery-based bone graft for scaphoid non-union: an anatomical study","authors":"Camilo Chaves, G. Asmar, M. Falcone","doi":"10.1177/1753193419876900","DOIUrl":"https://doi.org/10.1177/1753193419876900","url":null,"abstract":"","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419876900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43295386","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 : 2020-02-01DOI: 10.1177/1753193419880775
C. Surke, Rahel L. Meier, L. Haug, E. Vögelin
Metacarpal neck fractures with severe displacement are commonly treated surgically with intramedullary Kirschner wires. We present the results of treatment of fifth metacarpal neck fractures using a light curable intramedullary photodynamic polymer (IlluminOss™, IlluminOss Medical Inc., East Providence, RI, USA). Twenty-nine patients with isolated displaced fifth metacarpal neck fractures were included and followed up for 12–24 weeks. All fractures had radiologically healed after 3 months. In two cases, a secondary loss of reduction was seen, which did not require further correction. During the follow-up period, range of motion of the metacarpophalangeal joint was 89% after 6 weeks and increased to 100% after 3 months compared with the uninjured side. Grip strength improved over time from 61% to 85%. No implant removal was necessary. We conclude that osteosynthesis using an intramedullary photodynamic polymer is a reliable treatment option for displaced fractures of the fifth metacarpal neck. Level of evidence: IV
{"title":"Osteosynthesis of fifth metacarpal neck fractures with a photodynamic polymer bone stabilization system","authors":"C. Surke, Rahel L. Meier, L. Haug, E. Vögelin","doi":"10.1177/1753193419880775","DOIUrl":"https://doi.org/10.1177/1753193419880775","url":null,"abstract":"Metacarpal neck fractures with severe displacement are commonly treated surgically with intramedullary Kirschner wires. We present the results of treatment of fifth metacarpal neck fractures using a light curable intramedullary photodynamic polymer (IlluminOss™, IlluminOss Medical Inc., East Providence, RI, USA). Twenty-nine patients with isolated displaced fifth metacarpal neck fractures were included and followed up for 12–24 weeks. All fractures had radiologically healed after 3 months. In two cases, a secondary loss of reduction was seen, which did not require further correction. During the follow-up period, range of motion of the metacarpophalangeal joint was 89% after 6 weeks and increased to 100% after 3 months compared with the uninjured side. Grip strength improved over time from 61% to 85%. No implant removal was necessary. We conclude that osteosynthesis using an intramedullary photodynamic polymer is a reliable treatment option for displaced fractures of the fifth metacarpal neck. Level of evidence: IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419880775","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42006527","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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