The Journal of hand surgery, European volume最新文献

Bibliometric review involves systematically analysing the academic literature on a particular topic, enabling researchers to better understand the trajectory and future trends of a specific research field. This study uses various bibliometric tools to analyse relevant research on the spastic hand over the past two decades, aiming to identify key contributors, hotspots and emerging trends. The results show that early studies focused on cerebral palsy, stroke and botulinum toxin treatment, while recent advancements highlight surgical procedures such as neurectomy and soft tissue transfer. Future research should enhance international collaboration and the use of neuroimaging and electrophysiological techniques to gain a deeper understanding of the neural mechanisms underlying spasticity, optimize surgical procedures and explore novel treatments for spastic hand.

Wrist arthrodesis in spastic patients combined with proximal row carpectomy and ostectomy of the distal radius to allow a position of slight flexion (COF technique) results in a better outcome when compared to arthrodesis after proximal row carpectomy only technique.Level of evidence: III.

The object of this study was to perform an anatomical dissection of Thiel-embalmed specimens in a step-by-step procedure, to establish a 'safe zone' in which to perform a less invasive supercharged end-to-side (SETS) anterior interosseous nerve to ulnar motor nerve transfer without tension and to demonstrate its feasibility. The sample size was calculated with a 5 mm error to reach a 95% confidence interval. Dissection was performed in 15 specimens and the 'safe zone' was established between 40 and 90 mm proximal to the pisiform. Several surgical tips are recommended to help complete the procedure. A reproducible 'safe zone' was found for performing a SETS anterior interosseous to ulnar motor nerve transfer with 95% certainty, reducing soft tissue damage and enhancing the original surgical technique.

We compared 3-D-printed patient-specific implants (PSIs) with standard palmar locking plates for radiological accuracy after extra-articular corrective osteotomy for malunited distal radial fractures. Eleven patients were operated on with a PSI. Additionally, a plastic printed model of each patient was operated on with a standard plate in vitro. Three months postoperatively, radial alignment in patients and models was compared with the preoperative ideal planning using CT scans. Patients with PSIs showed smaller rotational deviations (median 7°) compared with standard plate models (9°). Deviations in the direction of translation, radial inclination, palmar tilt, radial height and ulnar variance were also smaller or similar with the PSI compared with the standard plates. The preoperative grip strength with a median of 8 kg and a Patient-Rated Wrist Evaluation score of 44 improved to 23 kg and 3 points, respectively, at a median follow-up of 13.5 months. Our results indicate superior radial alignment after PSI compared with standard plates, but the clinical relevance of these findings needs to be investigated.Level of evidence: IV.

This study describes patient-reported outcomes of robot-assisted percutaneous scaphoid fracture fixation of 62 patients from two medical centres and the learning curve of this new technique. One attempt to place the guidewire was sufficient in 97% of cases. All fractures achieved radiographic union at a mean of 9 weeks. There were no complications observed. At a mean follow-up of 36 months (range 12-68 months), the mean patient-rated wrist evaluation (PRWE) was 2 (range 0-22) and the mean Mayo Wrist Score was 96 (range 70-100). After the initial ten to 20 cases, the learning phase was reasonably surmountable with a marked reduction of operative duration and improvement of the screw accuracy.Level of evidence: IV.

This study compares wrist motion, biomechanical behaviour and radiographic parameters before and after total wrist arthroplasty using a fourth-generation spherical articulation prosthesis. A total of 10 cadaveric specimens were assessed using a hexapod Stewart platform robot. After arthroplasty, there were significant increases in both stiffness and phase angle of wrist motion across all planes of motion assessed. In three specimens, a sudden increase in moment was observed on load/displacement curves. Radiographically, carpal height increased by 14%, and the centre of rotation was displaced 11.1 mm proximally, 4.6 mm dorsally and 3.9 mm radially. This stretched the musculotendinous units, tightening the joint, while increasing the moment arm of the wrist flexors and decreasing the moment arm of the extensors, potentially important in the development of postoperative flexion contractures. Possible alterations in technique and/or implant design are considered to assist surgeons in achieving optimal clinical and survivorship outcomes.

The feasibility and accuracy of robot-assisted bone tunnel construction in the transosseous repair of the triangular fibrocartilaginous complex (TFCC) were compared with those of freehand arthroscopic repair. A total of 20 cadaveric specimens were randomized into robotic-assisted and arthroscopy-guided groups. Three bone tunnels were constructed in the ulnar foveal region in each specimen. The discrepancy between the planned and actual tunnel exits was determined in the robot-assisted group by merging images. The success rate of tunnel construction, time consumption and number of drilling attempts were compared between groups. The median planned/actual exit discrepancy was 0.8 mm in the robot-assisted group, with 90% of tunnel exits successfully placed in the footprint region, compared to 63.3% in the arthroscopy-guided group. The robot-assisted group spent less time and required fewer drilling attempts to construct bone tunnels. These results indicated that the robot-assisted technique can accurately construct multiple bone tunnels in the foveal region and reduce the difficulty of TFCC transosseous repair.Level of evidence: III.

The potential for reinforcement of unhelpful thinking and feelings of distress was present in half the sentences from the general description of the condition and management recommendation sections in three sources of information describing upper extremity conditions for clinicians.