Revista Iberoamericana de Cirugia de la Mano最新文献

{"title":"Rehabilitation in Triangular Fibrocartilage Complex Injuries: Treatment Algorithm","authors":"Eva Guisasola Lerma, Francisco Javier Lucas García, Alberto Márquez Caraballo, David Santosjuanes Royo","doi":"10.1055/s-0042-1748854","DOIUrl":"https://doi.org/10.1055/s-0042-1748854","url":null,"abstract":"Abstract Injuries to the triangular fibrocartilage complex (TFCC) can lead to instability of the distal radioulnar joint (DRUJ). In fact, they are the most frequent cause of it. But, in other cases, depending on the type of injury, the DRUJ remains stable. This will condition different types of treatments, from conservative management to the different options of surgical treatment. Since a controversy persists regarding the management of these lesions, our purpose is to disclose the foundations of the rehabilitation treatment and propose an algorithm of treatment according to the different types of injuries and their repairs. Resumen Las lesiones del complejo del fibrocartílago triangular (CFCT) pueden provocar una inestabilidad de la articulación radiocubital distal (ARCD). De hecho, son la causa más frecuente de ésta. Pero, en otras ocasiones, según el tipo de lesión, la ARCD se mantiene estable. Esto va a condicionar distintos tipos de tratamientos, desde el conservador hasta distintas opciones de intervenciones quirúrgicas. Dado que persiste la controversia en cuanto al manejo de estas lesiones, nuestro propósito es exponer las bases del tratamiento rehabilitador y proponer un algoritmo de tratamiento según los distintos tipos de lesiones y sus reparaciones.","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"50 1","pages":"e49 - e59"},"PeriodicalIF":0.0,"publicationDate":"2022-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45011441","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}

{"title":"Dorsal Wrist Ganglia: Influence of Arthroscopic Dorsal Capsulodesis – A Pilot Study","authors":"M. Ribau, Elisabete Ribeiro, Cecília Barros, Juvenália Ribeiro, Pedro Varanda, L. Rodrigues","doi":"10.1055/s-0042-1748852","DOIUrl":"https://doi.org/10.1055/s-0042-1748852","url":null,"abstract":"Abstract Background  Dorsal wrist ganglia are the commonest soft tissue tumor in the upper extremity. Management with arthroscopic excision yields good results and few complications, but recurrence is still a matter of concern. Purpose  To address the influence of dorsal capsulodesis in postoperative results. Patients and Methods  Two groups with eight patients each were evaluated: group A – simple arthroscopic resection (SAR), and group B – arthroscopic resection combined with dorsal capsulodesis (ARDC). Results  The mean age of group A was of 36.10 ±  7.96 (range: 28–53) years, and that of group B was of 34.17 ±  29.60 (range 18–44) years. The duration of the follow-up was of 30.67 ±  13.90 (range: 13.45–53.55) months and 29.60 ±  16.80 (range 12.68–62.13) months, respectively. Both groups achieved a a significant decrease in the postoperative score on the Visual Analog Scale (VAS) (of around 2/10), and the scores on the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were below 5/100. All the functional parameters (range of motion and strength) were above 80% on the contralateral side, with no differences between groups. More than 75% of the patients were completely satisfied. Group A (37.5%) had a significantly higher recurrence rate than that of group B (12.5%). Conclusions  In conclusion, SAR and ARDC provided good clinical results, with no significant differences. Dorsal capsulodesis resulted in an important decrease in the recurrence rate. Level of Evidence  Level III (Retrospective Comparative Study). Resumen Antecedentes  Los ganglios dorsales de la muñeca son el tumor de tejidos blandos más común en el miembro superior. El manejo con resección artroscópica proporciona buenos resultados y pocas complicaciones, pero la recurrencia sigue siendo motivo de preocupación. Objetivo  Comprender la influencia de la capsulodesis dorsal en los resultados postoperatorios. Pacientes y métodos  Se evaluaron dos grupos con ocho pacientes cada uno: el grupo A, de resección artroscópica simple (RAS), y el grupo B, de resección artroscópica combinada con capsulodesis dorsal (RACD). Resultados  La edad media del grupo A fue de 36,10 ±  7,96 (rango: 28–53) años, y la del grupo B fue de 34,17 ±  29,60 (rango: 18–44) años. El período de seguimiento fue de 30,67 ±  13,90 (rango: 13,45–53,55) meses y 29,60 ±  16,80 (rango: 12,68–62,13) meses, respectivamente. Para ambos grupos, se logró una disminución significativa en la escala visual analógica (EVA) posoperatoria (alrededor de 2/10), y los valores del cuestionario de Discapacidades del Brazo, Hombro y Mano ( Disabilities of the Arm, Shoulder and Hand , DASH, en inglés) estuvieron por debajo de 5/100. Todos los parámetros funcionales (rango de movimiento y fuerza) estuvieron por encima del 80% del lado contralateral, sin diferencias entre grupos. Más del 75% de los pacientes quedaron completamente satisfechos. Hubo una diferencia estadísticamente significativa para la tasa de recurrencia entre","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"50 1","pages":"e34 - e42"},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48464664","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}

{"title":"Epidemiological Analysis of Glomus Tumors of the Hand and Association with Recurrence Rate","authors":"Giovanni Vilardo Cerqueira Guedes, D. Jácome, G. F. Alves, Anderson Vieira Monteiro","doi":"10.1055/s-0042-1744466","DOIUrl":"https://doi.org/10.1055/s-0042-1744466","url":null,"abstract":"Abstract Introduction  Glomus tumors are benign, characterized by microvascular alteration, and mostly found in the subungual region of the hand. They are rare and associated with paroxysmal pain, tenderness on palpation, and thermal sensitivity. The aim of the present research was to analyze the epidemiology of glomus tumors and relate each of the variables with cases of recurrence. Materials and Methods  A retrospective review of medical records was undertaken in our hospital to collect epidemiological numerical variables (time between the onset of symptoms and diagnosis and surgery, age, size of the tumor on magnetic resonance imaging and the histopathological examination, time until recurrence and reoperation after surgery, duration of the follow-up) and categorical variables (gender, ethnicity, laterality, affected finger, location in the hand, surgical technique, smoking, preoperative symptoms, recurrence, and comorbidities). Then, we performed a statistical analysis to identify possible associations of the hand tumors with recurrences. Results  The review identified 66 patients with glomus tumors 52 of which were located in the hand. The mean age of the sample was 49 years, and it was mostly composed of white female patients. Pain was the main related symptom, and most tumors presented sizes between 5 mm and 1 cm. Among the 52 patients, 11 cases presented recurrences, with a mean time until onset of 39.4 months, but 3 of them were initially operated on at other hospitals. None of the variables was shown to be a predictor of recurrence, although we saw that bone involvement on radiographs was only present in certain cases of recurrence. Conclusion  The sample studied was large for this rare disease, and reinforced previous results regarding its epidemiology. As 54% of the cases of recurrence occurred at least twice, we think that genetic, histological and immunohistochemical analyses should be the focus of futures studies, as well as a search for bone and tendon involvement. Resumen Introducción  Los tumores glómicos son benignos, caracterizados por una alteración microvascular, y se encuentran con más frecuencia en la región subungueal de la mano. Son raros, y están asociados con dolor paroxístico, y sensibilidad al tacto y térmica. El objetivo de esta investigación fue analizar la epidemiología de los tumores glómicos y relacionar cada una de las variables con casos de recurrencia. Materiales y métodos  Se realizó una revisión retrospectiva de los historiales en nuestro hospital para recoger variables epidemiológicas numéricas (tiempo entre el inicio de los síntomas y el diagnóstico y la cirugía, edad, tamaño del tumor en resonancia magnética y en el examen histopatológico, tiempo hasta la recurrencia y la reintervención después de la cirugía, y tiempo de seguimiento) y categóricas (género, etnia, lateralidad, dedo afectado, localización en la mano, técnica quirúrgica, tabaquismo, síntomas preoperatorios, recurrencia, y comorbilidades). L","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"50 1","pages":"e27 - e33"},"PeriodicalIF":0.0,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49306216","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}

{"title":"Diaphyseal Radius Fracture Associated with Irreducible Head Dislocation. Case Report Fractura diafisaria de radio asociada a luxación irreductible de la cabeza. Relato de caso","authors":"A. Blanco, P. G. Barbero, M. Aparicio, J. P. Correa","doi":"10.1055/s-0041-1731768","DOIUrl":"https://doi.org/10.1055/s-0041-1731768","url":null,"abstract":"Abstract Irreducible dislocation of the radial head is an extremely rare lesion, especially in an adult patient. We present a case of diaphyseal radius fracture associated with a posterior elbow dislocation and an irreducible radial head dislocation. After closed reduction of the elbow, we performed open reduction and ostheosynthesis of the radius, and the radial head remained irreducible. We finally found, surrounding the radius, the interposition of the insertion of the biceps, and, after extracting it, we performed the correct reduction of the radial head. Six months after the surgery, the patient presented a full articular balance, with no pain. We have not found any similar case in the literature. Resumen La luxación no reductible de cabeza radial es una lesión extremadamente infrecuente, especialmente en el paciente adulto. Presentamos el caso de una fractura diafisaria de radio asociada a una luxación posterior de codo y a una luxación irreductible de la cabeza radial. Tras una reducción cerrada de codo, se realizó la reducción abierta y osteosíntesis de radio, permaneciendo irreductible la cabeza radial. Finalmente hallamos circundando al radio la interposición de la inserción del bíceps, y, tras la retirada de la misma, realizamos la correcta reducción de la cabeza radial. Seis meses tras la cirugía, el paciente presentaba un balance articular completo sin dolor. No hemos hallado en la literatura ningún caso similar.","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"49 1","pages":"e155 - e159"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47586271","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}

{"title":"AMIC Technique for the Treatment of Chondral Injuries of the Hand and Wrist Técnica AMIC para el tratamiento de las lesiones condrales de mano y muñeca","authors":"Pau López-Osornio de Vega, Vicente Carratalà Bauxauli, F. Corella, C. Andrade","doi":"10.1055/s-0041-1739163","DOIUrl":"https://doi.org/10.1055/s-0041-1739163","url":null,"abstract":"Abstract Scaffolds, either alone or combined with cultured chondrocyte cells, are an effective treatment for chondral or osteochondral defects of the knee and ankle joints. Scaffolds are a more sophisticated solution and have some advantages compared with the isolated use of the more traditional treatments of microfractures or nanofractures. In addition, scaffolds represent a less complicated technique and a less expensive treatment compared with chondrocyte culture treatments, which are accessible by very few patients. In the present article, we detail the surgical technique and provide advices and tips for the treatment of ostecochondral hand and wrist lesions using the Chondro-Gide (Geistlich Pharma AG, Wolhausen, Switzerland) scaffold and its patented autologous matrix-induced chondrogenesis (AMIC, Geistlich Pharma AG) technique. Resumen Las matrices, ya sea utilizadas de forma aislada o asociadas al cultivo de condrocitos, se han demostrado una técnica quirúrgica eficaz para el tratamiento de las lesiones condrales u osteocondrales en rodilla, tobillo y cadera. Son una alternativa más sofisticada, y aportan algunas ventajas respecto a las más tradicionales técnicas de microfracturas o nanofracturas, usadas éstas de forma aislada. Asimismo, representan una técnica menos complicada logísticamente y mucho menos cara que las tradicionales del cultivo de condrocitos, al alcance de muy pocos pacientes. En este artículo, detallamos la técnica a emplear, así como algunas recomendaciones, para el tratamiento de dichas lesiones, en mano y muñeca, mediante la utilización de la matriz de colágeno de origen porcino denominada Chondro-Gide (Geistlich Pharma AG, Wolhausen, Suiza) y su técnica registrada de condrogénesis autóloga inducida por matriz (autologous matrix-induced chondrogenesis, AMIC, en inglés; Geistlich Pharma AG).","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"49 1","pages":"e165 - e175"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46023367","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}

{"title":"Reconstructive Principles for the Metacarpal Hand: Case Report Principios reconstructivos en la mano metacarpiana: relato de caso","authors":"Iker Miguel Escuredo, Guillermo Ibarrondo Arzua, Juan José García Gutiérrez","doi":"10.1055/s-0041-1731769","DOIUrl":"https://doi.org/10.1055/s-0041-1731769","url":null,"abstract":"Abstract Metacarpal hand is one of the most devastating upper-extremity lesions. We report a case of a multidigit amputation corresponding to a Wei et al.5 IA metacarpal hand in a 56 year-old-male. He underwent a sequential toe-to-hand transfer to the third and fourth radii. Reconstruction of the metacarpal hand, either in an acute or deferred presentation, must consider some reconstructive principles, including the identification of the structures to be spared and the coverage strategies for the acute stage. Toe-to-hand transfer is the preferred technique when replantation is not an option. It is critical to know which structures should be transferred to which positions, as well as to adapt the reconstructive plan to the characteristics from each patient. Resumen La mano metacarpiana es una de las lesiones más devastadoras de la extremidad superior. Nuestro caso clínico corresponde a un varón de 56 años con una amputación multidigital de la cual resultó una mano metacarpiana tipo IA de Wei. Se planteó la reconstrucción con la transferencia secuencial de dos dedos de pie a la mano en los radios tercero y cuarto. A la hora de plantearnos la reconstrucción de una mano metacarpiana, tanto de forma aguda como diferida, es necesario tener en cuenta ciertos principios reconstructivos. En primer lugar, las estructuras vitales a conservar y los métodos de cobertura en el proceso agudo. Cuando el reimplante no es posible, la transferencia de dedos del pie a la mano es la técnica de elección. Es necesario conocer qué estructuras y a qué posiciones se debe realizar la transferencia, así como adecuar las opciones a las características de cada paciente.","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"49 1","pages":"e160 - e164"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46998759","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}

{"title":"Fifth Metacarpal Neck Fractures: Outcome-influencing Factors Fracturas del cuello del quinto metacarpiano: factores que influyen en el resultado","authors":"C. Pereira, A. Ribau, T. Barbosa, F. Rodrigues, Diogo Catelas, P. Neves","doi":"10.1055/s-0041-1739170","DOIUrl":"https://doi.org/10.1055/s-0041-1739170","url":null,"abstract":"Abstract Introduction Fifth metacarpal neck fractures are extremely common, but there is still no consensus regarding the ideal course of treatment. Volar angulation and shortening are decisive factors; however, there is still controversy about the cut-off values that translate into worse clinical results. The present study aims to answer these questions in order to provide additional data to aid in the clinical practice and decision making. Materials and Methods A retrospective study evaluated patients with fifth metacarpal fractures treated between 2013 and 2018. A total of 133 patients were included, with an average follow-up of 2 months. Surgery was performed in 21 patients, and 112 were treated conservatively. The radiological assessment of volar anguation and shortening was based in the first and last radiographs of the follow-up. The patients were contacted and submited to a questionnaire that included the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score and subjective evaluations of pain (Visual Analogue Scale, VAS), hand strength, stiffness and finger mobility, and cosmetic result. Results Surgery was more successful in reducing angulation than the conservative treatment, achieving more anatomic final values for angulation and shortening (p < 0.05). On the other hand, surgery seems to be associated with a higher notion of limited finger mobility (p = 0.02). Among patients treated conservatively, inicial angulations > 60° and final angulations > 50° were associated with worse cosmetic results (p = 0,039). Final shortening > 4 mm translated into a higher notion of stiffness and limited finger mobility (p = 0.034). More advanced age showed a correlation with higher scores on the VAS (p = 0.023) and QuickDASH (p < 0,001). Female patients (p = 0.02) were also associated with higher VAS scores. The overall satisfaction rate was of 97%. Conclusion Although globally the functional outcome of these fractures is very good, the present study reports several factors that should be considered when treating fifth metacarpal neck fractures. Resumen Introducción Las fracturas del cuello del quinto metacarpiano son muy comunes, pero no hay consenso sobre el tratamiento de elección. Angulación y reducción son factores decisivos en la elección del tratamiento; sin embargo, hay alguna controversia sobre los valores a partir de los cuales se da un peor resultado clínico. Este estudio busca responder a estas cuestiones a fin de proporcionar una evidencia más para auxiliar en la decisión terapéutica. Materiales y Métodos Este estudio retrospectivo evaluó a enfermos con fractura del quinto metacarpiano tratados entre 2013 y 2018. Se incluyó en el estudio a 133 enfermos, con 2 meses de seguimiento medio. Se trató quirúrgicamente a 21 enfermos, y a 112 se aplicó el tratamiento conservador. La evaluación radiográfica de la angulación volar y acortamiento se basó en las imágenes al inicio y al final del seguimiento médico. Se contactó a los enferm","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"49 1","pages":"e115 - e120"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46427175","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}

{"title":"Percutaneous Dorsal Approach for Fractures of the Hook of the Hamate: A Less Common but Effective Option Abordaje dorsal percutáneo para las fracturas del gancho del ganchoso: una alternativa menos común pero eficaz","authors":"Borja Gómez, Á. Olea, Virginia Sierra","doi":"10.1055/s-0041-1741322","DOIUrl":"https://doi.org/10.1055/s-0041-1741322","url":null,"abstract":"Abstract Introduction Hook of hamate fractures are rare. The best treatment option is a source of debate; it ranges from conservative to surgical techniques, including resection of the hook or a volar approach followed by internal fixation. These techniques are not exempt from risk. Minimal invasive fixation using a dorsal percutaneous approach and a headless, cannulated mini screw is another option, although not commonly considered. We present a case series of patients who underwent this surgical technique. Methods This is a retrospective review of four patients with nondisplaced hook of hamate fractures treated with dorsal percutaneous fixation. The evaluation included symptoms, physical examination, and radiological (radiographs, magnetic resonance imaging [MRI], and computed tomography [CT]) findings, as well as pre and postoperative strength (determined with a Jamar (JLW Instruments, Chicago, USA) hydraulic dynamometer) and quick disabilities of the arm, shoulder and hand (QuickDASH) scores. Results The union rate was 100% with no associated complications. All patients resumed their preinjury activities 3 months after the surgery and reported they would undergo surgery again if needed. Conclusion This retrospective study shows that safe treatment of nondisplaced hook of hamate fractures with percutaneous dorsal fixation is feasible, with excellent clinical outcomes. In any case, our sample is limited, and further studies are required. Resumen Introducción Las fracturas del gancho del ganchoso son infrecuentes. Se debate el tratamiento óptimo, desde el conservador hasta técnicas quirúrgicas, que incluyen la resección del gancho o un abordaje volar y fijación interna. Estas técnicas no están exentas de riesgo. Una alternativa reciente y segura es la fijación interna mediante un abordaje dorsal percutáneo. Presentamos una serie de casos de pacientes a los que se aplicó esta técnica en fracturas agudas o con retrasos de unión. Métodos En este estudio, se han revisado 4 pacientes con fracturas del gancho del ganchoso no desplazadas, de hasta 9 meses de evolución, intervenidos mediante una fijación percutánea dorsal. Se revisó la sintomatología, la exploración física, y la radiología (radiografías, resonancia magnética [RM] y tomografía computarizada [TC]). Se evaluó la fuerza de presión mediante el dinamómetro de Jamar (JLW Instruments, Chicago, IL, USA) y el puntaje en la versión corta del cuestionario de Discapacidades del Brazo, Hombro y Mano (Quick Disabilities of the Arm, Shoulder and Hand, Quick DASH, en inglés) pre y postoperatorios. Resultados En el 100% de los casos, se consiguió la unión de la fractura, sin complicaciones asociadas. En tres de los cuatro casos, la fractura ocurrió en la mano no dominante. Todos los pacientes volvieron a su actividad habitual tres meses después, y declararon que volverían a operarse con esta técnica si fuera necesario. Conclusión Este estudio retrospectivo muestra que las fracturas no desplazadas del gan","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"49 1","pages":"e90 - e96"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43115876","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}

{"title":"Arthroscopic Lunotriquetral Ligamentoplasty, from the Cadaver Lab to the Clinical Practice Ligamentoplastia lunotriquetral artroscópica, de la sala de disección a la práctica clínica","authors":"M. Cruz-Sánchez, Cristóbal Martínez-Andrade","doi":"10.1055/s-0041-1740093","DOIUrl":"https://doi.org/10.1055/s-0041-1740093","url":null,"abstract":"Abstract Introduction There has been an increase in the diagnosis of injuries to the intrinsic ligaments of the wrist due to the more widespread use of arthroscopy in the treatment of patients with musculoskeletal wrist pain, and arthroscopy is particularly very helpful to determine the etiology of these lesions at the ulnar level. The treatment of lunotriquetral ligament injuries encompasses different techniques with results that are little reproducible. Ligament reconstruction through tendon grafting has shown favorable results, but it involves extensive open approaches that lead to a slower recovery a lower range of joint motion due to the excess of scar tissue. The objective of the present study is to describe the performance, in a cadaver, of a minimally-invasive lunotriquetral and secondary-stabilizer ligamentoplasty and its application in a representative clinical case. Material and Methods A preliminary study of six specimens in which a lunotriquetral and secondary-stabilizer ligamentoplasty was performed consecutively through a free tendon graft with arthroscopic assistance. We proceeded to recreate the complete ligament injury, and to perform an assessment of lunotriquetral instability according to the Geissler classification and an arthroscopic ballottement test. We describe the surgical technique, ligament stability after the ligamentoplasty, and the subsequent anatomical dissection, assessing the anatomical structures susceptible to iatrogenic injury. We also describe the application of the technique in one case, comparing the clinical parameters before and after the procedure: range of motion of the joint, strength, pain and the shortened version of the Disabilities of the Arm, Hand, and Shoulder (QuickDASH) questionnaire. Results The ligamentoplasties performed showed recovery of the stability of the lunotriquetral interval assessed according to the Geissler classification and the arthroscopic ballottement test. In the dissection of the specimens, no iatrogenic lesions were found in the tendons or the surfaces of the mediocarpal and radiocarpal joints. The average distances between the nearest bone tunnels and nerves were of 7.3 mm for the sensory branch of the ulnar nerve, of 3.6 mm for the posterior interosseous nerve, and of 4.5 mm for the ulnar neurovascular bundle. No fractures were observed in the tunnelled bones. In the clinical case herein presented, six months after the intervention, there was an improvement in strength and preoperative pain, with a slight decrease in the joint range of motion (15% compared to the contralateral joint). Conclusions The lunotriquetral ligamentoplasty herein described could contribute to the biomechanical restoration of the carpus and be an option for recosntruction in selected cases. Its performance through minimally-invasive techniques, and the use of a free tendon graft together with specific rehabilitation should be considered to optimize the outcomes. Resumen Introducción El diagnóstico ","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"49 1","pages":"e121 - e127"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45242321","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}

{"title":"Usefulness of the Ultrasound in Hand Surgery: Part I Utilidad de la ecografía en la cirugía de la mano: parte I","authors":"Homid Fahandezh-Saddi Díaz, F. Fernández, Á. Horcajadas, Manuel Villanueva Martínez, María Elena Cantero Yubero","doi":"10.1055/s-0041-1739295","DOIUrl":"https://doi.org/10.1055/s-0041-1739295","url":null,"abstract":"Abstract In the last years, ultrasonography (US) of the wrist and hand have increased in popularity. Technical advances led us to improve image quality and have the ability to see superficial soft-tissue structures with high resolution with the patient in our office. The advantages of US are the fact that it is noninvasive, its lack of ionising radiation, low cost, and portability. The dynamic real-time assessment in the office is an additional benefit. Ultrasound can be used in hand surgery for both diagnostic and therapeutic purposes. We can use US for injections with needle guidance, for the evaluation of soft-tissue masses, foreign bodies, tendon injuries, compressive neuropathies, and rheumatologic joint disease. It also helps us perform ultrasound-guided procedures: carpal tunnel syndrome, trigger finger, and intersection syndrome or compartimental syndrome. The aim of the present review is to describe different uses of US in hand surgery to show its important role of providing to the surgeon more information on the diseases of their patients. Resumen En los últimos años, la ecografía de muñeca y mano ha aumentado en popularidad. Los avances técnicos nos llevaron a mejorar la calidad de la imagen y a tener la capacidad de ver estructuras superficiales de tejidos blandos con alta resolución con el paciente en nuestro consultorio. Las ventajas de la ecografía son el hecho de que es no invasiva, su falta de radiación ionizante, el bajo costo y la portabilidad. La evaluación dinámica y en tiempo real en el consultorio es un beneficio adicional. El ultrasonido puede ser utilizado en la cirugía de la mano con fines diagnósticos y terapéuticos. Podemos utilizar la ecografía para inyecciones con guía de aguja, para la evaluación de masas de tejidos blandos, cuerpos extraños, lesiones de tendones, neuropatías compresivas, y enfermedad articular reumatológica. También nos ayuda a realizar procedimientos guiados por ecografía: síndrome del túnel carpiano, dedo en gatillo, síndrome de intersección, o síndrome compartimental. El objetivo de la presente revisión es describir diferentes utilidades de la ecografía en cirugía de mano que muestran el importante papel de la ecografía en ayudar al cirujano a tener más información de la enfermedad del paciente.","PeriodicalId":32931,"journal":{"name":"Revista Iberoamericana de Cirugia de la Mano","volume":"49 1","pages":"e128 - e139"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47107146","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}