Techniques in Hand and Upper Extremity Surgery最新文献

Trapeziometacarpal Arthrodesis Technique and Outcomes using a Nitinol Compression Staple. 使用镍钛诺加压钉钉的斜跖关节融合术和疗效。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-05-13 DOI: 10.1097/BTH.0000000000000519

Alec J Talsania, Nathan F Miller, Jay S Talsania

{"title":"Trapeziometacarpal Arthrodesis Technique and Outcomes using a Nitinol Compression Staple.","authors":"Alec J Talsania, Nathan F Miller, Jay S Talsania","doi":"10.1097/BTH.0000000000000519","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000519","url":null,"abstract":"Trapeziometacarpal (TMC) arthrodesis is a reliable procedure to treat individuals with trapeziometacarpal osteoarthritis (TMC OA) who have failed conservative treatment. Arthrodesis has classically been deemed as a suitable treatment for young, active males, particularly in the post-traumatic setting, who desire maximum strength. There are numerous arthrodesis techniques described in the literature, however, reported high nonunion rates may deter surgeons from treating TMC OA with arthrodesis. A technique for TMC arthrodesis using the Speed™ Continuous Compression Nitinol Fixation System (BioMedical Enterprises, Inc., San Antonio, TX) and autogenous bone graft is presented here, along with outcomes of 60 consecutive patients (72 thumbs) who underwent the procedure. Subjective, clinical, and radiographic outcomes were collected and analyzed. Average patient age was 54.2 years (range, 30 to 69), and 51.7% were male. Fusion rate was 95.8% (69/72). Two of the three nonunions required revision fusion surgery. Key pinch strength increased from an average of 6.7 to 9.3 kg (P<0.05) and grip strength increased from an average of 33.7 to 41.1 kg (P<0.05) at an average follow-up of 23.4 months (median, 16.5). Patient satisfaction was 94%. Ninety percent of patients would repeat the procedure. Average postoperative Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) score was 11.7 (median, 4.5) at an average follow-up of 54.2 months. Trapeziometacarpal arthrodesis using Nitinol Compression staples is a reliable treatment option for TMC OA, with a low nonunion rate. This technique leads to excellent patient satisfaction and improved key pinch and grip strength.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053162","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}

引用次数: 0

Pulley Reconstruction for Bowstringing After Gracilis Free Functioning Muscle Transfer for Elbow Flexion in Adult Traumatic Brachial Plexus Injury. 成人外伤性臂丛损伤肘关节屈曲无股薄肌移植后弓形弓系的滑轮重建。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-04-23 DOI: 10.1097/BTH.0000000000000516

Ellen Y Lee, Allen T Bishop, Robert J Spinner, Alexander Y Shin

引用次数: 0

Minimally Invasive Screw Fixation in Bennett Fractures: A New Reposition Technique in a Case Series. 微创螺钉固定治疗Bennett骨折：一种新的复位技术。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-04-15 DOI: 10.1097/BTH.0000000000000515

Ramon Buechel, Joerg Hainich

{"title":"Minimally Invasive Screw Fixation in Bennett Fractures: A New Reposition Technique in a Case Series.","authors":"Ramon Buechel, Joerg Hainich","doi":"10.1097/BTH.0000000000000515","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000515","url":null,"abstract":"Transfixation or open reduction are conventional methods for treating Bennett fractures, with no current gold standard. Transfixation only allows for insufficient reduction, while the open approach by Wagner is relatively invasive. We present a minimally invasive surgical approach that allows anatomical reduction and short operation time. We report previous experiences in a case series of five patients. The disabilities of arm, shoulder, and hand score, visual analog scale, range of motion of the thumb, grip, and pinch strength were used for assessing the outcomes. Closed reduction employs an additional K-wire drilled through the ulnar base of metacarpal 2 into the Bennett fragment or into the oblique posteromedial ligament, followed by fixation with 2 cannulated compression screws. By the new technique, anatomical reduction and fixation of the Bennett fragment can be achieved minimally invasive. Previous interventions demonstrated good clinical, radiographic, and patient-reported outcomes after 6 months. In conclusion, minimally invasive screw fixation in Bennett fractures, coupled with repositioning using an additional guide wire, combines the advantages of allowing anatomical reduction and a less invasive approach seen in established methods.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048815","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}

引用次数: 0

Arthroscopy in Intra-articular Fractures of the Base of the Proximal Phalanx of the Hand. 关节镜治疗手部近端指骨基部关节内骨折。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-03-31 DOI: 10.1097/BTH.0000000000000511

Carlos E Torres Fuentes, Paula Alejandra López González, Maria Paula Castiblanco Díaz

{"title":"Arthroscopy in Intra-articular Fractures of the Base of the Proximal Phalanx of the Hand.","authors":"Carlos E Torres Fuentes, Paula Alejandra López González, Maria Paula Castiblanco Díaz","doi":"10.1097/BTH.0000000000000511","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000511","url":null,"abstract":"Intra-articular fractures of the base of the proximal phalanx tend to have a significant functional impact in the metacarpophalangeal joint since the articular congruency and gliding motion of the tendons are compromised, with some degree of postoperative stiffness, limited range of motion and pain. We describe a case series of 12 patients who attended our institution, diagnosed with an intra-articular fracture of the base of the proximal phalanx. They underwent surgery for reduction and internal fixation with screws, miniplates and/or Kirschner wires, with an arthroscopic evaluation of the articular surface. In the postoperative follow-up, we evaluated functional outcomes, mobility range, stiffness and recovery time needed to return to daily activities. The functional and clinical outcomes in patients with arthroscopic assistance were satisfactory and allowed them to return promptly to their daily activities without any limitations, with no evidence of articular damage and minimum postoperative pain. The evaluation of the articular surface with a small arthroscopic lens allows the surgeon to visualize possible step-offs and gaps that were not evident in the fluoroscopic examination, with proper placement of osteosynthesis material, using either Kirschner wires or screws through conventional minimally invasive approaches. Even though arthroscopic skills usually tend to go through a learning curve, this method is an alternative and complementary procedure for providing a healing environment for early postoperative mobilization. Alignment and stability preserve the gliding motion of the tendons, which allows an early active range of motion.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755004","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}

引用次数: 0

Management of Impending and/or Pathologic Fractures of the Proximal Radius in the Setting of Metastatic Bone Disease With an Intramedullary Photodynamic Nail. 髓内光动力钉治疗转移性骨病中桡骨近端迫近性和/或病理性骨折

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-03-28 DOI: 10.1097/BTH.0000000000000513

Megan H Goh, Sarah E Ballatori, Marcos R Gonzalez, Santiago A Lozano-Calderon

{"title":"Management of Impending and/or Pathologic Fractures of the Proximal Radius in the Setting of Metastatic Bone Disease With an Intramedullary Photodynamic Nail.","authors":"Megan H Goh, Sarah E Ballatori, Marcos R Gonzalez, Santiago A Lozano-Calderon","doi":"10.1097/BTH.0000000000000513","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000513","url":null,"abstract":"Metastatic bone disease of the radius is rare, but the functional loss of an upper extremity can profoundly impact patient quality of life and hinder independent living. When the mechanical stability of the radius is compromised, surgical intervention such as intramedullary (IM) nailing or plating may be considered in combination with radiation therapy (RT) to alleviate pain, control local tumor progression, and provide immediate stability to the bone. There are several limitations to traditional metallic IM nails, such as limited use in adults, complicated postoperative CT planning for RT, the obscuring of local tumor recurrence or progression, and metal scattering that affects RT dosing. Photodynamic nail IM stabilization is a novel, minimally invasive surgical technique that circumvents several of these shortcomings, in which a photocurable monomer is introduced through a balloon that can conform to the irregularities of an osteolytic metastatic lesion. We describe the photodynamic nail technique for the treatment of impending and/or pathologic fractures of the proximal radius.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732318","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}

引用次数: 0

Vascularized Proximal Fibula Transfer to Distal Radius: Reconstruction of Large Bone Defects Including DRUJ Stabilization After Giant Cell Tumor Excision. 带血管的腓骨近端向桡骨远端转移：巨细胞瘤切除后包括DRUJ稳定在内的大骨缺损重建。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-03-28 DOI: 10.1097/BTH.0000000000000514

Laura C Burlage, Liron Duraku, David Stewart

引用次数: 0

Subcondylar Fossa Reconstruction in Pediatric Patients Following Malunion of Proximal Phalangeal Neck Fractures: Technique and Case Series. 小儿近端指骨颈骨折畸形愈合后的髁下窝重建：技术和病例系列。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-03-27 DOI: 10.1097/BTH.0000000000000512

David P VanEenenaam, Sarah L Struble, Eliza Buttrick, Benjamin Chang, Apurva S Shah

{"title":"Subcondylar Fossa Reconstruction in Pediatric Patients Following Malunion of Proximal Phalangeal Neck Fractures: Technique and Case Series.","authors":"David P VanEenenaam, Sarah L Struble, Eliza Buttrick, Benjamin Chang, Apurva S Shah","doi":"10.1097/BTH.0000000000000512","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000512","url":null,"abstract":"The subcondylar fossa is the bony depression between the articulating surface of the proximal and middle phalanges of the fingers that allows for full flexion at the proximal interphalangeal joint. A bony block may form in the subcondylar fossa secondary to the malunion of a proximal phalangeal neck fracture. If there is a substantial loss of flexion, surgical correction could be indicated. Corrective osteotomy is technically challenging in the proximal interphalangeal joint area as the phalangeal head is small, creating fixation challenges and carrying the risk of avascular necrosis and joint contracture. Current literature describes multiple techniques with varying complexity and there is no consensus on the ideal operation to manage these fractures after malunion. The subcondylar fossa reconstruction first proposed by Simmons and colleagues is a simple and safe surgical technique that involves directly removing the bony block at the phalangeal neck. Despite its utility, it has not been described in pediatric patients since its original report of 3 patients in 1987. This study describes the subcondylar fossa reconstruction technique and presents the outcomes of its application in 4 pediatric patients.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721797","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}

引用次数: 0

Femoral Trochlea Osteochondral Autograft Transplant for Scaphoid Proximal Pole Nonunions. 自体股骨滑车骨软骨移植治疗舟状骨近端骨不连。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-03-06 DOI: 10.1097/BTH.0000000000000510

Ellen Y Lee, Allen T Bishop, Alexander Y Shin

引用次数: 0

Elbow Interposition Arthroplasty With Meniscal Allograft. 半月板同种异体肘关节置换术。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-03-04 DOI: 10.1097/BTH.0000000000000509

Ryan C Xiao, Christine S Williams, Amanda L Walsh, Jaehon M Kim, Michael R Hausman

{"title":"Elbow Interposition Arthroplasty With Meniscal Allograft.","authors":"Ryan C Xiao, Christine S Williams, Amanda L Walsh, Jaehon M Kim, Michael R Hausman","doi":"10.1097/BTH.0000000000000509","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000509","url":null,"abstract":"Painful, end-stage elbow arthritis in young, active patients remains a challenging and unsolved problem. Lifetime weight-bearing restrictions make total elbow arthroplasty (TEA) an unrealistic and unsustainable option for most of these patients, and the alternatives for treating a failed TEA are limited and mostly unsatisfactory. Elbow interposition arthroplasty can provide good pain relief and reasonable restoration of motion while avoiding weight-bearing restrictions. However, resurfacing materials such as fascia, Achilles tendon, and skin are not durable and are likely torn or displaced. We propose using meniscus allograft as the interposition material, as it is strong, robust, and designed to resist high compressive and shearing loads. It can heal the native tissue, and the topological properties of an amphitheater-shaped meniscus wrapped in a semicircle anatomically simulates the native shape of the trochlea, conferring additional stability that abets concentric motion. We present a series of 5 patients who underwent meniscal allograft arthroplasty from 2021 to 2023 at a single institution. All patients had resurfacing with meniscus allographs with supplemental stabilization using a double internal joint stabilizer. All patients demonstrated improvement in pain and ulnohumeral range of motion. Our technique of meniscus allograft interposition arthroplasty demonstrates good short-term pain relief and functional improvement. Further follow-up is warranted to assess the longevity of the meniscus interposition. Level of Evidence: Level IV-treatment study.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543724","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}

引用次数: 0

Minimally Invasive Arthroscopic-Assisted Treatment for Isolated Scaphoid Fossa Die Punch Nascent Malunion. 微创关节镜辅助治疗孤立性舟状窝凹模新生儿畸形愈合。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-03-01 DOI: 10.1097/BTH.0000000000000499

Lucian Lior Marcovici, Alessandro Greco, Antonio Luca Muscatiello, Beatrice Chiossi, Alessia Pagnotta

{"title":"Minimally Invasive Arthroscopic-Assisted Treatment for Isolated Scaphoid Fossa Die Punch Nascent Malunion.","authors":"Lucian Lior Marcovici, Alessandro Greco, Antonio Luca Muscatiello, Beatrice Chiossi, Alessia Pagnotta","doi":"10.1097/BTH.0000000000000499","DOIUrl":"10.1097/BTH.0000000000000499","url":null,"abstract":"A die punch fracture is an intra-articular fracture of the distal radius characterized by a localized depression of the articular surface, typically occurring in the lunate fossa. Misdiagnosis or incorrect management can lead to articular malunion. While die punch fractures in the scaphoid fossa are less common, their nascent malunions pose significant treatment challenges. Traditionally, these fractures are treated with an open dorsal and volar approach, combined with osteotomy and internal fixation. Arthroscopic-assisted osteotomy has emerged as a promising technique due to its precision and minimally invasive nature. We present a new arthroscopic assisted minimally invasive technique for treating isolated dislocated die punch fracture nascent malunion of the scaphoid fossa. We treated an isolated scaphoid die punch nascent malunion, with a 5 mm joint surface depression. Using a 3-4 portal and a 30-degree curved mini osteotome, we performed an intra-articular osteotomy of the fragment. A small 2 cm skin incision over the Lister tubercle and a 1 cm bone window facilitated the introduction of a 30-degree curved curette to elevate and anatomically reduce the fragment under arthroscopic guidance. Definitive fixation was achieved with 3 K-wires. Postoperative x-rays at 6 weeks show complete fracture consolidation, confirmed by a subsequent computed tomography scan. At 3 months, patients demonstrated satisfactory clinical recovery with wrist range of motion and grip strength equal to the contralateral wrist, returning to normal activities. This technique is feasible and safe, minimizing soft tissue damage, preserving proprioception and vascularity, and enabling faster recovery.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469453","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}

引用次数: 0