Journal of Hand and Microsurgery最新文献

{"title":"Surgical Management of Enchondromas of the Hand: A 12-Year Experience.","authors":"Natalie Redgrave, Dariush Nikkhah, Norbert Kang, Neil Toft","doi":"10.1055/s-0041-1736004","DOIUrl":"10.1055/s-0041-1736004","url":null,"abstract":"<p><p><b>Objective</b>  Enchondromas are benign tumours of hyaline cartilage most frequently arising in the bones of the hand and the optimum surgical management strategy for these is debated. We present an audit of the surgical management of 57 enchondromas referred to our tertiary hand surgery department over a period of 12 years (2008-2020) and describe our surgical technique for this procedure as well as a comparison with other studies in the literature. <b>Materials and Methods</b>  Retrospective audit of our practice. Data were extracted from our institutional operative database to identify all patients undergoing surgical management of enchondromas during the time period. The individual electronic patient records were then evaluated to extract demographics and outcome data. <b>Results</b>  Our results demonstrate excellent clearance of enchondroma (74% Tordai group 1 radiological resolution) with very low complication rates and no recurrence. Our results also emphasize the importance of surgical management of enchondromas to allow diagnosis of rare chondrosarcoma (3.5% in this study). <b>Conclusion</b>  A larger randomized controlled trial is still required to adequately determine the differences between the surgical options available and determine the best possible surgical approach to these cases. Level of evidence is III.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 3","pages":"188-195"},"PeriodicalIF":0.3,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306994/pdf/10-1055-s-0041-1736004.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9729629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Solution for Total Carpectomy due to Destructive Wrist Pan-Osteomyelitis Using a Free Femoral Condyle Osteocutaneous Flap for Wrist Arthrodesis.","authors":"Francisco Guillermo Castillo-Vázquez, Ignacio Palafox-Carral, Ranulfo Romo-Rodríguez, Marisol Limón-Muñoz, Efraín Farías-Cisneros","doi":"10.1055/s-0041-1736083","DOIUrl":"10.1055/s-0041-1736083","url":null,"abstract":"<p><p>Osteomyelitis of the hand is rare, even more so in the carpal bones. Patients with rheumatoid arthritis (RA) have a higher infection rate overall, and up to a 14-fold increase in the incidence of septic arthritis of the hand. The destruction of immunologic barriers, such as cartilage and joint capsules, as well as the use of immunosuppressive medications will have an impact on the higher incidence of articular infections and osteomyelitis in these patients. Infection in these cases is often overlooked because of the similarity of presentation to an acute event of RA. When osteomyelitis is present, rapid and aggressive treatment should be given. Surgical debridement, lavage, and excision of necrotic bone is the best choice, followed by cemented antibiotic impregnated spacer to resolve the acute scenario. Vascularized bone grafts (VBG) can then be used for a definitive solution, as these have great biologic properties that increase the possibility of a good outcome. We hereby present a report of a wrist arthrodesis, using a free medial femoral condyle VBG for the treatment of destructive osteomyelitis of the carpal bones in a female patient with RA.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"1 1","pages":"100-106"},"PeriodicalIF":0.3,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41387391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Aneurysmal Bone Cyst of the Phalanx.","authors":"Satvik N Pai, Srinivasan Rajappa, V Pavithra","doi":"10.1055/s-0041-1736005","DOIUrl":"10.1055/s-0041-1736005","url":null,"abstract":"","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 3","pages":"242-244"},"PeriodicalIF":0.3,"publicationDate":"2021-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306992/pdf/10-1055-s-0041-1736005.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Distal Radius Fractures in Women Older than 80 Years: A Preliminary Report of Functional and Radiographic Outcomes after Open Reduction and Internal Fixation.","authors":"Lili E Schindelar, Richard M McEntee, Robert E Gallivan, Brian Katt, Pedro K Beredjiklian","doi":"10.1055/s-0041-1729439","DOIUrl":"10.1055/s-0041-1729439","url":null,"abstract":"<p><p><b>Background</b>  Distal radius fractures are one of the most common fractures seen in the elderly. The management of distal radius fractures in the elderly, especially patients older than 80 years, has not been well defined. The purpose of this study was to evaluate operative treatment of distal radius fractures in patients older than 80 years to determine functional outcomes and complication rates. <b>Materials and Methods</b>  A retrospective review was performed to identify patients 80 years or older who were treated for a distal radius fracture with open reduction and internal fixation (ORIF). Medical records were reviewed for demographics, medical history, functional outcomes including quick Disabilities of the Arm, Shoulder, and Hand (qDASH), radiographs, and postoperative complications. <b>Results</b>  There were 40 patients included for review. Average age was 84 years. The preoperative qDASH score was 69. At 6 months follow-up, the postoperative qDASH score was 13 ( <i>p</i>  < 0.001). There were five (12.5%) complications reported postoperatively. All fractures healed with adequate radiographic alignment and there were no hardware failures. <b>Conclusion</b>  Distal radius fractures in patients older than 80 years treated with ORIF have good functional outcomes and low complication rates. Increased functionality and independence of the elderly, as well as updated implant design can lead to the effective surgical management of these patients. When indicated from a clinical perspective, operative fixation of distal radius fractures should be considered in patients older than 80 years.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 2","pages":"116-123"},"PeriodicalIF":0.3,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069995/pdf/10-1055-s-0041-1729439.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9299934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Bilateral Spaghetti Injuries in Children due to Assault by Mother and Analysis of Functional Outcome at Three Years.","authors":"Parag B Lad, N Venkateshwaran, M R Thatte, Sanket Tanpure","doi":"10.1055/s-0041-1735346","DOIUrl":"10.1055/s-0041-1735346","url":null,"abstract":"<p><p>Management of child abuse with flexor tendons, neurovascular injuries, and life-threatening conditions is challenging. It needs a multisectoral coordinated and synchronized team effort for successful outcomes. We present a case series of children abused by a parent with a sharp object. The children sustained multiple flexor tendon injuries, neurovascular injuries in upper limbs, and tracheal injury compromising respiration. We performed a tracheostomy to save a child and subsequently repaired numerous flexor tendons, nerves, and arteries. During follow-up, these children required secondary reconstruction (tenolysis, tendon lengthening, nerve reconstruction) for flexor contractures, stiffness, and sensory loss in distal forearms. We measured the range of movements and assessed the children's functional outcome using the Strickland score at 3-year follow-up. The range of movement and functional outcome was excellent in both children in our series. A timely performance of surgery, aided with efficient intensive care, therapy, and consistent posttraumatic psychosocial rehabilitation, produced excellent results in our series.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 3","pages":"230-235"},"PeriodicalIF":0.3,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306995/pdf/10-1055-s-0041-1735346.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head and Neck Reconstruction in Patients with Polycythemia Vera: Case Series and Literature Review.","authors":"Sophia Dang, Leila J Mady, Rahilla Tarfa, Jonathan C Li, Frank Bontempo, Irina Chibisov, Mark W Kubik, Mario G Solari, Shaum Sridharan","doi":"10.1055/s-0041-1734398","DOIUrl":"10.1055/s-0041-1734398","url":null,"abstract":"<p><p><b>Background</b>  Polycythemia vera (PV) is a myeloproliferative disease with overproduction of erythrocytes, leukocytes, and platelets causing an increased risk of both thrombosis and hemorrhage. There are limited reports and no established guidelines for managing such patients undergoing reconstructive surgery. <b>Methods</b>  We present four patients with PV and head and neck cancer who required reconstruction after resection and provide a review of the current literature. <b>Results</b>  Preoperatively, patients on cytoreductive therapy continued with their treatment throughout their hospital course and had hematologic parameters normalized with phlebotomy or transfusions if needed. Two patients who underwent free flap surgery (cases 1 and 2) had postoperative courses complicated by hematoma formation and persistent anemia, requiring multiple transfusions. Cases 3 and 4 (JAK2+ PV and JAK2- PV, respectively) underwent locoregional flap without postoperative complications. <b>Conclusion</b>  Concomitant presentation of PV and head and neck cancer is uncommon and presents unique challenges for the reconstructive surgeon. Overall, we recommend that patients should have hematologic parameters optimized prior to surgery, continue ruxolitinib or hydroxyurea, and hold antiplatelet/anticoagulation per established department protocols. It is essential to engage a multidisciplinary team involving hematology, head and neck and reconstructive surgery, anesthesia, and critical care to develop a standardized approach for managing this unique subset of patients.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 1","pages":"67-74"},"PeriodicalIF":0.3,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904977/pdf/10-1055-s-0041-1734398.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10679261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Handprint for Clinical Evaluation of Dupuytren's Contracture.","authors":"Takashi Ajiki, Akira Murayama, Yukinori Hayashi, Katsushi Takeshita","doi":"10.1055/s-0041-1735347","DOIUrl":"10.1055/s-0041-1735347","url":null,"abstract":"<p><p><b>Objective</b>  We have developed a handprint-based method for visualizing and quantifying the palmar contact of patients with Dupuytren's contracture. The purpose of this study was to examine whether the generated handprint was useful for assessing the severity of flexion contracture of the fingers and for evaluating the therapeutic effects of collagenase clostridium histolyticum (CCH) injection for Dupuytren's contracture. <b>Methods</b>  The handprint was created by applying medical-grade ethanol-containing hand sanitizer over the entire palmar surface of the affected hand and then pressing it on thermal paper for word processors. The reliability of the handprint was evaluated through test-retest of 10 healthy volunteers at an interval of 10 days, and the validity of the handprint was assessed using a flexion contracture model in which the little finger was fixed in an Alfence splint. In addition, we obtained handprints of the affected hand in 33 patients with unilateral Dupuytren's contracture both before CCH injection and at the final observation after injection to investigate the contact area of the hand (CAH) and the length of the hand (LH). The relationships between CAH, LH, total extension deficit angle (TEDA), and patient-reported outcome measures (Japanese Society for Surgery of the Hand Version of the Quick Disability of Arm, Shoulder, and Hand Questionnaire [Quick DASH-JSSH] and Hand20) were examined. <b>Results</b>  The test-retest correlation coefficient was 0.9187 ( <i>p</i>  < 0.001) for CAH and 0.9052 ( <i>p</i>  < 0.001) for LH, indicating high reliability of the handprint. The ratios of CAH and LH decreased gradually as the contracture angle of the splinted finger increased. The handprint revealed a marked improvement of palmar contact after CCH injection for Dupuytren's contracture. Furthermore, the ratios of CAH and LH were strongly correlated with TEDA, Quick DASH-JSSH, and Hand20 before treatment. <b>Conclusion</b>  Our handprint-based assessment method was extremely useful for clinical evaluation of CCH treatment for Dupuytren's contracture. <b>Type of Study/Level of Evidence</b>  Therapeutic.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 3","pages":"181-187"},"PeriodicalIF":0.3,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306974/pdf/10-1055-s-0041-1735347.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of the I-HaND Scale with Other Musculoskeletal Patient-Reported Outcome Measurement Scores.","authors":"Joost T P Kortlever, S Ryan Pierson, David Ring, Lee M Reichel, Gregg A Vagner","doi":"10.1055/s-0041-1735348","DOIUrl":"10.1055/s-0041-1735348","url":null,"abstract":"<p><p><b>Background</b>  Experiments can determine if nerve-specific patient-reported outcome measures (PROMs) can outperform regional or condition-specific PROMs. We compared a nerve-specific PROM of the upper extremity, the Impact of Hand Nerve Disorders (I-HaND) scale, to other validated measures quantifying activity intolerance and sought to assess interquestionnaire correlations and factors independently associated with activity intolerance and pain intensity. <b>Methods</b>  One hundred and thirty patients with any upper extremity nerve-related condition completed measures of demographics, psychological limitations, quality of life, activity intolerance, and pain intensity. To quantify activity intolerance, we used the I-HaND, Patient-Reported Outcomes Measurement Information System Physical Function Upper Extremity, and Disabilities of the Arm, Shoulder and Hand short form. <b>Results</b>  Strong interquestionnaire correlations were found between the activity intolerance measures ( <i>r</i> between 0.70 and 0.91). Multivariable analysis revealed that greater activity intolerance and greater pain intensity correlated most with greater symptoms of depression on all scales, with symptoms of depression accounting for 53 to 84% of the variability in the PROMs. <b>Conclusion</b>  There is no clear advantage of the nerve-specific I-HaND over shorter, regional PROMs, perhaps because they are all so closely tied to mental health. Unless an advantage relating to responsiveness to treatment is demonstrated, we support using a brief arm-specific PROM for all upper extremity conditions. <b>Level of Evidence</b>  Level II; Prognostic.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 3","pages":"175-180"},"PeriodicalIF":0.3,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306978/pdf/10-1055-s-0041-1735348.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9741484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini TightRope Suspension Allows for Accelerated Rehabilitation following Ligament Reconstruction Interposition Arthroplasty of the Basal Joint of the Thumb.","authors":"Rasmus Wejnold Jørgensen, Kiran Annette Anderson, Claus Hjorth Jensen","doi":"10.1055/s-0041-1730887","DOIUrl":"10.1055/s-0041-1730887","url":null,"abstract":"<p><p><b>Introduction</b>  Surgical treatment of thumb trapeziometacarpal osteoarthritis usually involves 4 to 8 weeks of postoperative casting and splinting followed by varying mobilization protocols. Suspension arthroplasty has been described as an alternative to allow earlier range of motion exercises. The purpose of this study was to compare patient-reported outcomes (PRO) when adding a two-string suture-button suspension arthroplasty (Mini TightRope, MTR) to our usual procedure of ligament reconstruction and tendon interposition (LRTI), allowing early mobilization. Can we allow early mobilization using this technique without jeopardizing the PRO results at the 1 year follow-up and without an increased risk of complication? <b>Materials and Methods</b>  A prospective study using the MTR system (Arthrex) as a suture-button suspensionplasty was conducted. Twelve patients (MTR group) and 36 historical patients (LRTI alone) were included. <b>Results</b>  At 12 months, the median value for quick disabilities of the arm, shoulder, and hand was 11.3 (range, 0-43.2) in the MTR group and 13.6 (range, 0-88.6) in the LRTI group, resulting in similar improvements, <i>p</i>  = 0.46. One in twelve patients in the MTR group was dissatisfied and 9 in 36 in the LRTI group were dissatisfied, <i>p</i>  = 0.41. No complications were observed during the first year. <b>Conclusion</b>  Supplemental suture-button suspensionplasty can be utilized for high demand patients and patients who want to reduce immobilization time without major complications and with similar PRO as LRTI at 6 and 12 months. <b>Level of evidence</b>  Four case series.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 2","pages":"141-147"},"PeriodicalIF":0.3,"publicationDate":"2021-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070004/pdf/10-1055-s-0041-1730887.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9299927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free Vascularized Joint Transfer from Toes for Finger Reconstruction in a 2-Year-Old Child with Good Functional Recovery.","authors":"Jyoshid R Balan","doi":"10.1055/s-0041-1732807","DOIUrl":"10.1055/s-0041-1732807","url":null,"abstract":"<p><p>A 2-year-old male child sustained injury to middle and ring fingers of the right hand following a road traffic accident. He had mutilated fingers with loss of middle phalanx along with proximal interphalangeal (PIP) joint, distal interphalangeal joint of middle finger, and loss of part of middle phalanx and PIP joint of the ring finger. There was dorsal tissue loss of both the fingers. With staged reconstructive strategy, we could salvage the fingers. In the initial part, the soft tissue reconstruction was done using pedicled groin flap. In the later stage, free PIP joint transfer from the second toes of both feet was used to reconstruct the bone and PIP joint of the ring and middle finger. A year following the joint transfer, the child had good functional outcome.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 2","pages":"152-155"},"PeriodicalIF":0.3,"publicationDate":"2021-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069999/pdf/10-1055-s-0041-1732807.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9626462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}