{"title":"Thumb opposition: its definition and my approach to its measurement","authors":"M. Tonkin","doi":"10.1177/1753193419889504","DOIUrl":"https://doi.org/10.1177/1753193419889504","url":null,"abstract":"The trapeziometacarpal (TMC) joint allows movement in extension/flexion (alternatively termed radial abduction/adduction) in the frontal plane; abduction/adduction (alternatively, antepulsion/retropulsion) in the sagittal plane; and supination/pronation (rotation around the longitudinal thumb axis) (Figure 1). The first two are angular movements and the third is an axial rotation. I prefer to use the terminology extension/flexion and abduction/adduction for movements in the frontal and sagittal planes, and not those in brackets. Nevertheless, both are used by different authors. Circumduction is the path followed by the thumb in movement from full supination of 30 (reposition); to neutral rotation of 0 when the thumbnail is at 90 to the frontal plane with 20 of extension and 30 of abduction (neutral position); to full pronation of 90 with the thumbnail parallel to the frontal plane of the palm (opposition) (Figure 1).","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"315 - 317"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419889504","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43986614","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":"Partial flexor carpi radialis tendon transfer technique for midcarpal instability","authors":"Hero J. A. Zijlker, K. Harmsen, S. Strackee","doi":"10.1177/1753193419889307","DOIUrl":"https://doi.org/10.1177/1753193419889307","url":null,"abstract":"demonstrated, however, that the knot outside the repair was stronger only early in the healing process; they found no difference between inside and outside knot repair strength 6 weeks after. Recently, a knotless, asymmetric repair was reported to be even stronger compared with the Lim/Tsai configuration, highlighting that the knot was the weakest link in flexor tendon repairs (Lim et al., 2018). There are several limitations to this study. First, we did not add an epitendinous suture to our repair configurations before testing. This was done on purpose to avoid extra variables when analysing the results, but might not truly reflect the flexor tendon repair configurations used in vivo. Second, this is a basic science study, and the ex vivo setup might not mimic the in vivo environment. The knot position outside of the repair zone might be more prone to adhesions compared with the inside position, whereas the inside position causes decreased tendon-to-tendon contact in vivo. Lastly, the repair constructs were loaded to failure and did not undergo cyclic testing.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"304 - 306"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419889307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42147293","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}
R. Poelstra, Y. V. van Kooij, M. J. van der Oest, H. Slijper, S. Hovius, R. Selles
{"title":"Patient’s satisfaction beyond hand function in Dupuytren’s disease: analysis of 1106 patients","authors":"R. Poelstra, Y. V. van Kooij, M. J. van der Oest, H. Slijper, S. Hovius, R. Selles","doi":"10.1177/1753193419890284","DOIUrl":"https://doi.org/10.1177/1753193419890284","url":null,"abstract":"This study investigates the outcomes of 1106 patients with Dupuytren’s disease treated with limited fasciectomy or percutaneous needle fasciotomy over 16 years according to the different domains of patient-reported hand function. These patients completed the Michigan Hand Outcomes Questionnaire before and 3 months after surgery. Scores for the various outcome parameters were calculated and linear regression analyses were used to examine associations between the changes in digital extension deficit and change in Michigan Hand Outcomes Questionnaire (sub)scores. We found the largest effects of surgical treatment in the decreases in extension deficit, the appearance of the hand, and the satisfaction with the hand function. However, associations between different domains of evaluation were weak. We conclude that improvement of digital extension deficits is not parallel to varying aspects of patient satisfaction. The findings underline the importance of assessing domains relating to patient satisfaction other than objective hand function measures in Dupuytren’s disease. Level of evidence: IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"280 - 285"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419890284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49629394","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}
S. Hulkkonen, Kaisa Lampainen, J. Auvinen, J. Miettunen, J. Karppinen, J. Ryhänen
{"title":"Incidence and operations of median, ulnar and radial entrapment neuropathies in Finland: a nationwide register study","authors":"S. Hulkkonen, Kaisa Lampainen, J. Auvinen, J. Miettunen, J. Karppinen, J. Ryhänen","doi":"10.1177/1753193419886741","DOIUrl":"https://doi.org/10.1177/1753193419886741","url":null,"abstract":"The aim of this study was to investigate the incidence rates and operations for carpal tunnel syndrome and ulnar and radial neuropathies in specialist care in Finland. Patients diagnosed with entrapment neuropathies of the upper extremity were identified from the Care Register for Health Care, 2007–2016. There were 81,911 cases in 54,095,070 person-years. The total crude incidence rates per 100,000 person-years among women and men were 197 and 105 for carpal tunnel syndrome, 26 and 36 for ulnar neuropathies, and 5.7 and 8.5 for radial neuropathies, respectively. Of these, carpal tunnel syndrome was operated on in 63% of women and 61% of men, ulnar neuropathy in 43% of women and 47% of men, and radial neuropathy in 11% of women and 8% of men. Incidence of carpal tunnel syndrome and ulnar neuropathies increased up to late middle age, while radial neuropathies were less common. Level of evidence: III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"226 - 230"},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419886741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42713039","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":"Re: Gschwind CR, Yeomans JL, Smith BJ. Upper limb surgery for severe spasticity after acquired brain injury improves ease of care. J Hand Surg Eur. 2019, 44: 898–904.","authors":"Daisy Ryan, Marie Song, J. Chan","doi":"10.1177/1753193419887339","DOIUrl":"https://doi.org/10.1177/1753193419887339","url":null,"abstract":"We thank Drs Andersson and Karlsson for their letter, which highlights the clinical relevance of our paper (Sun et al., 2019). We see this paper as an extension of our previously published work on CT scans of distal radius fractures (Mandziak et al., 2011). We have identified that distal radius fractures are significantly more likely to occur between the ligaments (Mandziak et al., 2011; Bain et al., 2013), especially in low velocity injuries. Therefore, each fragment will have its own ligament. We have identified that these ligaments are important in the initiation of the fracture, the settling of the fracture, and in establishing a pathoanatomic-based treatment plan (MacLean and Bain, 2019). This Osteoligamentous concept is important to understand in the assessment and treatment of all fractures (MacLean and Bain, 2019). In our recent paper (Sun et al., 2019), we identified significant widening in the scapholunate interval in specific 2-part distal radial fracture sub-types; namely radial styloid oblique, dorsal ulnar corner types. We agree that it is important to preoperatively assess the distal radius fracture and signs of carpal instability. We also agree with the authors that wrist arthroscopy is a valuable intra-operatively tool for diagnosis and assessment of the reduction. We support the important work of Lindau et al. (1997), where he provides an understanding of the longer-term outcome of these associated injuries. However, we feel that our work has highlighted the importance of sub-group analysis, and we believe that further research is required to better define which osteoligamentous injuries have a poorer prognosis. Our study highlights the important pathoanatomy of osteoligamentous injuries of the distal radius, appreciating both the osseous and soft tissue component. From a greater understanding of these osteoligamentous injuries, we can hopefully provide a more focused treatment plan.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"311 - 314"},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419887339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65456531","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}
R. Jakubietz, S. Erguen, Silvia Bernuth, R. Meffert, F. Gilbert, M. Jakubietz
{"title":"An anatomical study on the Stener-type lesion of the radial collateral ligament of the metacarpophalangeal joint of the thumb","authors":"R. Jakubietz, S. Erguen, Silvia Bernuth, R. Meffert, F. Gilbert, M. Jakubietz","doi":"10.1177/1753193419887344","DOIUrl":"https://doi.org/10.1177/1753193419887344","url":null,"abstract":"The Stener-type lesion of the radial collateral ligament is rare. The insertion of the abductor pollicis brevis is believed to preclude its occurrence. The aim of this study was to determine whether this lesion can be induced mechanically. Four specimens were tested in neutral rotation and 20° of supination, in 45° and 30° of flexion, and in the neutral position. The angle of ulnar adduction to form a Stener-type lesion was measured. The lesion occurred only in 45° flexion in all specimens. A lesser angle of flexion decreased the rate of ligament displacement. In the neutral position no ligament displacement was found. A Stener-type lesion of the radial collateral ligament can occur in ulnar adduction and flexion of the metacarpophalangeal joint. Supination of the joint increases the likelihood of ligament displacement. As distal ruptures of the radial collateral ligament are uncommon, a high index of suspicion is required for diagnosis.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"131 - 135"},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419887344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42863353","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}
K. W. Chin, A. Engelsman, T. V. van Gulik, S. Strackee
{"title":"Selective denervation of the wrist for chronic pain: a systematic literature review","authors":"K. W. Chin, A. Engelsman, T. V. van Gulik, S. Strackee","doi":"10.1177/1753193419886777","DOIUrl":"https://doi.org/10.1177/1753193419886777","url":null,"abstract":"Selective denervation of sensory nerve branches to the wrist is a palliative surgical treatment option for patients with chronic wrist pain when preserving the range of motion and function is preferred. Treatment varies from partial isolated denervation of the posterior interosseous nerve to extensive ‘complete’ denervations. This study aimed to provide an overview of the literature regarding treatment outcomes in the domains of pain, grip strength, patient satisfaction and return to work. MEDLINE (PubMed), EMBASE and Cochrane databases were systematically searched and identified 993 studies, of which 12 were eligible for analysis. Denervation resulted in high ‘return to work’ rates (up to 94%), patient satisfaction (up to 92%), increased grip strength (7%–64%) and improved average pain scores (36%–92%). Treatment outcomes of both partial and complete denervations were favourable; however, variations in outcomes suggest the need for improving evidence regarding surgical technique and nerve identification.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"265 - 272"},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419886777","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48405940","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":"The 14th IFSSH & 11th IFSHT Triennial Congress and combined FESSH Congress in Berlin in 2019","authors":"M. Haerle, J. van Schoonhoven, A. Eisenschenk","doi":"10.1177/1753193419886545","DOIUrl":"https://doi.org/10.1177/1753193419886545","url":null,"abstract":"","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"210 - 210"},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419886545","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47894450","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":"Bone marrow from the iliac crest versus from the distal radius for revitalizing the necrotic lunate for Kienböck disease","authors":"Takeshi Ogawa, N. Ochiai, Y. Hara","doi":"10.1177/1753193419886724","DOIUrl":"https://doi.org/10.1177/1753193419886724","url":null,"abstract":"We developed a technically simple procedure to revitalize the necrotic lunate for Kienböck disease using a combination of non-concentrated bone marrow (BM) transfusion from the radius to lunate, lowintensity pulsed ultrasound, and external fixation (Ogawa et al., 2013). The results were shown to be not inferior to those of conventional treatments for Kienböck disease (Ogawa et al., 2013). After 2007, our protocol was altered: non-concentrated BM from the iliac crest was used under the hypothesis that a greater number of BM cells would be advantageous to regenerate the necrotic lunate (Hernigou et al., 2005). We treated 16 patients (nine men and seven women) with Kienböck disease using the iliac crest as the BM donor site. Preoperative Lichtman stages were Stage II in five patients, Stage IIIa in six, and Stage IIIb in five. We performed the surgery in the same way as in our previous report (Ogawa et al., 2013), except that we collected the BM aspirate (approximately 5 mL) from the iliac crest (Figure 1). Mean age of the 16 patients at the surgery was 44 years (range 15–73); mean follow-up was 36 months (range 12–78). The length of external fixation was 69 Journal of Hand Surgery (European Volume) 2020, Vol. 45(3) 299–309 journals.sagepub.com/home/jhs","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"299 - 301"},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419886724","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43495710","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":"Evidence for efficacy of new developments in reconstructive upper limb surgery for tetraplegia","authors":"James P. Ledgard, C. Gschwind","doi":"10.1177/1753193419886443","DOIUrl":"https://doi.org/10.1177/1753193419886443","url":null,"abstract":"Nerve transfers are increasingly utilized for upper limb reconstruction in tetraplegia. We reviewed the literature for results achieved by nerve transfers for elbow extension, wrist control and finger and thumb flexion and extension. Muscle strength grading was the only outcome measure consistently reported. The results confirm that nerve transfers can effectively reanimate muscles in selected cases, with comparable strength with those achieved with tendon transfer for elbow extension but inferior strength for finger and thumb flexion. Transfer of supinator nerve branches to the posterior interosseous nerve appears to be reliable and offers increased span and better hand opening than is observed after tendon transfers. Only one publication demonstrated how reinnervation of muscles with nerve transfers translated into improved function, activity and participation for patients. More prospective studies, using standardized outcome measures, are needed to define the precise role of nerve transfers.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"45 1","pages":"43 - 50"},"PeriodicalIF":0.0,"publicationDate":"2019-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419886443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44570619","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}