Hand surgery & rehabilitation最新文献

{"title":"Treatment of long finger metacarpophalangeal arthritis using HAPY® pyrocarbon interposition implants: a study of 34 cases.","authors":"Thomas Daoulas, François Ducournau, Hélène Agneray, Ludovic Ardouin, Etienne Gaisne, Philippe Bellemère","doi":"10.1016/j.hansur.2024.102068","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.102068","url":null,"abstract":"<p><strong>Introduction: </strong>Destruction of the metacarpophalangeal joint can result in disabling pain and stiffness. Several therapeutic options are available, including pyrocarbon interposition implants. The primary endpoint of this study was assessment of clinical and radiographic outcomes in 34 patients treated with HAPY® pyrocarbon interposition implants (Tornier, Grenoble, France) with a minimum follow-up of 3 years. The secondary endpoint was to assess complications and the need for revision surgery.</p><p><strong>Materials and methods: </strong>Thirty-four patients (61 implants) who underwent metacarpophalangeal arthroplasty with the HAPY® implant were reviewed with a minimum follow-up of 3 years. The etiology was inflammatory (rheumatoid arthritis) in 18 cases (37 implants), primary osteoarthritis in 16 (21 implants), and post-traumatic in 3 (3 implants). Preoperative data comprised age, gender, operated finger, etiology (inflammatory, primary or post-traumatic), digital chain mobility, pain assessment on visual analog scale, grip strength on a standardized handheld dynamometer, and functional scores including QuickDASH and the Patient-Rated Wrist/Hand Evaluation. Immediate postoperative radiographs (anteroposterior, lateral and oblique views) centered on the metacarpophalangeal joint were compared with those at last follow-up. Metacarpal and phalangeal implant subsidence were assessed.</p><p><strong>Results: </strong>At a mean follow-up of 71.5 months, pain score was reduced by a mean 5.4 points: 6.4/10 versus 1/10 (p < 0.001). The mean active range of motion in flexion-extension showed a significant improvement of 27°: 42.9 ° versus 70 ° (p < 0.001). The QuickDASH and Patient-Rated Wrist/Hand Evaluation functional scores significantly improved by a mean 26.7 points (50.6 ± 20.1 versus 23.9 ± 25 (p < 0.001)) and 32.8 points (53.58 ± 21.6 versus 20.77 ± 22.1 (p < 0.001)), respectively. Comparison between pre- and post-operative grip strength did not show a significant difference. 94% of patients reported being satisfied with the procedure, while 6% were dissatisfied or very dissatisfied. One of the dissatisfied patients developed type 1 complex regional pain syndrome, while the other had persistent pain and stiffness. Mean implant subsidence in the metacarpal was 0.48 mm ± 4.2 mm, and in the first phalanx 3.6 mm ± 9.6 mm. One patient (2.9%) experienced implant dislocation in the immediate postoperative period. No further implant dislocations were observed during follow-up.</p><p><strong>Discussion: </strong>The HAPY® interpositional implant provided good clinical and radiographic outcomes for the management of long finger arthritis, offering functional results and improvement in range of motion, comparable to other series. The HAPY® interpositional implant has the advantage of being non-constrained and maximizing bone stock.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102068"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873688","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":"Radiographic Evaluation of Trapeziometacarpal Total Joint Arthroplasty: Why and How?","authors":"Joris Duerinckx, Kjell Van Royen","doi":"10.1016/j.hansur.2024.102067","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.102067","url":null,"abstract":"<p><p>Total joint arthroplasty is a promising surgical treatment for painful thumb trapeziometacarpal osteoarthritis. Strict surgical technique is essential to achieve a reliably good outcome. Preoperative radiographic evaluation before surgery and intraoperative fluoroscopy during surgery are valuable means of optimizing implant positioning. This article provides an overview of how to perform proper radiographic evaluation for trapeziometacarpal arthroplasty, and discusses radiographic guidelines for correct implant placement and how to use them during surgery.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102067"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873687","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":"Revision of trapeziometacarpal arthroplasty.","authors":"Pierre-Emmanuel Chammas, Jacques Teissier, Léo Chiche, Cyril Lazerges, Bertrand Coulet, Michel Chammas","doi":"10.1016/j.hansur.2024.102066","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.102066","url":null,"abstract":"<p><p>Complications of trapeziometacarpal arthroplasty are uncommon, but are classified as intra- and post-operative, dislocation and loosening being the main causes of revision surgery. Periprosthetic fracture and ossification are rare. Whenever possible, prosthetic revision techniques consist in partial or total replacement with modular implants. Trapeziectomy-ligamentoplasty is the last-resort revision technique, with results similar to those of primary trapeziectomy-ligamentoplasty.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102066"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866807","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":"Computed-tomography-based three-dimensional analysis of bilateral differences in phalanges.","authors":"Jana Betschart, Lea Estermann, Tobias Götschi, Andreas Schweizer","doi":"10.1016/j.hansur.2024.102065","DOIUrl":"10.1016/j.hansur.2024.102065","url":null,"abstract":"<p><p>Three-dimensional analysis of bones, especially for preoperative planning of corrective osteotomy in fracture malunion, assumes that the bilateral extremities exhibit a symmetrical mirror image when projected onto each other. No studies are available for phalanges. Three-dimensional bone models of all phalanges of 20 healthy participants (40 hands) were created from computed tomography data. For each phalanx, the difference between the left and right sides were assessed with respect to axis of rotation, ulnoradial deviation, flexion-extension and bone length. The average absolute side difference was small, but with significant differences of extension-flexion (mean 1.1°), supination-pronation (mean 1.8°), ulnoradial deviation (mean 0.9°) and translation (mean 0.2 mm). All left proximal phalanges were significantly pronated in comparison to the right side. The differences are likely unimportant, especially in corrective osteotomy using advanced 3D techniques.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102065"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822957","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":"Reply to Nathan Milliot, Jérome Jeudy, Nicolas Bigorre: metal hypersensitivity in trapeziometacarpal arthroplasty: a systematic pattern of progression.","authors":"Marie Witters, Jean-Baptiste de Villeneuve Bargemon, Charlotte Jaloux","doi":"10.1016/j.hansur.2024.102024","DOIUrl":"10.1016/j.hansur.2024.102024","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102024"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804203","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":"Innovative orthosis for proximal interphalangeal joint recovery: A new approach to finger rehabilitation.","authors":"Paolo Boccolari, Roberto Tedeschi, Dominique Thomas, Danilo Donati","doi":"10.1016/j.hansur.2024.102049","DOIUrl":"10.1016/j.hansur.2024.102049","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102049"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793086","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":"Trapezium reconstruction with pisiform autograft in trapeziometacarpal revision arthroplasty: a case report.","authors":"Alexandre Quemener-Tanguy, Jean-Baptiste De Villeneuve Bargemon, Michel Levadoux","doi":"10.1016/j.hansur.2024.102048","DOIUrl":"10.1016/j.hansur.2024.102048","url":null,"abstract":"<p><p>The authors used a pisiform autograft to fill trapezial bone defect and allow revision of a trapeziometacarpal prosthesis. At 18 months, the patient regained a level of indolence and resumed her daily activities. LEVEL OF EVIDENCE: IV.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102048"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786989","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":"Safety of dorsal screw penetration at the proximal holes of volar locking plates.","authors":"Harrison R Ferlauto, Dani Inglesby, Joshua Barnett, George Agriantonis, Eitan Melamed","doi":"10.1016/j.hansur.2024.102047","DOIUrl":"10.1016/j.hansur.2024.102047","url":null,"abstract":"<p><p>Tendon-related complications comprise a significant portion of overall complications following volar locked plating of distal radius fractures. While much is known about the effect of prominent hardware in the volar and dorsal metaepiphyseal region of the distal radius, less is known about the effect of hardware prominence in the dorsal meta-diaphyseal region. The purpose of this anatomic study was to evaluate the safety of dorsal screw penetration at the proximal holes of volar locking plates. We applied a 7-hole volar locking plate to the distal radius of 10 cadaver forearms. Screws were intentionally protruding on the dorsal side. Measurements were taken from each protruding dorsal screw-tip to the nearest point on the abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus and extensor digitorum communis, noting whether the nearest point was on the tendon or muscle belly. Results indicated that the muscle bellies of the abductor pollicis longus and extensor pollicis brevis were the structures most at risk from dorsal screw prominence, and that there was a smooth transition from the extensor pollicis brevis to abductor pollicis longus being the focus of risk as one moves from distal to proximal along the plate. The extensor pollicis brevis was most at risk at hole 3, and the abductor pollicis longus was most at risk at hole 6. All cases of direct contact between a protruding screw and the abductor pollicis longus or extensor pollicis brevis consisted of contact with the muscle belly, not the tendon. Average anteroposterior distal radius thickness ranged from 13.9 mm at the most distal proximal screw hole to 11.5 mm at the most proximal screw hole. We also found that the extensor pollicis longus tendon was at risk of contact with a protruding screw, but only at the most distal proximal screw hole. Overall, dorsal screw penetration at the proximal holes of volar locking plates appeared to be safe, particularly as one moves proximally along the plate.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102047"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782238","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":"Clinical effect of rehabilitation after distal radius fracture surgery using a wearable device: A comparative prospective cohort study.","authors":"SeongJu Choi, Joonha Lee, Kee Jeong Bae, Dong Kyun Kim, Young Ho Lee, Yohan Lee","doi":"10.1016/j.hansur.2024.101779","DOIUrl":"10.1016/j.hansur.2024.101779","url":null,"abstract":"<p><strong>Background: </strong>Appropriate postoperative rehabilitation of distal radius fractures is essential for early recovery and pain management, but may be limited by medical staff and equipment availability and costs. Home-based training or wearable devices provide an alternative.</p><p><strong>Objectives: </strong>To assess use of a wearable device and home-based training for rehabilitation after distal radius fracture surgery.</p><p><strong>Design: </strong>Prospective comparative cohort study.</p><p><strong>Method: </strong>Between April and November 2021, patients aged > 20 years with distal radius fracture who could understand and use wearable devices and their application were recruited. Patients with polytrauma, neurological disorder or musculoskeletal disorder were excluded. The control group underwent a regimen of passive and active finger and wrist exercises after surgery, while the experimental group performed equivalent rehabilitation using a wearable device (smart glove). Outcomes comprised pain on visual analog scale, wrist range of motion, Quick Disabilities of the Arm, Shoulder, and Hand score, Modified Mayo Wrist Score, and radiographic parameters (radial inclination, radial height, ulnar variance and volar tilt) at 6 and 12 weeks after surgery.</p><p><strong>Results: </strong>Fracture type, age and gender did not differ between the control (n = 7) and experimental (n = 7) groups. All participants achieved bone union and exhibited equivalent radiographic parameters at follow-up. The experimental group showed significantly improved Mayo scores (65.7 vs. 56.4, p = 0.044), wrist range of motion (259.3 vs. 179.3, p = 0.021), and pain (1.43 vs. 3.29, p = 0.011) at 6 but not 12 weeks' follow-up.</p><p><strong>Conclusions: </strong>Rehabilitation using a smart glove showed better short-term clinical outcomes after surgery than conventional rehabilitation. Rehabilitation using a wearable device may be beneficial for early recovery after distal radius fracture surgery.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101779"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335114","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":"Surgical treatment of proximal interphalangeal joint stress fracture in a climber.","authors":"Yuji Saeki, Mitsunori Shigetomi, Koji Yoshida, Yosuke Yamashita","doi":"10.1016/j.hansur.2024.101790","DOIUrl":"10.1016/j.hansur.2024.101790","url":null,"abstract":"<p><p>Proximal interphalangeal joint stress fractures commonly occur as epiphyseal line injuries in teenage climbers; however, fractures with closed epiphyseal lines are rare. Poor outcomes are more common if treatment is delayed. We report the case of a 16-year-old climber who underwent delayed surgical treatment for a fracture with a closed epiphyseal line, with a favorable outcome. There was 20 ° extension lag at the proximal interphalangeal joint and a fracture on the dorsal aspect of the base of the metaphyseal bone, with osteosclerosis at the fracture site. The fracture site was refreshed and internal fixation was performed using the tension-band wiring technique. At 3 months postoperatively, there was no pain, extension had improved, and bone union was achieved. This case illustrates the effectiveness of surgery in achieving favorable outcomes for delayed proximal interphalangeal joint stress fractures in climbers with epiphyseal line closure. LEVEL OF EVIDENCE: V.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101790"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484117","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}