Hand surgery & rehabilitation最新文献

{"title":"Hajdu-Cheney syndrome: A case of acral osteolytic deformity of both hands.","authors":"Jian Meng, Han Yang, Yikai Li, Kun Chen","doi":"10.1016/j.hansur.2024.101785","DOIUrl":"10.1016/j.hansur.2024.101785","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101785"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383061","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":"Comparison of WALANT versus locoregional nerve block in staged bilateral endoscopic carpal tunnel release.","authors":"Dries Verrewaere, Pieter Reyniers, Hanne Vandevivere, Filip Stockmans, Bart Berghs, Francis Bonte","doi":"10.1016/j.hansur.2024.101974","DOIUrl":"10.1016/j.hansur.2024.101974","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel release can be performed as open or endoscopic surgery. In WALANT (wide awake local anesthesia no tourniquet) a tourniquet is not used, ensuring less discomfort for the patient. In locoregional distal nerve block, on the other hand, a tourniquet is needed and can be painful. This raises the question as to which method of anesthesia is actually preferred for the patient and the surgeon. Patients undergoing staged bilateral carpal tunnel release present a unique opportunity to study this question.</p><p><strong>Methods: </strong>Fifteen patients were included in this prospective study. The primary endpoint was the preference for anesthesia type in patients and surgeons. Surgeon preference was based on the visibility and fluency of the procedure. Secondary endpoints for patients comprised pain scores for performing surgery and anesthesia and pain caused by the tourniquet.</p><p><strong>Results: </strong>Baseline demographic and clinical information was collected. There was no significant difference in pain for performing local anesthesia or surgery. Surgeons may find that performing endoscopic release under WALANT is more challenging, as visibility tends to be significantly poorer. The mean pain caused by the tourniquet used during the wrist block procedure was rated as 3.6. In both surgeries, 77% (10/13) of the patients preferred the WALANT anesthesia.</p><p><strong>Conclusion: </strong>In general, endoscopic carpal tunnel release was better tolerated under WALANT than locoregional distal nerve block. Although statistical analysis showed no significant difference in visibility and fluency for the surgeon between the two anesthesia techniques, we do not recommend endoscopic release under WALANT due to the consistent report of reduced visibility in the surgical field. This limitation, likely related to the presence of anesthetic fluid, may have failed to reach statistical significance due to small sample size, but is nevertheless a considerable challenge in practice.</p><p><strong>Level of evidence: </strong>1B.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101974"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565357","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":"Immobilization, rehabilitation and complications classification after thumb trapeziometacarpal total joint arthroplasty. A scoping review.","authors":"Elske E D J Bonhof-Jansen, Sander M Brink, Jeroen H van Uchelen, Corry K van der Sluis, Dieuwke C Broekstra","doi":"10.1016/j.hansur.2024.101783","DOIUrl":"10.1016/j.hansur.2024.101783","url":null,"abstract":"<p><p>The best way of immobilization as well as effectiveness of rehabilitation for trapeziometacarpal total joint arthroplasty is unknown. We aimed to identify and describe the available evidence, practice variation and knowledge gaps. The literature was searched without restrictions. 123 studies were included, reporting 21 types of prosthesis. Reported immobilization types were cast (23%), splint (18%), compression bandage (10%), or combinations (26%). In 19%, immobilization time and type was not reported. Supervised rehabilitation (22%), self-rehabilitation (11%), functional use (11%), or customized rehabilitation (16%) were the rehabilitation forms reported. In 28% rehabilitation type was not described. Two (2%) studies used complication classifications, but time to complication was not described in 53 (43%). Multiple evidence gaps exist; lacking studies comparing types of immobilization protocols as well as rehabilitation regimens after trapeziometacarpal total joint arthroplasty. Currently there is no scientific evidence for any postoperative regime. This means that decision-making is based on clinical experience rather than evidence, explaining the wide practice variation.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101783"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335116","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":"Median nerve entrapment after supracondylar humeral fracture: An ultrasonographic view.","authors":"Yakup Erden, Mustafa Hüseyin Temel, Mahmut Kurtboğan","doi":"10.1016/j.hansur.2024.101970","DOIUrl":"10.1016/j.hansur.2024.101970","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101970"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559848","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":"Hand therapy for a dorsal wrist ganglion cyst, monitored with ultrasound imaging.","authors":"Tom Lattré, Arne Decramer","doi":"10.1016/j.hansur.2024.101973","DOIUrl":"10.1016/j.hansur.2024.101973","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101973"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565358","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":"Ultrasound-guided radial nerve release at the arm under WALANT.","authors":"Thomas Apard","doi":"10.1016/j.hansur.2024.101787","DOIUrl":"10.1016/j.hansur.2024.101787","url":null,"abstract":"<p><p>Radial nerve entrapment at the LIS is an aching pain in the distal, lateral upper arm and leads to weakness in wrist and thumb/index finger extension. Additionally, a positive scratch collapse test and localized pain on pressure at the entrapment site are observed. The described approach uses a minimally invasive percutaneous ultrasound-guided technique under local anesthesia.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101787"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484118","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":"Anterior transfer of the long head of triceps nerve to the terminal part of the anterior division of the axillary nerve through two incisions: A cadaveric feasibility study.","authors":"Jean-Noël Goubier, Tanguy Perraudin, Camille Echalier","doi":"10.1016/j.hansur.2024.101971","DOIUrl":"10.1016/j.hansur.2024.101971","url":null,"abstract":"<p><strong>Purpose: </strong>Restoring shoulder function after axillary nerve injury is always a challenge. Transferring a branch of the radial nerve destined to the triceps onto the anterior division of the axillary nerve has become the preferred technique. However, this is not always possible, especially when the axillary nerve is severely injured around the posterior part of the humeral neck. The purpose of this cadaver study was to assess the feasibility of transferring the nerve of the long head of the triceps through an anterior and lateral humeral neck tunnel, directly onto the branch of the anterior division of the distal axillary nerve where it enters the deltoid fibers, by two surgical approaches.</p><p><strong>Materials and methods: </strong>This anatomical study was performed using 6 fresh cadavers (12 shoulders). A medial brachial approach was used to locate the radial nerve and its first branch, innervating the long head of the triceps. Then a second, transdeltoid approach was made to locate the end of the anterior branch near where it enters the deltoid fibers. The long head of the triceps nerve was transected as close as possible to the muscle, to provide the longest length possible. Then an anterior and lateral subdeltoid tunnel was made to retrieve this branch through the transdeltoid approach.</p><p><strong>Results: </strong>The long head of the triceps nerve could always be sutured to the anterior branch of the axillary nerve. Given the 7-12 mm surplus length (mean, 8.8 mm), tensionless suturing was possible in an anatomical region amenable to easier microsurgery.</p><p><strong>Discussion: </strong>Transfer of the long head of the triceps to the anterior branch of the axillary nerve through an axillary or posterior approach remains the preferred method for reinnervating the deltoid. However, in some patients, the axillary nerve is injured at or beyond the typical microsurgical suturing zone, which means that transfer cannot be accomplished under optimal conditions. For this reason, we suggest making the transfer more distally, using a dual approach that allows direct suturing of the long head of the triceps nerve onto the anterior terminal branch, which shortens the distance between the sutured nerve and the deltoid, and should improve outcome.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101971"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559847","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":"Pathophysiology of longitudinal forearm instability (Essex-Lopresti syndrome) and implications for treatment.","authors":"Bertrand Coulet, Hugo Barret, Pierre Emmanuel Chammas, Olivier Bozon, Lara Moscato, Cyril Lazerges, Michel Chammas","doi":"10.1016/j.hansur.2024.101968","DOIUrl":"10.1016/j.hansur.2024.101968","url":null,"abstract":"<p><p>Longitudinal forearm instability, or Essex-Lopresti syndrome, associates radial head fracture and rupture of the structures uniting the 2 bones, mainly the interosseous membrane and triangular fibrocartilage complex adjacent to the distal radioulnar joint. It is often overlooked at first, and should be screened for in case of comminuted radial head fracture without elbow dislocation or instability. Treatment should be prompt, within 4 weeks of trauma, to avoid soft-tissue retraction and hopefully allow healing. This interval is anecdotal, without firm evidence, but matches observations regularly reported in the literature [1]. In the acute phase, treatment consists in rigid, usually unipolar, radial head replacement, protected healing of the interosseous membrane by a TightRope suture button between the bones, radioulnar pinning and triangular fibrocartilage complex suture, followed by 6 weeks' immobilization. Progression is usually favorable. Chronic forms, beyond 4 weeks, when soft-tissue healing is impossible, require interosseous membrane reconstruction. In case of radiocarpal impingement due to ascension of the radius, ulnar shortening osteotomy must be associated. Medium-term results in such cases are much less certain. As a last resort, the \"one-bone forearm\" is a solution.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101968"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640232","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":"Ultrasound-guided needle knife release for stenosing tenosynovitis of the flexor pollicis longus: a prospective randomized controlled trial.","authors":"Zhengliang Li, Yahong Guo, Linfeng Chen, Wenyan Xue","doi":"10.1016/j.hansur.2024.101786","DOIUrl":"10.1016/j.hansur.2024.101786","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the efficacy and safety of ultrasound-guided needle knife release in the treatment of stenosing tenosynovitis of the flexor pollicis longus.</p><p><strong>Methods: </strong>In this prospective trial, 60 patients with clinically and ultrasonographically confirmed stenosing tenosynovitis of the flexor pollicis longus were randomly allocated to 1 of 3 groups: ultrasound-guided needle knife release (n = 20), traditional conservative treatment (n = 20), and open surgery (n = 20). The primary outcome measure was the Quinnell grade of triggering severity. Secondary outcomes comprised pain intensity (on visual analog scale), satisfaction (5-point Likert scale), and complications. Outcomes were evaluated at baseline, 1 week, 1 month and 3 months post-intervention by blinded assessors.</p><p><strong>Results: </strong>At all follow-up time points, the needle knife release group demonstrated significantly lower Quinnell grades (p < 0.05) and pain scores (p < 0.001) than the conservative treatment group; satisfaction was greater in the needle knife release group compared to the conservative treatment group at 1 month (p = 0.002) and 3 months (p < 0.001). There were no significant differences in outcomes between the needle knife release group and the open surgery group. The overall complications rate was 5% in the needle knife release group, 10% in the conservative treatment group, and 15% in the open surgery group (p = 0.574).</p><p><strong>Conclusion: </strong>Ultrasound-guided needle knife release is an effective and safe treatment for stenosing tenosynovitis of the flexor pollicis longus, with outcomes that are better than with traditional conservative treatment and similar to those of open surgery.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101786"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383062","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":"A new high-frequency ultrasound classification of De Quervain tenosynovitis.","authors":"Xiaoliang Yang, Xu Zhang, Xiuqing Ma, Mei Han, Yadong Yu, Shijun Mi","doi":"10.1016/j.hansur.2024.101975","DOIUrl":"10.1016/j.hansur.2024.101975","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to introduce a new high-frequency ultrasound classification of De Quervain tenosynovitis based on a large group of patients. Detailed characteristics of classification are also reported.</p><p><strong>Methods: </strong>From January 2014 to February 2024, patients diagnosed with De Quervain tenosynovitis were retrospectively reviewed. High-frequency ultrasound (7-14 MHz) scanning was performed to identify the anatomy of the extensor pollicis brevis and abductor pollicis longus tendons, presence of intertendinous septa, and pathologic changes. The affected wrist was compared to the contralateral wrist.</p><p><strong>Results: </strong>453 patients were included: 65 male and 388 female; mean age, 46 ± 27 years (range, 24-65 years). Symptom duration was 14 ± 27 weeks. Disease types were type 0 (n = 5), type 1 (n = 195), type 2a (n = 72), type 2b (n = 18), type 2c (n = 50), type 3 (n = 59), type 4 (n = 45), and type 5 (n = 9). Mean retinacular thickness was 2.1 ± 0.5 mm in affected wrists and 0.4 ± 0.1 mm in contralateral wrists (p < 0.01). The intercompartmental septum was significantly thicker on the affected side (1.2 ± 0.7 mm) than on the asymptomatic side (0.1 ± 0.4 mm) (p < 0.01).</p><p><strong>Conclusions: </strong>This novel classification provides detailed ultrasonographic characteristics of De Quervain tenosynovitis, based on a large population of patients. It may help in selecting treatment and predicting outcome. However, relevance and therapeutic significance remain to be demonstrated.</p><p><strong>Level of evidence: </strong>Therapeutic study, Level IV.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101975"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565356","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}