Hand surgery & rehabilitation最新文献

{"title":"Vascularized bone flaps from the hand and wrist.","authors":"Germain Pomares, Amandine Ledoux","doi":"10.1016/j.hansur.2024.101972","DOIUrl":"10.1016/j.hansur.2024.101972","url":null,"abstract":"<p><p>Vascularized bone flaps from the hand and wrist are an alternative to free bone transfer. Their obvious advantages recommend them for routine use. Indications and techniques should be known by hand surgeons.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101972"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565360","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":"Amyloidosis and carpal tunnel syndrome: can we predict occurrence?","authors":"François Saade, Camille Barani, Matthieu Guyard, Matthieu Malatray, Élisabeth Hugon-Vallet, Philippe Schiele","doi":"10.1016/j.hansur.2024.101789","DOIUrl":"10.1016/j.hansur.2024.101789","url":null,"abstract":"<p><strong>Introduction: </strong>Carpal tunnel syndrome, especially when bilateral, may be associated with amyloid deposits, a precursor of systemic amyloidosis. Systemic amyloidosis affects various organs, cardiac involvement having the poorest prognosis. Diagnosis is often delayed. Current treatments are only effective in the early stages of the disease. The primary objective of our study was to evaluate the incidence of amyloidosis in patients with bilateral carpal tunnel syndrome; the secondary aim was to screen for cardiac forms.</p><p><strong>Material and methods: </strong>Between 2019 and 2023, we conducted a single-center prospective observational and diagnostic study to investigate the anatomical pathology of amyloid deposits in tenosynovial samples taken during open nerve release surgery on the median nerve. The tenosynovial biopsy was sent to a specific laboratory for analysis, and typing if positive. If amyloidosis was detected, the patient was referred to a specialist for a specific work-up.</p><p><strong>Results: </strong>We included 54 patients, with a mean age of 67 years (range, 51-89 years): 16 men and 38 women. Sixteen analyses were positive, 12 of which were transthyretin and 4 non-typed.</p><p><strong>Discussion/conclusion: </strong>Bilateral carpal tunnel syndrome was predictive of amyloidosis. As synovial biopsy during surgery is simple and rapid, it should be implemented to identify amyloidosis at an early stage. This could change prognosis, by improving survival through screening and initiation of early specific treatment.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101789"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484116","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":"Functional outcome of trapeziometacarpal prostheses in pan-trapezial osteoarthritis.","authors":"Hubert Caignol, Anaïs Delgove, Marie-Laure Abi-Chahla, Clotilde Strugarek, Alison Delesque, Hugo Pelet","doi":"10.1016/j.hansur.2024.102025","DOIUrl":"10.1016/j.hansur.2024.102025","url":null,"abstract":"<p><p>Trapeziometacarpal osteoarthritis is frequently associated with scaphotrapeziotrapezoid osteoarthritis. Long-term outcomes have not been reported for trapeziometacarpal protheses in patients with radiological pan-trapezial osteoarthritis that is symptomatic only in the trapeziometacarpal compartment. The primary objective of this retrospective multicenter multi-operator study was to evaluate the effectiveness of trapeziometacarpal arthroplasty for pain relief in patients with radiographic pan-trapezial osteoarthritis without symptomatic scaphotrapeziotrapezoid involvement. A total of 70 thumbs in 67 patients were evaluated by a single independent operator at a mean follow-up of 58 months. Scaphotrapeziotrapezoid osteoarthritis severity on Crosby score was stage II in 84% of patients and stage III in 16%. Mean pain score on visual analog scale decreased from 7.7 preoperatively to 1.3 at last follow-up. There were no reoperations at last follow up. These results suggest that, in patients with radiological pan-trapezial osteoarthritis without symptomatic involvement of the scaphotrapeziotrapezoid joint, a trapeziometacarpal prothesis yields good medium-term clinical outcomes. LEVEL OF EVIDENCE: III.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102025"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775895","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":"Management of Lacertus syndrome: Perspectives for hand therapists.","authors":"Jean Paul Brutus, Anna Galstyan, Peter Korkmaz, Vincent Martinel","doi":"10.1016/j.hansur.2024.102026","DOIUrl":"10.1016/j.hansur.2024.102026","url":null,"abstract":"<p><p>Lacertus syndrome presents a diagnostic and therapeutic challenge for hand therapists, requiring a comprehensive understanding of its clinical manifestations, diagnostic considerations and evidence-based therapeutic interventions. The present article aims to provide hand therapists with practical insights into recognizing and treating Lacertus syndrome, highlighting nerve gliding exercises, muscle stretching and ergonomic education. By addressing symptom management and preventive strategies, therapists can help patients relieve lacertus syndrome symptoms, optimize functional outcome and improve occupational status.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"102026"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775899","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":"Correction of non-traumatic extensor tendon dislocation and ulnar drift at the metacarpophalangeal joint by the modified Dell technique.","authors":"Aurelie Wolf, Michel Chammas, Benjamin Degeorge, Bertrand Coulet, Cyril Lazerges, Pierre-Emmanuel Chammas","doi":"10.1016/j.hansur.2024.101788","DOIUrl":"10.1016/j.hansur.2024.101788","url":null,"abstract":"<p><strong>Background: </strong>Chronic ulnar extensor tendon dislocation at the metacarpophalangeal joint causes permanent extension deficit and ulnar drift. Several soft tissue procedures have been described for realignment of the extensor tendon in post-traumatic reducible instability or in combination with joint replacement in case of altered metacarpophalangeal joint in inflammatory conditions. However, no studies reported correction of both extension lag and ulnar deviation following isolated surgical treatment of ulnar extensor tendon dislocation at the metacarpophalangeal joint. The present study evaluated the clinical and functional results of isolated correction of chronic non-traumatic ulnar extensor tendon dislocation at metacarpophalangeal level using the modified Dell technique.</p><p><strong>Hypothesis: </strong>The study hypothesis was that the modified Dell technique allows realignment of the extensor apparatus and correction of both metacarpophalangeal extension lag and ulnar drift.</p><p><strong>Patients and methods: </strong>10 patients (24 fingers), operated on between June 2012 and May 2019, were evaluated at a mean follow-up of 36 months. The etiologies were rheumatoid arthritis in 17 cases, Jaccoud arthropathy due to systemic lupus erythematosus in 4, and degenerative in 3. A radial strip of distal-based extensor tendon, passed around the radial collateral ligament of the metacarpophalangeal joint downward from the surface, was sutured proximally to the remaining extensor tendon using the Pulvertaft technique.</p><p><strong>Results: </strong>Extension deficit improved significantly, by a mean 26° (-9° postoperatively vs -35° preoperatively, p < 0.001). MP joint ulnar drift also improved significantly, by a mean 15° (6° vs 21°, p < 0.001). Four fingers had preoperative swan neck deformity that improved postoperatively. There were 2 cases of recurrent dislocation.</p><p><strong>Conclusion: </strong>The modified Dell technique showed favorable results in treating chronic non-traumatic ulnar extensor tendon dislocation at metacarpophalangeal level in the long fingers, with realignment of the extensor system and correction of both metacarpophalangeal extension lag and ulnar drift.</p><p><strong>Level of evidence: </strong>Level 4, single-center retrospective observational study.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101788"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756063","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":"Validity and reliability of an immersive virtual reality adaptation of the 6-minute pegboard and ring test.","authors":"Çağtay Maden, Demet Gözaçan Karabulut, Burcu Bağcı","doi":"10.1016/j.hansur.2024.101981","DOIUrl":"10.1016/j.hansur.2024.101981","url":null,"abstract":"<p><strong>Background and aim: </strong>Virtual reality offers new clinical assessment and rehabilitation options that can complement or, in some cases, replace traditional methods. However, the applicability of using virtual reality tools for assessment of upper limb functional capacity has not been fully explored. We therefore developed an immersive virtual reality adaptation of the 6-Minute Pegboard and Ring Test (6PBRT-VR). The aim of the study was to test the validity and reliability of the 6PBRT-VR for the assessment of upper extremity functional capacity, and to assess the performance and feasibility of the proposed tool.</p><p><strong>Methods: </strong>Thirty healthy young adults were included in the study. The participants performed the classical 6-Minute Pegboard and Ring Test first and then the 6PBRT-VR. The test-retest reliability of the 6PBRT-VR was assessed on intraclass correlation coefficient. Concurrent validity was assessed on the correlation between the 6PBRT-VR test-retest scores (number of rings moved) and the correlation between the scores from the classical 6-Minute Pegboard and Ring Test and the 6PBRT-VR. Convergent validity was assessed on correlations with handgrip strength and the total Quick Disabilities of the Arm, Shoulder, and Hand score. Cardiorespiratory responses were also measured (at baseline and after each test). Perceived arm fatigue was assessed on the Modified Borg Scale.</p><p><strong>Results: </strong>The 6PBRT-VR exhibited excellent test-retest reliability, with an intraclass correlation coefficient of 0.866 (95% confidence interval 0.737-0.934). Mean 6PBRT-VR score correlated strongly with the mean score of the classical 6-Minute Pegboard and Ring Test (r = 0.817, p < 0.001). A significant association was found between the 6PBRT-VR and the classical 6-Minute Pegboard and Ring Test in terms of variations in heart rate, systolic blood pressure, and Modified Borg Scale score (p < 0.001). Mean 6PBRT-VR score showed moderate correlations with right (r = 0.571, p = 0.001) and left handgrip strength (r = 0.550, p = 0.002).</p><p><strong>Conclusion: </strong>The 6PBRT-VR is a reliable and valid virtual tool for assessing upper-extremity functional capacity in young adults.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101981"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565359","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":"Targeted Muscle Reinnervation in the Upper Arm: A Functional Anatomical Study.","authors":"Feng Li, Yong Yang, Bin Li, Mengqi Cao, Qipei Wei, Weiguang Zhang","doi":"10.1016/j.hansur.2024.101782","DOIUrl":"https://doi.org/10.1016/j.hansur.2024.101782","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to accurately locate the neural fascicle controlling hand movement in the upper arm, to enhance expression of motor intention after targeted muscle reinnervation.</p><p><strong>Methods: </strong>The right sides of the median, ulnar and radial nerves were dissected from distal to proximal in 6 fresh cadaver specimens. The sectional location and diameter of the functional fascicle were measured at 10 and 20 cm below the acromion. The diameter of the main muscle branches of muscle reinnervation target muscles was measured.</p><p><strong>Results: </strong>The median nerve branch of finger and wrist flexion was mainly located between the 9 and 12 o'clock positions in the plane 10 and 20 cm below the acromion, where the diameter of the nerve fascicle was 2.07 and 2.04 mm, respectively. The ulnar nerve branch of finger and wrist flexion was mainly located between the 8 and 12 o'clock positions, with a diameter of respectively 1.80 and 1.99 mm. The radial branch of finger and wrist extension was mainly located between the 10 and 2 o'clock positions in the plane 10 cm below the acromion and between 6 and 12 o'clock in the plane 20 cm below the acromion, with a diameter of respectively 2.57 and 3.03 mm.</p><p><strong>Conclusions: </strong>The nerve fascicles innervating the flexor and extensor fingers were distributed in relatively constant regions of the median, ulnar and radial nerve trunks, and their diameters closely matched the muscle branches of the target muscle.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":"101782"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335118","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":"Differential CpG methylation at <i>Nnat</i> in the early establishment of beta cell heterogeneity.","authors":"Vanessa Yu, Fiona Yong, Angellica Marta, Sanjay Khadayate, Adrien Osakwe, Supriyo Bhattacharya, Sneha S Varghese, Pauline Chabosseau, Sayed M Tabibi, Keran Chen, Eleni Georgiadou, Nazia Parveen, Mara Suleiman, Zoe Stamoulis, Lorella Marselli, Carmela De Luca, Marta Tesi, Giada Ostinelli, Luis Delgadillo-Silva, Xiwei Wu, Yuki Hatanaka, Alex Montoya, James Elliott, Bhavik Patel, Nikita Demchenko, Chad Whilding, Petra Hajkova, Pavel Shliaha, Holger Kramer, Yusuf Ali, Piero Marchetti, Robert Sladek, Sangeeta Dhawan, Dominic J Withers, Guy A Rutter, Steven J Millership","doi":"10.1101/2023.02.04.527050","DOIUrl":"10.1101/2023.02.04.527050","url":null,"abstract":"<p><strong>Aims/hypothesis: </strong>Beta cells within the pancreatic islet represent a heterogenous population wherein individual sub-groups of cells make distinct contributions to the overall control of insulin secretion. These include a subpopulation of highly-connected 'hub' cells, important for the propagation of intercellular Ca²⁺ waves. Functional subpopulations have also been demonstrated in human beta cells, with an altered subtype distribution apparent in type 2 diabetes. At present, the molecular mechanisms through which beta cell hierarchy is established are poorly understood. Changes at the level of the epigenome provide one such possibility which we explore here by focussing on the imprinted gene neuronatin (<i>Nnat</i>), which is required for normal insulin synthesis and secretion.</p><p><strong>Methods: </strong>Single cell RNA-seq datasets were examined using Seurat 4.0 and ClusterProfiler running under R. Transgenic mice expressing eGFP under the control of the <i>Nnat</i> enhancer/promoter regions were generated for fluorescence-activated cell (FAC) sorting of beta cells and downstream analysis of CpG methylation by bisulphite and RNA sequencing, respectively. Animals deleted for the de novo methyltransferase, DNMT3A from the pancreatic progenitor stage were used to explore control of promoter methylation. Proteomics was performed using affinity purification mass spectrometry and Ca²⁺ dynamics explored by rapid confocal imaging of Cal-520 and Cal-590. Insulin secretion was measured using Homogeneous Time Resolved Fluorescence Imaging.</p><p><strong>Results: </strong><i>Nnat</i> mRNA was differentially expressed in a discrete beta cell population in a developmental stage- and DNA methylation (DNMT3A)-dependent manner. Thus, pseudo-time analysis of embryonic data sets demonstrated the early establishment of <i>Nnat</i>-positive and negative subpopulations during embryogenesis. NNAT expression is also restricted to a subset of beta cells across the human islet that is maintained throughout adult life. NNAT⁺ beta cells also displayed a discrete transcriptome at adult stages, representing a sub-population specialised for insulin production, reminiscent of recently-described \"β_HI\" cells and were diminished in <i>db/db</i> mice. 'Hub' cells were less abundant in the NNAT⁺ population, consistent with epigenetic control of this functional specialization.</p><p><strong>Conclusions/interpretation: </strong>These findings demonstrate that differential DNA methylation at <i>Nnat</i> represents a novel means through which beta cell heterogeneity is established during development. We therefore hypothesise that changes in methylation at this locus may thus contribute to a loss of beta cell hierarchy and connectivity, potentially contributing to defective insulin secretion in some forms of diabetes.</p>","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10705251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82487063","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 treatment of the mallet fracture: Open or percutaneous procedure?","authors":"G. Caruso, Laura Martini, S. Sargenti, A. Vitali","doi":"10.1016/j.hansur.2022.09.102","DOIUrl":"https://doi.org/10.1016/j.hansur.2022.09.102","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43226124","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":"Intérêt de l’arthroscopie du poignet dans la prise en charge du syndrome d’Essex Lopresti au stade aigu","authors":"G. Herzberg, M. Burnier, Lyliane Ly","doi":"10.1016/j.hansur.2022.09.110","DOIUrl":"https://doi.org/10.1016/j.hansur.2022.09.110","url":null,"abstract":"","PeriodicalId":94023,"journal":{"name":"Hand surgery & rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41610827","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}