Results of Pyrocarbon Disc Interposition Compared to Trapeziectomy with Ligament Reconstruction and Tendon Interposition.

Background: To compare pyrocarbon disc interposition arthroplasty (PDI) with trapeziectomy plus ligament reconstruction tendon interposition (LRTI), the authors assessed whether PDI resulted in a higher pinch strength, and compared grip strength, range of motion (ROM), patient-reported outcomes, satisfaction, and complications between the approaches.

Methods: Because of scarcity of preoperative hand measurements, the authors performed a descriptional cross-sectional cohort study of patients operated on between 2006 and 2014, with a minimum of 5 years of follow-up. Patients were treated with PDI or LRTI.

Pseudotumor after Total Wrist Arthroplasty Mimicking a Neoplasm.

 Total wrist arthroplasty can lead to a variation of complications. One of these is the formation of a pseudotumor. Although this complication is well known after total hip arthroplasty, it is rare in patients with wrist implants.

Trapeziectomy and Alternative Suspension Technique in Thumb Carpometacarpal Arthritis: Patient-Reported Outcome Measures.

Purpose: For treatment of carpometacarpal thumb joint osteoarthritis, a trapeziectomy with an alternative suspension technique can be performed as the primary surgery or as the secondary after a failed primary surgery. This study evaluates the midterm follow-up (median, 54 months) for this technique using patient-reported outcome measures.

Methods: After trapeziectomy, an alternative suspension technique is performed with a flexor carpi radialis tendon strip.

Long-term follow-up of patients treated with pyrocarbon disc implant for thumb carpometacarpal osteoarthritis: the effect of disc position on outcomes measures.

Pyrocarbon disc interposition arthroplasty is an effective treatment for thumb base osteoarthritis. However, as with all implant techniques, the disc can (sub)luxate over time. The relationship between disc position, the experienced pain, and the necessity for revision surgery is not known.

Effect of Tendon Strip (FCR vs APL) on Outcome of CMC Thumb Joint Arthroplasty With Pyrocarbon Disk Interposition.

Background: Pyrocarbon disk interposition for carpometacarpal (CMC) thumb joint osteoarthritis can be performed with a flexor carpi radialis (FCR) or abductor pollicis longus (APL) tendon strip. With the FCR technique, a ligament reconstruction is performed in addition to disk fixation, whereas with the APL technique the disk is simply secured in place. Our aim is to compare long-term postoperative outcomes between both techniques.

Medium to Long-Term Follow-Up After Pyrocarbon Disc Interposition Arthroplasty for Treatment of CMC Thumb Joint Arthritis.

Purpose: Pyrocarbon disc interposition arthroplasty has been designed for the surgical treatment of Eaton-Glickel grade II/III carpometacarpal thumb joint arthritis. This study presents the results of this technique with a minimum 5-year follow up.

Methods: We assessed 4 questionnaires for patient-reported outcome measurements in a cross-sectional study: the Patient-Rated Wrist and Hand Evaluation, Disabilities of Arm, Shoulder, and Hand questionnaire, Michigan Hand Questionnaire, and questions about satisfaction at the 5-year follow up.

Radiographs and Corticosteroid Injections at a New Patient Visit for Care of Carpal Tunnel Syndrome and Ulnar Neuropathy at the Elbow.

 The benefit of radiographs or steroid injection for idiopathic carpal tunnel syndrome (CTS) or ulnar neuropathy at the elbow (UNE) is open to debate. We assessed: (1) Radiographs ordered and injections performed at a new patient visit for patients presenting with either idiopathic CTS or UNE; (2) The estimated payment reduction if we omit these interventions; and (3) Patient age, sex, geographic region, and work status associated with radiographs or injections at a new patient visit for patients presenting with either idiopathic CTS or UNE.  Using a large database of commercial insurance claims, we identified patients with a new visit for either CTS ( = 9,522), UNE ( = 2,507), or both ( = 962; 8.

Arthrodesis of the Carpometacarpal Thumb Joint for Osteoarthritis; Long-Term Results Using Patient-Reported Outcome Measurements.

 Results following carpometacarpal (CMC) arthrodesis of the thumb for osteoarthritis vary widely in literature. Data on long-term patient-reported outcome measurements (PROMs) after thumb CMC joint arthrodesis for osteoarthritis are scarce.  We report the long-term outcomes of PROMs (function, pain, and satisfaction) after arthrodesis of the thumb CMC joint.

An Anatomical Study to the Branching Pattern of the Posterior Interosseous Nerve on the Dorsal Side of the Hand.

Partial denervation of the wrist can benefit patients with chronic wrist pain. A complication of partial denervation is loss of proprioception and hypesthesia on the dorsal side of the hand. Our aim is to evaluate whether the sensory branches of the posterior interosseous nerve could contribute to the loss of proprioception and sensation.

Patient Perspectives on Decision Making for Carpal Tunnel Syndrome.

Purpose: Interventions that improve a patient's understanding of the problem and their options might reduce surgeon-to-surgeon variation, activate healthier patient behaviors and mindset, and optimize stewardship of resources while improving quality of care. Patients with carpal tunnel syndrome (CTS) have more uncertainty about which course of action to take (so-called decision conflict) than hand surgeons. We studied patient preferences regarding shared decision making (SDM) for different parts of the treatment for CTS.

Fracture of the Sesamoid Bone of the Thumb: A Case Report and Review of the Literature.

Case: Fracture of a sesamoid bone of the thumb is rare. We report a case of such a fracture after hyperextension of the thumb in a 26-year-old woman. After a volar plate injury was excluded, she was treated nonoperatively with 5 weeks of immobilization followed by physical therapy.

Prognostic factors for return to work and resumption of other daily activities after traumatic hand injury.

The purpose of this study was to investigate prognostic factors for the time off work, the time to resumption of activities of daily living and hobbies, and duration of complaints in patients with a traumatic hand or wrist injury. In a 10-month longitudinal prospective cohort study, 383 patients were included and interviewed in person every 2 to 3 months. Several sociodemographic, psychological and work-related prognostic factors were investigated.

A Dorsal Approach for Ulnar Shortening Osteotomy.

 This study aims to evaluate the long-term complications, results, and patient satisfaction rates of a dorsally approached ulnar shortening osteotomy for ulnar impaction syndrome.  A retrospective chart review of 20 patients was performed. Primary outcomes of interest were subjective, measured using the Patient-Rated Wrist Evaluation (PRWE) score, Disability of the Arm, Shoulder, and Hand (DASH) score, and the third questionnaire about patient satisfaction, composed by the authors.

Functional Effects of the Adams Procedure: A Retrospective Intervention Study.

 Injury to the distal radioulnar joint (DRUJ) causes swelling and ulnar-sided wrist pain. The Adams procedure stabilizes the DRUJ and shows promising short-term results.  We studied the long-term functional outcome in patients who underwent the Adams procedure.

A randomised placebo-controlled double-blind trial to assess the safety of intramuscular administration of allogeneic mesenchymal stromal cells for digital ulcers in systemic sclerosis: the MANUS Trial protocol.

Introduction: Systemic sclerosis (SSc) is an autoimmune disease characterised by inflammation, fibrosis and vasculopathy. Digital ulcers (DUs) are a frequent manifestation of vasculopathy in patients with SSc. Despite recent advances in pharmacological treatments, DU still have major health and economic implications.

[The transthecal digital block].

Anaesthesia of an entire finger is a routinely performed procedure at the General Practice and the emergency room, and by many surgical disciplines. The method according to Oberst is the most-performed procedure to do this. The transthecal digital block is a new method that can be easily learned.

Risk Factors of Lunate Collapse in Kienböck Disease.

Purpose: Not all patients with Kienböck disease progress to collapse of the lunate and carpal malalignment, but it is difficult to determine which patients are at risk. We aimed to identify demographic or anatomical factors associated with more advanced stages of Kienböck disease.

Methods: We included all 195 eligible patients with Kienböck disease and available preoperative posteroanterior and lateral radiographs.

Replantation versus Prosthetic Fitting in Traumatic Arm Amputations: A Systematic Review.

Background: Traumatic arm amputations can be treated with replantation or surgical formalization of the stump with or without subsequent prosthetic fitting. In the literature, many authors suggest the superiority of replantation. This systematic review compared available literature to analyze whether replantation is functionally and psychologically more profitable than formalization and prosthetic fitting in patients with traumatic arm amputation.

Conservative treatment of thumb base osteoarthritis: a systematic review.

Purpose: To provide a systematic review of randomized controlled trials regarding the conservative treatment of thumb base osteoarthritis (OA).

Methods: A systematic literature search was conducted in the electronic bibliographic databases Medline (Pubmed) and Embase (both starting year to May 2014) using predetermined criteria for studies on nonoperative treatment of thumb base OA.

Results: Twenty-three articles fulfilled our inclusion criteria.

Soluble mediators in posttraumatic wrist and primary knee osteoarthritis.

Background: New discoveries about the pathophysiology changed the concept that all forms of osteoarthritis are alike; this lead to the delineation of different phenotypes such as age, trauma or obese related forms. We aim to compare soluble mediator profiles in primary knee and posttraumatic wrist osteoarthritis. Based on the general faster progression rate of wrist osteoarthritis, we hypothesize a more inflammatory profile.

A new distal radioulnar joint prosthesis.

Pain and instability of the distal radioulnar joint (DRUJ) are common sequelae following a fracture of the distal radius. Many soft tissue procedures have been described, not all of which are successful. Ulnar head replacement prostheses are available but do not always provide stability.

The value of 3.0-tesla MRI in diagnosing scapholunate ligament injury.

Objective To determine the sensitivity and specificity of 3.0-tesla (T) magnetic resonance imaging (MRI) and a dedicated hand coil in diagnosing scapholunate ligament (SLL) injury compared with intraoperative findings. Methods From January 2006 until September 2010, 3.

An alternative suspension technique after trapeziectomy for advanced thumb carpometacarpal osteoarthritis.

Osteoarthritis of the first carpometacarpal joint is often treated by (partial) trapeziectomy and tendon interposition or suspension arthroplasty procedures. In this article, an alternative suspension technique, using 2 osseous tunnels (through the first and second metacarpal) and a flexor carpi radialis tendon strip, is described.