Clinical, radiological and dynamic CT results of scapholunate intercarpal ligamentoplasty for scapholunate dissociation.

A clinical, radiological and four-dimensional computed tomography (4DCT) assessment of the outcomes of scapholunate intercarpal ligamentoplasty (SLICL) was done with a minimum follow-up of 2 years. Twenty-nine patients (23 men and 6 women) with a mean age of 40 years (22-57) who had chronic scapholunate dissociation were treated with the SLICL procedure. There were 18 cases of dynamic instability and 11 of static instability.

Comparison between scaphotrapeziotrapezoid arthrodesis and Pyrocardan® implant for isolated scaphotrapeziotrapezoid osteoarthritis.

Introduction: Scaphotrapeziotrapezoid (STT) arthrodesis and Pyrocardan® implant for painful isolated STT osteoarthritis have shown good results, but no paper has compared their medium-term outcomes.

Hypotheses: Our main hypothesis would be that the Pyrocardan® implant, by preserving the carpal biomechanics, could lead to better wrist mobility. Our secondary hypotheses would be that no other clinical and radiological differences will be found between these two procedures at a mean 5 years follow-up.

First dorsal interosseous muscle transfer to restore opposition of the new thumb after index pollicization: anatomical description of an original technique and case report.

Index pollicization in severe thumb hypoplasia or aplasia in children or for the reconstruction of a mutilated thumb in adults is a rare and technically demanding procedure. Weakness of the new thumb is routinely reported after index pollicization. An inappropriate position of the first dorsal interosseous muscle (FDIM) can partly explain this strength deficit.

Correlation Between Dynamic 4-Dimensional Computed Tomography Data and Arthroscopic Testing of Scapholunate Instability: A Preliminary Study.

Purpose: The aim of this study was to test the validity and reliability of the assessments of scapholunate (SL) instability status on 4-dimensional (4D) computed tomography (CT) using wrist arthroscopy as a reference standard.

Methods: Thirty-three patients (16 men, 17 women; mean age, 48 ± 13 years) with suspected SL instability were evaluated prospectively with 4D-CT and wrist arthroscopy. Based on the arthroscopic testing of SL joint, 2 groups were defined: group 1 (n = 8) consisted of patients who had no, or slight, SL malalignment in the midcarpal space and group 2 (n = 25) consisted of patients who had moderate or severe SL malalignment.

Reconstruction of the distal radius using a double-barrel vascularized fibula flap: A case series.

Treatment of distal radius tumor sometimes requires sacrificing the epiphysis. We propose adding to currently available reconstruction options a technique using a double-barrel vascularized fibula flap fixed distally to the first carpal row, conserving midcarpal mobility. We monitored 4 cases of Campanacci III giant-cell tumor and 2 cases of osteosarcoma.

Proximal interphalangeal joint arthroplasty with the Tactys® prosthesis: Clinical and radiological outcomes at a mean 3.1 years' follow-up.

Preliminary results with the Tactys® modular gliding prosthesis for proximal interphalangeal joint (PIPJ) replacement were encouraging, with notable improvement in clinical and functional scores at 1 and 2 years' follow-up. However, a recent study found a trend for deterioration over time. We wanted to check this by analyzing medium-term outcomes.

Pollicization in the treatment of congenital severe hypoplasia and aplasia of the thumb: a systematic review.

Pollicization of the index is the treatment of choice for severe hypoplasia and aplasia of the thumb. After a historical overview, we present a systematic review of this procedure. The main steps of this procedure were reported by Dieter Buck-Gramcko in 1971 and are still relevant nowadays.

Coverage of soft tissue defects in the thumb: Essential flaps in daily practice.

Coverage of soft tissue defects in the thumb involves a variety of techniques ranging from simple second-intention healing to skin grafting with or without dermal substitutes, to local homodigital or heterodigital flaps and partial toe transfers. The arsenal in terms of skin coverage and especially flaps is very diverse. Our objective is not to make an exhaustive catalog of all the technical possibilities described in the literature, but rather to present in detail the options we have adopted in our daily practice.

Index Finger Pollicization Incisions for Congenital Thumb Aplasia: Review and Design of an Educational Anatomical Model for Skin Incisions.

Background: Pollicization of the index finger can be considered the gold standard technique for the treatment of congenital thumb aplasia. The aim of this study was to review the described incisions for pollicization and to create an anatomical framework enabling the study and comparison of these incisions.

Methods: A systematic review was performed to collect descriptions of incision sets.

Secondary finger amputation after a work accident.

Introduction: The main aim of the present study was to compare motives between patients requesting secondary finger amputation following or unrelated to a work accident. The secondary objective was to assess correlation between sick leave duration and motive for amputation following a work accident.

Method: A single-center retrospective study was conducted over an 11-year period in a hand clinic.

Scaphotrapeziotrapezoid arthrodesis for isolated osteoarthritis: results at a mean 8 years' follow-up.

The aim of this retrospective study was to report medium- to long-term outcome of scaphotrapeziotrapezoid (STT) arthrodesis with staple fixation to treat painful isolated osteoarthritis (OA). Twenty-one consecutive patients (22 wrists) who had undergone STT arthrodesis were retrospectively reviewed by an independent examiner. Clinical and radiological evaluation was performed.

Comparison between the MAIA Implant and Trapeziectomy for Trapeziometacarpal Osteoarthritis: Outcomes at 9 Years' Follow-Up.

The purpose of this retrospective study was to report and compare the outcomes of the MAIA prosthesis and trapeziectomy for trapeziometacarpal osteoarthritis. We included 92 consecutive patients (8 men, 84 women) with a mean age of 57 years (range 44-75 years) who underwent trapeziectomy (44 patients) or trapeziometacarpal joint replacement with a MAIA prosthesis (48 patients) for painful osteoarthritis. All patients were evaluated (pain, range of motion, strength, function, X-rays) by an independent examiner.

CT angiography and MRI of hand vascular lesions: technical considerations and spectrum of imaging findings.

Vascular lesions of the hand are common and are distinct from vascular lesions elsewhere because of the terminal vascular network in this region, the frequent hand exposure to trauma and microtrauma, and the superficial location of the lesions. Vascular lesions in the hand may be secondary to local pathology, a proximal source of emboli, or systemic diseases with vascular compromise. In most cases, ischaemic conditions are investigated with Doppler ultrasonography.

Innervation and vascular supply of the first dorsal interosseous muscle and palmar interosseous muscle of the index: An anatomic descriptive study.

Introduction: The first dorsal interosseous muscle (FDI) and palmar interosseous muscle of the index (P2I) are essential for the strength and mobility of the index finger. This study aims to describe the course of the deep branch of the ulnar nerve (DBUN) and the blood supply to these muscles.

Material And Methods: An anatomical cadaver study was carried out with 14 upper limbs from fresh, non-embalmed cadavers.

A new capsulotomy-based dorsal approach to the wrist: A cadaver study.

Using a cadaver study, we described a new dorsal approach to the wrist joint using a "U-shaped with proximal base" capsulotomy. Six fresh adult cadaveric wrists were dissected after intra-arterial silicone injection. We did a dorsal approach to expose the dorsal joint capsule.

Evaluation of Dorsal Scaphoid Displacement Using Posterior Radioscaphoid Angle in Patients With Suspected Scapholunate Instability: A Preliminary Study.

Purpose: To assess the validity and reliability of the posterior radioscaphoid angle (PRSA), an indicator of dorsal displacement of the scaphoid, in distinguishing wrists with and without chronic scapholunate instability (SLI).

Methods: We prospectively evaluated 40 patients (22 men and 18 women; mean age, 46 ± 13 years) with suspected SLI with radiographs and computed tomography arthrography. Based on these data, 3 groups were defined: positive SLI (n = 16), negative SLI (n = 19), and questionable SLI (n = 5).

Traumatic upper-limb amputation: The process toward acceptance.

Introduction: After traumatic upper-limb amputation (TULA), one-third of patients develop traumatic pathological grief (PG). However, are the other two-thirds unscathed? The main aim of the present study was to assess the rate of TULA victims claiming to have dealt with the consequences and showing no PG. The secondary objective was to determine positive and negative factors enabling and preventing coping.

Management of loss of tissue substance in children's limbs. What are the salient peculiarities? A proposed algorithm.

Loss of tissue substance in children's limbs has the same etiologies and in many cases, the same severity as in adults' limbs, and the means placed at the disposal of a surgeon are likewise comparable. It may nonetheless prove difficult to strategically position the different treatment methods in a decision-making tree. After all, a child presents numerous peculiarities: high quality of vascularization (both microcirculation and macrocirculation), better ability to achieve nerve regeneration and durable bone consolidation and, last but not least, a pronouncedly superior overall functional prognosis.

Intercarpal ligamentoplasty for scapholunate dissociation: comparison of two techniques.

We modified our original surgical technique of scapholunate intercarpal ligamentoplasty for treating chronic scapholunate dissociation. The aim of this study was to compare the outcomes in patients treated by the same surgical team with the original method and the modified method over two different time periods. Nineteen patients with a mean age of 40 years were treated with the original method (mean follow-up of 34 months, range 12-54), and 21 patients with a mean age of 38 years were treated with the modified method (mean follow-up of 27 months, range 13-40).

Four-corner arthrodesis with a dorsal locking plate: 4-9-year follow-up.

We report the outcomes of four-corner arthrodesis for advanced wrist collapse in 50 patients (51 wrists) using a dorsal locking plate. At a mean follow-up of 6 years (range 4-9), pain was significantly reduced and wrist function was significantly improved compared with preoperative status. After four-corner arthrodesis, grip strength was 80% of the contralateral side, and wrist motion averaged 50° flexion-extension and 30° radioulnar deviation.

Radioscapholunate fusion for posttraumatic osteoarthritis with consecutive excision of the distal scaphoid and the triquetrum: A comparative study.

The aim of this study was to assess the clinical and radiographic outcomes after radioscapholunate (RSL) fusion for posttraumatic osteoarthritis. This was a retrospective, dual-center study of all patients who underwent RSL fusion between 1995 and 2015 for posttraumatic radiocarpal osteoarthritis. Patients were assessed at the final review to determine clinical (pain, wrist range of motion and strength), self-reported (QuickDASH, PRWE and MWS scores) and radiological (degenerative osteoarthritis in the scaphotrapeziotrapezoid (STT) or midcarpal joint and radiocarpal fusion) outcomes.

Pedicled flap from the first dorsal branch of the proper palmar digital artery of the fingers: An anatomy study.

The pedicled flap from the first dorsal branch of the proper palmar digital artery (FBPPDA) of the fingers is an option for reconstructing digital skin defects. It has the advantage of being innervated by the dorsal branch of the proper palmar digital nerve (DBPPDN) associated with the artery. However, no studies on the anatomical variations of the neurovascular pedicle have been performed yet.