WALANT surgery of the hand: state of the art.

Wide-awake local anesthesia no tourniquet is named the WALANT technique. WALANT has had a major positive impact on cost, convenience, ecology, patient satisfaction, access to surgical care, and outcomes in hand surgery in the last 20 years. Safe and efficient application of the technique is based on two principles.

Ultrasound measurement of subsynovial connective tissue thickness in the carpal tunnel: An intrarater/interrater reliability and agreement study.

Objectives: Non-inflammatory thickening of the subsynovial connective tissue (SSCT) in the carpal tunnel is commonly found in subjects with carpal tunnel syndrome (CTS), and quantification may shed light on CTS pathogenesis. To date, information on the reliability of ultrasound quantification of SSCT is scarce. Therefore, we investigated intrarater and interrater reliability/agreement for ultrasound quantification of SSCT thickness in subjects with and without CTS, and predictors for tissue thickness.

In Situ Stabilization of the Ulnar Nerve as an Alternative to Transposition in Traumatic Ulnar Nerve Instability: A Case Report.

Case: We present the case of a 25-year-old male sports climber treated with in situ ulnar nerve stabilization for ulnar nerve instability (UNI) by using 2 fascial flaps.

Conclusion: Symptomatic UNI has traditionally been managed with subcutaneous or submuscular ulnar nerve transposition. Transposition is relatively invasive and when performed subcutaneously, embeds the ulnar nerve in an exposed location, which may render it prone to mechanical injury in physically active patients.

Flexor carpi radialis tendon tear due to scaphoid osteoid osteoma: A case report.

Osteoid osteoma is a benign osteoblastic tumor with a low incidence. Due to its uncommon and often confusing clinical presentation, accurate diagnosis is frequently significantly delayed. We report a case of a 56-year old right-handed woman with a history of increasing pain in her right scaphotrapeziotrapezoidal (STT) joint and distal flexor carpi radialis (FCR).

Full-thickness skin grafting in preventing recurrence of Dupuytren's disease: A systematic review.

Dupuytren's disease is a progressive hand disorder characterized by the formation of pathologic nodules and cords in the palm, often leading to progressive flexion contractures. Hand surgery is currently the only efficient treatment to restore hand function, however, reported recurrence rates vary widely. Currently, it remains unclear which type of fasciectomy is associated with the lowest recurrence rate.

Microfasciectomy in Dupuytren's disease: microsurgery in the evolution toward safer and more efficient fasciectomy and hand surgery.

In the long term, limited fasciectomy is currently the most reliable treatment for Dupuytren's contracture. The risk for complications is significant, certainly in recurrent disease and in the presence of abundant scar tissue. Meticulous surgical technique is mandatory.

Treatment practice for Dupuytren disease in Belgium before 2020: results from an online survey.

The treatment of Dupuytren disease (DD) continues to evolve. New insights in risk factors for recurrence and new treatment modalities have changed the management strategies for DD over the past decades. However, several differences may remain between these insights and their clinical application.

The prevalence of frozen shoulder in patients with limited Dupuytren disease.

Evidence from the literature suggests an association between Dupuytren disease and frozen shoulder syndrome, both clinically and histologically. An increased tendency for fibrotic healing after repetitive microtrauma could be an underlying mechanism. However, it remains unclear how strong this association is and if only mild signs of Dupuytren disease would also increase the risk of frozen shoulder.

Is DISI Deformity Related to Presence of a Medial Lunate Facet in Patients with Scapholunate Dissociation?

 Lunate morphology has been suggested to influence carpal kinematics.  We investigate a possible relation between presence of a medial lunate facet and dorsal intercalated segment instability (DISI) of the wrist in patients with a scapholunate (SL) dissociation.  We retrospectively reviewed patients diagnosed with SL dissociation between 2000 and 2017.

Midterm Functional Outcome of the Linked Semiconstrained Distal Radioulnar Joint Prosthesis.

 A painful unstable distal radioulnar joint (DRUJ) can seriously compromise hand and wrist function. The semiconstrained prosthesis was developed to restore DRUJ function. To date, most outcome reports are coauthored by the designer.

The Impact of Dupuytren Disease on Recovery of Motion at the Knee after Total Knee Arthroplasty.

Arthrofibrosis is a complication of total knee arthroplasty (TKA) that can lead to poor outcome. Idiopathic arthrofibrosis and Dupuytren disease (DD) have similar histological appearance. The aim of this study is to determine the influence of DD on the recovery of motion after TKAy.

Palmar skin elasticity measured by the Cutometer MPA 580 is decreased in mild Dupuytren's disease compared to healthy controls.

Introduction: Involvement of the palmar skin is often seen in patients with Dupuytren's disease (DD) with severe finger contractures. However, skin elasticity may be already decreased earlier in the disease. The Cutometer MPA 580 could provide an objective skin measurement tool to assess this decrease in elasticity.

Pulley Rupture in Rock Climber after Collagenase Treatment for Dupuytren Contracture.

Pulley injuries and Dupuytren disease are quite common in rock climbing. We report a rock climber who was treated for a Dupuytren contracture with collagenase injection therapy. Two months later, he developed a traumatic pulley injury during climbing and was treated with a ring orthosis.

Spectacular Accidental Distraction Arthroplasty in Dupuytren Contracture with Good Outcome: A Case Report.

Case: An exceptional event occurred during gradual extension with an external fixator for recurrent small finger Dupuytren flexion deformity. A massive proximal interphalangeal joint distraction arose, possibly because of the center of rotation misalignment and a hasty patient-controlled correction. The device was removed, and a plaster splint protected the finger for 5 days to prevent dislocation of the unstable joint.

Long-term follow-up of the three-ligament tenodesis for scapholunate ligament lesions: 9-year results.

We report on a retrospective cohort of 50 cases of three-ligament tenodesis for scapholunate instability. Fifteen cases (30% of our cohort) needed salvage surgery (11 proximal row carpectomies, 2 partial and 2 total wrist fusions) at an average of 33 months and are considered "failures". Of the 35 remaining cases ("success"), 16 (32% of our cohort) were reviewed at average 111 months and had good functional outcomes (QuickDASH 18/100, PRWE 11/100, pain 1/10, satisfaction 9/10).

Skin grafting prevents recurrence in Dupuytren's disease and extension correlates with fibrosis diathesis score.

Full thickness grafting can be considered after fasciectomy for Dupuytren contracture in severe cases with skin shortage or in radical dermofasciectomy. It is a common dogma that these skin grafts may prevent disease recurrence. We reviewed 47 patients after fasciectomy and full-thickness skin grafting for Dupuytren contracture at 3-16 years' follow-up.

Lateral elbow tendinopathy: surgery versus extracorporeal shock wave therapy.

Lateral elbow pain caused by tendinopathy - tendinosis - or tennis elbow is a highly prevalent problem. Unfortunately, no treatment method can guarantee clinical success. Inspired by the lithotripsy technique used for kidney stones, extracorporeal shock wave therapy (ESWT) has been introduced as an alternative to surgical treatment 25 years ago.

Pain in Dupuytren's disease.

To investigate pain in patients with Dupuytren disease, we analyzed the literature on pre- and post-interventional pain and complex regional pain syndrome. The pre-interventional pain intensity score of primary Dupuytren ranged from 0.3/10 to 2.

Trapeziectomy with ligament reconstruction and tendon interposition arthroplasty in a male cohort : a retrospective study.

Osteoarthritis of the carpometacarpal joint of the thumb is a common disease, mostly affecting middle aged women. This article presents the results of a trapeziectomy with a ligament recontruction/tendon interposition procedure. We evaluated 60 male patients with 76 operated thumbs.

Patient satisfaction with intravenous regional anaesthesia or an axillary block for minor ambulatory hand surgery: A randomised controlled study.

Background: Intravenous regional anesthesia (IVRA) and the axillary brachial plexus block are popular alternatives to general anaesthesia in ambulatory hand surgery. Although both have proven their effectiveness, patients' preferences have never been evaluated.

Objectives: We investigated patient satisfaction with both techniques and hypothesised that satisfaction after IVRA is noninferior compared with axillary brachial plexus block.

Four-corner fusion versus proximal row carpectomy : a retrospective review with a minimal follow-up of 9 years.

A retrospective survey on the long-term outcomes of both proximal row carpectomy (PRC) and scaphoidectomy with 4-corner arthrodesis (4CA) was conducted. Seventeen PRC and nine 4CA wrists were retrieved with a minimal follow-up of 9 years. Pain, satisfaction and disability were not significantly different.