WITHDRAWN: Surgery for thumb (trapeziometacarpal joint) osteoarthritis.

Background: Surgery is used to treat persistent pain and dysfunction at the base of the thumb when conservative management, such as splinting, or medical management, such as oral analgesics, is no longer adequate in reducing disability and pain. This is an update of a Cochrane Review first published in 2005.

Objectives: To assess the effects of different surgical techniques for trapeziometacarpal (thumb) osteoarthritis.

Surgery for thumb (trapeziometacarpal joint) osteoarthritis.

Background: Surgery is used to treat persistent pain and dysfunction at the base of the thumb when conservative management, such as splinting, or medical management, such as oral analgesics, is no longer adequate in reducing disability and pain. This is an update of a Cochrane Review first published in 2005.

Objectives: To assess the effects of different surgical techniques for trapeziometacarpal (thumb) osteoarthritis.

A new surgical approach to Dupuytren's disease.

We present a new surgical approach for Dupuytren's disease which overcomes some of the problems seen with traditional approaches. The approach is simple but allows full exposure and accommodates all options for closure. It comprises transverse incisions at the skin creases of the digit joined by oblique incisions at 45°.

Hand surgery on anticoagulated patients: a prospective study of 121 operations.

The management of anticoagulated patients requiring surgery presents a challenge to hand surgeons. The risk of bleeding related complications needs to be weighed up against the increased risk of thrombotic events if anticoagulants are altered or ceased. There is literature reporting the safety of hand, skin, eye and dental surgery on patients taking anticoagulants, and there is literature highlighting the risks associated with altering regular anticoagulant medication.

Spiralling of the neurovascular bundle in Dupuytren's disease.

Displacement of the neurovascular bundle within a digit affected by Dupuytren's disease can occur when disease superficial to the neurovascular bundle is connected to disease deep to it. Contraction of such cords results in spiralling of the neurovascular bundle, classically when a pretendinous cord connects with the lateral digital sheet and Grayson's ligament via the oblique cord, but also in association with an isolated digital cord. We describe six cases in which cord formation and contraction resulted in a distal spiral, which may occur in isolation or in combination with a classical proximal spiral, creating a double spiral or corkscrew neurovascular bundle.

Surgery for thumb (trapeziometacarpal joint) osteoarthritis.

Background: This is an update of a Cochrane Review first published in 2005. Surgery has been used to treat persistent pain and dysfunction at the base of the thumb. However, there is no evidence to suggest that any one surgical procedure is superior to another.

Isolated scaphotrapeziotrapezoid osteoarthritis: preliminary results of treatment using a pyrocarbon implant.

The scaphotrapeziotrapezoid (STT) joint is the second most common site in the wrist affected by degenerative arthritis. STT fusion has been the traditional treatment for patients with isolated STT arthritis but there are concerns about the complication rate and loss of wrist movement post-surgery. The current study presents the results of an interposition arthroplasty using a scaphoid trapezium pyrocarbon implant (STPI, BIOProfile).

Surgery for thumb (trapeziometacarpal joint) osteoarthritis.

Background: Surgery has been used to treat persistent pain and dysfunction at the base of the thumb. However, there is no evidence to suggest that any one surgical procedure is superior to another.

Objectives: To investigate the effect of surgery in reducing pain and improving physical function, patient global assessment, range of motion, and strength in people with trapeziometacarpal osteoarthritis at 12 months.

Lateral fracture dislocation of the second and third carpometacarpal joints.

We report a case of a rare injury, lateral fracture dislocation of the second and third carpometacarpal joints, which presented late and was managed by fusion of the involved joints.

Spinal and spinal cord injuries in horse riding: the New South Wales experience 1976-1996.

Objectives: The objective of the present study was to determine the incidence of acute spinal cord injuries (ASCI) in all forms of horse riding in New South Wales (NSW) for the period 1976-1996. Other aims of the present study were to compare and contrast ASCI with vertebral column injuries (VCI) without neurological damage and to define appropriate safety measures in relation to spinal injury in horse-riding.

Design: A retrospective review was done of all ASCI cases (n = 32) admitted to the two acute spinal cord injury units in NSW for the cited period.

Huckstep intramedullary nailing for non-union of humeral shaft fractures.

Background: Various techniques of internal fixation for non-union of humeral shaft fractures have been attempted, leading to union rates of between 50 and 90% with persisting non-union causing pain and disability. Some of these techniques have led to shoulder and elbow dysfunction.

Methods: Eight patients treated with Huckstep nail fixation for humeral shaft non-union were reviewed and the rate of union was determined.

Brachial plexus palsy and carotid artery dissection.

We report a case of stroke due to carotid artery dissection in a young man following a traumatic brachial plexus palsy associated with a pseudoaneurysm of the axillary artery.

Fusion of the first metacarpophalangeal joint for post-traumatic conditions.

Fusion of the metarcarpophalangeal joint of the thumb is an accepted treatment in the management of instability or osteoarthritis following trauma to this joint. A review was made of the literature and 30 of the senior author's (RH) patients who had had this operation, in order to determine what effect the operation had on the pain in their thumb, any symptoms of instability, interference with work and daily activities, and strength in the hand. All of the patients achieved bony union and the average angle of fusion was 7.

Prevention of dislodgement of Cotrel-Dubousset rods from tulip screws.

The authors report a case of posterior fusion of the lumbar spine using Cotrel-Dubousset instrumentation in which the rods dislodged from the tulip-headed pedicle screws postoperatively. They recommend that, to avoid this complication, particular care be taken to ensure the locking washers are inserted tightly without cross threading and that an adequate length of rod is left protruding beyond the screw.

Injuries of the distal femoral growth plate and epiphysis: should open reduction be performed?

A retrospective study for the period 1978-91 revealed 33 patients with fractures involving the distal femoral growth plate and epiphysis. Treatment by closed reduction and casting resulted in a high rate of loss of position. Twenty-three of the patients were followed up for an average of 4.

Spontaneous bone graft resorption in os odontoideum.

Two children are presented who had posterior fusion of the upper cervical spine for os odontoideum. Both patients achieved radiographic fusion but spontaneous bone graft resorption occurred, resulting in a recurrence of the original instability. An awareness of this phenomenon, which has been rarely reported, is important in the pre-operative counselling and postoperative follow-up of these patients.

Open subtalar dislocation.

Open subtalar dislocation is a rare injury, accounting for about 0.1% of all dislocations and, consequently, the natural history and outcome of this injury and their relevance to treatment are not well documented. A retrospective study at Westmead Hospital revealed 10 patients who presented with this injury between 1978 and 1988.