[Postoperative Pain Level Following Surgery of the Hand and Wrist in the Ambulatory Setting].

Background: Surgical procedures of the hand are increasingly performed in an ambulatory setting. Postoperative analgesia is based empirically on the painfulness of individual surgical procedures without these having been examined systematically.

Patients And Methods: The painfulness (visual analogue scale) of 722 surgical procedures of the hand and wrist (1 July 2021 to 30 June 2023) was assessed until day 5.

Surgical experience and different glove wearing conditions affect tactile sensibility.

Background: The fingers' tactile sensibility is essential in surgery, especially in microsurgery. Therefore, surgeons seeking to improve their performance often prefer certain glove brands and wearing habits. There is the need of objectively testing these glove wearing conditions and determine the effect of surgical experience with regard to tactile sensibility by comparing surgeons with non-surgeons.

Long-term preservation of metacarpophalangeal joint function in traumatic defects by metatarsophalangeal osteochondral transplantation.

Introduction: The integrity of the metacarpophalangeal (MCP) joints is essential for finger and hand function. Preservation of range-of-motion is one of the aims in reconstruction of complex injuries to these joints. Osteochondral transplants have shown to be reliable in reconstruction of various joint defects.

[Arthroscopic reconstruction of scaphoid nonunions].

Objective: Minimally invasive arthroscopically assisted reconstruction of scaphoid nonunions.

Indications: Delayed union or nonunion of the scaphoid with sclerosis and with indication for bone transplantation. Limited arthritic changes at the radial styloid.

Corrigendum to "Do your surgical glove characteristics and wearing habits affect your tactile sensibility?" [Ann. Med. Surg. Volume 57, September 2020, Pages 281-286].

[This corrects the article DOI: 10.1016/j.amsu.

Bacterial bioburden of wounds: influence of debridement and negative-pressure wound therapy (NPWT).

Objective: To clarify the role of microbiological swabs in surgical decision-making, we investigated the effect of negative-pressure wound therapy (NPWT) and serial surgical debridement on bacterial bioburden in hard-to-heal wounds and ultimately correlated them with the success of surgical closure.

Method: All patients were treated with surgical debridement, jet lavage and NPWT before their wounds were finally closed. The treatment effect was assessed by correlating microbiological swabs obtained immediately after intervention with those obtained after removal of the dressings during the following surgical procedures.

Geographical differences in carpometacarpal joint osteoarthritis treatment of the thumb: A survey of 1138 hand surgeons from the USA and Europe.

Background: Carpometacarpal osteoarthritis of the thumb (CMC OA) is treated with various therapeutic approaches. However, the literature remains inconclusive regarding the ideal procedure for each disease stage. In this study, we assessed the international application of surgical treatment options including CMC I implants and non-surgical treatment options for CMC OA depending on the disease stage, with a strong focus on the detection of geographical disparities.

Do your surgical glove characteristics and wearing habits affect your tactile sensibility?

Backround: Tactile sensibility plays a critical role in medicine, especially in surgical practice. In order to prevent surgical site infections and protect the surgeon, the use of surgical gloves is standard practice. However, wearing these might affect the sensibility of the hand disadvantageously, especially in disciplines that require precision work.

New Insights on Lipedema: The Enigmatic Disease of the Peripheral Fat.

Background: Although a large number of adult women worldwide are affected by lipedema, the physiologic conditions triggering onset and progression of this chronic disease remain enigmatic. In the present study, a descriptive epidemiologic situation of postoperative lipedema patients is presented.

Methods: The authors developed an online survey questionnaire for lipedema patients in Germany.

Four-corner fusion: Comparing outcomes of conventional K-wire-, locking plate-, and retrograde headless compression screw fixations.

Purpose: Several operative approaches and various implants for osseous fixation have been described to achieve four-corner fusion of the wrist. Given the discordance and to aid in further standardizing the technique, this study directly compares the outcomes of K-wire, fusion plate, and headless retrograde compressive screw fixations to achieve four-corner arthrodesis.

Methods: Sixty-four patients underwent four-corner fusion over a period of 5 years and were reviewed retrospectively.

Occlusive dressing-induced secretomes influence the migration and proliferation of mesenchymal stem cells and fibroblasts differently.

Background: Fingertip injuries treated with occlusive dressings (ODs) lead to nearly scar-free, functionally, and aesthetically pleasing results. We hypothesized that paracrine factors in the wound fluid (secretome) may influence migration and proliferation of mesenchymal stem cells (MSCs) and fibroblasts and modulate the wound-healing process.

Methods: We could collect wound fluid samples from 4 fingertip injuries and 7 split skin donor sites at the 5th day during dressing change.

[DRG revenues and costs of multimorbid patients in the German DRG system - Analysis of the surgical treatment of chronic wounds at a university hospital based on the example of pressure ulcers].

Background: The treatment of complex patients with chronic wounds, such as pressure ulcers, is often not adequately reimbursed in patients with need for daily intensive care due to multimorbidity and chronic co-diagnoses. The present study analyses revenues, principle cost factors as well as possible complications.

Methods: We analysed 51 patients with the DRG principle diagnosis of decubitus stage III and IV, treated in our maximum care clinic in 2014 and 2015.

Lipofilling of Fingertips for Volume Defects after Fingertip Injuries.

Introduction: Regardless of the good outcomes of conservatively treated fingertip injuries, many patients complain about volume defects and hypoesthesia. Injection of autologous fat into the defect zone may resolve the volume problem and stimulate digital nerve regeneration by adipose derived stem cell transplantation.

Methods: We analyzed 5 volume defects resulting from conservatively treated fingertip injuries in 4 patients (male to female ratio, 2:2), 6 months after the injection of autologous abdominal fat into the defect zone retrospectively.

Total Endoprosthesis Versus Lundborg´s Resection Arthroplasty for the Treatment of Trapeziometacarpal Joint Osteoarthritis.

Background: There exist various operative approaches for the treatment of trapeziometacarpal joint osteoarthritis. The aim of this study was to compare the results of Lundsborg's resection arthroplasty (RA) with implantation of a total endoprosthesis.

Patients And Methods: In this 2-center study, we retrospectively analyzed 71 patients with symptomatic osteoarthritis of the carpometacarpal I joint stage III according to the Eaton-Littler classification.

Treatment of Ulnar Impaction Syndrome with and without Central TFC Lesion.

 Arthroscopic debridement of the triangular fibrocartilage (TFC) is well accepted in patients with ulnar impaction syndrome with central TFC lesions. Treatment remains controversial, however, when there is no such lesion from radiocarpal view.  This study assessed the clinical outcome of arthroscopic central TFC resection and debridement and secondary ulnar shortening in patients with ulnar impaction with central TFC lesion compared with patients without TFC lesion.

Significance of Scapholunate Gap Width as Measured by Probe from Midcarpal.

 Geissler's classification is widely accepted in arthroscopic diagnostics of scapholunate (SL) ligament injury. Thereby, probe insertion into the SL gap from the midcarpal would indicate treatment necessity in patients with SL tear as seen from radiocarpal view.  In this review, the SL gap width, examined by the probe from midcarpal, was arthroscopically assessed in patients with intact SL ligaments, who were treated for ulnar impaction syndrome.

Autologous Fat Injection versus Lundborg Resection Arthroplasty for the Treatment of Trapeziometacarpal Joint Osteoarthritis.

Background: Various operative approaches exist for treatment of trapeziometacarpal joint osteoarthritis. The aim of this study was to compare the results of Lundborg resection arthroplasty with solely autologous fat injection.

Methods: Twenty-one patients with symptomatic osteoarthritis of the trapeziometacarpal joint (Eaton-Littler classification stages III/IV) underwent either a Lundborg resection arthroplasty (n = 12) or autologous fat injection into the trapeziometacarpal joint (n = 9).

[Lundborg's resection arthroplasty vs. Pyrocarbon spacer (Pyrocardan®) for the treatment of trapeziometacarpal joint osteoarthritis: a two-centre study].

Various operative approaches exist for osteoarthritis of the trapeziometacarpal joint. The aim of this two-centre study was to compare the results of Lundsborg's resection arthroplasty with the implantation of the Pyrocardan spacer. We treated 20 patients with symptomatic osteoarthritis of the trapeziometacarpal joint in stage III / IV (Eaton-Littler classification).

Treatment Options for Pilonidal Disease.

Pilonidal disease can be treated medically; however, surgical excision remains the gold standard. Nonetheless, all current surgical approaches are still associated with potential for tissue loss, wound healing disorders, and high rates of recurrence. Aim of this study is to assess the long-term outcomes of the minimal-invasive pit-picking operation in comparison to the well-established technique of Karydakis flap-closure.

Topical Negative Pressure Wound Therapy of Burned Hands: Functional Outcomes.

Extensive partial- and full-thickness burns, especially of the hands, continue to pose a surgical challenge. With improved knowledge regarding fluid balance, burn pathophysiology, and lately also given the introduction of topical negative pressure wound (TNPW) therapy, treatment regimes have changed in many burn centers. The authors evaluated the results regarding long-term outcomes of patients with partial- and full-thickness burns of the hands treated with TNPW.

Painful thumb carpometacarpal joint osteoarthritis: Results of a novel treatment approach.

Background: Pain reduction as well as preservation and improvement in range of motion remain the main aims in the treatment of thumb carpometacarpal (CMC) osteoarthritis (OA). We performed a retrospective outcome analysis of patients with symptomatic stage II-III thumb CMC joint arthritis treated with denervation, joint lavage and capsular imbrication.

Methods: 73 patients with stage II to III OA of the thumb CMC-joint underwent the described technique.

The required minimum length of video sequences for obtaining a reliable interobserver diagnosis in wrist arthroscopies.

Purpose: To examine the relationship between video length for wrist arthroscopy and interobserver reliability.

Materials And Methods: 100 consecutive wrist arthroscopies were documented by long and short videos of the radiocarpal and the midcarpal joints. The long videos were about twice as long as the short videos.

Microsurgeons do better--tactile training might prevent the age-dependent decline of the sensibility of the hand.

Recent data demonstrate that the normal sensibility of the hand seems to be age-dependent with the best values in the third decade and a consecutive deterioration afterwards. However, it is not clear if long-term tactile training might prevent this age-dependent decline. We evaluated sensibility of the hand in 125 surgeons aged between 26 and 75 years who perform microsurgical operations, thereby undergoing regular tactile training.