Revision of trapeziometacarpal arthroplasty.

Complications of trapeziometacarpal arthroplasty are uncommon, but are classified as intra- and post-operative, dislocation and loosening being the main causes of revision surgery. Periprosthetic fracture and ossification are rare. Whenever possible, prosthetic revision techniques consist in partial or total replacement with modular implants.

Correction of non-traumatic extensor tendon dislocation and ulnar drift at the metacarpophalangeal joint by the modified Dell technique.

Background: Chronic ulnar extensor tendon dislocation at the metacarpophalangeal joint causes permanent extension deficit and ulnar drift. Several soft tissue procedures have been described for realignment of the extensor tendon in post-traumatic reducible instability or in combination with joint replacement in case of altered metacarpophalangeal joint in inflammatory conditions. However, no studies reported correction of both extension lag and ulnar deviation following isolated surgical treatment of ulnar extensor tendon dislocation at the metacarpophalangeal joint.

Morbidity associated with pre-hospital upper-limb tourniquet in civilian trauma: a case series.

Introduction: The widespread pre-hospital use of tourniquets, particularly in the upper limb, raises questions about associated morbidity, which has been little studied and may have serious consequences for functional prognosis.

Methods: A review of 9 patients was carried out, analyzing pre-hospital tourniquet use in terms of complications affecting recovery.

Results: There were serious complications: musculocutaneous nerve palsy in 1 patient, and compartment syndrome, rhabdomyolysis and ischemia-reperfusion syndrome in another.

Intramedullary nailing of humeral shaft fractures: percutaneous nailing in the lateral position through the Neviaser approach is a reliable technique.

Background: Displaced humeral shaft fractures are frequently treated by osteosynthesis in the active patient. We aimed to evaluate the results of intramedullary nailing (IMN) in the lateral position with the Neviaser approach and to compare them with those from IMN nailing in the standard position and conventional approach.

Methods: In the retrospectively evaluated, single-center study, we compared 20 cases of long IMN for fractures of the proximal or middle third of the humerus shaft (Multilock; Synthes Laboratory) in the lateral position with the percutaneous Neviaser approach with 52 cases of IMN in the standard position.

Management of advanced metacarpal aneurysmal cysts: Surgical technique.

The hand is a rare site for aneurysmal bone cysts (ABCs). Depending on their degree of invasiveness, treatment of ABCs ranges from medical therapy to surgical curettage and bone filling. In the most advanced cases, bone resection and reconstruction, with or without adjuvant or neoadjuvant treatment, are indicated.

Incongruity of the scapulohumeral arch: an indirect sign of posterior subluxation of the humeral head in primary glenohumeral osteoarthritis.

Background: In symptomatic glenohumeral osteoarthritis, arthroplasty is the gold standard to restore a mobile and painless shoulder. The kind of arthroplasty chosen is mainly based on the evaluation of the rotator cuff and the type of glenoid. The aim of this study was to analyze the scapulohumeral arch in primary glenohumeral osteoarthritis (PGHOA) with an uninjured cuff and to determine whether posterior humeral subluxation influences the Moloney line, which corresponds to an intact scapulohumeral arch.

What is the patient acceptance when only scapulectomy is possible in case of malignant tumor? A case series.

Background: Scapulectomy is one of the surgical options in the case of malignant lesions in the scapula with an indication of surgical removal. Very few series in the literature have looked at postoperative quality of life and emotional acceptance, particularly in the case of scapulectomy without reconstruction. The objective is to assess the midterm results of scapulectomies in terms of function, quality of life, and acceptance for the patient.

Long-term survival analysis of 191 MAÏA® prostheses for trapeziometacarpal arthritis.

Surgery for trapeziometacarpal osteoarthritis after failure of medical treatment remains controversial. The aim of this study was to determine the long-term results of the MAÏA® trapeziometacarpal prosthesis (Lépine, Genay, France). This was a retrospective clinical and radiographic study of 191 MAÏA® trapeziometacarpal prostheses implanted between 2001 and 2016 from a single centre.

Comparative study of a Y- anatomical and innovative locking plate versus double plate for supracondylar humeral fracture.

Introduction: There is no "gold standard" for the type of plate to be used for distal extra-articular humeral fractures; the most used is plating of each column. The objective was to evaluate the short-term clinical and radiological results of a Y- anatomical and innovative locking plate (YALP).

Hypothesis: The hypothesis is: this anatomical and innovative locking plate will produce satisfactory and reliable results on extra-articular distal humerus fracture superior to double plate fixation.

Perilunate dislocation and fracture dislocation of the wrist: Outcomes and long-term prognostic factors.

Introduction: Perilunate dislocations and fracture-dislocations are severe injuries that often have serious functional sequelae. Our goal was to evaluate the long-term clinical and radiological results of these perilunate injuries, and to look for prognostic factors of a poor clinical outcome.

Hypothesis: All patients who suffered perilunate injuries in their wrist have functional sequelae and long-term radiographic changes despite optimal treatment with anatomical surgical reduction.

Morbidity of long head of the triceps motor branch neurotization to the axillary nerve: Retrospective subjective and objective assessment of triceps brachii strength after transfer.

Introduction: Morbidity is considered to be negligible in Leechavengvongs transfer (LT) of the long head of the triceps onto the axillary nerve, but the assessment methods used may lack reproducibility. We assessed triceps strength after LT objectively by the isokinetic technique, addressing the following questions: Is strength lowered after LT compared to the healthy limb? And 2) is there a good correlation between isokinetic dynamometry and subjective assessment?

Hypothesis: Isokinetic measurement shows a decrease in triceps strength at peak torque after LT compared to the healthy limb, and this morbidity is underestimated on subjective assessment.

Material And Methods: This single-center retrospective study included patients undergoing LT for axillary nerve trunk palsy between 2008 and 2020, with M5 triceps preoperatively on the British Medical Research Council (BMRC) scale.

Prospective study of 90 arthroscopic rotator cuff repairs for isolated distal supraspinatus tear, assessing the impact of cardiovascular risk factors on tendon healing.

Introduction: Cardiovascular risk factors have been shown to be relevant to onset of rotator cuff tear, but their influence on healing remains to be determined.

Objective: To assess the individual and cumulative impact of cardiovascular risk factors on tendon healing after arthroscopic rotator cuff repair.

Material And Method: A single-center prospective study included 90 patients undergoing arthroscopic repair of isolated distal supraspinatus tendon tear.

Clinical Impact of Malunion After All-Arthroscopic Coracoclavicular Stabilization for Displaced and Unstable Lateral Clavicle Fractures.

Objective: To evaluate the clinical outcome of lateral clavicle malunion treated with all-arthroscopic coracoclavicular (CC) stabilization.

Design: Retrospective, case series.

Setting: Department of hand and upper extremity surgery, university hospital center.

Diagnosis and treatment of hand tumors.

Hand tumors are a very common problem in hand surgery. While these lesions are most often benign, malignant lesions often have an atypical presentation and are discovered late, very often during an inappropriate treatment. To optimize the care of hand tumors and to reduce diagnostic and treatment errors, we will review the broad diagnostic and therapeutic principles and the most common clinical presentations.

The IBTIS score; a new prognostic score for arthroscopic biceps tenotomies.

Introduction: Shoulder pain associated with tendinopathy of the long head of biceps (LHB) is common. Surgical treatment with arthroscopic tenotomy of the LHB has been shown to be effective. However, it's efficacy is inconsistent.

Palliative surgery for thumb involvement in ulnar paralysis.

Ulnar paralysis has multiple clinical presentations, which are due to partial recovery or to anatomical variations between the ulnar and median nerves. The main sequelae of ulnar nerve paralysis are the loss of hand strength with impairment of all intrinsic functions of the fingers and some of the thumb's functions. Weakness of the adductor pollicis and flexor pollicis brevis muscles may manifest as weak key pinch with automatic flexion of the thumb interphalangeal joint when gripping.

Tendon transfers to restore elbow flexion.

Elbow flexion paralysis is one of most significant deficiencies in the upper limb. When secondary to brachial plexus palsy or nerve trunk lesions, restoration of elbow flexion by means of early nerve surgery or palliative transfers should be part of a comprehensive treatment plan. Tendon transfers are indicated in long-standing palsies, in those who are poor candidates for nerve surgery or when the results of nerve surgery are inadequate.

Metacarpophalangeal joint instability in trapeziometacarpal osteoarthritis: A systematic review.

Thumb metacarpophalangeal instability is commonly found in conjunction with trapeziometacarpal osteoarthritis. If not corrected, it can have detrimental effects on the outcome. The authors describe the two types of metacarpophalangeal deformities - hyperextension and valgus - their pathophysiology and the surgical repair techniques available to surgeons.

Modification of matched distal ulnar resection for distal radio-ulnar joint arthropathy: Analysis of distal instability and radio-ulnar convergence.

Background: In palliative surgery on the distal radio-ulnar joint (DRUJ), ulnar head resection and the Sauvé-Kapandji procedure are often followed by instability and radio-ulnar convergence. The objective of this study was to evaluate the stability of the DRUJ after modified matched distal ulnar resection performed alone or with partial or complete wrist arthrodesis.

Hypothesis: A modification of matched distal ulnar resection, consisting in reconstruction of the sixth compartment and dorsalisation of the extensor carpi ulnaris, minimises these complications, regardless of the cause and associated procedures.

Allograft-Composite Reverse Shoulder Arthroplasty for Malignant Tumor of the Proximal Humerus.

Composite-allograft reverse shoulder arthroplasties are a surgical alternative in malignant tumor reconstructions following segmental bone resection of the proximal humerus. They allow reinsertion of the rotator cuff tendons and reliable restoration of humeral height, increasing prosthetic stability and mobility. Preoperative local tumor extension assessment must be thorough and a strict surgical technique must be followed to obtain satisfactory functional results.

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.