[Surgical treatment of polydactyly].

This clinical lesson addresses the treatment options for polydactyly, emphasizing the lack of consensus in the Netherlands regarding the timing and method of intervention. The study aims to provide evidence-based recommendations for the management of post-axial polydactyly type B. Two cases are presented, each illustrating different approaches to surgical intervention for post-axial polydactyly type B in a 1-year-old boy (Patient A) and a newborn girl (Patient B).

Recurrent lipoma: an uncommon presentation in the wrist after incomplete excision.

Patient: Female, 58-year-old.

Final Diagnosis: Benign recurrent lipoma following incomplete surgical removal.

Symptoms: Discomfort, Aesthetic Dissatisfaction.

Replacement of a destroyed scaphoimodelled prosthesis.

Preiser disease is a rare condition where ischaemia and necrosis of the scaphoid bone occurs without previous fracture. A female patient in her 30s presented with severe right wrist pain caused by Preiser disease. Initially, she was treated by a pedicled vascularised bone graft, but unsuccessfully.

Dutch Multidisciplinary Guideline on Dupuytren Disease.

Purpose: To provide a comprehensive, evidence-based overview of the treatment for Dupuytren disease, specifically needle techniques, radiotherapy, primary conservative therapy, surgery, lipofilling, operative arthrolysis, salvage techniques, and the postoperative protocol and to make clinical recommendations for health care practitioners and patients.

Methods: Comprehensive multidisciplinary guideline process funded by the Quality Foundation of the Dutch Federation of Medical Specialists. This process included a development, commentary, and authorization phase.

Scapholunate Ligament Reconstruction without Immobilization Is Safe and Leads to Better Functional Results.

Reconstruction of the scapholunate ligament (SL) is associated with a reduction in range of motion. In this study, we compared SL reconstruction and early mobilization with SL reconstruction and Kirschner wires (K-wire) fixation for 6 weeks. We performed a nonrandomized trial involving patients with an arthroscopically confirmed SL ligament injury.

The effect of carpal tunnel release on health-related quality of life of 2346 patients over a 5-year period.

In this prospective cohort study, the health-related quality of life (HRQoL) from a societal perspective of carpal tunnel syndrome (CTS) patients was determined and compared with other diseases. In addition, the effect of carpal tunnel release (CTR) was analysed 6 weeks postoperatively with regard to mean EQ-5D index value improvement, side-effects of surgery and cost per quality adjusted life year (QALY) gained. We found a baseline mean EQ-5D index value of 0.

Night Orthosis After Surgical Correction of Dupuytren Contractures: A Systematic Review.

Purpose: To determine the role of night orthosis use after surgical correction of Dupuytren contracture.

Methods: We searched MEDLINE, EMBASE, CINAHL, AMED, OTSeeker, and CENTRAL for articles published from inception of the databases to August 2015. Assessment was undertaken by 2 independent reviewers (O.

Spinal cord stimulation for complex regional pain syndrome type I: a prospective cohort study with long-term follow-up.

Objectives: Spinal cord stimulation (SCS) is an effective treatment for intractable complex regional pain syndrome type I pain. Long-term data are scarce on effectiveness, degree of pain relief, predictors, and complications.

Materials And Methods: From 1997 to 2008, 84 consecutive patients who received an implanted SCS system after positive test stimulation were included in the prospective study.

The cost-effectiveness of spinal cord stimulation for complex regional pain syndrome.

Objectives: Health-care policymakers and payers require cost-effectiveness evidence to inform their treatment funding decisions. The aims of this study were to assess the cost-effectiveness of the addition of spinal cord stimulation (SCS) compared with conventional management alone (CMM) in patients with complex regional pain syndrome (CRPS), and to determine the cost-effectiveness of nonrechargeable versus rechargeable SCS implanted pulse generators (IPGs).

Methods: A decision analytic model was used to synthesize data on CRPS patient outcomes and health-care costs over a 15-year time horizon from the perspective of the UK National Health Services.

Brush-evoked allodynia predicts outcome of spinal cord stimulation in complex regional pain syndrome type 1.

Background: Spinal cord stimulation (SCS) has proven to be an effective however an invasive and relatively expensive treatment of chronic Complex Regional Pain Syndrome type 1(CRPS-1). Furthermore, in one third of CRPS-1 patients, SCS treatment fails to give significant pain relief and 32-38% of treated patients experience complications. The aim of the current study was to develop effective prognostic factors for prediction of successful outcome of SCS.

Effect of spinal cord stimulation for chronic complex regional pain syndrome Type I: five-year final follow-up of patients in a randomized controlled trial.

Object: Chronic complex regional pain syndrome-Type I (CRPS-I) is a painful, disabling disorder for which no treatment with proven effect is available. In the present randomized controlled trial, the authors assessed the effectiveness of spinal cord stimulation (SCS) in reducing pain due to CRPS-I at the 5-year follow-up.

Methods: The authors performed a randomized trial in a 2:1 ratio in which 36 patients with CRPS-I were allocated to receive SCS and physical therapy (PT) and 18 patients to receive PT alone.

Duration of preoperative traction associated with sciatic neuropathy after hip fracture surgery.

Unlabelled: An unknown percentage of patients who have internal fixation for hip fractures have sciatic neuropathy develop. In most cases, the cause for this complication is unknown. We retrospectively reviewed 2202 consecutive patients treated in our hospital for hip fractures to ascertain whether there was any relationship between duration of preoperative traction and postoperative sciatic neuropathy, and to determine the incidence of sciatic neuropathy after surgery for hip fractures.

The effect of spinal cord stimulation in patients with chronic reflex sympathetic dystrophy: two years' follow-up of the randomized controlled trial.

Chronic reflex sympathetic dystrophy is a painful, disabling disorder for which no treatment with proven effect is available. We performed a randomized trial in a 2 to 1 ratio of patients, in which 36 patients were treated with spinal cord stimulation and physical therapy (SCS+PT), and 18 patients received solely PT. Twenty-four SCS+PT patients were given a permanent spinal cord stimulation system after successful test stimulation; the remaining 12 patients received no permanent system.

Economic evaluation of spinal cord stimulation for chronic reflex sympathetic dystrophy.

Objective: To evaluate the economic aspects of treatment of chronic reflex sympathetic dystrophy (RSD) with spinal cord stimulation (SCS), using outcomes and costs of care before and after the start of treatment.

Methods: Fifty-four patients with chronic RSD were randomized to receive either SCS together with physical therapy (SCS+PT; n = 36) or physical therapy alone (PT; n = 18). Twenty-four SCS+PT patients responded positively to trial stimulation and underwent SCS implantation.

The impact of chronic pain on life in the household.

To study what happens in a family where one member suffers from chronic pain, we quantitatively assessed the effect of chronic pain resulting from complex regional pain syndrome type 1 (CRPS) on 1) employment status, 2) time allocation, 3) additional domestic help, and 4) out-of-pocket expenses of Dutch patients (n = 50) and their spouses (n = 43). This study is the first to measure the effect of chronic pain on time allocation by means of a diary assessment technique. The results were compared with normative values for the Dutch population overall.