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.

Pathophysiology of longitudinal forearm instability (Essex-Lopresti syndrome) and implications for treatment.

Longitudinal forearm instability, or Essex-Lopresti syndrome, associates radial head fracture and rupture of the structures uniting the 2 bones, mainly the interosseous membrane and triangular fibrocartilage complex adjacent to the distal radioulnar joint. It is often overlooked at first, and should be screened for in case of comminuted radial head fracture without elbow dislocation or instability. Treatment should be prompt, within 4 weeks of trauma, to avoid soft-tissue retraction and hopefully allow healing.

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.

Metacarpophalangeal hyperextension in trapeziometacarpal osteoarthritis: Relationship to first metacarpal head shape, and clinical impact.

Purpose: The aim of this study was to determine whether the shape of the first metacarpal head influences metacarpophalangeal hyperextension, and to evaluate the influence of metacarpophalangeal hyperextension on hand pain and function in patients with trapeziometacarpal osteoarthritis.

Methods: 362 patients with painful basal thumb osteoarthritis were evaluated over a 2-year period. Pain rating on a visual analog scale, trapeziometacarpal and metacarpophalangeal motion, and grip and pinch strength were evaluated.

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.

Standard views do not suffice in assessing distal scaphoid articular cannulated screw penetration.

Background: Articular screw penetration is one of the most common hardware-related problems after scaphoid fracture fixation, occurring in up to two-thirds of patients, in particular into the scaphotrapezotrapezoidal (STT) joint. The aim of this study was to investigate whether this clinically important issue could be detected using standard anteroposterior (AP) and lateral, as well as additional nonstandard fluoroscopic views using direct open visualization with magnifying loupes as reference standard.

Materials And Methods: Ten fresh cadaver wrists were used for this imaging study.

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.

"Champagne Fracture": A Superior Fracture-Dislocation of the Proximal Humerus: A Case Report.

A 79-year-old right-handed woman presented with an indirect trauma to her left shoulder after a fall down the stairs. X-rays and computed tomography showed a four-part glenohumeral fracture-dislocation with a subcutaneous ectopic location of the humeral head in the retroclavicular space. A reverse total shoulder arthroplasty was performed using a deltopectoral approach with direct superior extraction of the humeral head.

After failed radial head arthroplasty, what are the options? Risk factors and results of revisions in a multicenter study.

Introduction: Few multicenter studies have analyzed the outcome of revision surgery of radial head arthroplasties (RHA) in the medium term follow up. The objective is twofold: to determine the factors associated with revision of RHAs and to analyze the results of revision with 2 surgical techniques: isolated removal of the RHA or revision with a new RHA (R-RHA).

Hypothesis: There are associated factors of RHA revision and RHA revision results in satisfactory clinical and functional outcomes.

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.

Proximal row carpectomy generates better mid- to long-term outcomes than four-corner arthrodesis for post-traumatic wrist arthritis: A meta-analysis.

Introduction: In posttraumatic wrist arthritis of intermediate severity, two main palliative procedures are used to preserve some mobility in the wrist: proximal row carpectomy (PRC) and scaphoid excision followed by four corner arthrodesis (4CA). Despite satisfactory overall results, the debate continues about which one provides the best results and long-term outcomes, particularly prevention of arthritis progression. Recent comparative studies now provide us with information about mid- and long-term results.

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.

Restoration of elbow extension and construction of a "key grip" in people with tetraplegia. Comparative study of a surgical plan in one or two stages.

Aim: We report the comparative results of functional upper extremity surgery plans in patients with tetraplegia, including restoration of elbow extension and construction of a key grip in a "one-stage" or "two-stage" operation.

Materials And Methods: A series of 36 patients with tetraplegia, with a total of 45 operated upper limbs, was analyzed retrospectively with a mean follow-up of 23 months (13-39 months). We evaluated the analytical strength of elbow extension using the MRC (Medical Research Council) score, the strength of the key grip (kg/F) as well as the autonomy of the patients using functional scores; Lamb (/100) and QIF (Quadriplegia Index of Function) (/100).

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.

Preliminary study of biodegradable PLA-PEU-PLA anti-adhesion membranes in a rat Achilles tendon model of peritendinous adhesions.

Peritendinous adhesions are complications known to occur up to 6 weeks after surgery and cause chronic pain and disability. Anti-adhesion barriers are currently the best option for prevention. In a previous study, we designed two biodegradable membranes, D-PACO1 and D-PACO, based on new triblock copolymers and conducted evaluations.

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.