Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis.

Objectives: Intra-articular steroid injection is commonly used to treat base of thumb osteoarthritis (BTOA), despite a lack of large-scale data on safety and effectiveness. We estimate the incidence of serious complications and further procedures following BTOA injection, including the risk of post-operative serious surgical site infection for subsequent operative intervention.

Methods: Hospital Episode Statistics data linked to mortality records from 1 April 1998 to 31 March 2017 were used to identify all BTOA injections undertaken in adults in the National Health Service secondary care in England.

Systematic Review of Thumb Carpometacarpal Joint Hemiresection Interposition Arthroplasty Materials.

Background: Osteoarthritis of the first carpometacarpal joint is a common condition. Various management options and surgical procedures have been described to treat symptomatic cases. Many systematic reviews examine aspects of thumb carpometacarpal joint osteoarthritis treatment, although none solely examines the outcomes of trapezial partial resection and interposition arthroplasty in stage II to III patients in detail, yet this technique is of growing interest as surgeons seek more nuanced, tailored approaches for osteoarthritis of the first carpometacarpal joint.

Salvage of the Failed Total Wrist Arthroplasty: A Systematic Review.

 Although the performance of total wrist arthroplasty systems has improved, failure is encountered and is a major challenge to manage.  Does physical function improve with surgical management of the failed wrist arthroplasty? Is there an improvement in secondary outcome measures including pain, grip strength, and range of motion? What are the reasons for failure in primary total wrist arthroplasty? What are the complications associated with revision of the failed total wrist arthroplasty? What are the survival profiles of the different revision strategies?  A systematic review of available literature was performed. Studies were systematically assessed, and data extracted from suitable studies for review.

Outcome of arthrodesis for severe recurrent proximal interphalangeal joint contractures in Dupuytren's disease.

We report long-term outcomes of proximal interphalangeal joint arthrodesis for treatment of severe recurrent joint contractures secondary to Dupuytren's disease. The patients had at least two previous procedures for Dupuytren's contracture that involved the same joint, before undergoing joint fusion. Patient demographics, satisfaction, functional outcome, complications, revision and re-operation rates are reported.

Population Study of Hand and Wrist Manifestations of Congenital Insensitivity to Pain.

Congenital insensitivity to pain is a rare autosomal recessive condition characterized by insensitivity to painful stimuli due to absence of sensory and sympathetic post ganglionic neurons in the skin and skeletal system leading to lack of protective sensation and altered joint propioception. This study was performed to assess hand and wrist manifestations of patients with congenital insensitivity to pain in the Maltese Islands. Records of public and private hospitals were reviewed to identify patients suffering from this condition.

The Orthopedic Manifestations of Congenital Insensitivity to Pain: A Population-based Study.

Background: Congenital insensitivity to pain (CIP) is an extremely rare condition in which there is a failure of the development of the afferent sensory nerves in the dorsal root ganglia resulting in indifference to painful stimuli. The associated orthopedic manifestations are various and often present a diagnostic quandary for the treating surgeon.

Purpose: This population study provides insight into the orthopedic manifestations and functional scores in patients with CIP, to guide prognosis and management.

Three Year Review of Dorsal Plating for Complex Intra-Articular Fractures of the Distal Radius.

Background: The volar approach is commonly used for plating intra-articular fractures of the distal radius. Despite this, certain fracture configurations are more suitable for dorsal plate fixation. This technique has not gained favour due to the reported high incidence of extensor tendon irritation and attrition ruptures.

Distal radius volar rim plate: Technical and radiographic considerations.

Aim: To determine technical considerations and radiographic outcomes of the Synthes volar rim distal radius plate to treat complex intra-articular fractures.

Methods: This review highlights technical considerations learnt using this implant since it was introduced in a major trauma unit in November 2011, including anatomical reduction and whether this was maintained radiographically.

Results: Twenty-six of the 382 internally fixed distal radial fractures at our unit (6.

Four corner fusion using a multidirectional angular stable locking plate.

Aim: To review the results of our experience with the Medartis Aptus plating system for four corner arthrodesis of the wrist, which uses a combination of compression screws and variable angle locking screws.

Methods: We reviewed the results of 17 procedures in 16 patients that underwent scaphoid excision and four corner fusion using the Medartis Aptus system between May 2010 and June 2014. The primary outcome measure was radiographic and clinical union.