Total joint arthroplasty versus trapeziectomy in the treatment of trapeziometacarpal joint arthritis: a randomized controlled trial.

The aim of this double anonymized, randomized controlled trial was to determine whether total joint arthroplasty has superior outcomes than trapeziectomy 1 year after surgery for trapeziometacarpal osteoarthritis. A total of 62 women aged 40 years and older, scheduled for surgery for stage II or III osteoarthritis of the trapeziometacarpal joint, were included and randomized to trapeziectomy or total joint arthroplasty. The primary outcome was the total score of the Michigan Hand Outcomes Questionnaire.

[Local anaesthetics containing epinephrine for use in the hand and fingers].

In the Netherlands there is no consensus regarding the addition of epinephrine (adrenaline) to local anaesthetics for use in the fingers. This is based on the persistent belief that the addition of epinephrine to local anaesthetics for use in the fingers is contraindicated due to the risk of ischaemic complications. Ischaemic complications arising from the use of modern anaesthetics containing epinephrine have, however, never been described.

The unilateral deep inferior epigastric perforator flap: comparing university to community hospital.

The deep inferior epigastric perforator (DIEP) flap is considered to be the gold standard for autologous breast reconstruction. This study evaluates the outcome of unilateral DIEP flap reconstructions, comparing university with a community hospital setting. A total of 77 unilateral DIEP flaps were performed at one university hospital and two community hospitals by the same two surgeons.

Substantial chest-wall deformity following tissue expansion after radiotherapy.

We present the case of a 54-year-old woman who underwent a two-stage breast reconstruction with a tissue expander after sustaining a lumpectomy and local radiotherapy for breast cancer. During expansion, the woman developed an abnormal concave deformity of the chest wall. Although respiratory or aesthetic consequences were expected, our patient reported only pain and was satisfied with the end result.