Simple Trapeziectomy for Arthrosis of the Basal Joint of the Thumb: 49 Thumbs Reviewed After Two Years.

Background: Many different surgical strategies for arthrosis of the carpometacarpal joint of the thumb are described in the literature. In 2010 we changed our routine procedure from an interposition arthroplasty using the abductor pollicis longus (APL) tendon to simple trapeziectomy without suspension or interposition. The purpose of this study was to review the clinical outcome after trapeziectomy and to compare it to those we had achieved with the APL procedure.

The clinical outcome after extra-articular colles fractures with simultaneous moderate scapholunate dissociation.

Background An increased scapholunate gap is sometimes seen in patients with a distal radial fracture. The question remains as to whether this represents a scapholunate ligament injury that requires treatment. Questions/purposes We wished to examine the natural history of an increased scapholunate gap in patients following an extra-articular distal radial fracture.

[The significance of displacement in dorsally angled distal radial fractures].

Background: Distal radial fractures occur very frequently. Most are dorsally displaced (Colles' fracture). In contrast to previously, approximately a quarter of these patients now undergo surgery.

Percutaneous pinning of fractures of the distal radius.

Reduction of fractures of the distal radius is often supplemented with percutaneous pinning, but there is little evidence that this affects the clinical outcome. A total of 43 patients with pinned, and 296 with conservatively-treated, fractures were reviewed a mean of 6 (range 3-13) years after injury. We found controls among the conservatively-treated patients who matched 30 of the patients with pinned fractures with respect to age, sex, trauma energy, and radiographic measurements at injury.

The relationship between displacement and clinical outcome after distal radius (Colles') fracture.

We reviewed 260 patients who had been treated non-operatively for a dorsally displaced distal radius fracture a mean 6.3 (range 2.5-12.

Accurate radiographic measurement of the distal radial tilt.

Both wrists in 189 patients who had been treated for dorsally displaced distal radius fracture were X-rayed with both right angle and 15° tilted lateral views. Two investigators measured the radial tilt. The mean difference in the angles recorded by the two investigators was 2.

Obstetric brachial plexus palsy: a birth injury not explained by the known risk factors.

Objective: To determine the incidence and prognosis of obstetric brachial plexus injuries and analyze associated risk factors.

Design: Analysis of prospectively collected information comprising all births from 1991 to 2000, with complete follow-up of affected children. Setting.

Neurophysiology not required before surgery for typical carpal tunnel syndrome.

Sixty-eight patients with typical carpal tunnel syndrome underwent neurophysiological investigations preoperatively, but these were not assessed until the end of the study. Open carpal tunnel release was performed and the clinical diagnosis of carpal tunnel syndrome was considered as confirmed when there was a prompt resolution of the preoperative symptoms. Sixty-three of the 68 patients responded well to surgery, three had equivocal outcomes and two did not improve, and thus were considered not to have carpal tunnel syndrome.

No advantage from splinting the wrist after open carpal tunnel release. A randomized study of 82 wrists.

To study the value of postoperative splinting after open carpal tunnel surgery, we randomly selected 82 wrists for 4 weeks of postoperative immobilization or no immobilization. The distributions of scar discomfort or pain and "pillar pain" were equal in the two groups both at 6 weeks and 6 months. Median sick leave was 6 weeks in both groups.

Tendon interposition arthroplasty for basal joint arthrosis. 38 thumbs followed for 4 years.

We reviewed 38 thumbs (35 patients) operated with a modified Burton procedure for basal joint arthrosis. There were 3 pintrack infections and 9 patients reported severe discomfort during the postoperative period in a plaster of Paris. After a follow-up of 4 (1-7) years, 28 patients rated the overall result as excellent, while 1 would not have consented to the operation if she had known the result in advance.

Metacarpal lengthening after traumatic amputation of the thumb.

In nine patients of median age 34 years who had sustained an amputation of the thumb at a median 24 (5 to 131) months previously, we lengthened the first metacarpal by 30 (17 to 36) mm. Seven amputations had been through the proximal phalanx and two through the metacarpal. The first two patients had autogenous grafting at a second stage, but the other seven had callotasis alone.

Lumbar intervertebral disc herniation in the young.

A survey of 37 young patients, 10 to 18 years of age, with lumbar intervertebral disc herniation is presented. Local physical findings and limitation in straight-leg raising are often more marked in the young than in adults, whereas pain may be slight or even absent. Neurological findings were normal in 40 per cent of the cases, and when deficits were found, they were usually of a minor nature.