Swan-Neck and Boutonniere Deformity in Rheumatoid Hand.

Rheumatoid arthritis (RA) is an inflammatory disease for which the exact cause is unknown. It is an autoimmune disorder that primarily affects such joints which allows free movement in different directions, but also has many other severe complications related to mortality. On the other hand, this disease is responsible for digital deformities, arising out of a combination of synovitis, intrinsic muscles, and extrinsic tendons impairment, ligament rupture, joint dislocation, and final ankylosis.

Surgical Reconstruction of Severe Tophaceous Gout in the Hand: A Customized Approach.

Tophaceous gout can represent a major problem for hand surgeons when it turns into aggressive nodules, spreading and destroying soft tissue and bone. The combination of ablative and reconstructive surgery may also be complex when the patient refuses amputations and multiple segments are involved. We present a difficult case, where a customized approach, chosen according to the different features of the osteoarticular and tendon involvement of fingers, adopted different solutions for the four affected rays.

Up to five-week delay in primary repair of Zone 2 flexor tendon injuries: outcomes and complications.

We report the outcomes of delayed primary repair of flexor tendons in Zone 2 in 31 fingers and thumb (28 patients) averaging 15 days (range 4-37) after injury in 2020. The delay was longer than usual due to the COVID-19 pandemic. The tendons were repaired with a 6-strand core suture (M-Tang method) or a double Tsuge suture and a peripheral suture.

Fragment specific fixation with APTUS wrist system for volar rim fractures of the distal radius: a multicentric study.

Purpose: Volar rim fractures of the distal radius are a spectrum of pathology that must be well identified and treated to achieve good outcomes and avoid surgical failures. New devices of fragment specific fixation have been developed during the last decades to fix this fragment. The purpose of this retrospective study was to evaluate the ability of APTUS wrist distal radius system to securely fix different types of volar rim fractures.

How to ease the fixation of carpal bones? Twenty-four lesions treated by 1,5 mm headless compression screws.

Background: Carpal bone lesions are common, even in acute injuries or as sequalae of missed fractures. If not correctly diagnosed and treated, can lead to loss of function, especially in active patients. The surgical management remain difficult particularly in case of small, atypical or non-unions fragments.

Outcomes of 173 metacarpal and phalangeal fractures treated by intramedullary headless screw fixation with a 4-year follow-up.

Surgical treatment of extra-articular metacarpal and phalangeal fractures should be considered when there is instability or in patients with high demand. To overcome the issues related to the use of Kirschner wires, external fixators, and open reduction and internal fixation procedures, intramedullary headless screw fixation (IHSF) is an alternative technique to achieve primary fracture stability and early return to daily activities. We report the data of the Italian Multicentric Intra-Medullary Experience, which includes 173 cases of extra-articular unstable fractures (38 phalanges and 135 metacarpals) treated with the IHSF.

How hand and wrist trauma has changed during covid-19 emergency in Italy: Incidence and distribution of acute injuries. What to learn?

Background: the purpose is to gather and analyze the statistical datas of wrist and hand injuries admitted to the Hand and Reconstructive Microsurgery and Replantation Hub center of Careggi Hospital, Florence during the first two months of COVID-19 epidemic in Italy. The Authors investigated how the drastic changes in daily activities modified the epidemiology of hand trauma lesions.

Methods: The Authors analyzed the characteristics of hand and wrist traumatic disorders during the months of February and March comparing 2019 to 2020.

Combined nerve and tendon transfer to restore elbow extension in tetraplegic patients: surgical technique and case report.

Introduction: In individuals with tetraplegia, elbow extension is critical for overhead activities, weight shifting, independent transfers, and to perform self-care tasks such as eating. At present, restoration of elbow extension in tetraplegic patients can be performed using either tendon or nerve transfers. Each procedure presents several advantages and limitations that must be discussed with the potential surgical candidate, based on remaining muscular functions and functional goals.

Jammed ulnar nerve after distal radius fracture: A case report.

Background: Ulnar nerve lesions represent a rare complication of wrist fracture. The present manuscript describes the case of a particular traumatic mechanism in which the nerve resulted crushed between radial fracture fragments.

Case Presentation: A 47-year-old man suffered a subtotal lesion of the ulnar nerve following an open displaced distal radius fracture.

TFCC Lesions in Children and Adolescents: Open Treatment.

Background: There has been little discussion regarding the lesion of the TFCC in pediatric and adolescent patients. This study examines 11 cases treated with open technique.

Methods: Range of motion (ROM), strength and functional scores (QUICK DASH, PWRE, VAS pain, and NAKAMURA score) were evaluated.

Universal 2 Wrist Arthroplasty in Rheumatoid Arthritis.

 The aim of this study was to evaluate the mid- to long-term outcomes and complications in patients affected by rheumatic diseases treated with the Universal 2 (U2) total wrist arthroplasty (TWA).  We reviewed, in a retrospective, noncontrolled cohort study, 22 patients affected by rheumatoid arthritis (RA), who underwent U2 total wrist replacement between March 2003 and January 2014 for the treatment of 23 rheumatoid wrists with the aim of obtaining the remission of pain and a range of motion (ROM) useful for daily activities, according to the patients' demands, as an alternative to total wrist arthrodesis. The cohort of patients included 20 females and 2 males, with a mean age of 54.

Proximal interphalangeal (PIP) joint replacements with pyrolytic carbon implants in the hand.

Until the late 1980s, proximal interphalangeal (PIP) joint reconstruction had been almost exclusively performed by the use of monobloc silicone spacers and associated with acceptable to good clinical outcomes.More recently, new materials such as metal-on-polyethylene and pyrocarbon implants were proposed, associated with good short-term and mid-term results.Pyrocarbon is a biologically inert and biocompatible material with a low tendency to wear.

A new autocentering hinged external fixator of the elbow: a device that stabilizes the elbow axis without use of the articular pin.

Background: Hinged external fixation of the elbow is an important tool for the orthopedic surgeon. It enables early postoperative mobilization that may result in better outcomes. All models require correct alignment with the elbow axis of rotation.