Acceptability and safety of 3D printed wrist-based orthoses compared to fiberglass casts for the treatment of non-surgical distal radius- and scaphoid fractures: A randomized feasibility trial.

Background: Non-invasiveness and comfort are crucial in the conservative management of distal radius and scaphoid fractures. While fiberglass casts are standard, three-dimensional (3D)-printed orthoses offer a promising alternative.

Purpose: To compare patient experiences, safety perceptions, and satisfaction between a 3D orthosis and fiberglass cast for distal radius or scaphoid fractures.

Percutaneous sonography-guided treatment of Dupuytren contracture under liquid immersion. Case reports.

Introduction: Dupuytren's contracture is a fibrotic disorder of the palmar fascia, leading to debilitating finger deformities. Traditional treatments, like open fasciectomy and collagenase injection, carry high risks of complications and recurrence. Ultrasound-guided techniques offer a potentially safer, minimally invasive alternative but are limited by the irregular skin surfaces and flexion deformities in Dupuytren's disease.

Percutaneous Ultrasound-Assisted Carpal Tunnel Release Using Sono-Instruments®.

Percutaneous ultrasound-assisted carpal tunnel (CT) release is an emerging minimally invasive technique in hand surgery that could reduce complications, enhance patient satisfaction, and facilitate earlier return to daily activities. Among the various devices employed for this procedure, the Sono-Instrument allows pin-hole surgery. Its safety and effectiveness have been established.

Prospective evaluation of a novel device for ultrasound-guided percutaneous treatment of carpal tunnel and trigger finger disease. Efficacy and safety of sono-instruments®.

Purpose: To evaluate the safety and effectiveness of percutaneous release procedures under sonography using Sono-Instruments® in the treatment of carpal tunnel syndrome (CTS) and trigger finger (TF).

Methods: Prospective study involving 30 patients, divided into two groups (15 CTS, and 15 TF). The primary outcomes were surgical performance-related outcomes (visibility, ease of use, satisfaction, duration) using Sono-Instruments® and patient-related outcomes (pain, activity limitations, time to return to work, functional scores).

Reconstruction of Intercalary Bone Defects After Tumour Resection with the Use of a Free Vascularised Fibular Graft: the Concealed Advantages of the External Fixator.

The free vascularised fibular graft represents the mainstay of intercalary bone defect reconstruction after tumour resection. Different reconstruction techniques are described, favouring internal fixation and possibly overlooking potential advantages of external fixation. This series is a description of the technique performed at our institution using an external fixator for the reconstruction of segmental bone defects which enables to maintain limb length and rotational alignment after large segmental bone resection.

Retrograde Percutaneous Release of Trigger Finger or Thumb Using Sono-Instruments®: Detailed Technique, Pearls, and Pitfalls.

Percutaneous release is a common treatment option for trigger finger stenosing tenosynovitis. While surgical and conservative treatments are available, percutaneous techniques offer several advantages, including faster recovery time, reduced complications, and simultaneous treatment of multiple trigger fingers. The sono-instrument is a minimally invasive device designed for surgical release of the A1 pulley in adults.

Ulnar lateral digital flap for Dupuytren's disease of the fifth finger, a technique not be forgotten.

Dupuytren's disease is a common condition in hand surgery. The fifth finger is frequently affected, pre- senting the highest recurrence rate after surgical treatment. The ulnar lateral-digital flap is used when a skin defect prevents direct closure after fasciectomy of the fifth finger at the level of the MP joint.

Osteonecrosis of the Lunate Following Three-Corner Arthrodesis: A Case Report.

Scaphoid lunate advanced collapse (SLAC) is the most frequently encountered cause of wrist osteoarthritis. Proximal row carpectomy (PRC) and four-orner arthrodesis (4CA) are the two main surgical options to address it. Three three-corner arthrodesis (3CA) was introduced in 1997 as an alternative to PRC and 4CA.

Arthroscopically Assisted Eaton-Littler Trapeziometacarpal Ligamentoplasty.

 Eaton-Littler ligamentoplasty has proven its efficacy in the treatment of trapeziometacarpal (TMC) instability.  In this article, we describe the arthroscopically assisted Eaton-Littler ligamentoplasty through two clinical cases.  Arthroscopy is used to accurately place the metacarpal bone tunnel and pass the slip of flexor carpi radialis tendon in the latter.

Volar Ganglion Cyst and Echo-Guided Assistance for the Arthroscopic Removal.

The ganglion of the wrist is very common but with uncertain prognosis. The arthroscopic resection seems to improve the result compared with open procedure, in decreasing recurrence and morbidity. Volar ganglions are close to the radial artery, the flexor pollicis longus tendon, and even the median nerve.

Three-dimensional analysis of the gap space under forearm casts.

Purpose: Secondary displacement represents a frequent complication of conservative treatment of fractures, particularly of the distal radius. The gap space between skin and cast may lead to a certain degree movements and this increased mobility might favor redisplacement. The aim of this study was to develop a new 3D method, to measure the gap space in all 3 geometrical planes, and to validate this new technique in a clinical setting of distal radius fractures.

Three-Corner Arthrodesis (lunate - hamate - capitate) : clinical and kinematical evaluation.

In the absence of prosthetic arthroplasty offering good results for the treatment of wrist osteoarthritis, we studied the arthrodesis of three carpal bones (lunate - hamate - capitate) completed by triquetrum and scaphoid excision in the presence of Scapholunate Advanced Collapse (SLAC) or Scaphoid Nonunion Advanced Collapse (SNAC) stage II or III. Clinical data on eight patients between the ages of 32 and 61 years at an average of 29 months after surgery was analyzed. Seven patients reached fusion with a carpal height ratio of 0.

Normative values of the DASH questionnaire in healthy individuals over 50 years of age.

This study aimed to define the normative values of the DASH score in healthy individuals over 50 years of age. One hundred and twenty subjects equally representing both genders and six age categories (50-54, 55-59, 60-64, 65-69, 70-74 and 75-80 years), with no past medical history affecting the upper limb, were asked to complete the DASH questionnaire. A visual analogue scale for pain and an HAQ-DI questionnaire were also completed to confirm the absence of symptomatic untreated upper limb pathologies.

Lunate biomechanics: application to Kienböck's disease and its treatment.

Kienböck's disease was initially considered as lunate osteomalacia due to lesions of its nutrient arteries during carpal ligament tears. It has also been suggested following primary fractures, or because of repeated microtrauma. It is only in the past 20 or 30 years that it has appeared as aseptic necrosis.

Lunate loads following different osteotomies used to treat Kienböck's disease: A 3D finite element analysis.

Background: One of most accepted principles for treating Kienböck's disease before wrist degeneration settles in is to decompress the lunate by an osteotomy. Several osteotomies have been proposed since 1935. However, they are based on biomechanical hypotheses that are sometimes conflicting: This study compares the decompression effect of radius transverse shortening, radius lateral closing and medial closing wedge osteotomies, capitate shortening - with and without hamate shortening - and a Camembert-type radius wedge osteotomy with and without ulnar head shortening according to Sennwald.

Treatment of diaphyseal clavicular nonunion with special emphasis on microsurgery.

Diaphyseal fractures of the clavicle had until recently the reputation to always heal with abundant callus formation, except if operated, due to a reported high rate of nonunion after plate fixation by older series. The reason would be that the bone has only periosteal vascularization, easily destroyed by periosteal stripping for implant apposition. Bone autograft and external fixation has been reported as the best technique to heal a nonunited clavicle nonunion.

Treatment of supracondylar humeral non-union by bone autograft and Hoffmann II external fixation.

Supracondylar humeral nonunions are difficult to heal by internal fixation. Prosthetic arthroplasty is a solution in elderly patients. Both therapeutic options are contraindicated in the case of an infection.

Microvascular reconstructive techniques in orthopaedic traumatology.

Great evolution has taken place in Orthopaedic Traumatology, regarding techniques, surgical means and equipment. However, we still encounter complicated cases of limb trauma that necessitate microvascular reconstruction. Through three different illustrative cases (one emergency foot revascularization by a free flap, covering an ankle arthrodesis and bridging the anterior tibial artery, one cure of a complex infected tibial non-union with extensive skeletal defect by double barrel fibular transfer and one osteo-chondral reconstruction of the scaphoid proximal pole using a vascularized graft harvested from the femoral medial condyle), the authors remind the Orthopaedic community about the benefits of microsurgery, especially if used in proper indication and timing.

Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know.

Objectives: The aim of this study was to review the impact of smoking tobacco on the musculoskeletal system, and on bone fractures in particular.

Methods: English-language publications of human and animal studies categorizing subjects into smokers and nonsmokers were sourced from MEDLINE, The Cochrane Library, and SCOPUS. This review specifically focused on the risk, surgical treatment, and prevention of fracture complications in smokers.

Joint contact areas after radial head arthroplasty: a comparative study of 3 prostheses.

Background: Contact stresses of radial head prostheses remain a concern, potentially leading to early capitellar cartilage wear and erosion. In particular, point contact or edge loading could have a detrimental effect. The purpose of this study was to compare 3 different types of radial head prostheses in terms of joint contact areas with each other and with the native situation.

Effects of humeral shortening on the three-dimensional configuration of the brachial plexus: a cadaveric study.

This study reports the gains in length of nerves after three different humeral shortenings. Ten brachial plexuses were dissected. The lengths of the different parts of the brachial plexus were measured using a three-dimensional digitizing system after humeral shaft shortenings of 2, 4 and 6 cm and after a standardized force of 0.

The Role of the Muscle Brachioradialis in Elbow Flexion: An Electromyographic Study.

Background: In the classical conception, the brachioradialis is a forearm supinator. The hypothesis of this study was that, at least in certain positions of elbow flexion and forearm rotation, the brachioradialis is, along with the biceps and brachialis, one of the main elbow flexors.

Methods: Fifteen young healthy male volunteers participated in this research.