Variant type and position predict two distinct limb phenotypes in patients with GLI3-mediated polydactyly syndromes.

Introduction: Pathogenic DNA variants in the GLI-Kruppel family member 3 ( gene are known to cause multiple syndromes: for example, Greig syndrome, preaxial polydactyly-type 4 (PPD4) and Pallister-Hall syndrome. Out of these, Pallister-Hall is a different entity, but the distinction between Greig syndrome and PPD4 is less evident. Using latent class analysis (LCA), our study aimed to investigate the correlation between reported limb anomalies and the reported variants in these GLI3-mediated polydactyly syndromes.

Speckle Tracking of Tendon Displacement in the Carpal Tunnel: Improved Quantification Using Singular Value Decomposition.

Ultrasound is a real-time image modality enabling the analysis of tendon dynamics for the diagnosis of carpal tunnel syndrome. Automatic tendon displacement quantification algorithms based on speckle tracking generally suffer from underestimation due to stationary background present in the tendon region. We propose an improved quantification method using singular value decomposition (SVD) filtering to suppress the clutter.

A Secondary Analysis of Longitudinal Prevalence Data to Determine the Use of Pressure Ulcer Preventive Measures in Dutch Nursing Homes, 2005-2014.

Pressure ulcers (PUs) are an important and distressing problem in Dutch nursing homes. A secondary analysis of longitudinal data from the Dutch National Prevalence Measurement of Care Problems (LPZ) - an annual, multicenter, point-prevalence survey - was conducted for the years 2005-2014 to determine the use of specific recommended PU preventive measures from the European Pressure Ulcer Advisory Panel 1998, the National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel 2009, and the 2002 and 2011 Dutch PU guidelines. Preventive care was investigated among nursing home residents at risk for PUs and included skin care (moisturization); nutritional and hydration status assessment and optimization; and pressure redistribution involving mattresses, cushions, and heel pressure-relieving strategies and devices.

A Systematic Review on the Prevalence, Etiology, and Pathophysiology of Intrinsic Pain in Dermal Scar Tissue.

Background: Scars can cause pain, even without symptoms of underlying nerve damage. A lack of knowledge on intrinsic scar pain hampers effective treatment of these complaints.

Objective: Aggregate current knowledge on the prevalence, etiology, and pathophysiology of intrinsic pain in dermal scars.

Surgical stabilization for symptomatic carpometacarpal hypermobility; a randomized comparison of a dorsal and a volar technique and a cohort of the volar technique.

Background: Hypermobility of the first carpometacarpal joint is mostly surgically treated with a volar approached stabilization by Eaton, but recent studies indicate the importance of the dorsoradial and intermetacarpal ligaments (DRL and IML) for carpometacarpal joint stability. The aim of this study was to compare a dorsal and volar technique for primary carpometacarpal hypermobility regarding pain and functional outcome.

Methods: Patients with non-degenerative, painful carpometacarpal hypermobility were included and were randomly assigned to either the volar technique using the FCR, or a dorsal technique using the ECRL.

Trapeziometacarpal Arthrodesis or Trapeziectomy with Ligament Reconstruction in Primary Trapeziometacarpal Osteoarthritis: A 5-Year Follow-Up.

Purpose: To compare the long-term outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) with trapeziometacarpal arthrodesis for osteoarthritis (OA) of the basal thumb joint.

Methods: Patients were evaluated for pain, daily functioning, strength, and complications after a mean follow-up of 5.3 years.

The Rotterdam Foot Classification: A Classification System for Medial Polydactyly of the Foot.

Background: Polydactyly at the medial side of the foot ("medial polydactyly" of the foot) is a rare and diverse congenital anomaly. In order to plan and evaluate surgical treatment, the classification of medial polydactyly is useful. The aim of our study was to develop a reliable and valid classification system for medial polydactyly of the foot that is more useful than previous systems for preoperative evaluation and surgical planning.

Burden of Keloid Disease: A Cross-sectional Health-related Quality of Life Assessment.

Keloid scars may be painful, itch severely and be cosmetically disturbing. The burden of keloid disease, however, has not yet been determined. This study evaluated the association of keloid disease with health-related quality of life (HRQL) and identified indicators of burden using a cross-sectional survey study, with one disease-specific HRQL measure (Skindex-29) and 2 generic HRQL measures (SF-36 and EQ-5D-5L).

Identification of independent risk factors for flap failure: A retrospective analysis of 1530 free flaps for breast, head and neck and extremity reconstruction.

Reconstructive microsurgery is a powerful method of treating various complex defects. However, flap loss remains a possibility, leading to additional surgery, hospitalisation and costs. Consequently, it is important to know which factors lead to an increased risk of flap failure, so that measures can be undertaken to reduce this risk.

Quantitative STIR of muscle for monitoring nerve regeneration.

Purpose: To assess whether short tau inversion recovery (STIR) MRI sequences can provide a tool for monitoring peripheral nerve regeneration, by comparing signal intensity changes in reinnervated muscle over time, and to determine potential clinical time points for monitoring.

Materials And Methods: For this prospective study, 29 patients with complete traumatic transection of the ulnar or median nerves in the forearm were followed up to 45 months postsurgery. Standardized 1.

A Matched Comparative Study of the Bilhaut Procedure Versus Resection and Reconstruction for Treatment of Radial Polydactyly Types II and IV.

Purpose: To compare outcomes of the Bilhaut procedure with outcomes of conventional resection and reconstruction in radial polydactyly types II and IV.

Methods: Patients treated with the Bilhaut procedure were radiologically matched with patients treated with reconstruction. Evaluated outcomes included the Rotterdam assessment system, pinch strength, and thumb size measurements.

The Effect of a Bone Tunnel During Ligament Reconstruction for Trapeziometacarpal Osteoarthritis: A 5-Year Follow-up.

Purpose: To compare in trapeziometacarpal (TMC) osteoarthritis the effects of trapeziectomy with tendon interposition and ligament reconstruction (LRTI) with or without a bone tunnel after a mean follow-up of 5 years.

Methods: We randomized 79 women (aged 40 years or older) with stage IV TMC osteoarthritis to either trapeziectomy with LRTI using a bone tunnel (Burton-Pellegrini) or a tendon sling arthroplasty (Weilby). Before surgery and at 3 months and 1 year after surgery, patients were evaluated for pain, function, strength, satisfaction, and complications.

Percutaneous Aponeurotomy and Lipofilling (PALF): A Regenerative Approach to Dupuytren Contracture.

Dupuytren disease is a progressive fibroproliferative disorder, which leads to flexion contractures of the digits. A minimally invasive technique consisting of an extensive percutaneous aponeurotomy of the cord with a needle combined with lipofilling is presented. The selective cutting of the cords under continuous tension disintegrates the cords while sparing the looser neurovascular bundles.

Bone Grafts for Scaphoid Nonunion: An Overview.

The scaphoid is the most common fractured bone in the wrist. Despite adequate non-surgical treatment, around 10% to 15% of these fractures will not heal. Untreated scaphoid non-union can cause a scaphoid non-union advance collapse (SNAC), this is a progressive deformity and can cause degenerative changes in the wrist.

Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome.

Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls.

The effect of a simple 3-step pressure relieving strategy for preventing pressure ulcers: an explorative longitudinal study from 2002-2011.

Objective: Pressure ulcers (PUs) still form an important and distressing problem in Dutch nursing homes. Pressure ulcer prevention protocols are generally based on current guidelines. The authors developed an alternative 3-step protocol to help prevent pressure ulcers.

Long-term follow-up of peptidergic and nonpeptidergic reinnervation of the epidermis following sciatic nerve reconstruction in rats.

Object: Peripheral nerve injuries are a commonly encountered clinical problem and often result in long-term functional deficits. The current gold standard for transected nerves is an end-to-end reconstruction, which results in the intermittent appearance of neuropathic pain.

Methods: To improve our understanding of the relation between this type of reconstruction and neuropathic pain, the authors transected and immediately end-to-end reconstructed the sciatic nerve in rats.

Prognostic factors for outcome after median, ulnar, and combined median-ulnar nerve injuries: a prospective study.

Background: A major problem in the surgical treatment of peripheral nerve injuries of the upper extremities is the unpredictable final outcome. More insight and understanding of the prognostic factors is necessary to improve functional outcome after repair of the peripheral nerves. The objective of this study was to identify prognostic factors for the functional recovery of peripheral nerve injury of the forearm and their independent contribution in the outcome in the first year after reconstruction.

Surgical technique: hemi-extensor carpi radialis brevis tenodesis for stabilizing the midcarpal joint in Ehlers-Danlos syndrome.

Patients with the hypermobility type of Ehlers-Danlos (EDS-HT) often complain of wrist pain, usually originating from subluxations. As a result of the laxity, wrist function in these patients can be highly limited. This paper presents a surgical technique that stabilizes the lunocapitate joint with the use of an extensor carpi radialis brevis strip.

Quality of measurements of acute surgical and traumatic wounds using a digital wound-analysing tool.

The aim of this study was to assess the reliability of measurements using a wound-analysing tool and their interpretability. Wound surface areas and tissue types, such as granulation, slough and necrosis, in twenty digital photographs were measured using a specific software program. The ratio of these tissue types in a wound was calculated using a wound profile.