Long term functional outcome for the cubital tunnel syndrome after endoscopic assisted release of the ulnar nerve.

Introduction: The endoscopic assisted release for cubital tunnel syndrome (CuTS) gained popularity in recent years with unclear long-term results. This study aims to evaluate long term results regarding functional and subjective outcomes after endoscopic assisted release for the CuTS.

Materials And Methods: Thirty one patients who have been treated by endoscopic assisted release for CuTS between 2006 and 2013 were followed up both clinically and with a questionnaire with a mean follow up of 152 months (range 120-204 months).

[Microsurgical nerve repair].

Substantial nerve lesions almost always lead to persistent functional deficits, even with ideal treatment. Nerve lesions commonly occur in young patients, are often part of complex injuries, and are repeatedly diagnosed and treated with delay. Functional outcome crucially depends on early and adequate treatment.

[Postoperative Pain Level Following Surgery of the Hand and Wrist in the Ambulatory Setting].

Background: Surgical procedures of the hand are increasingly performed in an ambulatory setting. Postoperative analgesia is based empirically on the painfulness of individual surgical procedures without these having been examined systematically.

Patients And Methods: The painfulness (visual analogue scale) of 722 surgical procedures of the hand and wrist (1 July 2021 to 30 June 2023) was assessed until day 5.

[Peripheral nerve grafting].

Objective: Peripheral nerve lesions often lead to significant and permanent loss of motor and sensory function. The aim of peripheral nerve grafting is to bridge nerve defects.

Indications: When tension-free nerve repair is not possible, peripheral nerve grafting is indicated.

The Conservative and Operative Treatment of Carpal Fractures.

Background: Carpal fractures (incidence: 30-60 per 100 000 persons per year) are one of the more commonly overlooked fracture types. They can have serious consequences, as the use of the hand is indispensable in everyday life. In the following article, we present the elements of the diagnosis and treatment of fractures of the carpal bones.

The Treatment of Closed Finger and Metacarpal Fractures.

Background: Fractures of the fingers and metacarpal bones are the most common fracture type in the upper limb, with an incidence of 114 to 1483 per 100 000 persons per year. The clinical importance of closed finger and metacarpal fractures is often underestimated; inadequate diagnostic and therapeutic measures may result in serious harm. This review concerns the basic elements of the diagnosis and treatment of finger and metacarpal fractures.

[Arthroplasty of the hand and wrist].

Arthrosis and autoimmune arthritis frequently lead to major impairment of hand function. Primary therapy consists of well- tried conservative treatments and joint preserving surgical options for special indications. In advanced stages silicon spacers remain the gold standard surgical option for replacement of proximal interphalangeal and metacarpophalgeal joints of the fingers.

[Radiocarpal dislocations and fracture dislocations].

Radiocarpal dislocations and fracture dislocations are rare but always severe and complex injuries. They occur frequently in young and active patients as a result of high energy accidents. A detailed clinical and imaging examination and an accurate classification leads to a suitable and mostly surgical treatment strategy.

[Trigger finger-pitfalls and differential diagnosis].

The differential diagnosis of a trigger finger presents a clinical challenge. This case depicts a 32-year-old male patient who presented with persistent snapping of the right index finger at the metacarpophalangeal joint without localized tenderness despite previous surgical A1-annular ligament release. CT diagnostics demonstrated a prominent articular tuberosity.

[Treatment of extensor tendon injuries of the hand].

The extensor apparatus of the hand is a complex system consisting of extrinsic and intrinsic muscles, which in combination enable the individual extension of the fingers. Extensor tendon injuries of the hand are frequent injuries and the operative or conservative treatment options are determined by the localization and involvement of osseus structures. For an optimal outcome of the treatment of extensor tendon injuries, correct diagnostics and a consistent hand aftercare are absolutely essential.

A retrospective analysis of controlled active motion (CAM) versus modified Kleinert/Duran (modKD) rehabilitation protocol in flexor tendon repair (zones I and II) in a single center.

Introduction: The aim of this study was to analyze primary flexor tendon repair results in zones I and II, comparing the rupture rate and clinical outcomes of the controlled active motion (CAM) protocol with the modified Kleinert/Duran (mKD) protocol.

Materials And Methods: Patients who underwent surgery with traumatic flexor tendon lacerations in zones I and II were divided in three groups according to the type of rehabilitation protocol and period of management: group 1 included patients who underwent CAM rehabilitation protocol with six-strand Lim and Tsai suture after May 2014. Group 2 and 3 included patients treated by six-strand Lim Tsai suture followed by a modified Kleinert/Duran (modK/D) protocol with additional place and hold exercises between 2003 and 2005 (group 2) and between 2011 and 2013 (group 3).

[Mid- to long-term functional results after Bowers' hemiresection interposition arthroplasty of the distal radio-ulnar joint].

Background: Bowers' hemiresection interposition arthroplasty of the distal radio-ulnar joint has been performed for decades, mainly for the treatment of osteoarthritis of the distal radio-ulnar joint. However, long-term test results are sparse.

Objective: Evaluation of a homogeneous patient population following a mid- to long-term postoperative follow-up interval after hemiresection interposition arthroplasty.

[Minimally invasive procedures in the early stages of trapeziometacarpal joint osteoarthritis : Denervation, arthroscopy and autologous fat transplantation].

Background: Resection arthroplasty of the trapezium with or without tendon interposition is the standard procedure in the treatment of advanced, symptomatic thumb carpometacarpal joint osteoarthritis. Treatment recommendation in the early stages without visible or minimal radiographic changes is often difficult, especially when conservative treatment methods have already been exhausted. In these cases, there is the possibility of the minimally invasive methods of denervation, arthroscopic procedures and autologous fat transplantation.

Diagnostic accuracy of wrist MRI in comparison to wrist arthroscopy regarding TFCC lesions in clinical practice.

Introduction: The purpose of this study was to arthroscopically verify MRI diagnostic accuracy for triangular fibrocartilage complex (TFCC) lesions in a regular clinical environment.

Methods: A total of 859 patients' data with both preoperative MRI of the wrist and additional wrist arthroscopy were retrospectively reviewed. Two board-certified hand surgeons and one orthopaedic surgeon executed wrist arthroscopy, whereas more than 100 radiologists examined the MRI of the wrist.

[Resection arthroplasty for thumb basal joint arthritis].

Due to the crucial role of the thumb for gripping, osteoarthritis of the first carpometacarpal joint leads to a substantial impairment of hand function. There are effective nonoperative and joint-preserving surgical treatment options for early stages of the disease. In advanced cases, after exploiting conservative treatment, carpometacarpal thumb arthrodesis or arthroplasty may be indicated in selected cases but trapeziectomy with or without interposition or suspension constitutes the gold standard surgical procedure.

The arthroscopic Bankart operation: a 10-year follow-up study.

Introduction: Traumatic shoulder instability most frequently occurs in young people often during sports events. Currently, the arthroscopic Bankart repair is the therapy of choice in the absence of extensive glenoid bone loss and has proved to be a safe and effective procedure. Nevertheless, we see recurrence of instability-especially if new trauma happens-and further data are needed to guide the right decision-making for these often young patients.

[Pyogenic Flexor Tenosynovitis].

Pyogenic flexor tenosynovitis (PFT) is still the most serious infections of the hand. If the typical cardinal signs of PFT according to Kanavel exist, the indication for surgery should be made immediately. The consequential damage of a delayed surgery with enormous restrictions on the movement of the fingers due to the destruction of the sliding layers and massive adhesions are so serious that conservative therapy attempts are very difficult to justify.

[Resection arthoplasty of the trapezium with ligament reconstruction and tendon interposition and variations].

Objective: Creation of a pain-free, flexible and stable (pseudo) joint between the carpus and the base of the 1st metacarpal bone.

Indications: Painful carpometacarpal (CMC)‑I joint due to primary or secondary osteoarthritis, CMC‑I instability.

Contraindications: Carpal instability, local infection, tumors.

Long-term outcome after arthroscopic debridement of Palmer type 2C central degenerative lesions of the triangular fibrocartilage complex.

Purpose: The purpose of this study was to report long-term objective and patient-reported outcome after arthroscopic debridement of central degenerative triangular fibrocartilage complex (TFCC) lesions.

Methods: A total of 17 patients with central degenerative TFCC (Palmer type 2C) lesions and ulnar positive variance who were treated by arthroscopic debridement were retrospectively reviewed. Mean follow-up was 8.

[Extensor tendon injuries of fingers in the region of the metacarpophalangeal joint (zone V)].

Due to the exposed situation of the extension side of the metacarpophalangeal joint when the fingers are bent, injuries in this region are not uncommon. The extensor apparatus lies directly below the skin and the various parts can be easily injured. Due to the complex anatomical structure, the different clinical appearances and the various forms of treatment, injuries of the extensor tendons in the region of the metacarpophalangeal joint must be examined in a very differentiated manner.

The Requirement for Closed Reduction of Dorsally Displaced Unstable Distal Radius Fractures Before Operative Treatment.

Background: Dorsally displaced distal radius fractures are generally treated with closed reduction followed by casting. Current evidence suggests that fracture reduction is of no benefit before either conservative or surgical treatment. It has not been studied to date whether the degree of pain suffered by the patient during preoperative casting is any different if the fracture is reduced beforehand.