6,200 results match your criteria: "Dislocation Hand"
Background: The purpose of this study was to evaluate differences in 90-day clinical outcomes between patients treated with generic volar locking plates (VLPs) and conventional VLPs in distal radius fractures. Secondary aims included assessing for differences in surgical characteristics and cost between the groups.
Methods: From November 2022 to April 2023, a prospective block-randomized study was undertaken in which surgeons alternated between using a generic VLP and a conventional VLP each month.
A 3-Dimensional Printed Dynamic External Fixator for the Treatment of Proximal Interphalangeal Fracture-Dislocations: A Biomechanical Study.
J Hand Surg Am
November 2024
Hand and Upper Extremity Surgery Department, "Prof. Dr. Carlos Ottolenghi Institute, " Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Article Synopsis
- - The study tested a 3D printed dynamic external fixator (3DPDEF) against a traditional pins and rubbers traction system (PRTS) for treating unstable proximal interphalangeal (PIP) fracture-dislocations in cadaver fingers, aiming to see if one method was superior at maintaining joint stability.
- - Ten cadaveric fingers were used to simulate PIP fracture-dislocations, and both fixators were assessed under 1,400 flexion-extension cycles using fluoroscopy to measure joint stability and displacement.
- - Results showed that both fixators maintained stability effectively, with the 3DPDEF offering similar stability to PRTS while being easier to apply and less expensive, making it a viable option for
Management Options and Clinical Outcomes After Flexor Tendon Ruptures Following Volar Plating of Distal Radius Fractures.
Hand (N Y)
November 2024
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
Article Synopsis
- The study investigates the occurrence of flexor tendon ruptures in patients treated with volar locking plates for distal radius fractures, highlighting the trade-off between improved recovery and the risk of tendon injuries.
- A review of cases from 2014 to 2023 found ten patients with flexor tendon ruptures post-surgery; the most affected tendon was the flexor pollicis longus (FPL), with various reconstruction methods employed.
- Despite the risk associated with volar plating, the majority of patients who underwent tendon reconstruction achieved functional movement in their affected digits, suggesting effective treatment options are available.
Prevalence and aggravation of cervical spine instabilities in rheumatoid arthritis during over 10 years: a prospective multicenter cohort study.
Sci Rep
November 2024
Department of Orthopaedic Surgery, Kobe Rosai Hospital, 4-1-23 Kagoike-dori, Chuo-ku, Kobe, 651-0053, Japan.
Article Synopsis
- A multicenter cohort study was conducted to investigate the long-term prevalence and worsening of cervical spine instabilities in patients with rheumatoid arthritis (RA), involving 634 outpatients, with 233 followed for over 10 years.
- Cervical spine instability was assessed through specific measurements, with findings indicating that both vertical and subaxial subluxation increased significantly over time.
- Key predictors for worsening conditions included advanced joint damage, prolonged duration of RA, elevated C-reactive protein levels, and past joint surgery, highlighting the importance of managing disease activity to prevent further complications.
Local/Regional Anesthesia Versus General Anesthesia in Phalanx Fractures/Dislocations.
Plast Surg (Oakv)
November 2024
Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Traditionally, surgical repair of phalanx fractures was performed under general anesthesia. However, the emergence of regional and local anesthesia, otherwise known as Wide-awake Local Anesthesia No Tourniquet, provides an alternative approach where general anesthesia is undesirable. The choice of anesthetic approach resides with clinicians, though it is important to factor in the evidence that regional/local provides not only an alternative anesthesia approach but also potentially avoids comorbidities associated with general anesthesia.
View Article and Find Full Text PDFRecommendations on the use of restrictions and assistive devices after total hip arthroplasty: an adolopment of guidelines.
Disabil Rehabil
November 2024
Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy.
Purpose: Movement restrictions and assistive devices have traditionally been recommended to prevent hip dislocation after total hip arthroplasty (THA). Considering the advancements in THA surgery, a review of treatment recommendations is worthwhile. The aim of this study was to investigate whether unrestricted protocol (without movement restrictions and assistive devices) should be recommended for THA patients.
View Article and Find Full Text PDFBrachial Plexus Injury Following Fracture-Dislocation of the Proximal Humerus: A Case Report.
Cureus
October 2024
Anesthesia, Lincoln County Hospital, Lincoln, GBR.
Fracture-dislocations of the proximal humerus with brachial plexus injury are exceedingly rare, and although infrequently encountered, it is important to recognize this complication due to its potentially devastating impact. We present the case of a 75-year-old female who sustained the described injury following a fall onto their left arm, demonstrating combined sensory and motor deficits in the radial, median, and ulnar distribution of the left forearm and hand shortly afterward. Immediate management involved closed reduction under anesthesia, resulting in the improvement of neurological symptoms.
View Article and Find Full Text PDFDetection, classification, and characterization of proximal humerus fractures on plain radiographs.
Bone Joint J
November 2024
Department of Orthopaedic Surgery, Flinders Medical Centre, and Flinders University, Adelaide, Australia.
Article Synopsis
- - This study aimed to create a convolutional neural network (CNN) to detect and classify fractures, focusing on specific characteristics like greater tuberosity displacement and neck-shaft angle, using plain X-rays.
- - The CNN was trained with over 1,700 X-rays from Australia and validated with data from the Netherlands, comparing results with CT scans evaluated by experts.
- - The CNN demonstrated a high detection accuracy of 94% for fractures, but less effectiveness in identifying specific fracture characteristics, particularly showing lower performance for greater tuberosity displacement and neck-shaft angles.
Background: In total hip arthroplasty (THA), even if there is a dislocated hip, restoring the anatomical center of rotation increases long-term survival and hip function. Even with a shortening osteotomy, the procedure is still challenging due to soft-tissue tension. Therefore, soft tissue releases such as iliopsoas tenotomy may be necessary.
View Article and Find Full Text PDFCast-OFF 2: one week versus three to five weeks of plaster cast immobilization for non-or minimally displaced distal radius fractures, a stepped wedge cluster randomized controlled trial.
J Orthop Trauma
October 2024
Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Article Synopsis
- The study aimed to evaluate the efficacy of shortening the cast immobilization period for distal radius fractures (DRF) from 3-5 weeks to 1 week followed by gradual mobilization.
- Conducted in various trauma centers, it involved randomly assigning hospitals to either the usual care or the shorter immobilization method, with patients aged 18 to 85 included if they had isolated, non- or minimally displaced DRF.
- Results showed no significant differences in functional outcomes, pain scores, or patient satisfaction between the two groups, suggesting that the shorter immobilization period may be equally effective as the conventional approach.
Outcomes of dual-mobility trapeziometacarpal arthroplasties: a systematic review.
J Hand Surg Eur Vol
October 2024
Trauma & Orthopaedics, Cambridge University Hospitals, Addenbrookes Hospital, Hills Road, Cambridge, UK.
Article Synopsis
- The systematic review analyzed 13 studies on dual-mobility trapeziometacarpal joint arthroplasties (using MAÏA®, Moovis®, and Touch® prostheses) and included data from 1421 procedures.
- Overall, the results showed improvements in strength, motion, pain relief, and patient satisfaction, but there was a 13% complication rate, while the risk of dislocation was low at 0.6%.
- The evidence was deemed low quality, indicating that longer-term follow-ups are needed to assess implant survival and to determine if dual-mobility TMC arthroplasty is better than trapeziectomy.
Fracture patterns, outcomes, and complications of terrible triad injury in elderly patients.
J Shoulder Elbow Surg
October 2024
Shoulder and Elbow Unit, Department of Traumatology and Orthopaedic Surgery, Clínico San Carlos Hospital, Madrid, Spain; Department of Surgery, Complutense University, Madrid, Spain.
Hypothesis: This study hypothesized that patients older than 65 years with terrible triad elbow injuries (TTEI) exhibit complex fracture patterns, a high prevalence of associated injuries, and increased rates of complications and reinterventions.
Methods: A retrospective study of 29 patients, mean follow-up of 48.7 ± 4.
Enhancing sports mouthguards with PLA + and PC: stress reduction, energy absorption, and topology optimization.
Clin Oral Investig
October 2024
Department of Oral Health Sciences, PGIMER, Sangrur, Punjab, India.
Objectives: The objective of this paper was to compare the effectiveness of different materials for mouthguards in preventing oral and maxillofacial injuries during sports activities. The present study compares the stress-reduction and energy absorption capabilities of two other fused filament materials - poly(lactic-acid plus) (PLA+) and polycarbonate (PC), with Ethylene-vinyl acetate (EVA), which is the most commonly used material for mouthguard fabrication.
Materials And Methods: Two human skulls were modelled, and a boxing glove simulated punches along the x, y, and z-axes with 5 mm displacement with 1 kN force.
Background: The 2 primary surgical approaches for proximal interphalangeal joint (PIPJ) arthroplasty, dorsal or volar, have been extensively described in the literature. However, the ongoing debate regarding which approach offers superior results or is associated with fewer complications persists. This systematic review aims to compare the outcomes of PIPJ arthroplasty between the dorsal and volar approaches.
View Article and Find Full Text PDFBado type III Monteggia fractures have a high injury- and treatment-related complication rate: a single center study of 73 fractures.
Acta Orthop
October 2024
Department of Pediatric Orthopedics and Traumatology, New Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Article Synopsis
- - The study analyzed 73 Monteggia fractures in children, aiming to understand complications, outcomes, and incidence based on the classification of these fractures, specifically Bado types.
- - Out of the fractures, Bado types I and III were most common, with type III showing a significantly higher risk of complications and treatment failures compared to type I.
- - Overall, while Monteggia fractures are rare, the clinical outcomes were generally positive, with most children achieving full motion and function, although Bado type III injuries presented more challenges.
Complications and morbidity of the extended delto-pectoral approach in treating complex humeral shaft fractures with proximal metaphyseal extension using a long locking plate for internal fixation.
BMC Musculoskelet Disord
October 2024
Department of Orthopaedics and Traumatology, Kantonsspital St.Gallen, St.Gallen, Switzerland.
Article Synopsis
- Humeral shaft fractures make up about 3% of all fractures, with complex types being rare; the study aimed to evaluate the effectiveness and complications of treating these fractures using an open method with a locking plate.
- A retrospective analysis involved 26 patients over an average age of 64, assessing fracture healing, complications, and quality of life through various evaluations.
- Results showed no infections and effective wound healing, though mechanical issues arose in some cases and 84% had healed fractures within a year; complications included temporary and persistent radial nerve palsy in two patients.
Treatment of Anterior Shoulder Instability: A Comprehensive Review.
J Hand Surg Glob Online
September 2024
Department of Orthopaedic Surgery, Duke University, Durham, NC.
Article Synopsis
- Anterior shoulder instability involves excessive movement of the humeral head in the shoulder joint, causing symptoms like discomfort and potential dislocations.
- Accurate diagnosis requires a detailed history, physical examination, and imaging to assess the instability's severity.
- Treatment options range from conservative methods to various surgical repairs, with choices depending on factors such as the patient's anatomy, severity of instability, and personal recovery goals.
A Percutaneous Triple K-Wire Fixation Technique for Nascent Malunion of Proximal Interphalangeal Joint Fracture-Dislocation: A Case Series With an Assessment of Functional Outcome.
J Hand Surg Am
October 2024
Department of Hand Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Article Synopsis
- The study investigates the effectiveness of the percutaneous triple K-wire technique in treating nascent malunion of proximal interphalangeal (PIP) joint fracture-dislocations, especially when treatment is delayed by 2-4 weeks.
- Thirteen patients with significant articular involvement were treated, showing an increase in active range of motion from 15 degrees pre-surgery to 83 degrees post-surgery, with favorable outcomes reported.
- The results suggest that this minimally invasive technique is a viable alternative to more invasive surgical options for managing PIP joint malunion.
Factors associated with the choice of treatment for coronoid fractures.
Bone Joint J
October 2024
Amsterdam Shoulder and Elbow Center of Expertise, OLVG, Amsterdam, Netherlands.
Article Synopsis
- * After three rounds of surveys, 18 out of 68 factors were identified as influential, with stable consensus on factors that favor operative treatment including professional athlete status and specific fracture characteristics.
- * Most disagreement arose regarding treatment for certain injuries, especially those involving an anterolateral coronoid tip fracture, indicating a need for more clarity in treatment guidelines among surgeons.
Incidental Triangular Fibrocartilage Complex Changes on Wrist MRI.
Hand (N Y)
September 2024
Thomas Jefferson University, Philadelphia, PA, USA.
Article Synopsis
- A study investigates the occurrence of asymptomatic triangular fibrocartilage complex (TFCC) changes in patients who underwent wrist MRIs for reasons other than ulnar-sided wrist pain.
- Of the 132 patients reviewed, 44% showed TFCC abnormalities on MRI, while 80% of those with ulnar-sided pain had similar findings.
- The results emphasize the need to consider a patient's symptoms alongside MRI findings, as many with non-painful TFCC changes might be identified in routine scans.
When the Going Gets Tough: A Review of Total Hip Arthroplasty in Patients with Ipsilateral Above- and Below-Knee Amputation.
Medicina (Kaunas)
September 2024
Orthopedic and Traumatology Clinic, IRCCS Rizzoli Orthopedic Institute, Via G.C. Pupilli 1, 40136 Bologna, Italy.
Article Synopsis
- Life expectancy and overall function of amputated patients have improved, leading to a higher incidence of hip issues requiring total hip arthroplasty (THA), but not all surgeons are adequately trained for these cases.
- This review analyzes 17 manuscripts, documenting 39 cases of THA in amputees, highlighting differences between above-knee amputations (AKA) and below-knee amputations (BKA) and emphasizing the need for careful planning and rehabilitation considerations before surgery.
- Patients with BKA often have higher functional demands post-surgery, requiring precise component positioning and intensive physiotherapy, while AKA patients may present unique challenges due to the lack of a knee joint and varying levels of mobility.
A Review of the Development of Titanium-Based and Magnesium-Based Metallic Glasses in the Field of Biomedical Materials.
Materials (Basel)
September 2024
School of Materials Science and Engineering, Harbin Institute of Technology, Shenzhen 518055, China.
Article Synopsis
- - This article discusses the potential of metallic glasses, which have unique structures lacking defects, making them strong, tough, and corrosion-resistant, for biomedical applications like implants.
- - It highlights how Ti-based metallic glasses are used for durable implants like bone plates, while Mg-based types are favored for biodegradable options like stents due to their ability to degrade in the body.
- - The article identifies challenges such as the stiffness of Ti-based glasses and rapid degradation of Mg-based glasses, suggesting solutions like introducing porous structures, improving surface bioactivity, and enhancing corrosion resistance to advance their use in medicine.
Radiocarpal Fracture Dislocations: A Retrospective Review on Operative Fixation and Postoperative Range of Motion.
Hand (N Y)
September 2024
Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Article Synopsis
- - The study focused on the outcomes of patients treated for radiocarpal dislocation (RCD) and radiocarpal fracture dislocation (RCFD) from 2013 to 2022, involving 17 cases reviewed for injury details and treatment response.
- - Most patients had dorsal dislocations, with a majority classified under Moneim type I and Dumontier type II; follow-ups showed limited range of motion improvements and several complications requiring additional surgeries.
- - The findings suggest RCD and RCFD are rare but complex injuries; with appropriate treatment, patients often return to work and regain functional movement despite the challenges.
Article Synopsis
- - The study aimed to examine the relationship between alignment of treatment goals between patients and physicians, patient satisfaction, and overall experience in hand and upper extremity surgery.
- - Among 169 participants, it was found that 62% experienced goal concordant care; however, this alignment did not significantly impact patient satisfaction or experience.
- - Notably, patients earning less than $50,000 showed higher chances of receiving goal discordant care, highlighting potential socioeconomic disparities in treatment outcomes that merit further investigation.
Iatrogenic Irreducible Pediatric Salter-Harris II Middle Phalanx Base Fracture With Dorsal Dislocation of the Proximal Interphalangeal Joint: A Case Report.
Hand (N Y)
September 2024
Hand Surgery Specialists of Nevada, Las Vegas, USA.
Article Synopsis
- * Radiographic analysis showed that the epiphysis was rotated 90° and the dorsal dislocation persisted alongside a fracture at the base of the middle phalanx.
- * The patient was referred to a trauma center where an on-call hand surgeon performed an open reduction and pinning procedure, highlighting a unique and previously undocumented injury pattern.