478 results match your criteria: "Roth-McFarlane Hand & Upper Limb Centre[Affiliation]"

How to salvage the fractured coracoid during the Latarjet Procedure? An empirical approach.

Orthop Traumatol Surg Res

June 2024

Alps Surgery institute, Hand, Upper Limb, Peripheral Nerve, Brachial Plexus and Microsurgery Unit, Clinique Générale, Annecy, France; Hand and Upper Extremity Surgery Unit, Department of Orthopaedic Surgery, Lapeyronie Hospital, Montpellier University Medical Center, Montpellier, France; Amsterdam University Medical Center, Department of Orthopaedic Surgery, Amsterdam, The Netherlands. Electronic address:

The Latarjet procedure is a frequently used stabilization procedure in case of anterior shoulder instability with critical glenoid bone loss and/or off-track Hill Sachs lesions. Although uncommon, intra-operative graft fractures do occur. When confronted with this potentially challenging intra-operative complication, having a secondary solution is paramount to achieve a successful outcome.

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Automatic bicipital groove identification in arthritic humeri for preoperative planning: A Random Forest Classifier approach.

Comput Biol Med

August 2024

Department of Mechanical Engineering, Western University, London, ON, Canada; The Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.

The bicipital groove is an important anatomical feature of the proximal humerus that needs to be identified during surgical planning for procedures such as shoulder arthroplasty and proximal humeral fracture reconstruction. Current algorithms for automatic identification prove ineffective in arthritic humeri due to the presence of osteophytes, reducing their usefulness for total shoulder arthroplasty. Our methodology involves the use of a Random Forest Classifier (RFC) to automatically detect the bicipital groove on segmented computed tomography scans of humeri.

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Article Synopsis
  • The study utilized ultrasound imaging to track changes in diseased fascia in patients with Dupuytren's disease undergoing non-surgical treatment methods like splinting and tissue mobilization.
  • Measurements of joint flexibility and ultrasound imaging were taken before treatment and again after 6 months, showing improvements in joint extension and reductions in the size and quality of the affected fascia.
  • The findings suggest that non-invasive techniques like orthosis and tissue mobilization can effectively manage mild to moderate Dupuytren's disease, serving as viable alternatives to surgery or enzymatic treatments.
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Background: The objective of this study was to examine the effect of wrist rotation on the scapholunate interval in the posteroanterior radiograph and to identify radiographic landmarks on the posteroanterior projection that can be used to assess position.

Methods: Eleven healthy cadaveric wrists were radiographed in the neutral position and subsequently were rotated and imaged from 30° pronation to 30° supination in 10° intervals. At each interval, the scapholunate interval was measured as well as the following landmarks: (1) the visible perimeter of the base of the hook of the hamate; (2) the radial-ulnar distribution of the dorsal nonarticular surface of the distal third metacarpal head; (3) the radial-ulnar distribution of the pisiform about the longitudinal axis of the ulna; and (4) the overlap of the pisiform and triquetrum.

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A scapular statistical shape model can reliably predict premorbid glenoid morphology in conditions of severe glenoid bone loss.

J Shoulder Elbow Surg

November 2024

Roth | McFarlane Hand and Upper Limb Centre, St Joseph's Health Care, London, Canada; Department of Surgery, Western University, London, Canada. Electronic address:

Background: Knowledge of premorbid glenoid parameters at the time of shoulder arthroplasty, such as inclination, version, joint line position, height, and width, can assist with implant selection, implant positioning, metal augment sizing, and/or bone graft dimensions. The objective of this study was to validate a scapular statistical shape model (SSM) in predicting patient-specific glenoid morphology in scapulae with clinically relevant glenoid erosion patterns.

Methods: Computed tomography scans of 30 healthy scapulae were obtained and used as the control group.

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The Kouvalchouk procedure vs. distal tibial allograft for treatment of posterior shoulder instability: the deltoid "hammock" effect exists.

J Shoulder Elbow Surg

October 2024

Roth | McFarlane Hand and Upper Limb Centre, St Joseph's Health Care, London, Canada; Department of Surgery, Western University, London, Canada.

Background: In 1993, Kouvalchouk described an acromial bone block with a pedicled deltoid flap for the treatment of posterior shoulder instability. This procedure provides a "double blocking" effect in that the acromial autograft restores posterior glenoid bone loss and the deltoid flap functions as a muscular "hammock" resembling the sling effect of the conjoint in the Latarjet procedure. The primary aim of this study was to compare the Kouvalchouk procedure to distal tibial allograft (DTA) reconstruction for the management of posterior shoulder instability with associated bone loss, while the secondary aim was to evaluate the deltoid hammock effect.

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Sciatic and tibial neuropathies.

Handb Clin Neurol

May 2024

Division of Plastic Surgery, Schulich School of Medicine and Dentistry, Western University, St. Joseph's Health Care, Roth McFarlane Hand and Upper Limb Centre, London, ON, Canada.

Article Synopsis
  • The sciatic nerve is the largest peripheral nerve in the body and can easily get injured due to its location and anatomy.
  • Identifying problems with this nerve can be tricky as they may be related to various conditions like lumbosacral issues, nerve root problems, or piriformis syndrome.
  • Accurate diagnosis is crucial and relies on a detailed medical history, physical exams, and possibly imaging or nerve tests; treatment advancements like nerve transfers are improving surgical options for lower limb nerve injuries.
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Background: Current commercial elbow braces have a straight hinge that does not account for the native carrying angle of the elbow. The objective of this study was to determine the effectiveness of a custom-designed hinged elbow orthosis (HEO) with variable valgus angulations in stabilizing a lateral collateral ligament (LCL) deficient elbow.

Methods: Eight cadaveric upper extremities were mounted in an elbow motion simulator in the abducted varus gravity-loaded position.

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Objective: To systematically scope the literature on posterior shoulder tightness (PST) and define a therapist-instructed and therapist-administered management framework.

Design: Scoping review.

Literature Search: We searched MEDLINE, EMBASE, CINAHL, Scopus and Google Scholar from inception to December 2021.

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Grip strength measured by squeezing a plastic bottle may be a valid alternative to a standard dynamometer for virtual care.

J Hand Ther

September 2024

Division of Orthopaedic Surgery, Department of Surgery, Western Univeristy, London, Ontario, Canada; Roth-McFarlane Hand & Upper Limb Centre, St. Joseph's Health Care, London, Ontario, Canada; Department of Mechanical and Materials Engineering, Western University, London, Ontario, Canada; Western University, London, Ontario, Canada.

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Reverse total shoulder arthroplasty (RTSA) accounts for over half of shoulder replacement surgeries. At present, the optimal position of RTSA components is unknown. Previous biomechanical studies have investigated the effect of construct placement to quantify mobility, stability and functionality postoperatively.

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Background: Newer generation humeral stem designs in total shoulder arthroplasty (TSA) are trending towards shorter lengths and uncemented fixation. The goal of this study is to report a 2-yr minimum clinical and radiographic outcomes of an uncemented short-stem press-fit humeral stem in anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA).

Methods: A retrospective multicenter database review was performed of all patients who received an uncemented short-length press-fit humeral stem (Equinoxe Preserve humeral stem, Exactech, Inc.

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Managing the unknowns in distal radial fractures: commentary and opinion.

J Hand Surg Eur Vol

March 2024

Division of Orthopedics, Roth|McFarlane Hand and Upper Limb Center, University of Western Ontario, London, ON, Canada.

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Purpose: To explore distal radius fracture (DRF) patients' and hand therapist/occupational therapist/physiotherapists' perceptions of integrating home and family work roles (HFWR) into rehabilitation.

Methods: Eighteen patients and eleven therapists completed a semi-structured telephone interview three months after DRF. Reflexive thematic analysis of the interviews and triangulation of patients' and therapists' themes was performed.

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Symptomatic varus malunion after proximal humeral fractures is associated with weakness and painful limitation of shoulder range of motion. When there is conformity of the articular surface and no avascular necrosis, a head-preserving procedure is best indicated. Arthroscopic arthrolysis, subacromial decompression, and tuberoplasty have been described for the treatment of mild deformity.

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Study Design: A large-scale retrospective case-control study.

Objective: Examine diabetes as a risk factor for lumbar spinal stenosis (LSS) development and evaluate the impact of diabetes duration, glycemic control, and associated complications on this risk.

Summary Of Background Data: Diabetes mellitus, a multiorgan disorder impacting various connective tissues, induces histological changes in spinal structures, particularly the ligamentum flavum.

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Patient-Reported Outcome Measures for Patients with Upper Extremity Arthritis: Overview of Systematic Reviews.

Clin Med Insights Arthritis Musculoskelet Disord

December 2023

Department of Physical Therapy, Faculty of Health Sciences, Elborn College, Western University, London, ON, Canada.

Background: Arthritis leads to disabilities impacting patients' physical and mental health.

Objective: To synthesize the evidence on measurement properties of the patient-reported outcome measures (PROMs) for people with upper extremity arthritis.

Design: Overview of systematic reviews (SRs).

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Peripheral nerve injuries are common and can have a devastating effect on physical, psychological, and socioeconomic wellbeing. Peripheral nerve transfers have become the standard of care for many types of peripheral nerve injury due to their superior outcomes relative to conventional techniques. As the indications for, and use of, nerve transfers expand, the importance of pre-operative assessment and post-operative optimization increases.

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A qualitative study of healthy eating, physical activity, and mental health among single mothers in Canada.

PLoS One

November 2023

Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.

Single motherhood is associated with higher demands in home and family responsibilities that may exist in similar sized households with grandparents. These demands can compete with opportunities and resources for maintenance of healthy behaviours. This may have been exacerbated during the COVID-19 pandemic since supports outside the home may have been restricted by public health measures.

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Purpose: This scoping review uniquely aims to map the current state of the literature on the applications of wearable sensors in people with or at risk of developing upper extremity musculoskeletal (UE-MSK) conditions, considering that MSK conditions or disorders have the highest rate of prevalence among other types of conditions or disorders that contribute to the need for rehabilitation services.

Materials And Methods: The preferred reporting items for systematic reviews and meta-analysis (PRISMA) extension for scoping reviews guideline was followed in this scoping review. Two independent authors conducted a systematic search of four databases, including PubMed, Embase, Scopus, and IEEEXplore.

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Background: Shoulder arthroplasty humeral stem design has evolved to include various shapes, coatings, lengths, sizes, and fixation methods. While necessary to accommodate patient anatomy characteristics, this creates a surgical paradox of choice. The relationship between the surgeon's selection of short-stem implant size and construct stiffness, resistance to subsidence and micromotion has not been assessed.

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Background: Mixed reality may offer an alternative for computer-assisted navigation in shoulder arthroplasty. The purpose of this study was to determine the accuracy and precision of mixed-reality guidance for the placement of the glenoid axis pin in cadaver specimens. This step is essential for accurate glenoid placement in total shoulder arthroplasty.

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Background: With advances in the surgical management for severe ulnar neuropathy with the introduction of the super charged-end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfer, a simple and reliable outcome measure is required. There is currently not "one" standardized outcome measure used to represent and compare results.

Purpose: To present the abduction hand diagram as a "novel", reproducible, and simple outcome measure for patients with severe ulnar neuropathy.

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Introduction: Despite technological advancements in recent years, glenoid component loosening remains a common complication after anatomical total shoulder arthroplasty (ATSA) and is one of the main causes of revision surgery. Increasing emphasis is placed on the prevention of glenoid component failure. Previous studies have successfully predicted range of motion, patient-reported outcomes and short-term complications after ATSA using machine learning methods, but an accurate predictive model for (glenoid component) revision is currently lacking.

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Article Synopsis
  • - The study investigates whether diabetes mellitus (DM) is linked to an increased risk of developing trochanteric bursitis (TB), finding that individuals with DM have a 55.8% higher likelihood of TB diagnosis compared to those without DM.
  • - It reveals that female patients are significantly more prone to TB, being 3.3 times more likely to be diagnosed than males, while insulin users have a lower risk of TB compared to non-insulin users.
  • - The research suggests that managing diabetes effectively with insulin may provide a protective effect against TB, highlighting the importance of glycemic control in preventing this condition.
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