Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function.

Purpose: This study aimed to assess how much symptoms resolve during a 6-week continued nonsurgical treatment with an orthosis and after trapeziectomy in people with thumb carpometacarpal joint osteoarthritis (CMC-1 OA) referred for surgical consultation. The data on symptom resolution magnitude and trajectory can help inform patients about postsurgical recovery and assist researchers in designing clinical trials to evaluate surgery's effectiveness for CMC-1 OA.

Methods: We recruited 52 patients with CMC-1 OA referred for surgical consultation.

Poly-l/d-Lactide Implant (RegJoint) Versus Tendon Interposition for Trapeziometacarpal Inflammatory Arthritis: A 15-Year Follow-up of a Randomized Controlled Clinical Trial.

Background: Traditional surgical management of trapeziometacarpal (TMC) joint destruction in rheumatoid arthritis involves trapezial resection with tendon interposition. The poly-l-d-lactide RegJoint (Scaffdex, Tampere, Finland) implant offers an alternative with promising short-term results in rheumatoid patients.

Methods: This study reports long-term outcomes from a randomized controlled trial comparing partial trapeziectomy with the RegJoint versus tendon interposition TMC arthroplasties in patients with inflammatory arthritis, including seropositive and juvenile rheumatoid arthritis, as well as a few cases of other inflammatory arthritis.

Computer-aided three-dimensional analysis of carpal alignment in scaphoid nonunion advanced collapse wrists: A comparative study with scapholunate advanced collapse and healthy wrists.

Objective: To analyze three-dimensional carpal malalignment and height in scaphoid non-union advanced collapse (SNAC) wrists.

Materials And Methods: Twelve cone-beam CT scans of SNAC wrists were analyzed using computer-aided software to define 3D carpal axes and measure intercarpal angles and carpal height ratio. Comparative data included 121 healthy wrists and 18 wrists with scapholunate advanced collapse (SLAC).

Comparative Computer-Aided Analysis of Three-Dimensional Carpal Alignment in Scapholunate Advanced Collapse and Healthy Wrists.

Purpose: Scapholunate dissociation frequently results in malalignment and scapholunate advanced collapse (SLAC). Previous analyses have relied on visual observations of carpal angles among the scaphoid, lunate, and capitate on lateral radiographs. However, the 3-dimensional carpal alignment during SLAC progression remains unclear.

Interposition of Free Vascularized Fascia Into the Trapezial Resection Cavity for the Surgical Treatment of Trapeziometacarpal Osteoarthritis.

Backround: Trapeziometacarpal osteoarthritis has been treated with interposition of autologous fascia into the trapezial resection cavity to prevent scaphometacarpal impingement with suboptimal results. Autologous fascia may undergo necrosis and gradual shrinkage due to avascularity. We propose vascularization of the interposed fascia using microvascular techniques as a new alternative to achieve a durable graft with sufficient soft tissue volume.

Antifibrotic and Pro-regenerative Effects of SMAD3 siRNA and Collagen I mRNA-Loaded Lipid Nanoparticles in Human Tenocytes.

Tendinopathy involves the inflammation and degeneration of the tendon due to repetitive strain injury. Current treatments primarily target inflammation resolution, yet they do not aim at tissue regeneration. In this study, a microfluidics approach is harnessed to develop a platform of lipid nanoparticles (LNPs) loaded simultaneously with SMAD3 siRNA and collagen I mRNA, aiming to explore its potential dual antifibrotic and regenerative effects in human tenocytes.

Radiographic measurements in distal radius fracture evaluation: a review of current techniques and a recommendation for standardization.

Radiographic measurements play a crucial role in evaluating the alignment of distal radius fractures (DRFs). Various manual methods have been used to perform the measurements, but they are susceptible to inaccuracies. Recently, computer-aided methods have become available.

Comparison of computer-aided and manual measurements in the evaluation of carpal alignment.

The purpose of this study was to compare computer-aided analysis and different methods of manual measurements in the evaluation of carpal alignment. The radioscaphoid, radiolunate, radiocapitate and radiometacarpal angles were measured on cone-beam computed tomography (CT) scans of 30 healthy wrists by automated software (Disior Ltd.) and by hand surgeons using lateral radiographs reconstructed from the CT data.

Association of ulnar variance with three-dimensional carpal alignment and demographics in asymptomatic volunteers.

Background: Several carpal pathologies are considered to be related to ulnar variance. Recently, computer-aided computed tomography (CT) analysis software was introduced to quantify three-dimensional (3D) carpal alignment with high accuracy and reliability.

Purpose: To determine the association of ulnar variance with 3D carpal alignment and demographics.

Proximal ROw carpectOmy versus four-corner Fusion (PROOF-trial) for osteoarthritis of the wrist: study protocol for multi-institutional double-blinded randomized controlled trial.

Background: Scapholunate advanced collapse (SLAC) and scaphoid non-union advanced collapse (SNAC) are common types of wrist osteoarthritis (OA). Non-operative treatment consists of pain medication, splinting, and avoiding activities that induce pain. However, in case a course of conservative treatment is unsuccessful, operative treatment is needed.

In Vitro Study of the Anti-inflammatory and Antifibrotic Activity of Tannic Acid-Coated Curcumin-Loaded Nanoparticles in Human Tenocytes.

Tendinitis is a tendon disorder related to inflammation and pain, due to an injury or overuse of the tissue, which is hypocellular and hypovascular, leading to limited repair which occurs in a disorganized deposition of extracellular matrix that leads to scar formation and fibrosis, ultimately resulting in impaired tendon integrity. Current conventional treatments are limited and often ineffective, highlighting the need for new therapeutic strategies. In this work, acetalated-dextran nanoparticles (AcDEX NPs) loaded with curcumin and coated with tannic acid (TA) are developed to exploit the anti-inflammatory and anti-fibrotic properties of the two compounds.

Three-dimensional carpal alignment: computer-aided CT analysis of carpal axes and normal ranges.

Assessment of carpal alignment traditionally uses carpal bone axes measured on lateral radiographs. In this study, three-dimensional axes were defined for carpal bones using segmentation and numerical modelling of CT data of 121 neutrally positioned, asymptomatic wrists. The geometric axis was used for radius, scaphoid and capitate, whereas the axis based on a line perpendicular to the articular surface was used for the other carpal bones.

Detecting Distal Radius Fractures Using a Segmentation-Based Deep Learning Model.

Deep learning algorithms can be used to classify medical images. In distal radius fracture treatment, fracture detection and radiographic assessment of fracture displacement are critical steps. The aim of this study was to use pixel-level annotations of fractures to develop a deep learning model for precise distal radius fracture detection.

Long-term outcomes after extension block pinning for fracture-dislocations of the proximal interphalangeal joint.

IV.

Minimal important difference and patient acceptable symptom state for the Numerical Rating Scale (NRS) for pain and the Patient-Rated Wrist/Hand Evaluation (PRWHE) for patients with osteoarthritis at the base of thumb.

Background: The Numerical Rating Scale (NRS) and Patient-rated wrist/hand evaluation (PRWHE) are patient-reported outcomes frequently used for evaluating pain and function of the wrist and hand. The aim of this study was to determine thresholds for minimal important difference (MID) and patient acceptable symptom state (PASS) for NRS pain and PRWHE instruments in patients with base of thumb osteoarthritis.

Methods: Fifty-two patients with symptomatic base of thumb osteoarthritis wore a splint for six weeks before undergoing trapeziectomy.

Substantial Increase in the Incidence of Surgery for Osteoarthritis of the Base of the Thumb Between 1997 and 2019 in Finland.

Background/aim: Osteoarthritis (OA) at the trapeziometacarpal joint (TMC) is common. However, no published data on the TMC-OA surgery incidence exist. The aim of this study was to evaluate the incidence and trends of TMC-OA surgical treatment.

Responsiveness of different pain measures and recall periods in people undergoing surgery after a period of splinting for basal thumb joint osteoarthritis.

Background: Basal thumb joint osteoarthritis (OA) is a common painful condition of the hand often treated surgically if non-operative care does not provide sufficient pain relief. Many instruments are available to measure pain for this condition including single item and multidimensional measures. To inform our choice of instrument for the purpose of evaluating the value of surgery for people with thumb OA, the aim of this study was to compare the longitudinal validity and signal to noise ratio of a single item numeric rating scale (NRS) for pain and the Patient-rated Wrist and Hand Evaluation (PRWHE) pain subscale, and to assess if recall period affects longitudinal validity of the NRS pain and reported pain levels.

Computer-based three-dimensional measurement of carpal alignment: measurement techniques and normal ranges.

The three-dimensional carpal alignment was measured in the neutral wrist position in 121 asymptomatic volunteers using computer-based cone-beam CT analysis. Normal values and the reliability of the automated analysis are reported. An analysis software based on segmentation of CT images and mathematical modelling was used to determine several axis variants based on different landmarks and to calculate the intercarpal angles automatically.

Outcomes of Revision of Interposition Implant Trapeziometacarpal Arthroplasty.

Background: Implant arthroplasties for trapeziometacarpal osteoarthritis are often associated with high complication and revision surgery rates. There are no previous studies reporting revision outcomes of failed interposition implant arthroplasty.

Methods: A patient register search was done for all implant arthroplasties performed for trapeziometacarpal osteoarthritis during a 10-year period in a single hand surgical unit.

Nerve Transfer of Brachialis Branch to Anterior Interosseus Nerve Using In Situ Lateral Antebrachial Cutaneous Nerve Graft in Tetraplegia.

Purpose: Reconstruction of finger motion is a therapeutic goal in tetraplegic patients. Although nerve transfer of the brachialis branch of the musculocutaneous nerve to the anterior interosseus nerve has been previously described, this results in unreliable reinnervation because the donor nerve is proximal to the target muscle. We describe an alternative technique in which nerve transfer is performed using the lateral antebrachial cutaneous nerve as a vascular in situ nerve graft.

Percutaneous Intramedullary Reduction Technique for Impacted Middle Phalanx Base Fractures.

Proximal interphalangeal joint injuries are common and are a major risk for functional deficits of the finger that affect range of motion and grip strength. Impacted intra-articular fractures and fracture dislocations of the middle phalanx base are challenging to treat because of troublesome joint reduction and difficulties in achieving articular congruity. Although treatment algorithms have been published, the anatomically delicate proximal interphalangeal joint often remains incomplete in function and may result in post-traumatic pain, stiffness, and osteoarthritis.