Total wrist arthrodesis epidemiology and prior surgeries survival.

This study investigates the indications for first- and second-line total wrist arthrodesis, focusing on conversion delays following prior wrist surgeries and analyzing complications based on the underlying etiology. We reviewed 121 patients who underwent total wrist arthrodesis over a nine-year period. First-line total arthrodesis was predominantly performed for inflammatory rheumatic conditions or spasticity, while 53% of second-line total arthrodesis were conducted for post-traumatic conditions.

Free medial sural artery perforator flap for soft tissue defects in the hand: a cadaver study.

We carried out a cadaver study using 10 fresh-frozen adult legs and hands to explore technical feasibility and reproducibility of the free Medial Sural Artery Perforator flap and its applicability for covering soft tissue defects in the hand. A mean of 2 cutaneous perforators (1-4) were found. Each flap had a pedicle composed of a main perforator that arose from the medial sural artery.

Perilunate Fracture-Dislocation: Results at Mean Follow-Up of 7 Years after ORIF.

Perilunate fracture-dislocations are frequently associated with a high risk of developing post-traumatic arthritis. Current studies indicate that during mid-term follow-ups, radiological signs of arthritis do not appear to correspond with functional score. The aim of this study was to assess the occurrence of posttraumatic arthritis and the wrist function after perilunate dislocations (PLD) and fracture dislocations at a mid-term follow-up of 7 years.

Comparison between scaphotrapeziotrapezoid arthrodesis and Pyrocardan® implant for isolated scaphotrapeziotrapezoid osteoarthritis.

Introduction: Scaphotrapeziotrapezoid (STT) arthrodesis and Pyrocardan® implant for painful isolated STT osteoarthritis have shown good results, but no paper has compared their medium-term outcomes.

Hypotheses: Our main hypothesis would be that the Pyrocardan® implant, by preserving the carpal biomechanics, could lead to better wrist mobility. Our secondary hypotheses would be that no other clinical and radiological differences will be found between these two procedures at a mean 5 years follow-up.

Thumb basal joint arthritis in 2023.

Thumb carpometacarpal or basal joint arthritis is the second most common location for osteoarthritis in the hand. It mainly affects women over 50years of age. Basal joint arthritis causes pain, loss of strength during pinch grips, and eventually stiffness and progressive deformity of the thumb column.

Reconstruction of the ulnar artery in Guyon's canal with an arterial graft: Anatomical study.

Ulnar artery thrombosis in Guyon's canal can lead to vascular insufficiency in the fingers. The recommended treatment is resection and reconstruction of the pathological area. A bypass may be necessary, which may be venous or arterial.

Secondary finger amputation after a work accident.

Introduction: The main aim of the present study was to compare motives between patients requesting secondary finger amputation following or unrelated to a work accident. The secondary objective was to assess correlation between sick leave duration and motive for amputation following a work accident.

Method: A single-center retrospective study was conducted over an 11-year period in a hand clinic.

Comparison between the MAIA Implant and Trapeziectomy for Trapeziometacarpal Osteoarthritis: Outcomes at 9 Years' Follow-Up.

The purpose of this retrospective study was to report and compare the outcomes of the MAIA prosthesis and trapeziectomy for trapeziometacarpal osteoarthritis. We included 92 consecutive patients (8 men, 84 women) with a mean age of 57 years (range 44-75 years) who underwent trapeziectomy (44 patients) or trapeziometacarpal joint replacement with a MAIA prosthesis (48 patients) for painful osteoarthritis. All patients were evaluated (pain, range of motion, strength, function, X-rays) by an independent examiner.

Traumatic upper-limb amputation: The process toward acceptance.

Introduction: After traumatic upper-limb amputation (TULA), one-third of patients develop traumatic pathological grief (PG). However, are the other two-thirds unscathed? The main aim of the present study was to assess the rate of TULA victims claiming to have dealt with the consequences and showing no PG. The secondary objective was to determine positive and negative factors enabling and preventing coping.

Four-corner arthrodesis with a dorsal locking plate: 4-9-year follow-up.

We report the outcomes of four-corner arthrodesis for advanced wrist collapse in 50 patients (51 wrists) using a dorsal locking plate. At a mean follow-up of 6 years (range 4-9), pain was significantly reduced and wrist function was significantly improved compared with preoperative status. After four-corner arthrodesis, grip strength was 80% of the contralateral side, and wrist motion averaged 50° flexion-extension and 30° radioulnar deviation.

Psychological effects of traumatic upper-limb amputations.

Introduction: The main aim of the present study was to determine the existence of pathological grief in victims of traumatic upper-limb amputation. The secondary objective was to determine risk factors for onset of pathological grief.

Method: A retrospective clinical study was conducted for an 11-year period, including all cases of traumatic upper-limb amputation in adults.

Radioscapholunate Fusion for Radiocarpal Osteoarthritis: Prognostic Factors of Clinical and Radiographic Outcomes.

 Radioscapholunate (RSL) fusion is a surgical option to manage radiocarpal osteoarthritis. Many authors upgrade the procedure by adding distal scaphoid excision with or without excision of the triquetrum. Our objective was to identify the prognostic factors for good clinical and radiographic outcomes of RSL arthrodesis.

Avascular necrosis of the capitate: case series of five patients and review of literature.

Avascular necrosis of the capitate is a rare disorder of unknown aetiology that causes wrist pain and limits function. From 2009 to 2017, we performed scaphocapitolunate arthrodesis on five patients (one male, four females) with a mean age of 35 years (range 30-37) who had idiopathic avascular necrosis of the capitate. All patients had scaphocapitate and lunocapitate arthritis confirmed by arthroscopy.

Four-dimensional CT Analysis of Wrist Kinematics during Radioulnar Deviation.

Purpose To determine the technical feasibility of four-dimensional (4D) CT for analysis of the variation of radioscaphoid angle (RSA) and lunocapitate angle (LCA) during wrist radioulnar deviation. Materials and Methods In this prospective study, 37 participants suspected of having scapholunate instability were evaluated from January 2015 to December 2016 with 4D CT and CT arthrography (mean age ± standard deviation, 42.3 years ± 15; range, 21-75 years; 27 men [mean age, 44 years ± 15] and 10 women [mean age, 38 years ± 14]).

Kienböck's disease: Role of cross-sectional imaging in treatment choice and patient follow-up.

The management of Kienböck's disease is complex and constantly evolving in parallel with progress in the understanding of the pathophysiological mechanisms of this condition. Cross-sectional imaging techniques have an essential role in the diagnosis and prognostic assessment of this disease. CT allows the optimal study of the morpho-structure of lunate bone.

Scapholunate instability: improved detection with semi-automated kinematic CT analysis during stress maneuvers.

Objectives: To evaluate the diagnostic performance of radioulnar deviation (RUD) and clenching fist (CF) maneuvers for the evaluation of scapholunate dissociation (SLD) using quantitative kinematic CT.

Methods: Thirty-seven patients with suspected scapholunate instability were prospectively evaluated with kinematic CT. Two radiologists independently evaluated the SLD during RUD and CF maneuvers.

Dynamic CT angiography for the diagnosis of patients with thoracic outlet syndrome: Correlation with patient symptoms.

Introduction: Vasculo-nervous structures serving the upper limbs may be compressed as they pass through three areas: the inter-scalene triangle (IST), the costo-clavicular space (CCS) and the retropectoralis minor space (RMS). The diagnosis of thoracic outlet syndrome (TOS) is essentially clinical, but requires imaging to specify the site of compression, its grade and the existence of predisposing anatomical factors, in order to guide the treatment and eliminate the main differential diagnoses.

Material And Methods: Images from 141 patients who underwent dynamic CT angiography of the thoracic outlets from June 2008 to January 2015 were analyzed retrospectively.

Morphology and Mobility of the Reconstructed Basilar Joint of the Pollicized Index Finger.

Purpose: To evaluate outcome and function of the reconstructed basilar thumb joint after index finger pollicization in patients presenting congenital thumb deficiency.

Methods: Plain radiographs and 4-dimensional dynamic volume computed tomography scan were used to evaluate the outcome of 23 pollicizations performed on 14 children between 1996 and 2009. The mean follow-up was 8 years.

Results of a unicentric series of 15 wrist prosthesis implantations at a 5.2 year follow-up.

Our retrospective study aimed to evaluate functional and radiological results of a unicentric series of 17 total wrist prostheses implanted between 2001 and 2011. Nine women and seven men, mean age 59, underwent wrist joint arthroplasty, bilateral in one case. Universal Total Wrist and Remotion prostheses were used and followed-up at a mean of 5.

Ulna-Shortening Osteotomy: Outcome and Repercussion of the Distal Radioulnar Joint Osteoarthritis.

Background: Ulnocarpal impaction syndrome occurs mostly in patients with positive ulnar variance. Ulnar-shortening osteotomy is a commonly used method to correct it, but degenerative changes may appear in the distal radioulnar joint. The authors evaluated outcome after ulnar-shortening osteotomy, particularly the impact of distal radioulnar joint osteoarthritis.

Posterior Radioscaphoid Angle as a Predictor of Wrist Degenerative Joint Disease in Patients With Scapholunate Ligament Tears.

Objective: The purpose of this study is to determine whether the posterior radioscaphoid angle, a marker of posterior displacement of the scaphoid, is associated with degenerative joint disease in patients with scapholunate ligament tears.

Materials And Methods: Images from 150 patients with wrist pain who underwent CT arthrography and radiography were retrospectively evaluated. Patients with and without scapholunate ligament ruptures were divided into two groups according to CT arthrography findings.

The effects of clonidine added to mepivacaine for paronychia surgery under axillary brachial plexus block.

We hypothesized that onset of sensory block is delayed in infected versus healthy tissues within the same nerve distribution after axillary brachial plexus block (ABPB) and that clonidine added to mepivacaine would enhance anesthesia and postoperative analgesia. Forty-one outpatients undergoing thumb/index paronychia surgery under ABPB were randomly assigned to receive in a double-blind fashion 400 mg mepivacaine plus either 100 microg clonidine (clonidine group, n = 21) or 2 mL saline (placebo group, n = 20). Onset of sensory block in the infected area was delayed compared with healthy areas of the same nerve distribution (24.

Transcranial magnetic stimulation for diagnosis of residual limb neuromas.

Objective: To analyze the mechanism and examine the potential diagnostic contribution of transcranial magnetic stimulation (TMS) in diagnosing painful, clonic, and/or autonomic manifestations in amputees' residual limbs.

Design: Prospective study.

Setting: Regional rehabilitation institute at a medical school in France.