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Hand Surgery and Rehabilitation

N Bigorre, F Delaquaize, F Degez, S Celerier
The repair of flexor tendon lesions in zone 2 remains a highly controversial subject in hand surgery. Currently, there is no consensus about the management of these lesions intra- and postoperatively, but the literature suggests that a solid suture will allow early active motion. We hypothesized that the management of flexor tendon injury in zone 2 varies widely. Two online surveys were conducted with surgeons and hand therapists. The questions captured the demographics of the surveyed population, surgical technique, common complications, postoperative management (duration of immobilization, type of splint, rehabilitation techniques and principles of self-rehabilitation)...
June 19, 2018: Hand Surgery and Rehabilitation
Z Tuna, D Oskay
After tendon injuries, it has been observed clinically that patient-reported disability is more severe than the patient's actual performance. This is thought to result from a fear of movement (kinesiophobia) after surgery. The aim of this study was to investigate the presence of kinesiophobia in this patient population and its effects on the clinical outcomes. Patients (n=118) with tendon repairs were included. All the participants received early passive mobilization and were assessed at the end of the 8th week...
June 7, 2018: Hand Surgery and Rehabilitation
B Karslıoğlu, M Uzun, C Tetik, E Tasatan, A C Tekin, C D Buyukkurt
Mallet fracture is an avulsion of the extensor tendon and fracture of the dorsal rim of the articular surface of distal phalanx at the same time. If a part of the mallet fracture is angled or rotated to such a degree that prevents full anatomic reduction, malunion and deformities may occur as a result. The objective of this study was to describe a new surgical technique to provide derotation of the mallet fracture. A 22G or 21G needle is used like a joystick to reduce the mallet fracture with small, gentle movements...
June 6, 2018: Hand Surgery and Rehabilitation
T Poujade, N Balagué, J-Y Beaulieu
The aim of this study was to assess distal radioulnar joint stability after unipolar ulnar head replacement for post-Darrach instability. All the patients who underwent ulnar head replacement between1999 and 2015 for post-Darrach procedure instability at our clinic were reviewed. Seven Hebert-type and two uHead (SBI/Stryker) prostheses were implanted. None of the implants were cemented. We assessed stability, pain, range of motion and strength pre- and postoperatively. The changes in the radiographic appearance between immediate postoperative and the last follow-up were determined...
June 4, 2018: Hand Surgery and Rehabilitation
B Degeorge, L Athlani, F Dap, G Dautel
The Tactys® implant is a total anatomic gliding and modular prosthesis for proximal interphalangeal (PIP) arthritis. We report the clinical and radiographic results of this implant with a minimum follow-up of 12 months. Thirty-three implants in 27 patients with a mean age of 67 years were reviewed. Surgical approach was mid-line dorsal and trans-tendinous. Postoperative active motion was performed with a protective splint for 4 weeks. All patients were evaluated (pain, range of motion, strength, function through QuickDASH and PRWE scores, X-rays) by an independent examiner...
May 31, 2018: Hand Surgery and Rehabilitation
R Pinet, G Raimbeau, Y Saint-Cast, P-A Fouque, F Rabarin
The superficial branch of the radial nerve (SBRN) at the wrist is susceptible to trauma and lacerations. These lesions can develop into painful neuromas with debilitating consequences. The aim of our study was to demonstrate the effectiveness of systematic use of vein conduits associated with microsurgical suture repair in SBRN injuries to prevent the occurrence of these neuromas. Our study was retrospective and performed at a single site. An independent examiner performed the clinical assessment. The study included 33 patients and the mean follow-up was 63 months...
May 29, 2018: Hand Surgery and Rehabilitation
Z Ramzi, R Chafik, M Madhar, H Elhaoury, Y Najeb
No abstract text is available yet for this article.
May 28, 2018: Hand Surgery and Rehabilitation
A Hamouya, B Barbato, V Beauthier-Landauer, C Hémon
Replanting complete ring avulsion injuries remains a challenge for hand surgeons. The prognosis depends on achieving satisfactory function. We present the results of our 16 years' experience with managing this type of injury. Our cohort consisted of 83 cases of complete ring avulsion injuries in patients with an average age of 23.5 years, treated in a Hand Emergency Unit between 1998 and 2014. Seventy-two were replanted. A vein graft was used in 57 cases to bridge the arterial injury and direct anastomosis was performed in 15 cases...
May 25, 2018: Hand Surgery and Rehabilitation
J I Efanov, C Papanastasiou, J Arsenault, M Moreau, M P Pomey, J Higgins, M A Danino
Clinical approach to surgical patients has evolved to include previous patients as part of the treating team in the role of "patient-advisors". Knowing that compliance to rehabilitation protocols is significant for a successful functional hand replantation, we set out to quantify functional patient-reported outcomes in individuals enrolled in a Patient-Advisor Program (PAP). We performed a prospective cohort pilot study of all patients admitted for a finger replantation between July 2015 to January 2016...
May 21, 2018: Hand Surgery and Rehabilitation
M Cegarra-Escolano, C Jaloux, O Camuzard
Rice bodies are very unusual lesions, generally encountered in chronic synovitis due to rheumatoid diseases or tuberculosis. A 31-year-old right-handed man presented with a 15-year history of progressively growing "sausage-like" swelling of the 4th finger and palm of his right hand. There was an immovable, painless mass with restriction of the finger's ROM without local or general associated signs. Imaging showed a large non-aggressive mass within the tendon sheath. Complete excision of the mass was performed...
May 18, 2018: Hand Surgery and Rehabilitation
G Meyer Zu Reckendorf, A Dahmam
Damage to the hand in patients suffering from gout is rare and is often detected at an advanced stage. The main clinical manifestations are the appearance of subcutaneous tophi at the finger joints. Other clinical manifestations of osteoarticular, tendinous or neurological lesions have been described in the hand and are often difficult to diagnose. In the majority of cases, surgery and adequate medical care with a suitable anti-gout treatment will allow the patient to recover normal hand function. However, surgical treatment is rare and is only performed after several months of carefully adapted medical treatment...
May 17, 2018: Hand Surgery and Rehabilitation
A Zemirline, C Taleb, K Naito, P Vernet, P Liverneaux, F Lebailly
Distal radius fractures (DRF) may trigger, reveal or decompensate acute carpal tunnel syndrome (CTS) in 0.5-21% of cases. Internal fixation and median nerve release must then be carried out urgently. Less invasive approaches have been described for both the median nerve release using an endoscopic device and for the DRF fixation using a volar locking plate. We assessed the feasibility of DRF fixation and median nerve release through a single, minimally-invasive 15mm approach on a series of 10 cases. We reviewed retrospectively 10 consecutive cases of DRF associated with symptomatic CTS in 8 women and 2 men, aged 57 years on average...
May 17, 2018: Hand Surgery and Rehabilitation
S Roner, P Fürnstahl, A Schweizer, K Wieser
Nonoperative treatment of an injured ulnar collateral ligament of the thumb metacarpophalangeal (MCP) joint (skier's thumb without a Stener lesion) is managed by immobilization. A splint is applied on the radial side with the thumb in slight flexion to immobilize the MCP joint and allow motion in the interphalangeal joint. Thermoplastic splints are mainly used for daily activities with the advantage of custom fabrication for optimal comfort. To immobilize the thumb during surgical procedures performed by an orthopedic surgeon, splints made of sterilizable materials are needed but not yet available to our knowledge...
May 17, 2018: Hand Surgery and Rehabilitation
G Pomares, C Duysens, C Camps, A Durand, A Falcone, T Jager
No abstract text is available yet for this article.
May 14, 2018: Hand Surgery and Rehabilitation
G Prunières, Y Igeta, J J Hidalgo Díaz, S Gouzou, S Facca, F Xavier, P Liverneaux
The usefulness of ultrasound for making the diagnosis of pyogenic flexor tenosynovitis (PFTS) has been demonstrated. The primary goal of this study was to show that the diameter of the flexor sheath near the A2 pulley was larger when PFTS was present compared to the healthy contralateral finger. The secondary goal was to determine the reproducibility of these ultrasound measurements. Our series included 20 patients (12 men and 8 women) operated due to PFTS. The average age was 41.7 years old. The average diameter of the digital sheath measured near the A2 pulley on transverse and longitudinal ultrasound sections was 5...
May 11, 2018: Hand Surgery and Rehabilitation
C Demirdover, F A Ozturk, H S Yazgan, N Yogurtcu, M Sevindik, H Vayvada
The aim of this study was to emphasize the importance of early surgical treatment of multicomponent soft tissue injuries of the wrist. A retrospective review was performed on 156 patients with multicomponent soft tissue injuries of the wrist who were treated between July 2007 and July 2015. All the patients included in the study were operated within the first 36hours of the injury and were hospitalized after the surgery based on the extent of their injury. The patients were evaluated in terms of age, gender, etiology, injured structures, total number of damaged structures, mean follow-up time, complications and reoperation...
June 2018: Hand Surgery and Rehabilitation
P Bellemère
Thanks to its remarkable mechanical properties and excellent biocompatibility, pyrocarbon is an ideal material for articular use. Various pyrocarbon implants for the hand and wrist have been developed over the past 25 years, with about 15 currently available for hemi-, total and interposition arthroplasty. This article describes the production methods and mechanical properties of pyrocarbon. The author summarizes the various implants available for each type of joint, their reported results in the literature, as well as his team's experience...
June 2018: Hand Surgery and Rehabilitation
R Imai, M Osumi, T Ishigaki, S Morioka
We investigated the relationship between pain and hesitation during movement initiation among 11 adult female patients who had undergone surgery for a distal radius fracture. Data on the patients' pain at rest, pain during movement and score on the Pain Catastrophizing Scale were analyzed. Movement characteristics were assessed by the administration of a finger tapping (FT) task using the thumb and index finger, with the movement repeated 10 times, recorded and analyzed to determine the patient's hesitation when opening or closing her thumb/forefinger during the task...
June 2018: Hand Surgery and Rehabilitation
Z Al-Amin, S A Senyürek, E M M Van Lieshout, M M E Wijffels
The aim of this study was to determine the rate of carpal tunnel syndrome (CTS) in patients with a volar plated distal radius fracture (DRF), with or without prophylactic carpal tunnel release (CTR). The PubMed database was searched for studies reporting on CTS in patients with a DRF fixed by a volar plate. Selected patients were those who underwent prophylactic CTR versus patients who did not. Pooled rates of CTS were calculated using inverse - variance weighting assuming a random effects model. Tests for heterogeneity were applied...
June 2018: Hand Surgery and Rehabilitation
C Gengler, N Pauchard
Dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint of the long fingers are in most cases unstable. They require surgery, whose primary aim is to restore and maintain articular congruency. While numerous techniques exist to treat these injuries, none have been shown to be superior to any of the others in terms of outcomes and complications. The least invasive techniques should be used as much as possible. We report here a rare case of incarceration of the flexor tendons in the PIP fracture which required open surgery...
June 2018: Hand Surgery and Rehabilitation
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