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Wrist denervation

Maureen A O'Shaughnessy, Eric R Wagner, Richard A Berger, Sanjeev Kakar
BACKGROUND: This study reviews long-term outcomes of partial wrist denervation focusing on need for and time to revision procedure. METHODS: A retrospective study was conducted of all patients undergoing partial wrist denervation between 1994 and 2014. At average latest follow-up of 6.75 years (range, 1-21 years), clinical and radiographic data and need for revision surgery were recorded. RESULTS: There were 100 wrists in 89 patients (61 male, 28 female) with average age at surgery of 54 years (range, 26-80)...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
A Lee Dellon
No abstract text is available yet for this article.
March 2018: Journal of Hand Surgery
Angel Ferreres
No abstract text is available yet for this article.
March 2018: Journal of Hand Surgery
Michael T Milone, Christopher S Klifto, Louis W Catalano
Wrist denervation addresses symptomatic wrist pain without the morbidity and complication profile of more extensive surgical procedures aimed to correct the underlying pathology. The concept of wrist denervation is not new, but its practical application has been modified over the past 50 years. A variety of techniques have been described for various indications, with generally good results. In the United States, a simple, single incision partial denervation consisting of neurectomies of the anterior and posterior interosseous nerves is most commonly performed...
March 2018: Journal of Hand Surgery
Imran Ahmad, Mohd Altaf Mir, Arshad Hafeez Khan
BACKGROUND: In this study, we investigated sensory and motor outcomes for different bridging techniques for short nerve gaps. MATERIAL AND METHODS: This study was conducted in the Postdoctoral Department of Burns, Plastic, and Reconstructive Surgery of our institution from August 2014 to May 2017. All patients with posttraumatic short nerve gaps of 3 cm or less of median, ulnar, and/or both in forearm and wrists were included in the study. Patients with known causes of neuropathies were excluded...
November 2017: Annals of Plastic Surgery
T Fuchsberger, C E Boesch, F Tonagel, T Fischborn, H E Schaller, P Gonser
The aim of this study was to examine the long-term results after the denervation of the wrist. Between 1977 and 2001, we treated 375 patients in our clinic. The mean age was 43.5 years; 81% were male and 19% female. The long-term results were assessed by a questionnaire assessing pain on a visual analog scale and patient satisfaction and by the DASH questionnaire. After a mean follow-up of 12.23 years, we found an overall pain reduction of 52.1%. In 67.7% of the patients, we found a relief of pain: of these, 44% are free of pain until today and 56% were temporarily asymptomatic...
January 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Takaaki Shinohara, Sayako Takahashi, Hitoshi Hirata
We describe the case of a patient with distal radius fracture who became unable to flex the distal interphalangeal joint of the index finger after internal fixation using a volar locking plate. There was palpable crepitus with active thumb motion, and wrist radiographs showed prominence of the volar plate at the watershed line. Therefore, our initial diagnosis was plate-induced closed rupture of the flexor digitorum profundus tendon of the index finger. However, upon surgical removal of the plate, no tendon rupture was found...
August 2017: Nagoya Journal of Medical Science
S Delclaux, F Elia, C Bouvet, C Aprédoaei, M Rongières, P Mansat
The goal of wrist denervation is to decrease pain at the wrist, whether caused by an intra- or extra-articular problem or even when the reason for the pain is unknown. It is an alternative to partial or total arthrodesis and proximal row carpectomy. Our hypothesis was that wrist denervation with a two-incision technique was a reliable and efficient way to treat painful degenerative wrists. Thirty-three patients, 48years old on average, were included in this study. Indications were scapholunate advanced collapse (SLAC) in 18 cases, scaphoid nonunion advanced collapse (SNAC) in 10, distal radius fracture sequelae with advanced radiocarpal osteoarthritis in 4, and post-traumatic ulnocarpal impingement in 1 case...
September 2017: Hand Surgery and Rehabilitation
R Kumar Kadiyala, Joseph M Lombardi
Wrist denervation for the management of chronic wrist pain is a safe and effective procedure that can delay or eliminate the need for more invasive and kinematically compromising salvage procedures. Wrist denervation has become increasingly popular since it was first described in 1959, and the technique has evolved from more extensive denervations to limited single-incision approaches. Many physicians have performed this procedure as a palliative approach to managing chronic wrist pain and as an adjunct to other procedures...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
M Luegmair, F Goehtz, K Kalb, J Cip, J van Schoonhoven
We carried out a retrospective study to analyse the long-term outcome of 36 patients after radial shortening osteotomy for treatment of Lichtman Stage IIIA Kienböck disease at a mean follow-up of 12.1 years (range 5.4-17.5). At review, seven wrists had progressed to Stage IIIB, eight wrists to Stage IV and 21 remained in Stage IIIA. Motion and grip strength were significantly improved. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score at review was 12 points (range 0-52), and patient satisfaction was high...
March 2017: Journal of Hand Surgery, European Volume
Betül Tepeli, Metin Karataş, Mehmet Coşkun, Oya Ümit Yemişçi
PURPOSE: The aim of this study was to evaluate the diagnostic value of magnetic resonance imaging (MRI) for muscle denervation due to focal lesions of the median nerve and to compare electrophysiological findings with MRI findings. METHODS: Twenty-six patients with electrophysiological studies diagnosed for focal lesions of the median nerve were included in this study. Electrophysiological studies and MRI were conducted on 34 patients' hands. Patients' hands were divided into two groups based on edema findings revealed by the MRI: group 1 (edema-negative group; n = 24) and group 2 (edema-positive group; n = 10)...
May 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Stephan Grechenig, Surjit Lidder, Manuel Dreu, Claudia Dolcet, Lucy Marguerite Cooper, Georg Feigl
PURPOSE: Full or selective wrist denervation is an effective treatment for chronic wrist pain. In this cadaveric study, a volar approach for prophylactic denervation of the posterior interosseous nerve (PIN) and the anterior interosseous nerve (AIN) was assessed, which can simultaneously be performed during volar approaches for distal radius fracture fixation or in combination with metalwork removal. MATERIALS AND METHODS: In total 40 adult upper limbs, embalmed using Thiel's method, were investigated...
June 2017: Surgical and Radiologic Anatomy: SRA
G M Hohenberger, M J Maier, C Dolcet, A H Weiglein, A Schwarz, V Matzi
The objective of this study was to determine the precise departure points of the articular branches innervating the distal radio-ulnar joint from the anterior and posterior interosseous nerves. The study sample consisted of 116 upper limbs from adult human cadavers. The articular branches were prepared under the dissection microscope to take measurements using the radial styloid process as point of reference. The articular branch departed from the anterior interosseous nerve at a mean distance of 2.9 cm proximal to the styloid for a radius length of 20...
November 1, 2016: Journal of Hand Surgery, European Volume
Katy Rose, Anne Davies, Matthew Pitt, Didi Ratnasinghe, Luigi D'Argenzio
Backpack palsy is a well-recognised, albeit rare, complication of carrying backpacks. Although it has been mostly described in cadets during strenuous training, sporadic cases of brachial nerve impairment have been reported in children and young adults. Here we reported the case of a 15-year-old girl who presented with a left-side brachial palsy with axonal denervation of C5C7 motor roots following a school challenge for the Duke of Edinburgh Award. Her symptoms began soon after starting the challenge and included weakness of shoulder abduction and elevation, as well as forearm, wrist and fingers extension...
September 2016: European Journal of Paediatric Neurology: EJPN
Vijay Patil, Joan Arenas-Prat
Denervation is a well recognized procedure to treat degenerative or posttraumatic joint conditions, especially in cases where pain is a significant impediment to function even in the presence of stable and supple joint. However, this procedure currently is not as widely used for wrist surgeries as it merits. Denervation procedure obeys all-or-none phenomenon and we believe that even a few residual intact sensory fibers are able to transmit severe pain sensation and therefore every attempt should be made to target all the sensory supply to the wrist joint...
September 2016: Techniques in Hand & Upper Extremity Surgery
Denis Ehrl, Holger C Erne, P Niclas Broer, Christian Metz, Erwin Falter
BACKGROUND: Pain reduction as well as preservation and improvement in range of motion remain the main aims in the treatment of thumb carpometacarpal (CMC) osteoarthritis (OA). We performed a retrospective outcome analysis of patients with symptomatic stage II-III thumb CMC joint arthritis treated with denervation, joint lavage and capsular imbrication. METHODS: 73 patients with stage II to III OA of the thumb CMC-joint underwent the described technique. A total of 42 patients complied with follow-up assessment and were included in this study...
July 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Philip L Riches, Firas K Elherik, Sean Dolan, Frank Unglaub, Steffen J Breusch
INTRODUCTION: A multitude of surgical interventions are recognised for the treatment of the rheumatoid hand and wrist, however there seems to be a distinct lack of patient rated outcome measures (PROMs) studies reporting on the efficacy of these procedures. The aim of this study was to assess the PROMs related to hand and wrist surgery in patients with rheumatoid arthritis (RA). MATERIALS AND METHODS: A single surgeon series identified 94 patients (133 hands) with RA who had undergone one of eight surgical procedures (Swanson's arthroplasty, finger joint or wrist arthrodesis, carpal tunnel decompression, posterior interosseous nerve denervation, RA nodule excision, synovectomy/tenosynovectomy and tendon repair/release) with a mean follow-up period of 3 years...
April 2016: Archives of Orthopaedic and Trauma Surgery
Oded Ben Amotz, Douglas M Sammer
Wrist ligamentous injuries can be challenging to treat successfully. In some cases the ligament repair or reconstruction fails, resulting in instability and progressive degenerative changes. In other cases the original injury is missed, and the patient presents for the first time with established wrist arthritis. Multiple operations have been devised to treat patients with arthrosis secondary to wrist ligament injuries. This article discusses definitive salvage operations such as intercarpal arthrodeses and proximal row carpectomy, as well as other alternatives such as wrist denervation and radial styloidectomy...
August 2015: Hand Clinics
Darren Roberts, Dominic Michael Power
This paper presents a rare case of trans-scaphoid perilunate fracture dislocation with concurrent scaphoid non-union of the left wrist following a motorcycle accident. Emergent CT identified scaphoid non-union advanced collapse and an acute scaphoidectomy, four-corner fusion, denervation and radiocarpal ligament repair was performed.
July 16, 2015: BMJ Case Reports
I Antonio-Rubio, C J Madrid-Navarro, E Salazar-López, M J Pérez-Navarro, C Sáez-Zea, E Gómez-Milán, A Mínguez-Castellanos, F Escamilla-Sevilla
BACKGROUND: An autonomic denervation and abnormal vasomotor reflex in the skin have been described in Parkinson's disease (PD) and might be evaluable using thermography with cold stress test. METHODS: A cross-sectional pilot study was undertaken in 35 adults: 15 patients with PD and abnormal [(123)I]-metaiodobenzylguanidine cardiac scintigraphy and 20 healthy controls. Baseline thermography of both hands was obtained before immersing one in cold water (3 ± 1 °C) for 2 min...
August 2015: Parkinsonism & related Disorders
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