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Metacarpal joint replacement

Samuel C R Pallapati, Binu Prathap Thomas, George A Anderson
PURPOSE: Benign aggressive expansile osteolytic lesions such as giant cell tumors and aneurysmal bone cysts involving the metacarpal head pose problems in management. Unacceptably high rates of recurrence are reported after curettage and bone grafting. An en bloc excision of such tumors ideally requires osteoarticular replacement of the excised metacarpal heads to retain mobility and function. We used nonvascularized metatarsal head and shaft harvested from the foot to replace the metacarpal defect after en bloc resection to retain movement and function of metacarpophalangeal (MCP) joint...
September 7, 2016: Journal of Hand Surgery
C K Goorens, D E C Van Schaik, J F Goubau
Several treatment options exist to surgically treat end-stage trapeziometacarpal osteoarthritis. Trapeziectomy is recognized as leading to a mostly acceptable functional outcome. Although rarely encountered, persisting failure of the trapeziectomy is difficult to address. We present a case where several procedures were subsequently performed to treat a failed trapeziectomy condition. First, a trapeziometacarpal prosthesis (Arpe(®), Biomet(®)) was inserted with the two components reversed: the cup in the first metacarpal and the stem in the scaphoid...
September 2015: Chirurgie de la Main
David J Hunter-Smith, Philip G Slattery, Alexandra Rizzitelli, Sarah R Hunter-Smith, Sian Fairbank, Warren Matthew Rozen, Michael W Findlay
PURPOSE: To describe a fibrocartilaginous structure on the dorsal surface of the metacarpophalangeal (MCP) joint. METHODS: A combination of anatomical dissection, histology, ultrasound, and magnetic resonance imaging was undertaken to explore the anatomical structure described, with clinical correlation undertaken by surgical exploration of MCP joints. RESULTS: A dorsal structure of the MCP joint was identified as fibrocartilagenous in composition, triangular in shape, and-together with the volar plate and collateral and accessory collateral ligaments-forming a deepened dorsal fossa in which the metacarpal head invaginated...
July 2015: Journal of Hand Surgery
X Wang, C D L Thomas, J G Clement, R Das, H Davies, J W Fernandez
In this study, the development of a mechanostatistical model of three-dimensional cortical bone remodelling informed with in vivo equine data is presented. The equine model was chosen as it is highly translational to the human condition due to similar Haversian systems, availability of in vivo bone strain and biomarker data, and furthermore, equine models are recommended by the US Federal Drugs Administration for comparative joint research. The model was derived from micro-computed tomography imaged specimens taken from the equine third metacarpal bone, and the Frost-based 'mechanostat' was informed from both in vivo strain gauges and biomarkers to estimate bone growth rates...
February 2016: Biomechanics and Modeling in Mechanobiology
Anne Wajon, Toby Vinycomb, Emma Carr, Ian Edmunds, Louise Ada
BACKGROUND: Surgery is used to treat persistent pain and dysfunction at the base of the thumb when conservative management, such as splinting, or medical management, such as oral analgesics, is no longer adequate in reducing disability and pain. This is an update of a Cochrane Review first published in 2005. OBJECTIVES: To assess the effects of different surgical techniques for trapeziometacarpal (thumb) osteoarthritis. SEARCH METHODS: We searched the following sources up to 08 August 2013: CENTRAL (The Cochrane Library 2013, Issue 8), MEDLINE (1950 to August 2013), EMBASE (1974 to August 2013), CINAHL (1982 to August 2013), Clinicaltrials...
2015: Cochrane Database of Systematic Reviews
J Pech, D Veigl, R Hromádka, J Dobiáš, T Zatrapa
PURPOSE OF THE STUDY: Arthrodesis of the trapeziometacarpal joint is the method of choice in the treatment of degenerative arthritis of this joint. This procedure was indicated most frequently in middle-age patients doing hard manual labor. Methods for achieving a solid fusion of the trapeziometacarpal joint are known and often reported in the literature. Frequently, they are associated with some failure rate, particularly as concerns bone union. Our study presents a simple and effective method verified in cadaver specimens and then currently used at our department...
2014: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Bilsev Ince, Ayse Ozlem Gundeslioglu, Aynur Emine Cicekcibasi, Mehmet Dadaci, Irfan Inan, Mustafa Buyukmumcu
Amputation of the thumb causes not only loss of significant functional use of the hand but also psychological and social problems. The procedures of toe-to-thumb transfer, pollicization, or metacarpal extension are recognized and well-documented options in thumb reconstruction. Although these techniques have been successfully applied, they have some disadvantages. This study aims to test the feasibility of the fifth finger for thumb reconstruction. The fifth finger was released following exploration of the digital artery, vein, nerve, and flexor and extensor tendons, including the flexor retinaculum...
October 2015: Surgical Innovation
Yang-Hua Tang, Lin-Ru Zeng, Zhong-Ming Huang, Zhen-Shuang Yue, Da-Wei Xin, Can-Da Xu
OBJECTIVE: To investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury. METHODS: From May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum...
March 2014: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Pietro M Schianchi, Menno E Sluijter, Susan E Balogh
BACKGROUND: The intra-articular (IA) application of pulsed radiofrequency (PRF) for pain in small and large joints represents a recent development that has proven to be effective in many cases. We performed a retrospective study of 89 such procedures in 57 consecutive patients with chronic articular pain. OBJECTIVES: The aim of this retrospective study is to evaluate the effectiveness of intraarticular PRF in a group of 57 consecutive patients with chronic joint pain...
September 2013: Anesthesiology and Pain Medicine
R Thorkildsen, J Theodorsson, M Mellgren, M Røkkum
Trapezium components from two uncemented total joint replacements were compared in a three-dimensional finite element model. A 100 N axial and angular load was applied in a normal and an osteoporotic bone model. The axial deformation and maximum periprosthetic stress are greater for the Elektra than the Motec CMC cup. The Motec CMC design is less sensitive to changing bone quality. The Elektra cup transmits more stress to the cortical bone rim in all load conditions, but under angular loading the proportionate increase in stress is lower...
2013: Hand Surgery
Souvik Adhikari, Tibar Bandyopadhyay, Tapan Sarkar, Jayanta Kumar Saha
PURPOSE: To characterize the common patterns of injury in detail in cases of blast injuries to the hand and to outline the possible pathomechanics of these patterns of injury while describing the treatment modalities for the same as practiced in our center. MATERIALS AND METHODS: A review of admitted patients in our department from september 2009 through december 2010 of blast injuries to the hand was made. Each patient had a careful characterization of their injuries as mild, moderate or severe with the help of X-rays, clinical photographs and operative notes...
January 2013: Journal of Emergencies, Trauma, and Shock
Pilar Aranda-Villalobos, César Fernández-de-Las-Peñas, Jose L Navarro-Espigares, Elisa Hernández-Torres, Mercedes Villalobos, Lars Arendt-Nielsen, Manuel Arroyo-Morales
OBJECTIVE: To evaluate the relevance of ongoing nociceptive joint inputs to the maintenance of widespread pain hypersensitivity in patients with hip osteoarthritis (OA) and to determine whether a reversal in the widespread pressure hypersensitivity together with an improvement in pain and function occurs after total hip replacement in these patients. METHODS: Forty patients with hip OA participated. Twenty patients underwent total hip replacement, and the other 20 patients were assigned to a waiting list...
May 2013: Arthritis and Rheumatism
V S Seng, C Chantelot
OBJECTIVES: The goal of our work was to evaluate the results of the Isis(®) trapeziometacarpal prosthesis. METHODS: Our retrospective study included 26 patients, 30 prosthesis. The mean follow-up was 30 months. Preoperatively, the pain was 8.1 out of 10, the QuickDASH was 68.5 and the average Kapandji score was 7.8. The Dell's stage was 2.3. The prosthesis used was hybrid: the trapezial cup was cemented in 90% of cases, and the metacarpal stem was cementless. RESULTS: Eighty-seven percent of patients were satisfied or very satisfied...
February 2013: Chirurgie de la Main
Syam P K Morapudi, William J Marlow, Daniel Withers, Peter Ralte, Ayman Gabr, Mohammad Waseem
PURPOSE: To report outcomes of 21 total wrist arthroplasties (TWA) using the Universal 2 prosthesis. METHODS: Five men and 14 women aged 44 to 82 (mean, 62) years underwent 21 total wrist arthroplasties for rheumatoid arthritis (n=19) and post-traumatic arthritis (n=2) by a single surgeon using the Universal 2 prosthesis. Pre- and post-operative pain and function were assessed by a single surgeon using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the patient-rated wrist evaluation (PRWE) score...
December 2012: Journal of Orthopaedic Surgery
Mark A Vitale, Fraser Taylor, Mark Ross, Steven L Moran
Trapezium prosthetic arthroplasty has been utilized to treat basal joint arthritis for nearly five decades in an attempt to mitigate some of the potential disadvantages of trapeziectomy while preserving range of motion. Implant arthroplasty seeks to preserve joint biomechanics, avoids metacarpal subsidence, and should provide immediate stability. These benefits may lead to improvements in strength, durability, and a decrease in metacarpophalangeal joint hyperextension which can occur subsequent to metacarpal shortening...
February 2013: Hand Clinics
Eugene Kim, Junichi Miyake, Toshiyuki Kataoka, Kunihiro Oka, Hisao Moritomo, Tsuyoshi Murase
PURPOSE: Only a few treatment options are available for Ollier disease, especially for improving appearance. The purpose of this study was to evaluate the efficacy of partial resection of the cortical bone with curettage of the tumor (corticoplasty) for treating hand deformity in Ollier disease. METHODS: Five hands (3 patients, 30 metacarpals and phalanges) were examined. Windows of thin cortical bone were elevated, the tumors were excised, and the cortex was trimmed and replaced to enhance the appearance...
November 2012: Journal of Hand Surgery
James W Pritchett, Louis S Habryl
BACKGROUND: Trapeziometacarpal joint osteoarthritis is a painful, disabling condition that primarily affects women who are postmenopausal. Arthroplasty has been performed to treat this condition; however, subluxation has been a problem with all previous implants. We report the results of hemiarthroplasty using a prosthesis designed to address the problems associated with previous implants. QUESTIONS/PURPOSES: We wished to (1) determine if this prosthesis results in pain relief and functional improvement and preserves the appearance of the thumb, (2) assess the prosthetic reconstruction during followup, (3) assess complications that occur with the use of this prosthesis, and (4) determine the survivorship of this prosthesis...
October 2012: Clinical Orthopaedics and related Research
Sybille Facca, Philippe A Liverneaux
BACKGROUNDS: The main complication of trapeziometacarpal replacement is trapezial cup loosening due to an imperfect positioning of the trapezial component. This problem is quite similar to those related to other arthroplasties. Hip surgery was progressed toward computer-assisted surgery (CAS) for the improvement of acetabular cup positioning. In this study, we propose an analysis of the feasibility of CAS in trapeziometacarpal replacement. METHODS: We implanted the hand of a cadaver with a trapeziometacarpal prosthesis (Elektra, by SBI)...
November 2012: Surgical and Radiologic Anatomy: SRA
Neil F Jones, Brian P Dickinson, Scott L Hansen
Radical resection of the entire ring finger metacarpal for a giant cell tumor resulted in a bony defect extending from the distal surface of the hamate to the proximal surface of the proximal phalanx. We reconstructed the metacarpal with a custom-contoured free fibular osteocutaneous flap and maintained motion at the new fibulophalangeal joint using a silicone arthroplasty. At 4.5 years postoperatively, the patient has shown no signs of recurrence of the giant cell tumor. The silicone arthroplasty has maintained 15° to 85° of motion at the new joint...
February 2012: Journal of Hand Surgery
D P A Jewell, M B S Brewster, M A Arafa
Trapezio-metacarpal joint arthritis is common, affecting 7% of men and 15% of women. Numerous surgical techniques are described for this condition but it is not clear which is best. Eighty-six silicone trapezium replacements were assessed at an average of 46 months (six to 156 months) postoperatively for patient satisfaction, pain, key and power grip strength, range of motion, complications and disability with DASH score. Patient satisfaction was 92%. There was excellent pain reduction from 4.2 to 0.6 on a scale of 0 to 5...
2011: Hand Surgery
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