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Mireia Esplugas, Alex Lluch-Bergada, Nathalie Mobargha, Manuel Llusa-Perez, Elisabet Hagert, Marc Garcia-Elias
Purpose In the presence of early osteoarthritis, changes to the trapeziometacarpal joint (TMJ) often result in pain and is associated with joint instability and a tendency of dorsoradial subluxation. In these instances, arthroscopy may be indicated to: (1) assess the extent of cartilage disease and the laxity of ligaments and to (2) treat TMJ instability. The purpose of our study was to biomechanically analyze which ligaments are the primary stabilizers of the TMJ. Methods Overall, 11 fresh-frozen human cadaver specimens were dissected and attached to a testing device with the thumb positioned in neutral abduction, neutral flexion, and neutral opposition...
November 2016: Journal of Wrist Surgery
Richard M Hinds, Michael B Gottschalk, Eitan Melamed, John T Capo, S Steven Yang
Background An accessory slip arising from the extensor carpi ulnaris (ECU) tendon that inserts on the fifth metacarpal bone has been identified. We describe the frequency of this accessory slip arising from the ECU tendon and provide both qualitative and quantitative description of the slip via cadaveric examination. Methods Fifty (28 males and 22 females) cadaveric upper extremity specimens were examined after loupe-aided dissection of the dorsoulnar wrist and hand with identification of the ECU tendon...
November 2016: Journal of Wrist Surgery
Cortie J Rolison, Milton Kyle Smoot
A 19-year-old golfer presented to the sports clinic with a 2-week history of dominant-hand pain after several months of daily golf. He had a metacarpal stress fracture. This case discusses the athlete's return-to-play timeline as well as reviews the current limited literature guiding return to play in grip athletes.
October 24, 2016: Sports Health
Jiang Yue, James F Griffith, Fan Xiao, Lin Shi, Defeng Wang, Jiayun Shen, Priscilla Wong, Edmund K Li, Martin Li, Tena K Li, Tracy Y Zhu, Vivian W Hung, Ling Qin, Lai-Shan Tam
Objective To compare the bone healing effects of denosumab and alendronate in female rheumatoid arthritis (RA) patients by high-resolution peripheral quantitative computed tomography (HR-pQCT). Methods This is a post-hoc analysis of a randomized-controlled trial (NCT01770106). 40 patients were randomized in a 1:1 ratio to receive either subcutaneous denosumab (60mg) once or oral alendronate (70mg) weekly for 6 months. The size of individual bone erosions and the presence and extent of erosion-associated sclerosis (marginal osteosclerosis) were measured in the second metacarpal head of the non-dominant hand at baseline, 3 and 6 months...
October 21, 2016: Arthritis Care & Research
Hiroyoshi Hagiwara, Takashi Ajiki, Suguru Hagiwara, Naoya Sugimoto, Katsushi Takeshita
We present a case of simultaneous ipsilateral fractures at the intra-articular second metacarpal head, intra-articular fourth metacarpal base, and ulnar styloid. These fractures were caused by the peculiar condition of a blow to the fist during an ice hockey game; the hand was struck while it was gripping a stick. The specific combination of these fractures has not been previously reported in the literature. In this incident, axial compression force was transmitted from the second and fourth metacarpal heads while skipping the third metacarpal head to the ulnar side of the wrist via the carpometacarpal joints and carpal bones...
July 27, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Riccardo Paolo Lia, Yasen Mutafchiev, Vincenzo Veneziano, Alessio Giannelli, Francesca Abramo, Mario Santoro, Maria Stefania Latrofa, Cinzia Cantacessi, Coralie Martin, Domenico Otranto, Andrea Bertuglia, Barbara Riccio
Equids can be infected by a range of skin-dwelling filarial nematodes, including four species of the genus Onchocerca. Current literature on equine onchocercosis is fragmentary and often limited to isolated case reports. The present study aimed to describe a clinical case of equine onchocercosis caused by Onchocerca boehmi (Supperer, 1953) (syn. Elaeophora boehmi) in an 8-year-old gelding Belgian show jumper from northern Italy. The horse was presented with a firm and painless mass on the proximal third of the right metacarpal region...
October 19, 2016: Parasitology Research
Anne J Spaans, L Paul van Minnen, Assa Braakenburg, Aebele B Mink van der Molen
OBJECTIVE: The purpose of this pilot study was to evaluate the feasibility of joint distraction of the first carpometacarpal (CMC1) joint in patients with CMC1 osteoarthritis (OA). METHODS: An external joint distractor was placed over the CMC1 joint by K-wire fixation in the trapezium and the metacarpal. The joint was distracted 3 mm during surgery. The device was then kept in place for 8 weeks. Disabilities of the Arm, Shoulder, and Hand (DASH) score, Michigan Hand Outcome Questionnaire (MHQ), Visual Analogue Scale (VAS), and grip strength were recorded preoperatively and at set postoperative intervals...
October 19, 2016: Journal of Plastic Surgery and Hand Surgery
Charlotte E Regan, Jill G Pilkington, Camillo Bérénos, Josephine M Pemberton, Per T Smiseth, Alastair J Wilson
When estimating heritability in free-living populations, it is common practice to account for common environment effects, because of their potential to generate phenotypic covariance among relatives thereby biasing heritability estimates. In quantitative genetic studies of natural populations, however, philopatry, which results in relatives being clustered in space, is rarely accounted for. The two studies to have done so suggest absolute declines in heritability estimates of up to 43% when accounting for space sharing by relatives...
October 17, 2016: Journal of Evolutionary Biology
Adam H Breiteneicher, Bo Norby, Kurt S Schulz, Sharon C Kerwin, Don A Hulse, Derek B Fox, W Brian Saunders
OBJECTIVE: To determine the effect of sliding humeral osteotomy (SHO) on frontal plane thoracic limb alignment in standing and recumbent limb positions. STUDY DESIGN: Canine cadaveric study. SAMPLE POPULATION: Canine thoracic limbs (n=15 limb pairs). METHODS: Limbs acquired from healthy Labrador Retrievers euthanatized for reasons unrelated to this study were mounted in a limb press and aligned in a standing position followed by axial loading at 30% body weight...
October 13, 2016: Veterinary Surgery: VS
Bharat Rekhi, Vivek Verma, Ashish Gulia, Nirmala A Jambhekar, Subhash Desai, Shashikant L Juvekar, Jyoti Bajpai, Ajay Puri
Giant cell tumor of bone (GCTB) is mostly a benign tumor, but associated with recurrences and metastasis. Lately, denosumab is being utilized in the treatment of certain GCTBs. Twenty-seven tumors, analyzed in the present study, occurred in 16 males and 11 females (M: F = 1.45:1), in the age-range of 16 to 47 years (mean = 29.5, median = 29). Most tumors were identified in the tibia(6) and femur(6), followed by the humerus(3), radius(3), pelvis(3), fibula(3), sacrum(1), metacarpal(1) and metatarsal(1) bones...
October 8, 2016: Pathology Oncology Research: POR
Nidal Farhan ALDeek, Yu-Te Lin, Fu-Chan Wei
The metacarpal-like and metacarpal hand injuries are devastating conditions that render the hand nonfunctional. Although the metacarpal hand is well-studied, the metacarpal-like hand is never addressed. The authors, using the same principles as in the classification and treatment of metacarpal hand, propose an easy to follow treatment algorithm for metacarpal-like hand injury to guide the reconstructive surgeon. For both injuries, microsurgical toe-to-hand transplantation can restore an acceptable level of function if done properly...
November 2016: Hand Clinics
Jennifer A Nichols, Michael S Bednar, Robert M Havey, Wendy M Murray
At the wrist, kinematic coupling (the relationship between flexion-extension and radial-ulnar deviation) facilitates function. Although the midcarpal joint is critical for kinematic coupling, many surgeries, such as four-corner fusion (4CF) and scaphoid-excision four-corner fusion (SE4CF), modify the midcarpal joint. This study examines how 4CF and SE4CF influence kinematic coupling by quantifying wrist axes of rotation. Wrist axes of rotation were quantified in eight cadaveric specimens using an optimization algorithm, which fit a two-revolute joint model to experimental data...
October 5, 2016: Journal of Applied Biomechanics
Kevin F Lutsky, Jonas L Matzon, Joseph Dwyer, Nayoung Kim, Pedro K Beredjiklian
Background: Posttraumatic finger stiffness can occur as a result of hand fractures. The purpose was to assess and quantify the improvement in range of motion (ROM) after surgical management of the stiff finger in patients who developed loss of motion following treatment for a metacarpal or phalangeal fracture. In addition, an aim was to identify possible risk factors for suboptimal improvement in ROM postoperatively. Methods: A retrospective review was performed on 18 patients who underwent surgery to improve finger stiffness following metacarpal or phalangeal fracture...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Michael B Gottschalk, Maxim Danilevich, Hilton P Gottschalk
Background: Carpal coalition and metacarpal synostosis are uncommon congenital anomalies of the carpus and hand. Methods: A comprehensive review of the literature was performed to help guide surgical and non-surgical treatment of carpal coalition and metacarpal synostosis. Results: The embryology, epidemiology, medical and surgical management, and associated outcomes are detailed. Conclusions: Most patients with these disorders will likely benefit from conservative measures. Surgery should be considered in patients with pain and limitations in wrist and hand function...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Alastair J M Key
The human hand is unparalleled amongst primates in its ability to manipulate objects forcefully and dexterously. Previous research has predominantly sought to explain the evolution of these capabilities through an adaptive relationship between more modern human-like anatomical features in the upper limb and increased stone tool production and use proficiency. To date, however, we know little about the influence that other manipulatively demanding behaviors may have had upon the evolution of the human hand. The present study addresses one aspect of this deficiency by examining the recruitment of the distal phalanges during a range of manual transportation (i...
2016: PloS One
Shepard P Johnson, Kevin C Chung, Lin Zhong, Melissa J Shauver, Michael J Engelsbe, Chad Brummett, Jennifer F Waljee
PURPOSE: To evaluate prolonged opioid use in opioid-naïve patients after common hand surgery procedures in the United States. METHODS: We studied insurance claims from the Truven MarketScan databases to identify opioid-naïve adult patients (no opioid exposure 11 months before the perioperative period) who underwent an elective (carpal tunnel release, carpometacarpal arthroplasty/arthrodesis, cubital tunnel release, or trigger finger release) or trauma-related (closed distal radius fracture fixation, flexor tendon repair, metacarpal fracture fixation, or phalangeal fracture fixation) hand surgery procedure between 2010 and 2012 (N = 77,573 patients)...
September 7, 2016: Journal of Hand Surgery
Erich M Gauger, Lauren L Casnovsky, Erica J Gauger, Deborah C Bohn, Ann E Van Heest
This study reviewed the clinical history and management of acquired growth arrest in the upper extremity in pediatric patients. The records of all patients presenting from 1996 to 2012 with radiographically proven acquired growth arrest were reviewed. Records were examined to determine the etiology and site of growth arrest, management, and complications. Patients with tumors or hereditary etiology were excluded. A total of 44 patients (24 boys and 20 girls) with 51 physeal arrests who presented at a mean age of 10...
September 29, 2016: Orthopedics
C Dana, J-C Aurégan, A Salon, S Guéro, C Glorion, S Pannier
: Metacarpal lengthening is a useful procedure to address hand deficiencies in children. In this study, we aimed to compare the results of three different techniques from one consecutive clinical series of hand deficiencies. A total of 15 metacarpal lengthenings have been performed in 12 children aged from 9 to 14 years. The callotasis technique was used in seven cases, the two-stage distraction-graft technique in four cases and the single-stage lengthening in four cases. All the metacarpals healed with bone...
September 22, 2016: Journal of Hand Surgery, European Volume
Christopher Hein, Barry Watkins, Lee M Zuckerman
Primary sarcomas of the thumb metacarpal are rare malignant lesions. Surgical treatment involves amputation versus tumor resection with thumb reconstruction. If complete tumor resection is possible, thumb preservation may be considered, as the thumb is vital to hand function. Following tumor resection, previous reports have described graft reconstruction with fusion to the trapezium or scaphoid. We present two cases of sarcoma necessitating resection of the thumb metacarpal that were reconstructed with an arthrodesis of the proximal phalanx to the second metacarpal shaft...
2016: Case Reports in Orthopedics
I M Mehling, K Schillo, A Arsalan-Werner, J Seegmüller, A C Langheinrich, M Sauerbier
Fractures of the first thumb ray are common and need accurate differential treatment to restore gripping hand functions. Displaced fractures of the distal and proximal phalanx of the thumb are often treated with screws or Kirschner wires. Stable fractures can also be treated non-operatively. Fractures of the base of the first metacarpal should be differentiated into extra-articular Winterstein fractures and intra-articular Bennett or Rolando fractures. Traction forces by the abductor pollicis longus tendon regularly lead to displacement of the shaft of the first metacarpal; therefore, these fractures usually require reduction and fixation...
September 14, 2016: Der Unfallchirurg
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