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Beatrice L Grasu, Andrew J Trontis, Brent G Parks, Raymond A Wittstadt
BACKGROUND: Suture-button fixation is an alternative to no fixation, first metacarpal distraction techniques, or Kirschner wire fixation after trapeziectomy in treatment of first carpometacarpal (CMC) arthritis. A 4-strand suture-button construct requires a 2.7-mm tunnel, whereas a 2-strand construct requires a 1.1-mm tunnel, potentially decreasing the risk of metacarpal fracture. We compared stability and failure criteria of 4-strand versus 2-strand construct in a biomechanical model of first CMC joint arthroplasty...
April 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
R C Whitton, B A Ayodele, P L Hitchens, E J Mackie
BACKGROUND: Microdamage accumulation leads to subchondral bone injury and/or fracture in racehorses. An understanding of this process is essential for developing strategies for injury prevention. OBJECTIVES: To quantify subchondral bone microdamage in the third metacarpal bone of Thoroughbred racehorses at different stages of the training cycle. STUDY DESIGN: Cross-sectional. METHODS: Bone blocks from the palmar aspect of the medial condyles of third metacarpal bones from 46 racing Thoroughbred horses undergoing post mortem were examined with micro computed tomography (microCT) to detect calcified microcracks, and light microscopy to quantify bulk stained microcracks...
April 16, 2018: Equine Veterinary Journal
George Pentazos, Katerina Laskari, Kleanthis Prekas, John Raftakis, Petros P Sfikakis, Elias Siores
OBJECTIVE: A prospective pilot study was performed using microwave radiometry (MR), a noninvasive method detecting in-depth tissue temperature, to evaluate whether temperature-of-small-joint-derived scores correlate to parameters commonly used to assess disease activity in rheumatoid arthritis (RA). METHODS: Ten patients with active, untreated RA underwent clinical and laboratory assessments and joint ultrasound and MR of hand and foot small joints at baseline and at 15, 30, and 90 days after treatment onset...
April 13, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Charles P Melone, Erez Dayan
Hallmark deformities of systemic scleroderma are early onset and progressively disabling flexion contractures of the proximal interphalangeal (PIP) joints often in conjunction with extension or, less frequently, flexion contractures of the metacarpophalangeal (MCP) joints. Although surgical correction is generally recommended, a prevailing reluctance for operative treatment exists owing to the inherent ischemia of the disease with its potentially compromised healing capacity. Nonetheless, with recognition and preservation of the tenuous but well-defined and constant periarticular vascular networks of the PIP and MCP joints, articular reconstruction with uncomplicated wound healing can prove consistently successful for patients with scleroderma...
April 9, 2018: Journal of Hand Surgery
Christian Moro, Jessica Covino
Measuring skeletal development throughout juvenile growth can provide a greater understanding into the health, hormonal function and genetics of children. The metacarpals have been of interest for their potential to provide insights into healthy juvenile skeletal development. This study investigated the growth patterns of developing females from isolated communities who had varied diets. Anthropometrical measurements and hand-wrist X-rays were taken of 353 juvenile females from three populations: Pari Coastal Village and Bundi Highlands Village, Papua New Guinea (PNG); and Brisbane, Australia between 1968 to 1983...
March 2018: Anatomy & Cell Biology
Samiullah Khan, Muhammad Mudassir, Naqab Khan, Asmatullah Marwat
Objectives: Brachdactyly a genetic disorder associated with the abnormal development of metacarpals, phalanges or both which results in the shortening of hands and feet. Mutations in the contributing genes has been recognized with the majority of the investigated syndromic form of brachdactyly. The current study was proposed to examine mutation in NOG and GDF5 genes in a Pakistani family. Methods: Poly Acrylamide Gel Electrophoresis and Polymerase Chain Reaction was used for the genomic screening and linkage analysis to observe the mutation in genes...
January 2018: Pakistan Journal of Medical Sciences Quarterly
Mahfouz Shehata Ibrahim Ahmed, Emad Salah Ibrahim, Hazem Ibrahim Eltayeb
BACKGROUND: Posttraumatic dorsal hand defects with exposed tendons and/or bones represent a challenge to reconstructive surgeons. Many options are suggested ranging from local, regional, distant up to free flaps. First dorsal metacarpal artery island flap was commonly prescribed for reconstructing the thumb or first web space defects. METHODS: During a 30 month's period, 23 patients, 15 males aged between 17 and 48 years and 8 females aged between 18 and 36 years presented by posttraumatic dorsal hand defects...
April 5, 2018: Asian Journal of Surgery
Salah Aldekhayel, Erfan Ghanad, Chaitanya S Mudgal
PURPOSE: To report on 4 cases of avascular necrosis of the metacarpal head. METHODS: We retrospectively reviewed 4 patients who received a diagnosis of avascular necrosis of the metacarpal head and were treated from 2000 to 2016. RESULTS: All patients were males with involvement of the dominant hand. Three patients had a history of trauma and/or fractures in another finger and one had a history of fracture in the same finger. The diagnosis was confirmed on regular x-rays and magnetic resonance imaging...
April 3, 2018: Journal of Hand Surgery
Xiao Yang, Xinfu Lin, Yaobin Zhu, Jiewei Luo, Genhui Lin
In the present study whole-exome sequencing using the Complete Genomics platform was employed to scan a proband from a split‑hand/split‑foot malformation (SHFM) 4 family. The missense mutation c.728G>A (p.Arg243Gln) in the TP63 gene was revealed to be associated with SHFM. Sanger sequencing confirmed the sequences of the proband and his father. The father was diagnosed with SHFM and harbored a CGG‑to‑CAG mutation in exon 5, which produced a R243Q substitution in the zinc binding site and dimerization site of TP63...
March 29, 2018: Molecular Medicine Reports
Peter C Rhee, Aaron Paul, Brian Carlsen, Alexander Y Shin
BACKGROUND: Trapeziectomy with ligament reconstruction tendon interposition (LRTI) or suspensionplasty is an effective treatment in older patients with end-stage thumb basilar arthritis. However, the survivability of this procedure is unknown in younger patients who may impart more stress on their thumbs. METHODS: A retrospective review was performed on all patients who underwent trapeziectomy and LRTI or suspensionplasty at 55 years of age or younger from 1992 to 2008...
April 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Till Wagner, Oliver Kloeters, Dietmar Ulrich
The dorsal-metacarpal-artery (DMCA) flap in its standard or extended version is considered as the working horse to cover dorsal soft tissue finger defects with exposed extensor tendon or bone. We hereby present a clinical case of an 80-year-old male patient who is right-handed and sustained a soft tissue defect of the proximal dorsal aspect of his left 5th finger and the postoperative outcome employing a modified transposition flap. The double-pedicled DMCA flap (dpDMCA flap) of the hand poses in adequate clinical scenarios a comparably fast and safe solution to cover dorsal finger defects extending just distal to the PIP joint...
2018: European Journal of Plastic Surgery
Travis Rayne Pickering, Jason L Heaton, Ron J Clarke, Dominic Stratford
We describe eleven hominin metacarpals and phalanges recovered from Jacovec Cavern and Member 4 of the Sterkfontein Formation between 1998 and 2003. Collectively, the fossils date in excess of 2.0 Ma, and are probably attributable to Australopithecus africanus and/or Australopithecus prometheus. When combined with results of previous studies on Australopithecus postcranial functional morphology, the new data presented here suggest that at least some late Pliocene and/or early Pleistocene hominins from Sterkfontein were arboreally adept...
May 2018: Journal of Human Evolution
Ibrahim Khansa, Lara Khansa, Gregory D Pearson, Sonu A Jain
PURPOSE: To evaluate the effect of the Affordable Care Act (ACA) on the payer distribution and reimbursement rate for hand surgery at our institution. METHODS: We reviewed records of 4,257 patients who underwent hand surgery at our institution between January 2008 and June 2016; 2,601 patients underwent surgery before the implementation of the ACA, and 1,656 patients after. Type of procedure, insurance status, amount of money billed, and amount collected were recorded...
March 27, 2018: Journal of Hand Surgery
Mads Terndrup, Thomas Jensen, Søren Kring, Martin Lindberg-Larsen
BACKGROUND: Burying Kirschner wires (K-wires) under the skin after metacarpal and phalangeal fracture osteosynthesis may reduce risk of infection, but it might also complicate later removal. PURPOSE/AIM OF STUDY: To examine infection and reoperation rates after metacarpal and phalangeal fracture osteosynthesis with buried versus exposed K-wires. MATERIALS AND METHODS: Metacarpal and phalangeal fractures treated with K-wire osteosynthesis at our institution from 1st of January, 2009 to 1st of February, 2015 were identified retrospectively...
March 22, 2018: Injury
Xiao-Hui Wang, Cai-Li Zhang, Su-Hong Shen, Shao-Yong Guo, De Li
OBJECTIVE: To study clinical efficacy of manual reduction and traction fixation for the treatment of metacarpal neck fracture under ultrasound-guided. METHODS: From April 2013 to August 2016, 30 patients with metacarpal neck fractures were treated with manual reduction and traction fixation under ultrasound-guided, including 26 males and 4 females aged from 14 to 56 years old with an average of (25.6±1.6) years old, the courses of diseases ranged from 7 h to 5 d with an average of (2...
March 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Mark R McCann, Philippa A Rust, Robert Wallace
Background: The trapeziometacarpal joint (TMCJ) is inherently unstable, relying on ligament restraint to prevent subluxation. Subluxation of the thumb in a dorsoradial direction is often observed in clinical practice, either after acute ligament injury or more commonly with osteoarthritis (OA). This subluxation follows loss of function of trapeziometacarpal ligaments that stabilise this joint, resisting the deforming force of abductor pollicis longus (APL). The exact ligaments that stabilise and prevent the thumb from the pull of APL causing dorsoradial subluxation remain unknown, although the anterior oblique ligament (AOL) has been implicated...
March 2018: Archives of Bone and Joint Surgery
Zachary C Lum, Lily Park, Kathryn E Huff, Mohamed A Ibrahim
CASE: We describe an unusual case of an isolated close-range shotgun injury to the thumb with substantial osseous loss and intact vascularity, followed by treatment with the Masquelet technique and iliac crest tricortical bone autograft reconstruction. CONCLUSION: Gunshot injuries to the thumb with concomitant soft-tissue and osseous loss are devastating. Reconstruction depends on the level of the injury, the severity of the soft-tissue and osseous damage, and the viability of the digit, as well as patient factors, including occupation, physical demands, and expectations...
January 2018: JBJS Case Connector
David J Shewring, Ryan W Trickett, Adam Smith
We describe the treatment of 101 patients with 113 fractures of the proximal phalanx at the junction of the diaphysis with the proximal metaphysis. Fractures were stabilized using a single extra-articular percutaneous Kirschner wire passed lateral to the metacarpal head into the base of the phalanx base and across the fracture to engage the lateral cortex. Patients were treated semi-electively on a day surgery unit. The metacarpophalangeal joint was splinted in flexion with mobilization of the proximal inter-phalangeal joints, until the wire was removed at 24 days and the hand then freely mobilized...
January 1, 2018: Journal of Hand Surgery, European Volume
Schneider K Rancy, Eugene T Ek, Sophia Paul, Robert N Hotchkiss, Scott W Wolfe
Purpose  This study aims to compare the outcomes and complications of our technique for nonspanning total wrist arthrodesis using a locking plate with the standard carpometacarpal spanning technique. Methods  A retrospective review of charts was performed to identify patients who underwent total wrist arthrodesis by the senior author (S.W.W.). We compared the outcomes of 15 cases of nonspanning wrist fusion with a 2.4/2.7 mm locking T plate to 11 cases of spanning wrist fusion with a 2.7/3.5 mm locking compression plate...
April 2018: Journal of Wrist Surgery
A Righi, M Sbaraglia, M Gambarotti, S Cocchi, G Drago, R Casadei, P Picci, D Vanel, A P Dei Tos
Extra-axial chordoma is an exceedingly rare tumor, with only 28 cases reported in the literature to date. Axial and extra-axial chordoma exhibits complete morphologic and immunophenotypic (expression of brachyury) overlap. However, in consideration of the non-canonical presentation, extra-axial chordoma is under-recognized and often misdiagnosed, most often as extraskeletal myxoid chondrosarcoma or myoepithelioma. To increase our understanding of the clinicopathologic features of extra-axial chordoma, six cases have been retrieved from the files of the Istituto Ortopedico Rizzoli and of the General Hospital of Treviso...
March 20, 2018: Virchows Archiv: An International Journal of Pathology
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