Introduction

Distal radius fractures (DRF) are a common injury in the A&E departments, being a major cause of disability of the upper extremity. The aim of this prospective study is to assess the possible association between objective physical variables such as wrist range of movement (ROM), radiological parameters, and upper extremity disability (measured by the DASH questionnaire), after conservative treatment of DRF.

Introduction: Osteoarthritis of the thumb basal joint is a very common and disabling condition that frequently affects middle-aged women, sometimes bilaterally. The purpose of this work is to present the methodology of the preoperative and postoperative assessment carried out in 52 patients who underwent a trapeziometacarpal joint replacement procedure (Roseland prosthesis).

Material and Methods: Total joint arthoplasty of the trapeziometacarpal joint was performed on 52 thumbs in 44 patients (15 dominants hands) to treat osteoarthritis (Eaton-Littler stages II and III) between 1995 and 2007. 18 patients were missed for follow-up purposes. Average age of 59,4 years. The Roseland trapeziometacarpal joint prosthesis was used in this study. We analyzed the ROM for abduction-adduction, flexo-extension of the trapeziometacarpal joint and the opposition of the thumb by the modified Kapandji test. We also measured radiographic distance of the TMC space in preoperative radiographies and compared it with the postoperative ones. Finally, strength was quantified for the lateral, tip-to-tip, and tridigital pinch in the treated hands. Pain was measured with VAS and the DASH questionnaire was completed by all the patients. The average follow-up period was of 5,3 years (range, 1,1–12,1 years).

Results: At the final follow-up visit we obtained the following Results: for thumb abduction average 66°, thumb opposition to the base of the smaller finger was present in 58%, and thumb flexo-extension average 59°. The average tip-to-tip pinch strength was 2,7, for the lateral pinch 3,6 and for the tridigital pinch was 3,7. We observed that in 36% of the radiographies the TMC space was the same pre and postoperative. Average VAS and DASH scores were of 1,6 and 26,3 respectively. Five patients (10%) needed a revision surgery (2 for infection and 3 for aseptic loosening of the prosthesis)

Conclusions: Most of the protocols evaluating surgical outcomes on the trapeziometarcarpal joint don’t allow a functional analysis of ROM and strength of this joint. That’s why we developed the idea of designing a new methodology, that we currently use in our centre, to analyze the functional outcome of the surgery on the trapeziometacarpal joint. We specially recommend the measurement of the tridigital pinch strength, as is the most representative feature of the hand function.

Introduction and purpose: The purpose of this retrospective study is to determine the clinical outcome of Weil’s triple osteotomy as a treatment of metatarsalgia in the Department of Trauma and Orthopedic Surgery of the Hospital de Mòsteles (Madrid).

Materials and methods: We analyzed the first 50 cases performed in this department, with a mean follow-up of 2.5 years (range: 2–3.5 years). Of the total 50 patients, 45 were women and 5 were men. A mean amount of 3 metatarsals were corrected in each procedure (range: 1–5) with simultaneous hallux valgus correction in 38 cases.

Results: The results were evaluated according to the scale of the American Orthopedic Foot and Ankle Society for minor metatarsals pre and postoperatively, assessing function (45 points), pain (40 points) and alignment (15 points). Significant improvement of pain (30 or more points) was seen in 80% of the patients, a good to very good improvement in function was seen in 70% of cases (above 35 points) and alignment correction was seen in 90% of cases (more than 10 points). The complications were: superficial infection in 2 cases, metatarsophalangeal extension deficit in 3 cases, persistent pain in 1 case and deep venous thrombosis in 2 cases. Only one female patient with persistent pain required a new corrective surgery.

Conclusions: We consider that this is a technique that shortens and realigns the metatarsals achieving a significant decrease in symptoms without the stiffness and functional limitations caused by other techniques.