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: Activated platelets release various growth factors, some ot which are recognize to improve nerve regeneration. The present study evaluated the effect of platelet-rich-plasma (PRP) in end to end neurorraphy.

Material and method: A total of 38 Spragle-Dawley rats were used. The PRP was obteined from each rat and applicated to the same rat. The left hind limb were used as experimental, with the right as control. The animals were treated in two grups. In both groups the sciatic nerve was dissected from the sciatic notch to the bifurcation. The nerve was transected an repaired with epineural suture (ethilon 9–0). Group A (n=12): suture without PRP. Group B (n=15) suture with PRP. The rats were anestherized and electromyographic studie was performed after the following, 120,5 days for group A and 125,86 for group B. Prior to sacrifice muscular and nerve tissue harvesting was performed.

The amplitude was expressed as the amplitude at the experimental sde divided by the amplitude at the contralateral, untreated side, multiplied by 100%. Recording was done in gastrocnemius and tibialis anterior muscle.

Results: The stimulation was performed in supramaximal form on both groups: Group A: (without PRP)

The mean of intensity was 1.49 mA and the mean of threshold was 0,56 mA

No stadistical difference on both groups was found.

Histological studies were performed and results are no available at the moment of send this abstract

Conclusions:

No evidence has been found that the use of PRP has a beneficial effect on peripheral nerve regeneration

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: Neuropathy associated with syringomyelia is a relatively rare entity that predominantly affects the glenohumeral joint. It is characterized by joint destruction, which is in many cases severe and which requires a differential diagnosis from other severe conditions. The therapeutic options are based on maintaining function rather than on immobilization. We present our experience of treating this condition in 4 cases.

Materials and methods: The cases were 4 females with a mean age of 53.25 years. One of the cases had both the glenohumeral and carpal joints affected. Only in one case was there a known history of syrinogomyelia associated with Arnold Chari disease, whereas in the other 3 the diagnosis of syringomyelia was established by studying the neuroarthropathy.

Results: Two of the patients were treated by means of joint replacement (one total and the other partial) with a favorable postoperative evolution in the medium term. Acceptable pain control and joint balance were achieved. At the end of 5 and 2 years respectively, the total and partial prosthesis had to be revised due to aseptic loosening of the components and joint instability, respectively. The conservative treatment applied to the two remaining cases achieved a functional range of movement for activities of daily living and one of the cases was able to continue with their usual work activities.

Conclusions: In spite of numerous sources in the literature that advise against joint replacement, there are very few documented cases and series that substantiate that recommendation. In the long run, in our experience joint replacement is not a satisfactory treatment for glenohumeral neuroarthropathy.

Introduction: We present 34 patients diagnosed with hallux rigidus treated by percutaneous surgery. We analyzed the surgical techniques used and the functional results achieved.

Materials and methods: We retrospectively collected 34 patients (24 women). Patients were stratified by means of parametric x-rays (Hanft classification from 1 to 4). Treatment consisted in a double osteotomy, also known as Keller’s technique, using percutaneous procedures. The postoperative protocol consisted of walking, use of orthopedic footware, and early mobilization.

Results: Mean age was 68.78 years and mean follow-up was 31.45 months. Mean time from first clinical visit to surgery was 4.38 years; most patients had received conservative treatment. The mean degree of hallux rigidus according to the standard classification was 2.5. The mean value of the metacarpophalangeal joint arc and interphalangeal joint arc was 40.35°and 52.14° respectively. Return to work activities was achieved in 90.9%. The mean value according on the VAS (visual analogue scale) (0–10) was 3.14. The mean value on the AOFAS scale was 62.57 (0–100).

Conclusions: Percutaneous surgery is a satisfactory method for the treatment of hallux rigidus, enabling the patient to quickly return to work. This procedure avoids the use of osteosynthesis materials and minimizes the complications seen in open surgery.