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The Bone & Joint Journal
Vol. 95-B, Issue 12 | Pages 1687 - 1696
1 Dec 2013
Nishizuka T Tatebe M Hirata H Shinohara T Yamamoto M Iwatsuki K

The purpose of this study was to evaluate treatment results following arthroscopic triangular fibrocartilage complex (TFCC) debridement for recalcitrant ulnar wrist pain. According to the treatment algorithm, 66 patients (36 men and 30 women with a mean age of 38.1 years (15 to 67)) with recalcitrant ulnar wrist pain were allocated to undergo ulnar shortening osteotomy (USO; n = 24), arthroscopic TFCC repair (n = 15), arthroscopic TFCC debridement (n = 14) or prolonged conservative treatment (n = 13). The mean follow-up was 36.0 months (15 to 54). Significant differences in Hand20 score at 18 months were evident between the USO group and TFCC debridement group (p = 0.003), and between the TFCC repair group and TFCC debridement group (p = 0.029). Within-group comparisons showed that Hand20 score at five months or later and pain score at two months or later were significantly decreased in the USO/TFCC repair groups. In contrast, scores in the TFCC debridement/conservative groups did not decrease significantly. Grip strength at 18 months was significantly improved in the USO/TFCC repair groups, but not in the TFCC debridement/conservative groups. TFCC debridement shows little benefit on the clinical course of recalcitrant ulnar wrist pain even after excluding patients with ulnocarpal abutment or TFCC detachment from the fovea from the indications for arthroscopic TFCC debridement.

Cite this article: Bone Joint J 2013;95-B:1687–96.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XL | Pages 120 - 120
1 Sep 2012
Natsume T Nishizuka T Yamamoto M Shinohara T Hirata H
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Background

Calcium phosphate cement (CPC) is a promising biomaterial which can be used in numerous medical procedures for bone tissue repairing because of its excellent osteoconductivity. An injectable preparation and relatively short consolidation time are particularly useful characteristics of CPC. However, the low strength of CPC and its brittleness restrict its use. One method for toughening brittle CPC is to incorporate fibrous materials into its matrix to create a composite structure. Fibers are widely used to reinforce matrix materials in a variety of areas.

Objective

We hypothesized that there must be an optimal fiber length and structure which can balance these conflicting aspects of fiber reinforcement. The purpose of this study is to prove our conjectures that adding a small amount of short fibers significantly improves the hardness and the toughness of CPC while maintaining its injectability with a syringe and that fiber morphologies that have crimps and surface roughness are favorable for reinforcing.


The Journal of Bone & Joint Surgery British Volume
Vol. 92-B, Issue 7 | Pages 963 - 969
1 Jul 2010
Suzuki M Kurimoto S Shinohara T Tatebe M Imaeda T Hirata H

We have developed an illustrated questionnaire, the Hand20, comprising 20 short and easy-to-understand questions to assess disorders of the upper limb. We have examined the usefulness of this questionnaire by comparing reliability, validity, responsiveness and the level of missing data with those of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

A series of 431 patients with disorders of the upper limb completed the Hand20 and the Japanese version of the DASH (DASH-JSSH) questionnaire. The norms for Hand20 scores were determined in another cross-sectional study.

Most patients had no difficulty in completing the Hand20 questionnaire, whereas the DASH-JSSH had a significantly higher rate of missing data. The standard score for the Hand20 was smaller than the reported norms for the DASH.

Our study showed that the Hand20 questionnaire provided validation comparable with that of the DASH-JSSH. Explanatory illustrations and short questions which were easy-to-understand led to better rates of response and fewer missing data, even in elderly individuals with cognitive deterioration.