The aim of this study was to describe the introduction of a virtual pathway for the management of patients with a suspected fracture of the scaphoid, and to report patient-reported outcome measures (PROMs) and satisfaction following treatment using this service. All adult patients who presented with a clinically suspected scaphoid fracture that was not visible on radiographs at the time of presentation during a one-year period were eligible for inclusion in the pathway. Demographic details, findings on examination, and routine four-view radiographs at the time of presentation were collected. All radiographs were reviewed virtually by a single consultant hand surgeon, with patient-initiated follow-up on request. PROMs were assessed at a minimum of one year after presentation and included the abbreviated version of the Disabilities of the Arm, Shoulder and Hand Score (QuickDASH), the EuroQol five-dimension five-level health questionnaire (EQ-5D-5L), the Net Promoter Score (NPS), and return to work.Aims
Methods
The aim of this study was to assess arthritis of the basal joint of the thumb quantitatively using bone single-photon emission CT/CT (SPECT/CT) and evaluate its relationship with patients’ pain and function. We retrospectively reviewed 30 patients (53 hands) with symptomatic basal joint arthritis of the thumb between April 2019 and March 2020. Visual analogue scale (VAS) scores for pain, grip strength, and pinch power of both hands and Patient-Rated Wrist/Hand Evaluation (PRWHE) scores were recorded for all patients. Basal joint arthritis was classified according to the modified Eaton-Glickel stage using routine radiographs and the CT scans of SPECT/CT, respectively. The maximum standardized uptake value (SUVmax) from SPECT/CT was measured in the four peritrapezial joints and the highest uptake was used for analysis.Aims
Methods
The purpose was to evaluate early clinical, patient-reported, and radiological outcomes of the scapholunate ligament 360° tenodesis (SL 360) technique for treatment of scapholunate (SL) instability. We studied the results of nine patients (eight males and one female with a mean age of 44.7 years (26 to 55)) who underwent the SL 360 procedure for reducible SL instability between January 2016 and June 2019, and who were identified from retrospective review of electronic medical records. Final follow-up of any kind was a mean of 33.7 months (12.0 to 51.3). Clinical, radiological, and patient-reported outcome data included visual analogue scale (VAS) for pain, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Mayo Wrist Score (MWS), and Patient-Rated Wrist Examination (PRWE). Means were analyzed using paired Aims
Methods
The aim of this study was to investigate whether intraoperative 3D fluoroscopic imaging outperforms dorsal tangential views in the detection of dorsal cortex screw penetration after volar plating of an intra-articular distal radial fracture, as identified on postoperative CT imaging. A total of 165 prospectively enrolled patients who underwent volar plating for an intra-articular distal radial fracture were retrospectively evaluated to study three intraoperative imaging protocols: 1) standard 2D fluoroscopic imaging with anteroposterior (AP) and elevated lateral images (n = 55); 2) 2D fluoroscopic imaging with AP, lateral, and dorsal tangential views images (n = 50); and 3) 3D fluoroscopy (n = 60). Multiplanar reconstructions of postoperative CT scans served as the reference standard.Aims
Methods
Aims. Positive ulnar variance is an established risk factor for idiopathic
ulnar impaction syndrome (UIS). However, not all patients with positive
ulnar variance develop symptomatic UIS and other factors, including
the morphology of the lunate, may be involved. The aim of this study
was to clarify the relationship between lunate morphology and idiopathic
UIS. Patients and Methods. A cohort of 95 patients with idiopathic UIS (UIS group) was compared
with 95
Aims. Few studies have examined the long-term outcome of carpal tunnel
release (CTR). The aim of this study was to evaluate the patient-reported
long-term outcome of CTR for electrophysiologically severe carpal
tunnel syndrome (CTS). Patients and Methods. We reviewed the long-term outcome of 40 patients with bilateral
severe CTS who underwent 80 CTRs (46 open, 34 endoscopic) between
2002 and 2012. The outcomes studied were patient-reported outcomes
of numbness resolution, the Boston Carpal Tunnel Questionnaire (BCTQ)
score, and patient satisfaction. Results. The mean follow-up was 9.3 years. Complete resolution of numbness
was reported by 93.8% of patients, persistent numbness by 3.8%,
and recurrent numbness by 2.5%. The mean BCTQ symptom score was
1.1 (. sd. 0.3; 1.0 to 2.55) and the mean Boston function
score was 1.15 (. sd. 0.46; 1.0 to 3.5). 72.5% of patients
were
Aims. The aims of this study were: firstly, to investigate the influence
of the thickness of cartilage at the sigmoid notch on the inclination
of the distal radioulnar joint (DRUJ), and secondly, to compare
the sensitivity and specificity of MRI with plain radiographs for
the assessment of the inclination of the articular surface of the
DRUJ in the coronal plane. . Patients and Methods. Contemporaneous MRI images and radiographs of 100 wrists from
98
The aims of this study were to evaluate the clinical and radiological
outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients
with rheumatoid arthritis. This was a retrospective review of all 95 Universal-2 TWAs which
were performed in our institution between 2003 to 2012 in patients
with rheumatoid arthritis. A total of six patients were lost to
follow-up and two died of unrelated causes. A total of ten patients
had bilateral procedures. Accordingly, 75 patients (85 TWAs) were
included in the study. There were 59 women and 16 men with a mean
age of 59 years (26 to 86). The mean follow-up was 53 months (24
to 120). Clinical assessment involved recording pain on a visual
analogue score, range of movement, grip strength, the Quick Disabilities
of the Arm, Shoulder and Hand (DASH) and Wrightington wrist scores.
Any adverse effects were documented with particular emphasis on
residual pain, limitation of movement, infection, dislocation and
the need for revision surgery. Radiographic assessment was performed pre-operatively and at
three, six and 12 months post-operatively, and annually thereafter.
Arthroplasties were assessed for distal row intercarpal fusion and
loosening. Radiolucent zones around the components were documented
according to a system developed at our institution.Aims
Patients and Methods
Chronic conditions of the wrist may be difficult to manage because
pain and psychiatric conditions are correlated with abnormal function
of the hand. Additionally, intra-articular inflammatory cytokines
may cause pain. We aimed to validate the measurement of inflammatory cytokines
in these conditions and identify features associated with symptoms. The study included 38 patients (18 men, 20 women, mean age 43
years) with a chronic condition of the wrist who underwent arthroscopy.
Before surgery, the Self-Rating Depression Scale (SDS), Hand20 questionnaire
and a visual analogue scale (VAS) for pain were used. Cytokine and
chemokine levels in the synovial fluid of the wrist were measured
using enzyme-linked immunosorbent assays and correlations between
the levels with pain were analysed. Gene expression profiles of
the synovial membranes were assessed using quantitative polymerase
chain reaction.Aims
Patients and Methods
We report a new surgical technique of open carpal
tunnel release with subneural reconstruction of the transverse carpal
ligament and compare this with isolated open and endoscopic carpal
tunnel release. Between December 2007 and October 2011, 213 patients with carpal
tunnel syndrome (70 male, 143 female; mean age 45.6 years; 29 to
67) were recruited from three different centres and were randomly
allocated to three groups: group A, open carpal tunnel release with
subneural reconstruction of the transverse carpal ligament (n =
68); group B, isolated open carpal tunnel release (n = 92); and
group C, endoscopic carpal tunnel release (n = 53). At a mean final follow-up of 24 months (22 to 26), we found no
significant difference between the groups in terms of severity of
symptoms or lateral grip strength. Compared with groups B and C,
group A had significantly better functional status, cylindrical
grip strength and pinch grip strength. There were significant differences
in Michigan Hand Outcome scores between groups A and B, A and C,
and B and C. Group A had the best functional status, cylindrical
grip strength, pinch grip strength and Michigan Hand Outcome score. Subneural reconstruction of the transverse carpal ligament during
carpal tunnel decompression maximises hand strength by stabilising
the transverse carpal arch. Cite this article:
