To analyze the short-term outcome of two types of total wrist arthroplasty (TWA) in terms of wrist function, migration, and periprosthetic bone behaviour. A total of 40 patients suffering from non-rheumatoid wrist arthritis were enrolled in a randomized controlled trial comparing the ReMotion and Motec TWAs. Patient-rated and functional outcomes, radiological changes, blood metal ion levels, migration measured by model-based radiostereometric analysis (RSA), bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA), complications, loosening, and revision rates at two years were compared.Aims
Methods
To explore individuals’ experience of a scaphoid waist fracture and its subsequent treatment. A purposive sample was created, consisting of 49 participants in the Scaphoid Waist Internal Fixation for Fractures Trial of initial surgery compared with plaster cast treatment for fractures of the scaphoid waist. The majority of participants were male (35/49) and more younger participants (28/49 aged under 30 years) were included. Participants were interviewed six weeks or 52 weeks post-recruitment to the trial, or at both timepoints. Interviews were semistructured and analyzed inductively to generate cross-cutting themes that typify experience of the injury and views upon the treatment options.Aims
Methods
The aim of this study was to assess and compare active rotation of the forearm in normal subjects after the application of a short-arm cast (SAC) in the semisupination position and a long-arm cast (LAC) in the neutral position. A clinical study was also conducted to compare the functional outcomes of using a SAC in the semisupination position with those of using a LAC in the neutral position in patients who underwent arthroscopic triangular fibrocartilage complex (TFCC) foveal repair. A total of 40 healthy right-handed volunteers were recruited. Active pronation and supination of the forearm were measured in each subject using a goniometer. In the retrospective clinical study, 40 patients who underwent arthroscopic foveal repair were included. The wrist was immobilized postoperatively using a SAC in the semisupination position (approximately 45°) in 16 patients and a LAC in 24. Clinical outcomes were assessed using grip strength and patient-reported outcomes. The degree of disability caused by cast immobilization was also evaluated when the cast was removed.Aims
Methods
The aim of this study was to analyze the association between the shape of the distal radius sigmoid notch and triangular fibrocartilage complex (TFCC) foveal tear. Between 2013 and 2018, patients were retrospectively recruited in two different groups. The patient group comprised individuals who underwent arthroscopic transosseous TFCC foveal repair for foveal tear of the wrist. The control group comprised individuals presenting with various diseases around wrist not affecting the TFCC. The study recruited 176 patients (58 patients, 118 controls). The sigmoid notch shape was classified into four types (flat-face, C-, S-, and ski-slope types) and three radiological parameters related to the sigmoid notch (namely, the radius curvature, depth, and version angle) were measured. The association of radiological parameters and sigmoid notch types with the TFCC foveal tear was investigated in univariate and multivariate analyses. Receiver operating characteristic curves were used to estimate a cut-off for any statistically significant variables.Aims
Methods
The aim of this study was to compare the Push Ortho Thumb Brace
CMC and a custom-made orthosis in the treatment of patients with
primary osteoarthritis of the carpometacarpal joint of the thumb.
Our outcome measures were pain scores, tests of hand function, patient
satisfaction and patient preference. A multicentre crossover randomised controlled trial was conducted
which included 63 patients (44 women) with primary osteoarthritis
of the carpometacarpal joint of the thumb. Of these, 59 patients
with a mean age of 60.1 years (standard deviation 8.2), completed
the study. Patients used both orthoses for two weeks with a two-week washout
period in-between. Pain was measured on a 10-cm visual analogue
scale. Hand function was assessed using the Jebsen Taylor Hand Function
test, Nine Hole Peg Test, key grip, pinch grip and Functional Index
for Hand Osteoarthritis. Patient preference was assessed using the
Dutch version of the Quebec User Evaluation of Satisfaction with
Assistive Technology score.Aims
Patients and Methods
Arthritis of the wrist is a painful disabling
condition that has various causes and presentations. The traditional treatment
has been a total wrist fusion at a price of the elimination of movement.
However, forms of treatment which allow the preservation of movement
are now preferred. Modern arthroplasties of the wrist are still
not sufficiently robust to meet the demands of many patients, nor
do they restore normal kinematics of the wrist. A preferable compromise
may be selective excision and partial fusion of the wrist using
knowledge of the aetiology and pattern of degenerative change to
identify which joints can be sacrificed and which can be preserved. This article provides an overview of the treatment options available
for patients with arthritis of the wrist and an algorithm for selecting
an appropriate surgical strategy. Cite this article:
There is no consensus on the benefit of arthroscopically
assisted reduction of the articular surface combined with fixation
using a volar locking plate for the treatment of intra-articular
distal radial fractures. In this study we compared the functional
and radiographic outcomes of fluoroscopically and arthroscopically
guided reduction of these fractures. Between February 2009 and May 2013, 74 patients with unilateral
unstable intra-articular distal radial fractures were randomised
equally into the two groups for treatment. The mean age of these
74 patients was 64 years (24 to 92). We compared functional outcomes
including active range of movement of the wrist, grip strength and Disabilities
of the Arm, Shoulder, and Hand scores at six and 48 weeks; and radiographic
outcomes that included gap, step, radial inclination, volar angulation
and ulnar variance. There were no significant differences between the techniques
with regard to functional outcomes or radiographic parameters. The
mean gap and step in the fluoroscopic and arthroscopic groups were
comparable at 0.9 mm (standard deviation Arthroscopic reduction conferred no advantage over conventional
fluoroscopic guidance in achieving anatomical reduction of intra-articular
distal radial fractures when using a volar locking plate. Cite this article:
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:
