Open and Closed Arthrodesis of the Rheumatoid Wrist Using a Modified (Stanley) Steinmann Pin

1999 ◽  
Vol 24 (6) ◽  
pp. 662-666 ◽  
Author(s):  
L. CHRISTODOULOU ◽  
M. S. PATWARDHAN ◽  
F. D. BURKE
Keyword(s):  
Rheumatoid Arthritis ◽  
Carpal Bones ◽  
Single Patient ◽  
Open Technique ◽  
Metacarpal Head ◽  
Closed Technique ◽  
Small Incision ◽  
Rheumatoid Wrist ◽  
Steinmann Pin

In a series of 21 patients (22 wrists) with rheumatoid arthritis, arthrodesis of the wrist was done using a modified Steinmann pin (Stanley) either by an open or closed technique. The open technique, which included fragmenting the carpal bones (12 cases), was mainly used when additional procedures were needed simultaneously. The closed technique simply required insertion of the Stanley pin under fluoroscan control through a small incision over the metacarpal head. Nine out of 12 wrists treated with the open technique and nine out of ten of those treated by the closed technique were successfully fused. Complications were few. A single patient was dissatisfied due to continuing pain. Two out of the four pins that migrated (both involving the open technique) have been removed.

Open Surgical versus Minimally Invasive in Situ Femorodistal Bypass: Long-term Results

2003 ◽  
Vol 10 (1) ◽  
pp. 117-120 ◽  
Author(s):  
Nomdo S. Renken ◽  
Cees H.A. Wittens ◽  
Peter M.T. Pattynama ◽  
Nico A.J.J. Du Bois ◽  
Lukas C. van Dijk
Keyword(s):  
Minimally Invasive ◽  
Limb Salvage ◽  
Long Term Results ◽  
Open Technique ◽  
Treatment Groups ◽  
Closed Technique ◽  
Open Versus

Purpose: To compare long-term patency and limb survival rates for the classical in situ surgical bypass procedure versus a minimally invasive technique for femorodistal revascularization. Methods: From May 1992 to June 1994, a prospective multicenter study was undertaken at 4 centers to evaluate the open versus closed technique for femorodistal bypass grafting. Of 97 patients enrolled in the trial, 73 patients (49 men; mean age 71 years) were assigned to the long-term follow-up protocol and prospectively randomized to the open (n = 38) or closed (n = 35) procedure. The classical open technique is characterized by a long incision over the length of the bypass graft, while the minimally invasive procedure involves only two short incisions over each anastomosis site (the side branches are closed with a coaxial embolization catheter system). Graft patency was evaluated with duplex imaging periodically throughout the 4-year observation period. Results: There was no statistically significant difference between the treatment groups with respect to age, sex, hypertension, ischemic heart disease, or smoking. However, the open group had a significantly greater incidence of diabetes (p = 0.037). Over a median 4.7-year follow-up (range 0.3–6.4), 9 (12%) patients (3 open and 6 closed) were lost to follow-up: 2 died and 7 refused the duplex examination. No significant differences in 4-year patency, limb salvage, or survival was demonstrated between the open versus closed treatment groups; 4-year secondary patency was 62% versus 64%, respectively, and limb salvage was 72% versus 86%. Conclusions: The closed technique for femorodistal in situ bypass procedures yields favorable long-term outcomes compared to the traditional open technique.

The Wrightington Classification of Rheumatoid Wrist X-Rays: A Guide to Surgical Management

1989 ◽  
Vol 14 (4) ◽  
pp. 451-455
Author(s):  
S. P. HODGSON ◽  
J. K. STANLEY ◽  
A. MUIRHEAD
Keyword(s):  
Rheumatoid Arthritis ◽  
Surgical Management ◽  
X Rays ◽  
Rheumatoid Disease ◽  
Rheumatoid Wrist ◽  
Practical Guidance ◽  
Surgical Choices ◽  
Results Of Surgery

We have reviewed the pre-operative radiological appearances, the type of operation performed and the results of surgery of 234 wrists in 179 patients with rheumatoid arthritis. Based on this, a classification of X-rays of the rheumatoid wrist is described. It is designed to provide practical guidance to the surgeon who is planning surgery in a patient with rheumatoid disease. The surgical choices at each stage of the disease are briefly discussed.

scholarly journals A Comparison between the Results of Open versus Closed Lateral Internal Sphincterotomy in the Surgical Management of Chronic Anal Fissure

2018 ◽  
Vol 8 (3) ◽  
pp. 235-239
Author(s):  
Md Mahabub ◽  
Md Mahbubur Rahman ◽  
Md Tanvirul Islam ◽  
Selina Sultana
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Lateral Internal Sphincterotomy ◽  
Complication Rates ◽  
Open Technique ◽  
Female Ratio ◽  
Internal Sphincterotomy ◽  
Closed Technique ◽  
Increased Risk ◽  
Open Versus

Background: Lateral internal sphincterotomy is regarded as the gold standard surgical treatment for chronic anal fissure. Some authors reported that the closed technique had lower complication rates than that by the open technique, but others reported that both of the techniques had no meaningful differences in complications.Methods: This was a comparative and cohort study carried out at Department of Colorectal Surgery, Combined Military Hospital (CMH) Dhaka, Bangladesh, from October 2013 to October 2017. Eighty three patients with chronic anal fissure not responding to medical treatment for at least three months were included in this study to compare the results of the open versus closed techniques of lateral internal sphincterotomy after four months follow up postoperatively.Results: The mean age at presentation was 34.15±11.4 years and the male to female ratio was 1.24:1. The results of open and closed techniques were compared regarding per-operative bleeding (35.71% versus 12.19%), post-operative urinary retention (4.76% versus 0%), symptom relief on first post-operative day (76.19% versus 70.73%), significant 1st post-operative day pain in the operated wound (33.33% versus 7.31%), temporary fecal soiling (2.38% versus 0%), temporary flatus incontinence (7.14% versus 0%), and fissure recurrence (0% versus 14.63%) respectively. Temporary incontinence to fecal and flatus recovered by conservative management within two and four months of surgery respectively.Conclusion: The closed technique of lateral internal sphincterotomy had lower post-operative complications, pain, bleeding, and incontinence compared to open technique, but increased risk of fissure recurrence.Birdem Med J 2018; 8(3): 235-239

Rheumatology

2011 ◽  
Author(s):  
David Warwick ◽  
Roderick Dunn ◽  
Erman Melikyan ◽  
Jane Vadher
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Surgical Treatment ◽  
Juvenile Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Metacarpophalangeal Joints ◽  
Ligamentous Laxity ◽  
Rheumatoid Wrist

General principles 362Rheumatoid arthritis 364Rheumatoid wrist 368Surgical treatment of the rheumatoid wrist 370Metacarpophalangeal joints 374Rheumatoid fingers 378Rheumatoid thumb 381Scleroderma 382Psoriasis 383Dactylitis 383Systemic lupus erythematosus 384Juvenile rheumatoid arthritis 385Generalized ligamentous laxity 386Diabetes and the hand ...

Fibrous Stabilization of the Rheumatoid Wrist

1995 ◽  
Vol 20 (2) ◽  
pp. 143-145 ◽  
Author(s):  
A. BIYANI ◽  
A. J. M. SIMISON
Keyword(s):  
Rheumatoid Arthritis ◽  
Important Determinant ◽  
Deep Infection ◽  
Wrist Movement ◽  
Range Of Movement ◽  
The Poor ◽  
Rheumatoid Wrist

19 patients (mean age 59.8 years) underwent fibrous stabilization of the wrist for rheumatoid arthritis. 17 patients were reviewed after a mean follow up of 24.5 months (range 13–40 months). There were four excellent, 11 good, and two poor results according to modified Koka and D’Arcy (1989) criteria. The poor results were due to deep infection in one patient and an unbalanced wrist due to ruptured radial extensors in another. The pre-operative range of wrist movement was an important determinant of the frequency of radio-carpal and/or mid-carpal fusion and the final post-operative range of movement.

scholarly journals OneShot-M: A New Device for Close Laparoscopy Pneumoperitoneum

2018 ◽  
Vol 25 (6) ◽  
pp. 570-577
Author(s):  
Giovanni Cassata ◽  
Vincenzo Palumbo ◽  
Luca Cicero ◽  
Antonino De Luca ◽  
Giuseppe Damiano ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Induction Time ◽  
Significant Risk ◽  
Veress Needle ◽  
White Female ◽  
Open Technique ◽  
Large White ◽  
New Device ◽  
Closed Technique ◽  
Critical Phase

Introduction. The induction of pneumoperitoneum is the first and most critical phase of laparoscopy, due to the significant risk of serious vascular and visceral complications. The closed technique for the creation of pneumoperitoneum could lead to several surgical complications. The present study aimed to overcome the complications associated with the insertion of Veress needle, improving its use, and facilitating the rapid creation of pneumoperitoneum. Methods. Thirty large white female pigs were enrolled in our study. A common plunger was modified in order to allow the passage of a 15-cm long Veress needle. This method was applied to 26 laparoscopic procedures (26 pigs) of several specialist branches. Results. OneShot-M close laparoscopy pneumoperitoneum creation device allowed us to obtain pneumoperitoneum quickly in all attempts, without any intraoperative and postoperative complications related to the use of the Veress needle. Conclusion. The use of the proposed device showed an induction time as quick as the standard laparoscopic closed abdominal entry. The patented device is cheap and allows a safe abdominal entry. In addition, abdominal entry is much faster than the classic open technique.

Comparison of two Different Surgical Modalities in the treatment of Pilonidal Sinus (Primary Closure and Open Technique)

2021 ◽  
Vol 15 (11) ◽  
pp. 2999-3001
Author(s):  
Muhammad Aamir Jamil ◽  
Muhammad Imran Anwar ◽  
Muhammad Waqas Saleem ◽  
Sameen Tahir ◽  
Haroon Javaid Majid
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pilonidal Sinus Disease ◽  
Open Technique ◽  
Sinus Disease ◽  
Closed Technique ◽  
Secondary Intention ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Pilonidal sinus is disease of young age andits prevalence is higher in men compared to women (almost twice).It is a disease that arises from hair follicles particularly present in the natal cleft. It occurs commonly in Jeep Drivers and hence gets the name from there “Jeep Drivers Disease” and also commonly occurs in Barbers. It leads to formation of abscesses and chronic wounds with discharge and pain. Disease can have huge impact on social life and quality of life. In most cases the treatment is incision and drainage. Study design: It is a case series study. Place and duration of study: Department of General Surgery at Shaikh Zayed Hospital Lahore from January 2019 to January 2021. Aim: To compare the relative effects of open and closed surgical techniques on the recurrence rate, rate of infection and time of healing for pilonidal sinus. Methodology: Patients with pilonidal sinus disease from January 2019 to January 2021 received surgical treatment either excision followed by primary closure as in closed technique (group A) or excision followed by leaving the wound open for healing by secondary intention as in open technique (group B). Surgical management is widely based upon two techniques open and closed. In open technique wound is left open and heals by secondary intention while in closed technique it is closed primarily and heals by primary intention. The better choice between these two techniques is still a topic of debate. Results: The most common age group for pilonidal sinus was between 16-25 years of age. The mean age came out to be 26.7 years. The mean healing time was 15 days in group A and 42 days in group B. The duration of hospital stay ranged between 2-8 days for group A and 5-16 days for group B. Early postoperative complications seen was infection in 1 patient (7.69%) in group A and 5 patients (35.71%) in group B and these cases were managed conservatively.1 (7.69%) case of aseptic gaping of wound after stitch removal was seen in group A and was managed with closed technique. Recurrences reported in group A was 1 case (7.69%) at 6 months and was surgically managed by open technique. There were a total of 4 (28.57%) recurrences which were left open to heal by granulation. Conclusion: It is concluded that better management option for pilonidal sinus disease is primary closure of defect. So it is suggested that management of pilonidal sinus disease should be individualized but preference must be given to closure of wound after excision. Keywords: Pilonidal sinus, Primary Closure, Open Technique.

A Comparison of Two Indices for Ulnar Translation and Carpal Height in the Rheumatoid Wrist

2004 ◽  
Vol 29 (2) ◽  
pp. 144-147 ◽  
Author(s):  
N. BORISCH ◽  
K. LERCH ◽  
J. GRIFKA ◽  
P. HAUSSMANN
Keyword(s):  
Rheumatoid Arthritis ◽  
False Negative ◽  
Hand Surgery ◽  
X Rays ◽  
Joint Surgery ◽  
Rheumatoid Wrist ◽  
Two Indices ◽  
Radiolunate Arthrodesis ◽  
Carpal Height

The indices for ulnar translation described by Chamay et al. (1983 , Annales de Chirurgie de la Main, Vol. 2, pp. 5–17), and Bouman et al. (1994 , Journal of Hand Surgery Vol. 19B, pp. 325–329), and for carpal height described by Youm et al. (1978 , Journal of Bone and Joint Surgery, Vol. 40A, pp. 423–431) and Bouman et al. (1994) were compared in pre- and postoperative wrist X-rays of 91 patients with rheumatoid arthritis undergoing radiolunate arthrodesis. Both indices described by Bouman had a higher applicability and sensitivity than the Chamay and Youm indices and are recommended for use with the rheumatoid wrist. However false-negative values may result when the Bouman index for ulnar translation is used to follow up radiolunate arthrodesis.

Arthroscopic Synovectomy of the Rheumatoid Wrist

1997 ◽  
Vol 22 (6) ◽  
pp. 711-713 ◽  
Author(s):  
L. ADOLFSSON ◽  
M. FRISÉN
Keyword(s):  
Rheumatoid Arthritis ◽  
Range Of Motion ◽  
Arthroscopic Synovectomy ◽  
X Ray ◽  
Time Of Surgery ◽  
Rheumatoid Wrist ◽  
Subjective Pain ◽  
Wrist Function

Twenty-four wrists in 19 patients with rheumatoid arthritis affecting the wrist were treated by arthroscopic synovectomy. Range of motion, subjective pain, wrist function and X-ray changes were recorded preoperatively and at an average of 3.8 years after operation. Arthroscopic synovectomy of the rheumatoid wrist reduced pain and improved wrist function in the majority of patients. Progress of arthritic degeneration was significantly less common in patients with no, or very early changes at the time of surgery.

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