scholarly journals Arthroscopic Trapeziectomy and Suture Button Suspensionplasty: A Review of the Literature and Description of the “Three-Step Arthroscopic Trapeziectomy Technique”

2020 ◽  
Vol 09 (05) ◽  
pp. 366-381
Author(s):  
Fernando Corella ◽  
Montserrat Ocampos ◽  
Rafael Laredo ◽  
José Tabuenca ◽  
Maribel Carnicer ◽  
...  

AbstractIn the last two decades, surgeons have rapidly developed arthroscopic techniques to treat basal joint osteoarthritis. Such techniques spare the joint capsule and ligaments, allow more accurate staging of cartilage degeneration to determine the most appropriate treatment, and decrease the risk of injury to the radial artery and superficial branch of the radial nerve. Arthroscopic resection arthroplasty of the trapezium can be performed as either partial or complete trapeziectomy. Many papers have described partial trapeziectomy but few have discussed complete trapeziectomy.Suture button implants avoid the drawbacks of temporary fixation using Kirschner wire, as well as the drawbacks of ligament reconstruction, which necessitates the sacrifice of a tendon and involves both wide exposure and scar tissue.This paper aimed to review the published data on the arthroscopic treatment of basal thumb osteoarthritis, with a special focus on stabilization using suture button suspensionplasty, and to present a technique that structures this procedure into three steps, allowing it to be performed in an easier, more organized, and faster way.

Hand ◽  
2021 ◽  
pp. 155894472199422
Author(s):  
Owolabi Shonuga ◽  
Kristen Nicholson ◽  
Jack Abboudi ◽  
Gregory Gallant ◽  
Christopher Jones ◽  
...  

Background Thumb carpometacarpal (CMC) joint arthroplasty is a common procedure in the surgical management of symptomatic thumb basal joint arthritis. Following trapeziectomy, a number of suspensionplasty techniques are often used, but limited comparative evidence exists between these techniques. The central aim of this study was to prospectively compare the outcomes of 2 suspensionplasty techniques following trapeziectomy: suture button (TightRope) versus ligament reconstruction and tendon interposition (LRTI). Methods Prospective data were collected on 112 consecutive patients with Eaton stage III-IV thumb CMC arthritis who underwent open trapeziectomy and suspensionplasty. There were 53 LRTI and 59 TightRope suspensionplasty procedures. Outcomes were measured using the Quick Disabilities of the Arm, Shoulder, and Hand ( QuickDASH) questionnaire, Visual Analogue Scale (VAS) for pain, radiographic analysis, and lateral pinch strength. Patient demographic data and complications were also recorded. Results Patients undergoing TightRope suspensionplasty had significantly higher trapeziometacarpal index and thus less subsidence than the LRTI group at 2 weeks (0.22 vs 0.17 [ P < .0001]) and 3 months (0.17 vs 0.15 [ P < .05]) postoperatively. TightRope suspensionplasty also had a significantly lower QuickDASH score at 2 weeks (64.7 vs 74.6 [ P < .05]), 3 months (20.7 vs 32.5 [ P < .05]), and 1 year postoperatively (7.57 vs 21.5 [ P < .05]) compared with the LRTI group. However, there was no difference in VAS pain, lateral pinch strength, reoperation, or complications at any time point between groups. Conclusions Thumb CMC joint arthroplasty performed with a TightRope suspensionplasty versus LRTI yielded short-term improved resistance to subsidence, long-term greater improvement in clinical outcome by QuickDASH, and no difference in pain or complication rates.


2021 ◽  
Author(s):  
Rika Yuliwulandari ◽  
Kinasih Prayuni ◽  
Intan Razari ◽  
Retno W Susilowati ◽  
Yenni Zulhamidah ◽  
...  

Background: Owing to the high resistance rate of tuberculosis (TB) to isoniazid, which is metabolized by N-acetyltransferase 2 (NAT2), we investigated the associations between NAT2 variants and multidrug-resistant (MDR)-TB. Materials & methods: The acetylator status based on NAT2 haplotypes of 128 patients with MDR-TB in Indonesia were compared with our published data from patients with anti-TB drug-induced liver injury (AT-DILI), TB and the general population. Results: NAT2*4 was more frequent in the MDR-TB group than in the AT-DILI group, TB controls and general controls. NAT2*4/*4 was significantly more frequent in patients with MDR-TB than in those with AT-DILI. NAT2*5B/7B, *6A/6A and *7B/*7B were detected at lower frequencies in patients with AT-DILI. Rapid acetylators were significantly more frequent in patients with MDR-TB than in those with AT-DILI. Conclusion: These results provide an initial data for optimizing TB treatment in the Indonesian population, and suggest that NAT2 genotyping may help to select appropriate treatment by predicting TB-treatment effect.


Author(s):  
Ayla C Newton ◽  
Marion Bohatschek ◽  
Andreas Rehm ◽  
Elizabeth Ashby

The Newborn and Infant Physical Examination screening is a national screening programme which aims to identify infants with congenital abnormalities to minimise the risk of long-term complications. It involves a top to toe examination with special focus on the heart, eyes, testes and hips. The hip component of the Newborn and Infant Physical Examination screen aims to pick up infants with developmental dysplasia of the hips and refer them for appropriate treatment in a timely manner. Guidelines for the hip section of have recently changed. This article reviews these changes, the timings of the follow up and investigations, and the diagnosis and management of developmental dysplasia of the hips.


2017 ◽  
Vol 9 (2) ◽  
pp. 97-107
Author(s):  
Martyna Chrzescijanska

ABSTRACTThis paper aims to discuss a relation between the theme of sacrifice in Ancient Greece and in the Jungian understanding of the process of individuation and other similar models of personality/self-development. My argument claims that models such as the process of individuation, Post-Traumatic Growth or Positive Disintegration share features on a structural level with a specific model of sacrifice. A special focus will be oneniautos daimon, the Year-King or a spirit of the year, a concept popularized in anthropology at the beginning of the twentieth century which I claim had influence on developing Jung’s theory of individuation. In this paper, I will apply a philosophical analysis to models of psychotherapy, and especially Jungian psychology. The philosophical analysis of models allows to indicate structural similarities between them without claiming anything about their accuracy.


2015 ◽  
Vol 3 (1) ◽  
pp. 32-37
Author(s):  
Konstantin Aleksandrovich Afonichev ◽  
Olga Vasilievna Filippova

Outcomes of III-VI AB degree burns in children,regardless of the nature of treatment in the acute andrecovery period, are the development of scar contractures and deformities of the joints. However, thecorrect organization of follow-up care and rehabilitation treatment can significantly reduce the severity and facilitates the full recovery of the affected segment. Based on the analysis of their own material, the author defines the early stage of rehabilitation in these patients before full maturation of scar tissue or before the formation of functionally significant joint contractures, and later period, when there are indications for surgical rehabilitation. In the early period, follow-up care is recommended in 1 month after discharge and then on a quarterly basis, and with the appearance of deformities - at least once in 2 months. At the2nd stage of rehabilitation, older children and children of secondary school age are subject to follow-up care at least 1 time per year of primary school age - atleast once in 6 months, preschool children - every3 months. The proposed assessment of scar tissuehelps to determine the terms of follow-up care. Usingthis scheme of follow-up care and appropriate treatment allowed the author to obtain excellent and goodresults in 87-90 % of cases at the stages of rehabilitaion.


Hand ◽  
2020 ◽  
pp. 155894472090655 ◽  
Author(s):  
Bryan A. Hozack ◽  
Brianna Fram ◽  
Asif M. Ilyas ◽  
Michael Rivlin ◽  
Frederic E. Liss ◽  
...  

Background: Surgical treatment of basal joint arthritis commonly consists of trapeziectomy followed by various suspensionplasty techniques to provide stability to the thumb ray. Our study goal was to assess the motion and stability of the thumb ray after trapeziectomy and placement of a suture button (Mini TightRope®, Arthrex, Naples, Florida) in a high- or low-angle trajectory. We hypothesized that a low-angle trajectory would yield the greatest stability while providing maximal motion of the thumb. Methods: Eleven fresh-frozen cadaver arms were imaged fluoroscopically in anterior-posterior and lateral views before and after trapeziectomy, and after placement of low- and high-angle suture buttons. The intermetacarpal angle between the thumb and index metacarpals was measured after application of a standard force. Radial abduction, opposition, subsidence, palmar abduction, adduction, and subsidence were measured. Results: Compared to posttrapeziectomy constructs, low- and high-angle TightRope constructs demonstrated less subsidence, low-angle TightRopes had less palmar abduction, and high-angle TightRope constructs had less radial abduction and adduction. High-angle TightRopes allowed more palmar abduction than low-angle constructs. The high-angle TightRopes trended toward more subsidence than low-angle constructs, although it was not significant. Conclusions: Both TightRope constructs provided improved axial stability after trapeziectomy while not excessively limiting any one motion of the thumb. Compared to the high-angle trajectory, the low-angle TightRope placement provided a more stable construct with respect to subsidence and angular motion. Given the concern for excessive motion of the first metacarpal base with the high-angle construct, we recommend a low-angle trajectory TightRope placement.


2017 ◽  
Vol 107 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Isidro Jimenez ◽  
Juan Pedro Rodriguez-Alvarez ◽  
Ricardo Navarro-Navarro

Fracture-dislocations of the tarsal navicular are rare and highly complex injuries to the midfoot. The only published data on this type of fracture are clinical case reports. These injuries are normally caused by high-energy trauma, and their pathophysiology and most appropriate treatment remain unclear. We report a clinical case of a dorsal fracture-dislocation of the tarsal navicular bone associated with a medial swivel dislocation of the Chopart joint caused by a bicycle fall in a 20-year-old healthy man. Open reduction and percutaneous pinning in a novel arrangement was performed, with an excellent outcome 18 months after the injury.


Radiocarbon ◽  
2018 ◽  
Vol 60 (3) ◽  
pp. 875-899 ◽  
Author(s):  
Alf Lindroos ◽  
Åsa Ringbom ◽  
Jan Heinemeier ◽  
Greg Hodgins ◽  
Pia Sonck-Koota ◽  
...  

ABSTRACTLime lumps and bulk mortars show different 14C contamination when analyzed in several CO2 fractions isolated from the effervescence of an ongoing hydrolysis reaction. Age profiles of both materials are therefore highly complementary and together they can provide a reliable date. Furthermore, they can also reveal the complexity of the radiocarbon (14C) distribution within the mortar and thus prevent over-interpretation of the data. The lime lump versus bulk mortar dating data presented here has been collected over 22 years, with only a small fraction of the results so far published internationally. Since there has been an increasing interest in mortar dating over recent years with a special focus on lime lumps, and since many laboratories have just begun mortar dating experiments, we wish to present some of the extensive data that already exist. Previously published data from 15 lime lumps (including 34 14C measurements from sequential dissolution) and 43 new 14C measurements from 17 lime lumps are presented here. The samples are from medieval Finland and Sweden, classical Rome and medieval Italy, and the Roman Jerash (Gerasa), Jordan.


Information ◽  
2022 ◽  
Vol 13 (1) ◽  
pp. 27
Author(s):  
Diego Garat ◽  
Dina Wonsever

In order to provide open access to data of public interest, it is often necessary to perform several data curation processes. In some cases, such as biological databases, curation involves quality control to ensure reliable experimental support for biological sequence data. In others, such as medical records or judicial files, publication must not interfere with the right to privacy of the persons involved. There are also interventions in the published data with the aim of generating metadata that enable a better experience of querying and navigation. In all cases, the curation process constitutes a bottleneck that slows down general access to the data, so it is of great interest to have automatic or semi-automatic curation processes. In this paper, we present a solution aimed at the automatic curation of our National Jurisprudence Database, with special focus on the process of the anonymization of personal information. The anonymization process aims to hide the names of the participants involved in a lawsuit without losing the meaning of the narrative of facts. In order to achieve this goal, we need, not only to recognize person names but also resolve co-references in order to assign the same label to all mentions of the same person. Our corpus has significant differences in the spelling of person names, so it was clear from the beginning that pre-existing tools would not be able to reach a good performance. The challenge was to find a good way of injecting specialized knowledge about person names syntax while taking profit of previous capabilities of pre-trained tools. We fine-tuned an NER analyzer and we built a clusterization algorithm to solve co-references between named entities. We present our first results, which, for both tasks, are promising: We obtained a 90.21% of F1-micro in the NER task—from a 39.99% score before retraining the same analyzer in our corpus—and a 95.95% ARI score in clustering for co-reference resolution.


Author(s):  
Eliana B. Souto ◽  
Joana R. Campos ◽  
Raquel Da Ana ◽  
Carlos Martins-Gomes ◽  
Amélia M. Silva ◽  
...  

Genotoxicity screening tests aim to evaluate if and to what extent a compound in contact with the human body (e.g., a drug molecule, a compound from the environment) interacts with DNA. The comet assay is a sensitive method used to predict the risk of DNA damage in individual cells, as it quantifies the tape breaks, being the alkaline version (pH > 13) the most commonly used in the laboratory. Epithelial cells serve as biomatrices in genotoxicity assessments. As ca. 80% of solid cancers are of epithelial origin, the quantification of the DNA damage upon exposure of epithelial cells to a drug or drug formulation becomes relevant. Comet assays run in epithelial cells also have clinical applications in human biomonitoring, which assesses whether and to what extent is the human body exposed to environmental genotoxic compounds and how such exposure changes over time. Ocular mucosa is particularly exposed to environmental assaults. This review summarizes the published data on the genotoxicity assessment in estimating DNA damage in epithelial cells with a special focus on ocular cell lines. General comet assay procedures for ex vivo and in vivo epithelium samples are also described.


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