Treatment with Buttress Plate Technique for Symptomatic Ulnar Styloid Base Nonunion

2021 ◽  
Author(s):  
Ömer Faruk Kümbüloğlu ◽  
Necmi Cam ◽  
Hacı Mustafa Özdemir
Keyword(s):  
Pain Score ◽  
Mean Value ◽  
Dash Score ◽  
Visual Analogue Pain Score ◽  
Ulnar Styloid ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Plate Technique ◽  
Buttress Plate

Abstract Background Surgical treatment options for symptomatic ulnar styloid base nonunion can be divided into two groups: styloid excision and styloid fixation methods. Styloid fixation is commonly performed using tension band wiring or distal ulna hook plate. However, these methods are more suitable for large styloids than small ones. For this reason, fixation of small styloids still remains a problem. Purpose To present the surgical details and results of patients operated using the buttress plate technique, due to the symptomatic ulnar styloid base nonunion. Patients and Methods In this study, 11 patients who underwent surgery for symptomatic ulnar styloid base nonunion using buttress plate technique were evaluated retrospectively. The patients were evaluated with the help of forearm and wrist range of motion, grip strength, disabilities of the arm, shoulder, and hand (DASH) score and visual analogue pain score. Results The mean follow-up period was 15 months (range: 13–21 months). Union was achieved in 10 patients. At the final follow-up, the forearm supination and pronation active range of motions were significantly higher than those in the preoperative period, the visual analogue pain score mean value was 0.7 (range: 0–5), and the DASH score mean value was 7 (range: 1–32). Conclusion We conclude that good results can be achieved with the buttress plate technique in patients with both large and small fragmented ulnar styloid base nonunions and no distal radioulnar joint instability. Level of Evidence This is a Level IV, therapeutic study.

scholarly journals Effects of Ulnar Styloid Fractures on Unstable Distal Radius Fracture Outcomes: A Systematic Review of Comparative Studies

2017 ◽  
Vol 07 (02) ◽  
pp. 172-181 ◽  
Author(s):  
Sami Almedghio ◽  
Fayez Almari ◽  
Indranil Chakrabarti ◽  
Mohammed Arshad
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Clinical Outcomes ◽  
Distal Radius ◽  
Wrist Pain ◽  
Dash Score ◽  
Ulnar Styloid ◽  
Level Of Evidence ◽  
Significant Difference

Purpose In this literature review, functional outcomes such as Disability of Arm, Shoulder and Hand (DASH) score and the visual analog scale (VAS) of pain along with clinical outcomes such as range of movement and grip strength of treated distal radius fractures (DRF) accompanied with ulnar styloid fractures (USF) will be compared with those with isolated DRF. Materials and Methods We analyzed articles from MEDLINE, Embase, and CINAHL that met our predetermined inclusion and exclusion criteria as per the Preferred Reporting Items for Systematic Reviews and Meta-analysis statements. This resulted in the identification of 464 articles with 18 potentially eligible studies of which 6 were included at the full-text screening stage. The primary outcomes were wrist pain, range of motion, functional outcome and satisfaction, such as VAS, and the DASH questionnaire along with radiological assessment and incidence of complications. Results These studies involved 796 participants with DRF and 806 wrists with DRF; 444 (55%) of DRF had an associated USF. Three studies did not report any statistically significant difference in DASH scores between the DRF patients with or without USF. Two studies reported worse DASH scores in the group with associated USF. Wrist pain was reported to be statistically significantly worse in patients with associated USF in two studies. Grip strength did not exhibit a statistically significant difference in any groups in four studies. On assessing the range of motion of the wrist and forearm, only one study reported a statistically significant difference in flexion at 2 years follow-up, with less flexion in patients with USF. Conclusion This review suggests that there is no significant correlation between a USF and the functional and clinical outcomes of DRF treatment, albeit wrist pain and less flexion were reported in some studies to be associated with USF. There is a need for more robust evidence from large randomized controlled trials to specifically look at the effects of fixation versus nonfixation of USF on DRF, or large prospective cohort studies assessing DRF with and without USF, with a minimum of 12 months follow-up. Level of Evidence Level II—therapeutic.

High revision rates with the metal-on-metal Motec carpometacarpal joint prosthesis

2015 ◽  
Vol 41 (3) ◽  
pp. 322-327 ◽  
Author(s):  
J. K. Thillemann ◽  
T. M. Thillemann ◽  
B. Munk ◽  
K. Krøner
Keyword(s):  
Rating Scale ◽  
Revision Rate ◽  
Numerical Rating Scale ◽  
Elevated Serum ◽  
Consecutive Series ◽  
Dash Score ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Thumb Carpometacarpal

We retrospectively evaluated a consecutive series of 42 Motec thumb carpometacarpal total joint arthroplasties. The primary endpoint was revision with implant removal and trapeziectomy. At follow-up the disability of the arm shoulder and hand (DASH) score, pain on numerical rating scale at rest and with activity and serum chrome and cobalt concentrations were assessed for both unrevised and revised patients. At a mean follow-up of 26 months, 17 patients had been revised. The 2 year cumulative revision rate was 42% (95% CI, 28–60%). The DASH score and pain scores at rest and with activity were comparable between the patients whose thumbs remained unrevised and those revised. Patients with elevated serum chrome and cobalt levels had significantly higher DASH and pain scores, but elevated levels were not associated with revision. The revision rate in this study is unacceptably high. However, pain and DASH scores after revision are acceptable and comparable with patients with non-revised implants. Level of evidence: IV

A new surgical technique for the treatment of scaphotrapezial arthritis associated with trapeziometacarpal arthritis: the narrow pseudoarthrosis

2016 ◽  
Vol 41 (7) ◽  
pp. 710-718 ◽  
Author(s):  
M. Rubino ◽  
L. Cavagnaro ◽  
V. Sansone
Keyword(s):  
Simple Technique ◽  
Stage Iv ◽  
Pinch Strength ◽  
Dash Score ◽  
Level Of Evidence ◽  
First Ray ◽  
Excision Arthroplasty ◽  
Surgical Treatments ◽  
New Surgical Technique

We describe a technique for treating Eaton stage IV osteoarthritis of the first ray, which is a development of our previously published technique for treating trapeziometacarpal arthritis. This simple technique is based on a limited resection arthroplasty of the first trapeziometacarpal and the scaphotrapezial joints, with the aim of inducing the formation of a narrow pseudoarthrosis at both sites. A total of 26 consecutive patients were treated for Eaton stage IV arthritis at a mean follow-up of 4.7 years (range 3.2–6.6). There were statistically significant improvements in all clinical parameters: mean appositional and oppositional pinch strength, mean DASH score (65 points pre-operatively to 8.7 points at final follow-up), and in mean visual analogue scale score (8.6 to 0.2 points). Although a larger cohort and a longer follow-up will be necessary to evaluate this new technique fully, these results encourage us to believe that the limited excision arthroplasty of the trapeziometacarpal and scaphotrapezial joints is a viable alternative to the existing surgical treatments for stage IV thumb arthritis. Level of evidence: 4

scholarly journals Artrodese posterolateral vs artrodese circunferencial no tratamento da espondilolistese degenerativa: avaliação clínica e impacto do IMC nos resultados

2013 ◽  
Vol 12 (3) ◽  
pp. 204-208
Author(s):  
Filipe Rodrigues Duarte ◽  
António Manuel Santos Nogueira de Sousa ◽  
Frederico José Antunes Raposo ◽  
Luís Filipe Almeida Valente ◽  
António Moura Gonçalves ◽  
...  
Keyword(s):  
Pain Score ◽  
Oswestry Disability Index ◽  
Visual Analogue Pain Score ◽  
Visual Analogue Pain

OBJETIVO: O tratamento cirúrgico da espondilolistese degenerativa (ED) apresenta vantagens quando comparado com o tratamento conservador. As técnicas cirúrgicas evoluíram no sentido de optimizar a fixação vertebral após descompressão, com o intuito de aumentar a taxa de artrodese. A fixação pedicular associada à fusão intersomática permite aumentar a área de contacto ósseo e assim a taxa de fusão, mas serão os resultados clínicos e funcionais superiores? MÉTODOS: Estudo retrospectivo incluindo 51 indivíduos (idade média de 61,2 anos) submetidos a artrodese posterolateral (APL) (19) e artrodese circunferencial (360º) (32) de 1996 até 2009 com acompanhamento médio de 5,8 anos (2 a 14 anos). Incluídas apenas descompressões de um nível. Avaliação clínica (VAS - Visual Analogue Pain Score), satisfação global e avaliação funcional (Oswestry disability Index modificado). Cálculo do IMC (índice de massa corporal) - avaliação clínica e funcional IMC ≥30 vs IMC <30. Estudo estatístico com SPSS®. RESULTADOS: Os resultados mostram franca melhoria clínica e funcional no tratamento cirúrgico da espondilolistese degenerativa, independentemente das técnicas estudadas. A taxa de satisfação é igualmente elevada. No confronto entre as duas técnicas de fixação não houve diferenças estatisticamente significativas. Relativamente ao IMC, os pacientes não obesos tiveram melhores resultados clínicos (p<0,05), não havendo diferenças relativas à função entre os dois grupos. CONCLUSÃO: A descompressão seguida de instrumentação vertebral é um tratamento eficaz para os pacientes com espondilolistese degenerativa. A técnica de artrodese utilizada não influencia os resultados clínicos e funcionais

Clinical, radiological and patient-rated outcome comparison between total and partial ulnar head implants

2021 ◽  
pp. 175319342110484
Author(s):  
Lea Estermann ◽  
Lisa Reissner ◽  
Andrea B. Rosskopf ◽  
Andreas Schweizer ◽  
Ladislav Nagy
Keyword(s):  
Grip Strength ◽  
Distal Radioulnar Joint ◽  
Joint Arthroplasty ◽  
Dash Score ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Outcome Comparison ◽  
Pain At Rest

This study aimed to analyse the clinical and radiological outcomes after ulnar head replacement and to compare partial and total ulnar head implants. Twenty-two patients with 23 implants were available with a mean follow-up time of 7 years (range 1.3 to 17) after distal radioulnar joint arthroplasty. At the final follow-up, patients had a low level of pain at rest and during effort, a median Disabilities of the Arm, Shoulder, and Hand (DASH) score of 12 and Patient-Rated Wrist Evaluation score of 12 with partial ulnar head implants, and scores of 20 and 22 in total ulnar head implants, respectively. While the range of motion in patients with partial ulnar head implants was slightly reduced in comparison with the preoperative condition and to the patients with total ulnar head implants, there was a tendency to a higher grip strength and rotational torque. Both types of prosthesis showed sigmoid notch resorptions and resorptions around the neck. We conclude that the results after partial ulnar head replacement do not significantly differ from the total ulnar head implants in many aspects. Level of evidence: III

Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal osteoarthritis: minimum 8-year follow-up

2020 ◽  
Vol 45 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Francesco Smeraglia ◽  
Sergi Barrera-Ochoa ◽  
Gerardo Mendez-Sanchez ◽  
Morena A. Basso ◽  
Giovanni Balato ◽  
...  
Keyword(s):  
Young Patients ◽  
Hand Surgery ◽  
Dash Score ◽  
Level Of Evidence ◽  
Interpositional Arthroplasty ◽  
Trapeziometacarpal Osteoarthritis ◽  
Select Group ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
Surgical Treatments

We undertook a retrospective study to evaluate minimal 8-year outcomes of 46 trapeziometacarpal joints (46 patients) treated with pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis in two different hand surgery units. The mean follow-up interval was 9.5 years (average 113 months with a range 97–144 months). The study showed that pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction. All patients experienced a reduction in the DASH score, with an average change of 30 points. The visual analogue scale score, the Kapandji score, and key pinch also showed remarkable improvement. The PyroDisk implant exhibited good longevity, with good implant survival. A review of the literature revealed that the functional outcomes after implant surgery are not superior to more common techniques, such as trapeziectomy with or without ligamentoplasty. Therefore, this is a reliable surgery but may not have added benefits over simpler surgical treatments. This implant could have a role, perhaps in a select group of young patients, as a time-procuring procedure. Level of evidence: IV

scholarly journals Three-Stage Masquelet Technique and One-Stage Reconstruction to Treat Foot and Ankle Tuberculosis

2019 ◽  
Vol 41 (3) ◽  
pp. 331-341 ◽  
Author(s):  
Wenqiang Qu ◽  
Chi Wei ◽  
Li Yu ◽  
Yu Deng ◽  
Panfeng Fu ◽  
...  
Keyword(s):  
Pain Score ◽  
Early Stage ◽  
Distal Tibia ◽  
Case Series ◽  
Cement Spacer ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Masquelet Technique

Background: The purpose of this article was to report the feasibility and effectiveness of 3-stage Masquelet technique and 1-stage operation for different stages of foot and ankle tuberculosis (TB). Methods: Ten consecutive patients with foot and ankle TB were retrospectively analyzed between January 2014 and December 2018. Five patients were treated with the 3-stage Masquelet technique, including thorough debridement with vacuum sealing drainage, implantation of antibiotic cement spacer, and subsequent reconstruction. Five patients were treated with a 1-stage reconstruction. The American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS) pain scores were recorded at the last follow-up. The follow-up was 30.3 ± 17.8 months. Results: No reactivation of TB was observed in any patients. For the 3-stage operation group, 1 patient developed a distal tibia fracture. The duration of anti-TB therapy was 12.0 ± 0.8 months. The AOFAS score increased from 39.5 ± 9.9 preoperatively to 75.3 ± 7.0 postoperatively ( P < .05). The VAS pain score decreased from 6.3 ± 1.9 to 1.5 ± 1.3 ( P < .05). For the 1-stage operation, 1 patient had wound necrosis. The duration of anti-TB therapy was 13.8 ± 1.1 months. The AOFAS score increased from 51.8 ± 15.0 to 81.8 ± 6.3 ( P < .05). The VAS pain score decreased from 5.4 ± 1.1 to 1.0 ± 0.7 ( P < .05). Conclusion: Three-stage operation was effective for foot and ankle TB with stage IV, sinus tracts or other infections, and 1-stage reconstruction was effective for early-stage TBs. Level of Evidence: Level IV, case series.

A Retrospective Study in the Treatment of a 2-Part Greater Tuberosity Fracture Using the F3 Biomet Plate

2016 ◽  
Vol 101 (9-10) ◽  
pp. 465-472
Author(s):  
Jun Ma ◽  
Liangyu Zhao ◽  
Tao Liu ◽  
Qiang Fu ◽  
Aimin Chen
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Constant Score ◽  
Shoulder Function ◽  
Open Reduction Internal Fixation ◽  
Dash Score ◽  
X Rays ◽  
Level Of Evidence ◽  
Greater Tuberosity

The purpose of this study was to evaluate the clinical efficacy of the F3 Biomet plate in the treatment of 2-part displaced humeral greater tuberosity fractures. We compared the clinical outcomes of patients with displaced greater tuberosity fractures who underwent surgical treatment using an F3 plate with those of patients who were treated nonsurgically. Eleven patients with 2-part displaced humeral greater tuberosity fractures were surgically treated with use of an F3 Biomet plate, whereas 12 patients with equal injuries were treated nonsurgically. Each patient underwent follow-up for at least 1 year. We retrospectively collected data and analyzed the clinical outcomes. The Constant score and DASH score were used to assess the shoulder function, and X-rays were taken to evaluate the fracture healing. X-rays of the patients in both groups showed that the fractures achieved union after the 1-year follow-up. Patients treated surgically with an F3 plate and open reduction internal fixation had better Constant score and DASH score results for shoulder function than those treated nonsurgically. In the present study, surgical treatment of displaced humeral greater tuberosity fractures with the use of an F3 plate led to a 100% union rate and good clinical outcomes. The F3 Biomet plate can be considered an effective implant for the treatment of displaced humeral greater tuberosity fractures. The level of evidence is therapeutic III.

One visual analogue pain score is sufficient after laparoscopic cholecystectomy

2002 ◽  
Vol 89 (1) ◽  
pp. 114-115 ◽  
Author(s):  
W. Schwenk ◽  
J. W. Mall ◽  
J. Neudecker ◽  
J. M. Müller
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Score ◽  
Visual Analogue Pain Score ◽  
Visual Analogue Pain

Functional outcomes of spasticity-reducing surgery and rehabilitation at 1-year follow-up in 30 patients

2020 ◽  
Vol 45 (8) ◽  
pp. 807-812
Author(s):  
Ulla Bergfeldt ◽  
Joakim Strömberg ◽  
Therese Ramström ◽  
Katarzyna Kulbacka-Ortiz ◽  
Carina Reinholdt
Keyword(s):  
Hand Surgery ◽  
Central Nervous System Disease ◽  
Occupational Performance ◽  
Level Of Evidence ◽  
Mean Values ◽  
Visual Analogue Pain ◽  
System Disease ◽  
Modified Ashworth Scale ◽  
Cord Injury

The effects of spasticity-reducing surgery in the upper extremity were assessed in a prospective observational study of 30 consecutive patients with stroke ( n = 13), incomplete spinal cord injury ( n = 9), traumatic brain injury ( n = 5), cerebral palsy ( n = 2), and degenerative central nervous system disease ( n = 1). Surgery, which included lengthening of tendons and release of muscles, was followed by early rehabilitation at three intensity levels depending on the patients’ specific needs and conditions. At 12 months follow-up there were significant improvements in all outcome measures with the following mean values: spasticity decreased by 1.4 points (Modified Ashworth Scale, 0–5), visual analogue pain score by 1.3 points, and both Canadian Occupational Performance Measures increased (performance by 3.4 and satisfaction by 3.6), and most measures of joint position or mobility improved. Hand surgery combined with early and comprehensive rehabilitation improves function, activity and patients’ satisfaction in patients with disabling spasticity with improvement lasting for at least 1 year. Level of evidence: II

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