Application of a Serrated Palmar Promoted Flap to Treat Camptodactyly

2019 ◽  
Vol 9 (9) ◽  
pp. 1250-1253
Author(s):  
Juntao Wang ◽  
Lu Cao ◽  
Yuliang Sun ◽  
Qingjia Xu ◽  
Yidong Cui ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Skin Grafting ◽  
Practical Method ◽  
Lateral Side ◽  
Active Motion ◽  
Minimal Trauma ◽  
Functional Exercise ◽  
Total Active Motion ◽  
And Function

Objective: Most camptodactyly patients require surgical treatment with skin-grafting, but the result remains unsatisfactory. The serrated palmar promoted flap was explored to treat camptodactyly as a new strategy for surgical treatment. We will make a retrospective analysis of the treatment effect after serrated palmar promoted flap. Methods: A total of 12 children (five males and seven females) with camptodactyly, who had a mean age of 5.7 years old, were treated with serrated palmar promoted flaps between 2013 and 2016 in our department. Five children had little finger involvement, while seven children had multiple digital involvement. All patients (20 fingers) received a serrated palmar promoted flap, a zigzag incision was made in the lateral side, and a V-Y flap was designed in the palmar. Then, the abnormal subcutaneous fibrous cords were cut, and the palmar flap was promoted to distal end, accompanied by PDP joint extension. Skin grafting was also performed for some severely contracted fingers. The total passive motion (TPM) and total active motion (TAM) of the proximal interphalangeal joints were preoperatively measured and calculated at each follow-up. Results: At postoperative follow-up 18 months, all flaps survived. All digitals met the cosmetic and function requirement, and the flexion and extension of the digitals were significantly improved. The mean TPM and TAM was 41 and 25 degrees preoperatively, respectively, and 95 and 65 degrees at final follow-up, respectively. One patient exhibited adhesion after surgery, but improved after functional exercise. Conclusion: The application of a serrated palmar promoted flap to treat camptodactyly is a simple and practical method, which results in minimal trauma and good function. This procedure is suitable for patients with moderate-severe contractures.

scholarly journals The Impact of Arthroscopic Capsular Release in Patients with Primary Frozen Shoulder on Shoulder Muscular Strength

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Michał Waszczykowski ◽  
Michał Polguj ◽  
Jarosław Fabiś
Keyword(s):  
Muscular Strength ◽  
Frozen Shoulder ◽  
Active Motion ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Limited Function ◽  
And Function ◽  
The Impact

The aim of this study was to evaluate the impact of arthroscopic capsular release in patients with primary frozen shoulder on muscular strength of nonaffected and treated shoulder after at least two-year follow-up after the surgery. The assessment included twenty-seven patients, who underwent arthroscopic capsular release due to persistent limitation of range of passive and active motion, shoulder pain, and limited function of upper limb despite 6-month conservative treatment. All the patients underwent arthroscopic superior, anteroinferior, and posterior capsular release. After at least two-year follow-up, measurement of muscular strength of abductors, flexors, and external and internal rotators of the operated and nonaffected shoulder, as well as determination of range of motion (ROM) and function (ASES) in the operated and nonaffected shoulder, was performed. Measurement of muscular strength in the patient group did not reveal statistically significant differences between operated and nonaffected shoulder. The arthroscopic capsular release does not have significant impact on the decrease in the muscular strength of the operated shoulder.

scholarly journals Intramedullary Screws versus Kirschner Wires for Metacarpal Fixation, Functional, and Patient-Related Outcomes

2018 ◽  
Vol 04 (01) ◽  
pp. e29-e33 ◽  
Author(s):  
Jose Couceiro ◽  
Higinio Ayala ◽  
Manuel Sanchez ◽  
Maria De la Red ◽  
Olga Velez ◽  
...  
Keyword(s):  
Return To Work ◽  
Grip Strength ◽  
Kirschner Wire ◽  
Kirschner Wires ◽  
Active Motion ◽  
Contralateral Hand ◽  
Total Active Motion ◽  
Quick Dash ◽  
Dash Questionnaire

Purpose The purpose of our study is to compare the intramedullary fixation of metacarpal fractures with cannulated headless screws and antegrade Kirschner wires in terms of final total active motion, grip strength, patient-related outcomes, need for casting, and return to work times. Methods The authors performed a retrospective review of the hospital records. Thirty fractures were included in the study, 19 in the screw fixation group, and 11 in the Kirschner wire group. Grip strength, and total active motion, was measured at the latest follow-up for both the injured and contralateral hand. Pain was measured on the visual analog scale. Patients were requested to fill a Quick disabilities of the arm and hand score (DASH) questionnaire at the latest follow-up. Satisfaction was measured on a scale from 0 to 10. The time to return to work was quantified from the accident to the point when the patient was back to active duty. Postoperative casting time was also quantified. Results The authors did not find any differences between the two groups in total active motion, grip strength, pain, satisfaction, or Quick DASH scores. We did find a difference in the return to work and casting times; these appeared to be shorter in the screw group. Conclusion Due to the small number of cases, we have been unable to clearly conclude that there were any benefits in the application of one particular technique when compared with the other.

scholarly journals EXTENSIVE NECROTIC TROPHIC FOOT AND LEG ULCER IN THE PRESENCE OF ESSENTIAL THROMBOCYTHEMIA

2015 ◽  
Vol 1 (1) ◽  
pp. 41-45
Author(s):  
V. O. Tsvetkov ◽  
V. V. Malovichko ◽  
A. S. Stupin ◽  
S. O. Arkhireev
Keyword(s):  
Platelet Count ◽  
Surgical Treatment ◽  
Essential Thrombocythemia ◽  
Excellent Result ◽  
Skin Grafting ◽  
Blood Platelet ◽  
Ulcer Recurrence ◽  
Rare Occurrence ◽  
Blood Platelet Count

We are to present a rare occurrence of large limb-threatening ulcer of the leg and foot in patient with thrombocytosis. Essential thrombocythemia was diagnosed based on peripheral blood platelet count and gen test findings. The improving of platelet count was obtained by oral hydroxyurea. Complex surgical treatment, including free-skin grafting, was performed with the excellent result. Two-year follow-up was retraced without any sign of ulcer recurrence. 

scholarly journals Dual Antegrade Intramedullary Headless Screw Fixation for Treatment of Unstable Proximal Phalanx Fractures

Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 494-499 ◽  
Author(s):  
Michael P. Gaspar ◽  
Shiv D. Gandhi ◽  
Randall W. Culp ◽  
Patrick M. Kane
Keyword(s):  
Grip Strength ◽  
Proximal Phalanx ◽  
Retrospective Chart Review ◽  
Active Motion ◽  
Minimally Invasive Surgical ◽  
Number Of Patients ◽  
Total Active Motion ◽  
Minimally Invasive Surgical Treatment ◽  
Study Inclusion

Background: Although intramedullary headless screw (IMHS) fixation is a promising minimally invasive surgical treatment option for unstable proximal phalanx fractures, a single IMHS may provide inadequate fixation for certain fracture patterns. The purpose of this study was to evaluate the short-term clinical outcomes in a pilot series of patients with proximal phalanx fractures treated with dual antegrade IMHS fixation. Methods: We performed a retrospective chart review of proximal phalanx fractures treated with dual antegrade IMHS fixation with a minimum 1 year of follow-up. Demographic information including patient age, sex, occupation, workers’ compensation status, mechanism of injury, hand dominance, and injured digit were obtained. Postoperative outcomes measured included range of motion, grip strength, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) outcome scores, return to full-duty work interval, and complications. Results: Ten fractures in 10 patients (4 male, 6 female) satisfied study inclusion. The mean age of patients was 39 years (range, 20-62), and average follow-up duration was 84 weeks (range, 61-106). Final postoperative total active motion was 258° (range, 245°-270°), mean grip strength was 97% (range, 84%-104%) of the uninjured side, and QuickDASH score was 3.9 (range, 0-13.6). No complications occurred, and no patients required additional intervention. Conclusions: Dual antegrade IMHS fixation of proximal phalanx fractures resulted in excellent postoperative motion, near-normal grip strength, positive self-reported patient outcomes, and no complications with follow-up of at least 1 year. Further study in a larger number of patients is warranted to determine if this promising technique is superior to other modes of fixation.

Clinical Outcomes of Zone 2 Flexor Tendon Repairs Using the Modified Lim/Tsai Technique

2019 ◽  
Vol 24 (01) ◽  
pp. 83-88
Author(s):  
Min Kai Chang ◽  
Sanchalika Acharyya ◽  
Zeus Yiwei Lim ◽  
Shian Chao Tay
Keyword(s):  
Retrospective Study ◽  
Clinical Outcomes ◽  
Flexor Tendon ◽  
Biomechanical Properties ◽  
Modified Technique ◽  
Active Motion ◽  
Satisfactory Outcome ◽  
Flexor Tendon Injuries ◽  
Total Active Motion

Background: The single looped suture modified Lim/Tsai technique is widely used for flexor tendon repairs. It has been shown to possess better biomechanical properties and require less repair time per tendon as compared to the double looped suture original Lim/Tsai technique. However, there is no clinical data on the modified technique. Methods: The retrospective study included zone 2 flexor tendon repairs made using the modified Lim/Tsai technique from January 2008 to December 2014. Clinical outcome was assessed using the revised Strickland and Glogovac criteria, which categorises repairs based on the total active motion of the repaired digit. Results: Sixty-two patients with 74 digits were included. The overall mean total active motion was 122°. The overall satisfactory outcome of the modified Lim/Tsai technique was 81.1%. The rupture rate of the modified Lim/Tsai technique was 2.7%. Using multivariate linear regression model, we found that outcomes were negatively influenced by subzone 2C and crush/saw injuries, but not by concomitant neurovascular injuries or post-operative follow-up duration. Conclusions: Based on this retrospective study of patients with zone 2 flexor tendon injuries, the clinical outcomes of modified and original Lim/Tsai techniques are comparable. As such, there is no clinical evidence favouring one over the other.

Effect of Oral Prednisolone after Collagenase Injection for Dupuytren’s Contracture: A Randomized, Controlled Trial with a 1-Year Follow-Up

2020 ◽  
Author(s):  
Yoshihiro Abe
Keyword(s):  
Controlled Trial ◽  
Oral Prednisolone ◽  
Metacarpophalangeal Joint ◽  
Control Group ◽  
Dupuytren’S Contracture ◽  
Active Motion ◽  
Dupuytren's Contracture ◽  
Significant Difference ◽  
Total Active Motion

Abstract Introduction This study verified the effectiveness of oral prednisolone after collagenase clostridium histolyticum (CCH) (10 mg/day for 2 weeks) for Dupuytren’s contracture with a 1-year follow-up. Materials and Methods This study included 31 patients with a contracture of the metacarpophalangeal joint of ≥ 30 degrees. A total of 16 patients were allocated randomly to treatment with prednisolone and 15 patients were treated without prednisolone (control group). Results At day 7, mean total active motion (TAM) was 235 degrees in the prednisolone group and 228 degrees in the control group. Mean Visual Analog Scale was 3.3 in the prednisolone group and 4.6 in the control group. There was significant difference between two groups. At day 30, mean TAM was 241 degrees in the prednisolone group and 233 degrees in the control group. There were significant difference between two groups The mean QuickDASH score was significantly higher in the control group (5.8 vs. 3.4). Recurrence was observed in 2/16 patients (13%) in the prednisolone group and 5/15 patients (33%) in the control group; there was no significant difference. Conclusion The administration of prednisolone decreased the likelihood of adverse effects, and also improved finger flexion range of motion and reduced pain after CCH.

Clinical outcomes of early active mobilization following flexor tendon repair using the six-strand technique: short- and long-term evaluations

2014 ◽  
Vol 40 (3) ◽  
pp. 250-258 ◽  
Author(s):  
K. Moriya ◽  
T. Yoshizu ◽  
Y. Maki ◽  
N. Tsubokawa ◽  
H. Narisawa ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Digitorum Superficialis ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Total Active Motion ◽  
Active Mobilization ◽  
Flexor Digitorum

We evaluated the factors influencing outcomes of flexor tendon repair in 112 fingers using a six-strand suture with the Yoshizu #1 technique and early postoperative active mobilization in 101 consecutive patients. A total of 32 fingers had injuries in Zone I, 78 in Zone II, and two in Zone III. The mean follow-up period was 6 months; 16 patients (19 fingers) participated in long-term follow-up of 2 to 16 years. The total active motion was 230° SD 29°; it correlated negatively with age. The total active motion was 231° SD 28° after repair of the lacerated flexor digitorum superficialis tendon, and was 205° SD 37° after excision of the flexor digitorum superficialis tendon ends ( p = 0.0093). A total of 19 fingers showed no significant increases in total active motion more than 2 years after surgery. The rupture rate was 5.4% in our patients and related to surgeons’ level of expertise. Five out of six ruptured tendons were repaired by inexperienced surgeons. Level of Evidence IV

Flexor Tenosynovectomy and Tenolysis in Longstanding Rheumatoid Arthritis

1996 ◽  
Vol 21 (4) ◽  
pp. 538-543 ◽  
Author(s):  
A. R. TOLAT ◽  
J. K. STANLEY ◽  
R. A. EVANS
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Disease ◽  
Surgical Indications ◽  
Active Motion ◽  
Total Active Motion ◽  
Tendon Ruptures ◽  
Finger Motion ◽  
Digital Surgery ◽  
Low Rate

A total of 43 patients (49 hands; 424 flexor tendons), who had rheumatoid arthritis of more than 15 years duration at the time of surgery, were clinically assessed at a mean follow-up of 5.7 years (range, 1.2–12 years). Pain and inability to flex actively despite a good passive range of motion were the main surgical indications. The results suggest that the patients had excellent sustained pain relief (mean score=0.9) and were highly satisfied with the outcome of the procedure (mean score = 2.2). 81% had adequate pulp-to-pulp and key pinch. Range of finger motion (total active motion, TAM) was excellent to good in 45% and fair in 22%. Thirty-three per cent were graded as poor and these were found to be multifactorial in origin, with associated significant joint disease, preoperative tendon ruptures, extensive digital surgery, readhesions and combinations of operative procedures which adversely affect the rehabilitation programme. Flexor tenosynovectomy with tenolysis is a useful procedure with a low rate of recurrence.

scholarly journals The Use of Hyaluronic Acid after Tendon Surgery and in Tendinopathies

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Michele Abate ◽  
Cosima Schiavone ◽  
Vincenzo Salini
Keyword(s):  
Hyaluronic Acid ◽  
English Language ◽  
Current Knowledge ◽  
Experimental Studies ◽  
Tendon Repair ◽  
Active Motion ◽  
Tissue Healing ◽  
Tendon Surgery ◽  
Total Active Motion ◽  
And Function

Viscosupplementation with hyaluronic acid is safe and effective in the management of osteoarthritis, but its use in the treatment of tendon disorders has received less attention. The aim of this review is to summarize the current knowledge on this topic, evaluating experimental and clinical trials. A search of English-language articles was performed using the key search terms “hyaluronic acid” or “viscosupplementation” combined with “tendon,” “tendinopathy,“ “adhesions,“ or “gliding,“ independently. In quite all the experimental studies, performed after surgical procedures for tendon injuries or in the treatment of chronic tendinopathies, using different hyaluronic acid compounds, positive results (reduced formation of scars and granulation tissue after tendon repair, less adhesions and gliding resistance, and improved tissue healing) were observed. In a limited number of cases, hyaluronic acid has been employed in clinical practice. After flexor tendon surgery, a greater total active motion and fingers function, with an earlier return to work and daily activities, were observed. Similarly, in patients suffering from elbow, patellar, and shoulder tendons disorders, pain was reduced, and function improved. The positive effect of hyaluronic acid can be attributed to the anti-inflammatory activity, enhanced cell proliferation, and collagen deposition, besides the lubricating action on the sliding surface of the tendon.

scholarly journals III cranial nerve cavernous malformation: A case report and review of the literature

2020 ◽  
Vol 11 ◽  
pp. 452
Author(s):  
Giuseppe Di Perna ◽  
Fabio Cofano ◽  
Roberto Altieri ◽  
Bianca Maria Baldassarre ◽  
Luca Bertero ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Cavernous Malformation ◽  
Cranial Nerves ◽  
Brain Parenchyma ◽  
Nerve Sparing ◽  
Review Of The Literature ◽  
Total Resection ◽  
Cavernous Malformations ◽  
And Function

Background: Cavernous malformations generally occur in brain parenchyma but rarely these lesions arise from cranial nerves (CNs). Case Description: This paper described a case of a woman presented with III CN dysfunction due to the presence of a right III CN cavernoma. Surgical treatment with nerve sparing gross total resection was performed. A 3-month follow-up was documented. Conclusion: Only few cases of CNs cavernomas have been described in the literature. These lesions have been described to show a more aggressive behavior compared to intraparenchymal cavernomas, especially in symptomatic patients. Differential diagnosis and surgical treatment could be challenging, especially trying to preserve nerve integrity and function.

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