scholarly journals Outcomes of Surface Replacement Proximal Interphalangeal Joint Arthroplasty Using the Self Locking Finger Joint Implant: Minimum Two Years Follow-up

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 637-645 ◽  
Author(s):  
Issei Komatsu ◽  
Yoshiya Arishima ◽  
Hirotomo Shibahashi ◽  
Toshihito Yamaguchi ◽  
Yoshitaka Minamikawa
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
Grip Strength ◽  
Joint Arthroplasty ◽  
The Self ◽  
Dash Score ◽  
Surface Replacement ◽  
Vas Score ◽  
Pip Joint

Background: The Self Locking Finger Joint (SLFJ) implant is a new type of surface replacement implant. The purpose of this study was to evaluate midterm clinical outcomes of the proximal interphalangeal (PIP) arthroplasty with the SLFJ implant. Methods: We retrospectively studied 26 PIP joint arthroplasties using the SLFJ implant in 17 patients with osteoarthritis or posttraumatic osteoarthritis. Preoperative and postoperative range of motion, grip strength and key pinch, radiographic findings, and complications were evaluated. The Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale (VAS) score, course of pain, and patient satisfaction were obtained. Results: The mean follow-up time was 44 months (range, 24-76 months). The average active PIP joint arc of motion improved from 36° before surgery to 44° after surgery. Grip strength and key pinch showed no statistical difference between preoperative and postoperative assessments. The average DASH score and VAS score improved from 40 to 15 and from 5 to 1, respectively. Overall patient satisfaction was 94%. Ninety percent of implants showed osteointegration, and there were no radiographic signs of migration and loosening. Three joints (12%) showed abnormal heterotopic bone formation. Four joints (15%) had secondary surgery—1 joint needing joint head and socket replacement and 3 joints needing contracture release. Conclusions: Our minimum 2 years of follow-up evaluation of the SLFJ implant PIP joint arthroplasty demonstrated good pain relief and good overall patient satisfaction while maintaining joint range of motion. The SLFJ implant showed good osteointegration. Further longer-term prospective studies with various types of currently available implants are needed.

scholarly journals Outcomes of Surface Replacement Proximal Interphalangeal Joint Arthroplasty Through a Volar Approach: A Prospective Study

Hand ◽  
2016 ◽  
Vol 12 (3) ◽  
pp. 290-296 ◽  
Author(s):  
Thomas E. Trumble ◽  
Dennis J. Heaton
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
Joint Arthroplasty ◽  
Extensor Mechanism ◽  
Dash Score ◽  
Surface Replacement ◽  
Dorsal Approach ◽  
Volar Approach ◽  
Pip Joint ◽  
Central Slip

Background: The dorsal approach to the proximal interphalangeal (PIP) joint provides the advantage of improved visualization of the articular surface, while the disadvantage of a dorsal approach is the disruption of the central slip and extensor mechanism requiring a delay in range of motion exercises. A volar approach keeps the central slip and extensor mechanism intact, allowing for early range of motion. The goal of this study was to evaluate patient outcomes of surface replacement (SR) PIP joint arthroplasty performed through a volar approach. Methods: Twenty-one patients were evaluated with primary osteoarthritis of a single PIP joint and underwent SR arthroplasty using the Stryker SR PIP joint implants. Patients included in this study were exclusively treated through a volar approach. Preoperative range of motion, coronal plan deformity, Disabilities of the Arm, Shoulder and Hand (DASH), and patient satisfaction were measured and compared with postoperative measurements using a paired Student t test. Results: The average length of follow-up was 34 months (± 9 months). Postoperative arc of motion for the PIP and distal interphalangeal (DIP) joints measured 87° (±12°) and 36° (±11°), respectively. The average improvement in PIP arc of motion was 58°, DASH score measured 14 (±5), satisfaction measured 4 (±1), and coronal plane deviation measured 2° (±2°). No evidence of implant subsidence was found on postoperative radiographs. Four patients required an extensor tendon tenolysis, and 1 patient suffered a superficial surgical site infection. Conclusion: SR arthroplasty, when performed through a volar approach, allows for early range of motion and greater improvements in arc of motion, DASH score, and patient satisfaction.

scholarly journals Surface Replacement Proximal Interphalangeal Joint Arthroplasty: A Case Series

Hand ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 669-674
Author(s):  
Pieter W. Jordaan ◽  
Duncan McGuire ◽  
Michael W. Solomons
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
Retrospective Review ◽  
Case Series ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Surface Replacement ◽  
Significant Difference

Background: In 2012, our unit published our experience with a pyrocarbon proximal interphalangeal joint (PIPJ) implant. Due to high subsidence rates, a decision was made to change to a cemented surface replacement proximal interphalangeal joint (SR-PIPJ) implant. The purpose of this study was to assess whether the change to a cemented implant would improve the subsidence rates. Methods: Retrospective review of all patients who had a cemented SR-PIPJ arthroplasty performed from 2011 to 2013 with at least 12 months follow-up. Results: A total of 43 joints were included with an average follow-up of 26.5 months. There was a significant ( P = .02) improvement in arc of motion with an average satisfaction score of 3.3 (satisfied patient). Subsidence was noted in 26% of joints with a significant difference in range of motion ( P = .003) and patient satisfaction ( P = .001) between the group with and without subsidence. Conclusions: The change to a cemented implant resulted in satisfied patients with an improvement in range of motion. The rate of subsidence improved but remains unacceptably high.

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

scholarly journals Cross finger flap cover for fingertip injuries

2017 ◽  
Vol 3 (2) ◽  
pp. 164 ◽  
Author(s):  
Srinivasan Rajappa ◽  
Tarun Prashanth
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Full Range ◽  
Hand Injuries ◽  
University Hospital ◽  
Dash Score ◽  
Dominant Hand ◽  
Flap Viability ◽  
Flap Cover

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Fingertip injuries are the most common form of hand injuries. Restoration of the anatomy is a technical challenge and is one of the basic tenets of the management of fingertip injuries. The cross finger flap is simple and easy to do and is a very useful tool in reconstruction of the pulp of the finger. The project aimed to study the efficacy of cross finger flap in the coverage of fingertip injuries.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The study was conducted on a prospective basis in Sri Ramachandra University Hospital in Chennai. The study period was from May 2013 to August 2016.  All adults who had fingertip injuries who had undergone cross finger flap cover were included in the study. Patients who had other flaps for reconstruction and who were lost for follow-up were excluded from the study. Preoperative parameters which were recorded were mechanism of injury, size of defect, size of the flap, location of donor site and method of coverage of secondary defect. Outcome measures recorded were flap viability, flap sensibility using two-point discrimination, range of motion of fingers, grip strength and presence of other complications</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">40 patients were included in the study. Six were lost for follow-up. Mean follow-up was 14 months.  All flaps survived. Full range of motion was obtained in 87% of patients. Average grip strength was 94% for dominant hand injuries and 78% for non-dominant hand injuries. Mean quick DASH score was 10.5. Mean two-point discrimination was 15.4 mm. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Cross finger flap is very effective for coverage of volar fingertip defects with minimal residual problems.</span></p>

Results of the Volar Approach in Proximal Interphalangeal Joint Arthroplasty

2018 ◽  
Vol 23 (01) ◽  
pp. 26-32 ◽  
Author(s):  
Scott F. M. Duncan ◽  
Anthony A. Smith ◽  
Kevin J. Renfree ◽  
Ross M. Dunbar ◽  
Marianne V. Merritt
Keyword(s):  
Range Of Motion ◽  
Joint Destruction ◽  
Retrospective Chart Review ◽  
Deep Infection ◽  
Joint Arthroplasty ◽  
Posttraumatic Arthritis ◽  
Dorsal Approach ◽  
Volar Approach ◽  
Pip Joint

Background: Most hand surgeons use a dorsal approach for proximal interphalangeal (PIP) joint implant arthroplasty. However, a volar approach offers the advantage of no disturbance to the extensor mechanism, thus allowing early initiation of active range of motion. We examined our results in patients who underwent PIP joint arthroplasty via a volar approach. Methods: Using a retrospective chart review, we evaluated the outcomes of patients undergoing PIP joint arthroplasty through a volar approach between 2001 and 2005 by 3 fellowship-trained hand surgeons at our institution. The indication for surgery was PIP joint pain with radiographic evidence of joint destruction. Variables included implant type, diagnosis, affected digit(s), preoperative and postoperative range of motion, and complications. Hand therapy was initiated on postoperative day 3 or 4. Results: Over the 5 years, 25 PIP joints were replaced in 18 women and 2 men with the volar approach. Replacements consisted of 14 surface replacement prostheses, 9 pyrocarbon prostheses, and 2 silicone prostheses. The average age of patients at prosthesis implantation was 64 years (range, 39–75 years). Prostheses were placed in 1 index, 12 long, 7 ring, and 5 small digits. Average follow-up period was 33 months (range, 24–69 months). Preoperative diagnoses were osteoarthritis (14), rheumatoid arthritis (4), and posttraumatic arthritis (2). Preoperative total arc of motion averaged 42° (range, 0° extension to 80° flexion); postoperative total arc of motion averaged 56° (range, –10° extension to 90° flexion). Complications comprised 1 swan neck deformity, 1 deep infection, 1 dislocation (early), and 2 loose implants with flexion contractures. Seventeen patients had minimal or no pain at their last follow-up visit. Conclusions: PIP joint arthroplasty can be successfully implemented through a volar approach with various implant types and has outcomes similiar to the published results of the dorsal approach.

scholarly journals Wrist tuberculosis-experience from eighteen cases: a retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Longfei Zou ◽  
Xing Guo ◽  
Hao Xue ◽  
Denghua Huang ◽  
Hui Lv ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Range Of Motion ◽  
Grip Strength ◽  
Wrist Joint ◽  
Kirschner Wire ◽  
Clinical Manifestations ◽  
Postoperative Recovery ◽  
Dash Score ◽  
Wrist Fusion

Abstract Background Wrist tuberculosis is a rare disease, which is easy to be misdiagnosed, leading to delayed treatment and poor prognosis. In this study, the clinical manifestations, diagnosis, treatment, and prognosis of 18 cases of wrist tuberculosis were analyzed retrospectively. Methods A retrospective study was conducted, investigating tuberculosis of the wrist, diagnosed in 18 patients from August 2013 to November 2018. Puncture biopsy confirmed the diagnosis. The study includes 11 males and 7 females, and 8 left and 10 right wrists. The average age was 53.5 ± 18.3 years and ranged from 15 to 81 years. The disease course was 1 to 42 months, with an average of 15.1 ± 11.3 months. Eighteen patients were underwent surgery and chemotherapy, 3 patients with severe bone defects were treated with wrist fusion, and 15 patients were underwent focus removal. The Gartland and Werley score, DASH score, the range of motion (ROM), grip strength, and imaging examinations were used to evaluate the postoperative recovery of the patients. Results Eighteen patients were followed up for 15 to 77 months, with an average follow up of 39.7 ± 15.3 months. The ESR and CRP levels were normal for all patients after chemotherapy. No recurrence of tuberculosis was observed in any of the patients. Among the 15 focus removals, the Gartland and Werley scores at admission, two weeks of chemotherapy, 1 month after surgery, and the last follow-up were 21.73 ± 4.33, 18.60 ± 3.16,11.27 ± 2.79, and 5.07 ± 2.28, respectively; and the DASH scores were 45.87 ± 5.58, 39.47 ± 4.72, 22.67 ± 6.54, and 6.73 ± 2.94, respectively. The range of motion (ROM) of the wrist and grip strength improved significantly when compared to those at admission. Among the three cases of wrist fusion, 2 were fixed with a steel plate and the fixation position of wrist joint was good. One case was fixed with Kirschner wire and resulted in a slightly deformed wrist joint. Conclusion For patients with wrist tuberculosis, early diagnosis, preoperative and postoperative chemotherapy, thorough focus removal, and appropriate fixation of the affected limb can help restore the function of the affected wrist, reduce the recurrence rate, and improve the quality of life.

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.

Surface replacement trapeziometacarpal joint arthroplasty – early results

2009 ◽  
Vol 34 (6) ◽  
pp. 748-757 ◽  
Author(s):  
A. PENDSE ◽  
A. NISAR ◽  
S. Z. SHAH ◽  
A. BHOSALE ◽  
J. V. FREEMAN ◽  
...  
Keyword(s):  
Joint Arthroplasty ◽  
Dash Score ◽  
Surface Replacement ◽  
Trapeziometacarpal Joint ◽  
Early Results ◽  
Asymptomatic Patients ◽  
The Mean ◽  
Quick Dash ◽  
Tendon Interposition

This study reviews the results of Surface Replacement Trapeziometacarpal (SR TMC, Avanta®, San Diego, CA) total joint arthroplasty. Fifty patients (62 joints) were included in the study. Forty-three patients (54 joints) were seen at final follow up. Seven patients (eight joints) were interviewed over the phone. Seven patients were revised to trapeziectomy and ligament reconstruction with tendon interposition, five for aseptic loosening and two for dislocation. At final follow up, the mean Quick DASH score was 30.4 and the Sollerman Score was 77.3. Radiological review of the surviving 55 joints showed subsidence of four trapezial components in asymptomatic patients. Cumulative survival rate was 91% at 3 years. Eighty-five percent of the patients were satisfied with the outcome of their treatment.

scholarly journals Wrist Tuberculosis-experience From Eighteen Cases: A Retrospective Study

2020 ◽  
Author(s):  
longfei zou ◽  
meiyun tan ◽  
xing guo ◽  
jiang guo ◽  
hao xue ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Range Of Motion ◽  
Grip Strength ◽  
Wrist Joint ◽  
Kirschner Wire ◽  
Clinical Manifestations ◽  
Postoperative Recovery ◽  
Dash Score ◽  
Wrist Fusion

Abstract Background Wrist tuberculosis is a rare disease, easy to cause misdiagnosis, delay treatment and lead to poor prognosis. In this study, the clinical manifestations, diagnosis, treatment and prognosis of 18 cases of wrist tuberculosis were analyzed retrospectively. Methods We conducted a retrospective study investigating tuberculosis of the wrist, diagnosed in 18 patients from August 2013 to November 2018. Puncture biopsy confirmed the diagnosis. The study includes 11 males and 7 females, and 8 left and 10 right wrists. The average age was 53.5 ± 18.3 years and ranged from 15 to 81 years. The disease course was 1 to 42 months, with an average of 15.1 ± 11.3 months. Eighteen patients were treated with surgery and chemotherapy, 3 patients with severe bone defect were treated with wrist fusion, and 15 patients were treated with focus removal. The Gartland and Werley score, DASH score, the range of motion (ROM), grip strength, and imaging examinations were used to evaluate the postoperative recovery of the patients. Results Eighteen patients were followed up for 15 to 77 months, with an average follow up of 39.7 ± 15.3 months. The ESR and CRP levels were normal for all patients after chemotherapy. No recurrence of tuberculosis was observed in any of the patients. Among the 15 focus removal, the Gartland and Werley scores at admission, two weeks of chemotherapy, 1 month after surgery, and the last follow-up were 21.73 ± 4.33, 18.60 ± 3.16,11.27 ± 2.79, and 5.07 ± 2.28, respectively; and DASH scores were 45.87 ± 5.58, 39.47 ± 4.72,22.67 ± 6.54, and 6.73 ± 2.94, respectively. The wrist range of motion (ROM) and grip strength improved significantly compared to those at admission. Among the three cases of wrist fusion, 2 were fixed with a steel plate and the fixation position of wrist joint was good. One case was fixed with Kirschner wire and resulted in a slightly deformed wrist joint. Conclusion For the patients with wrist tuberculosis, early diagnosis, preoperative and postoperative chemotherapy, thorough focus removal, and appropriate fixation of the affected limb can help restore the function of the affected wrist, reduce the recurrence rate, and improve the quality of life.

scholarly journals Volar Plate Fixation in Patients Older Than 70 Years with AO Type C Distal Radial Fractures: Clinical and Radiologic Outcomes

2017 ◽  
Vol 06 (03) ◽  
pp. 194-200 ◽  
Author(s):  
Ezequiel Zaidenberg ◽  
Matias Duarte ◽  
Jorge Boretto ◽  
Agustin Donndorff ◽  
Gerardo Gallucci ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Range Of Motion ◽  
Grip Strength ◽  
Mayo Clinic ◽  
The Elderly ◽  
Contralateral Side ◽  
Dash Score ◽  
Distal Radial Fractures ◽  
Type C

Introduction Treatment of unstable distal radial fractures (DRFs) in elderly patients is controversial, and considering the increasing life expectancy, their appropriate treatment is of growing importance. Our aim was to analyze the clinical and radiologic outcomes in the elderly patients with AO type C DRF treated with volar locking plate (VLP). Materials and Methods Between 2007 and 2011, 572 DRFs were operated on in our hospital with open reduction and internal fixation with VLP. Of these, only 64 patients (66 DRFs) met the selection criteria (AO type C DRF, age > 70 years, minimum 12-month follow-up). Mean follow-up was 28 months. Outcome assessment included range of motion, grip strength, VAS pain, Mayo Clinic Score, and DASH score. Analysis of pre- and postoperative radiographs was performed. Complications were recorded. Statistical analysis was performed comparing the results with the contralateral side. Results Mean postoperative range of motion of the injured wrist compared with the control contralateral side was 86% for flexion (p < 0.001), 92% for extension (p < 0.001). The average DASH was 12. Mayo Clinic Wrist Score showed 43 excellent results, 15 good, 4 satisfactory, and 4 poor. Articular step-offs were reduced in 34 of 38 wrists. Five (7%) patients required plate removal. Conclusion The treatment of articular DRF (AO type C) with VLP in the elderly patients achieved greater than 90% of the wrist range of motion and grip strength with no residual pain in greater than 90% of the patients. Level of Evidence Therapeutic IV, case series.

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