scholarly journals The benefit of radiologically-guided steroid injections for trapeziometacarpal osteoarthritis

2010 ◽  
Vol 92 (8) ◽  
pp. 680-684 ◽  
Author(s):  
MG Swindells ◽  
AJ Logan ◽  
DJ Armstrong ◽  
P Chan ◽  
FD Burke ◽  
...  
Keyword(s):  
Observational Study ◽  
Local Anaesthetic ◽  
Common Condition ◽  
Trapeziometacarpal Joint ◽  
Steroid Injections ◽  
Analgesic Effects ◽  
Trapeziometacarpal Osteoarthritis ◽  
Significant Disability

INTRODUCTION Osteoarthritis of the trapeziometacarpal joint (TMJ) is a common condition causing significant disability. Conservative treatments include intra-articular steroid injections. PATIENTS AND METHODS This clinical, observational study prospectively reviewed the longevity of benefit of steroid injections into the TMJ. Eighty-three patients were recruited with a median age of 62 years and injected with steroid and local anaesthetic under radioscopic guidance. They were followed up until the analgesic effects ceased with a questionnaire including visual analogue scores. RESULTS Two-thirds of patients were improved at 2 months, with nearly half having a 3-month improvement. One in six patients had a 6-month benefit, with some patients still improved 2 years after injection. Previously injected patients had a reduced duration of benefit compared to their previous injection. Severity of osteoarthritis did not affect the injection efficacy. CONCLUSIONS Based on this study, we recommend steroid injections in all degrees of TMJ osteoarthritis.

scholarly journals Vascular access cannulation and haemostasis: a national observational study of French practices

2020 ◽  
Author(s):  
Marion Sallée ◽  
Lucile Mercadal ◽  
Guillaume Jean ◽  
Bruno Guery ◽  
Didier Borniche ◽  
...  
Keyword(s):  
Observational Study ◽  
Arteriovenous Fistula ◽  
Skin Reaction ◽  
Local Anaesthetic ◽  
Calcium Alginate ◽  
Patient Knowledge ◽  
Know How ◽  
Allergic Skin ◽  
Improve Patient ◽  
Allergic Skin Reaction

Abstract Background We report the results of an observational study of arteriovenous fistula (AVF) cannulation and haemostasis practices in France. Methods The study (sponsored by Brothier Pharmaceutical Inc.) was conducted in 150 dialysis units. Data obtained from 150 supervisory nurses, 1538 nurses and 3588 patients with an AVF were analysed. Results The nurses reported using rope-ladder, area or buttonhole cannulation techniques in 68, 26 and 6% of cases, respectively. Metal needles were used most frequently (64%), with mainly a diameter of 15 G or 16 G. The needle was introduced with the bevel up in 56% of cases. Compression applied using dressings (in particular, pure calcium alginate dressings) was the method of choice for haemostasis of the puncture sites and was assessed as being strong by most of the nurses and very strong in cases of prolonged bleeding. Most (82%) of the patients reported the use of local anaesthetic before cannulation and 23% reported an allergic skin reaction to the anaesthetic. Bleeding of the puncture sites lasted for >10 min for 48% of the patients and it reappeared between two sessions for 29% of the patients. Whereas the nurses appeared to have a good understanding of AVF, more than half of the patients did not know how to care for it, with 55% requiring more information. Conclusions This study underlines the lack of national consensus concerning AVF cannulation practices. It suggests that haemostasis methods of the puncture sites can be improved and it highlights the need to improve patient knowledge.

Bilateral Osteoarthritis of the Trapeziometacarpal Joint Treated by Bilateral Tendon Interposition Arthroplasty

1997 ◽  
Vol 22 (1) ◽  
pp. 96-99 ◽  
Author(s):  
A. DAMEN ◽  
B. VAN DER LEI ◽  
P. H. ROBINSON
Keyword(s):  
Long Term Results ◽  
Interposition Arthroplasty ◽  
Trapeziometacarpal Joint ◽  
Flexor Carpi Radialis ◽  
Trapeziometacarpal Osteoarthritis ◽  
Tendon Interposition

Twenty-four flexor carpi radialis (FCR) tendon interposition arthroplasties of the trapezium for bilateral trapeziometacarpal osteoarthritis were reviewed. Pain was reduced in all cases. Function was improved in all right hands and in 92% of the left hands. FCR tendon interposition arthroplasty for bilateral trapeziometacarpal osteoarthritis yields satisfactory long-term results on both sides.

scholarly journals 942 Outcome of Image Guided Intra-Articular Thumb Base Steroid Injections-Retrospective Study of Consecutive Patient Over 4 Years in A Plastic and Hand Surgery Unit in West Lothian, Scotland

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N N Thazhathe Peedika ◽  
P Goswami
Keyword(s):  
Pain Relief ◽  
Image Intensifier ◽  
Hand Surgery ◽  
The Elderly ◽  
Operative Management ◽  
Steroid Injections ◽  
Image Guided ◽  
Subjective Pain ◽  
Significant Disability ◽  
Hospital Management System

Abstract Introduction Osteoarthritis of the thumb base is a common condition. Usually effects the elderly population causing significant disability. Modalities of treatment of osteoarthritis which includes conservative measures, non-operative interventions, and surgery. In this study we endeavored to assess how effective are image guided steroid injections for base of thumb Osteoarthritis as assessed by subjective pain relief perceived by patient and what percentage of these patients proceed to operative treatment. Method Retrospective data between January 2015 and December 2018 of the patients who underwent Steroid injections to the Base of thumb joints (CMCJ and/or STTJ) for Osteoarthritis under image intensifier guidance was collected from Hospital management system –TRAK and eHealth services. Follow up of the patients were done for Maximum 1 to 5 years. Results A total number of 692 patients with thumb base osteoarthritis were included in the study of which 546 patients underwent Image guided steroid injection to the thumb base. The mean Age of patients was 64.5 years and the Female: Male ratio was 401:145. Mean number of injections each patient received- 3.25 (1 – 7 times). Pain relief after first, second and third injections were 3.15 months, 2.63 and 1.75 months, respectively. 127 (23.2% of injections patients) underwent trapeziectomy. Mean time between first injection & Surgery was 1.3yrs (6 months -2 years) Conclusions This study demonstrates the effectiveness of image guided steroid injections for thumb base osteoarthritis. Though about a quarter of these patients proceed to operative management, steroid injections can delay the same considerably.

scholarly journals An observational study to compare the outcome of local steroid injections and ultrasonic wave therapy in frozen shoulder patients

2018 ◽  
Vol 4 (1b) ◽  
pp. 98-101
Author(s):  
Dr. Rajinder Kumar ◽  
Dr. Nitin Bansal ◽  
Dr. AS Sidhu ◽  
Dr. Parminder Singh Kular ◽  
Dr. Swapnil Sharma ◽  
...  
Keyword(s):  
Observational Study ◽  
Ultrasonic Wave ◽  
Frozen Shoulder ◽  
Steroid Injections

scholarly journals SURGICAL TREATMENT OF TRAPEZIOMETACARPAL OSTEOARTHRITIS (REVIEW)

2018 ◽  
Vol 24 (3) ◽  
pp. 135-144
Author(s):  
L. A. Rodomanova ◽  
I. V. Orlova
Keyword(s):  
Surgical Treatment ◽  
Life Quality ◽  
Pain Syndrome ◽  
Key Factors ◽  
Trapeziometacarpal Joint ◽  
Trapeziometacarpal Osteoarthritis ◽  
Surgical Options ◽  
Criteria For Selection ◽  
Selection Of

 The sellar joint plays a key role in wrist function ensuring thumb contraposition when gripping. Lesions of sellar joint are accompanied by pain syndrome and deformity of the first metacarpal which substantially affects life quality of the patients. The authors carried the analysis of literature dedicated to surgical treatment of degenerative lesions of trapeziometacarpal joint. The present review describes features of joint anatomy and biomechanics, reports the key factors contributing to disease progression, covers various approaches and criteria for selection of surgical options for reconstruction of sellar joint. 

scholarly journals Efficacy of local anaesthetic and steroid combination in prevention of post-herpetic neuralgia: A meta-analysis

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Xiaolu Zhang ◽  
Zhiwei Wang ◽  
Yiyuan Xian
Keyword(s):  
Nerve Block ◽  
Local Anaesthetic ◽  
Meta Analysis ◽  
Local Anaesthetics ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Post Herpetic Neuralgia ◽  
Steroid Injections ◽  
Creative Commons ◽  
Neuralgic Pain

Objective: The objective was to provide synthesized evidence on the efficacy of local anaesthetics and steroid injections for prevention and management of PHN, compared to the standard treatment using anti-viral and analgesic medications. The primary outcomes of interest were incidence of PHN and duration of neuralgic pain. Methods: Comprehensive searches were done systematically through PubMed, Scopus, Cochrane Central Register of Controlled Trials and Google scholar databases. Randomized controlled trials that compared the efficacy of local anaesthetics and steroid injections for preventing and managing PHN were included for this meta-analysis. A comprehensive search was done for papers published until 15th July 2021. Results: A total of 10 RCTs were included in the meta-analysis. In the overall pooled analyses, compared to standard care/placebo, those receiving a combination of local anaesthetic and steroid injection had 55% lower risk of PHN at 3 months from onset of rash (RR 0.45; 95% CI, 0.29; 0.70). Out of the different modes of intervention delivery i.e., intravenous, subcutaneous and nerve block, maximum beneficial effect in reducing the incidence of PHN was noted in nerve block (RR 0.55; 95% CI, 0.34, 0.89). Conclusions: The meta-analysis provides some evidence to support the use of combined local anaesthetic and steroids in reducing risk of post-herpetic neuralgia and duration of neuralgic pain in patients with herpes zoster rash. doi: https://doi.org/10.12669/pjms.38.3.5140 How to cite this:Zhang X, Wang Z, Xian Y. Efficacy of local anaesthetic and steroid combination in prevention of post-herpetic neuralgia: A meta-analysis. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5140 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

FIVE TO EIGHT YEARS FOLLOW-UP FOR TRAPEZIECTOMY AND WEILBY LIGAMENT RECONSTRUCTION FOR THE TREATMENT OF TRAPEZIOMETACARPAL OSTEOARTHRITIS

Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 369-373 ◽  
Author(s):  
A. S. C. Bidwai ◽  
W. J. Marlow ◽  
Y. Khan ◽  
M. Waseem
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Ligament Reconstruction ◽  
Interposition Arthroplasty ◽  
Trapeziometacarpal Joint ◽  
Post Surgery ◽  
Trapeziometacarpal Osteoarthritis ◽  
And Function

Trapeziectomy and Weilby ligament reconstruction is a recognized treatment for osteoarthritis of the trapeziometacarpal joint. Studies published using this procedure have limited follow-up post-surgery. In this series of 24 cases assessed objectively and 36 subjectively with a minimum follow-up of five years, patients continue to have pain relief and function comparable to the opposite non-operated hand. Patient satisfaction is high at 92% and the rate of complications is low. Despite these encouraging results the need for interposition arthroplasty and/or ligament reconstruction in addition to trapeziectomy alone is discussed.

Management of hyperextension of the metacarpophalangeal joint in association with trapeziometacarpal joint osteoarthritis

2011 ◽  
Vol 36 (4) ◽  
pp. 280-284 ◽  
Author(s):  
R. J. Poulter ◽  
T. R. C. Davis
Keyword(s):  
Clinical Outcome ◽  
Kirschner Wire ◽  
Metacarpophalangeal Joint ◽  
Sesamoid Bone ◽  
Bone Anchor ◽  
Trapeziometacarpal Joint ◽  
Trapeziometacarpal Osteoarthritis ◽  
Trapeziometacarpal Joint Osteoarthritis

This study investigates the management of metacarpophalangeal joint (MCP) hyperextension in patients undergoing trapeziectomy for thumb base osteoarthritis. A total of 297 thumbs with painful trapeziometacarpal osteoarthritis were assessed on pain and thumb key and tip pinch preoperatively and at 1 year. Before surgery 101 had no MCP hyperextension, 168 had hyperextension ≤30° and 28 had hyperextension ≥35°. Of these 157 hyperextension deformities ≤30° and eight ≥35° were not treated. The others were treated by temporary insertion of a Kirschner wire (n = 9), MCP fusion (n = 6), sesamoid bone tethering to the MC head (n = 5) and palmar capsulodesis using a bone anchor (n = 11). Untreated MCP hyperextension deformities <30° did not influence the outcome of trapeziectomy. MCP hyperextension deformities ≥35° can be improved by capsulodesis or MCP fusion but this may not improve the clinical outcome.

scholarly journals Nerve Anastomosis-our Experience of Thirteen Cases

2019 ◽  
Vol 9 (1) ◽  
pp. 33-38
Author(s):  
Kaisar Haroon ◽  
Tania Taher ◽  
Shafiul Alam ◽  
Abdullah Alamgir ◽  
Md Arif Reza ◽  
...  
Keyword(s):  
Observational Study ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Motor Function ◽  
Peripheral Nerve Injury ◽  
Common Condition ◽  
Life Threatening ◽  
Nerve Anastomosis ◽  
Grade 3

Background: Peripheral nerve injury is a common condition. Though it is not life threatening, it may cause disability to a person. In this study we have analysed our experience of anastomosis of injured nerves. Materials and methods: This is an observational study that was done within a period from January 2014 to December 2018. 13 patients with injury to the nerves were operated upon. There were 11 male and 2 female patients. All patients were followed up in OPD upto one and half years. 5 patients were lost from follow up, of these, two were female. Results: After surgery, touch returned in 5 patients. Of motor function,there was no improvement in 1 patient, grade 1 in 1 patient, grade 2 in 4 patients and grade 3 in 3 patients. Those who came earlier had better outcome, so had those with small injury and distal to the limb. Conclusion: peripheral nerve injury has to be repaired as soon as possible. The sooner it can be done the better will be the outcome. Bang. J Neurosurgery 2019; 9(1): 33-38

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