scholarly journals A prospective study on outcome of function after proximal row carpectomy

Author(s):  
Chaitanya Gadi ◽  
S. M. Venugopal ◽  
Bhaskaranand Kumar ◽  
Karthik Gudaru

<p class="abstract"><strong>Background:</strong> Proximal row carpectomy (PRC) is a procedure with varied indications. The purpose of this study was to evaluate functional outcomes with PRC in wrist flexion deformities, neuromuscular disorders and also post-traumatic wrist arthritis.</p><p class="abstract"><strong>Methods:</strong> A prospective study was performed on all patients who underwent PRC between April 2015 and December 2017, in BIRRD (T) hospital, Tirupati, Andhra Pradesh with a minimum follow up of 6 months. Outcome was assessed in terms of range of motion (ROM), grip strength, quick disabilities of the arm, shoulder, and hand (QDASH) score and pain score. Data was analyzed using the Student t-test.<strong></strong></p><p class="abstract"><strong>Results:</strong> Thirty-two patients underwent PRC of which 12 are neuromuscular disorders, 10 are wrist flexion deformities, 10 are post-traumatic wrist arthritis. On the final follow-up, significant improvement in ROM was observed in wrist flexion deformities and neuromuscular disorders, whereas grip strength and QDASH scores showed a significant difference in post-traumatic wrist arthritis. Pain was studied only in post-traumatic wrist arthritis, all were very much pleased with pain reduction.</p><p class="abstract"><strong>Conclusions:</strong> PRC is fairly a reliable procedure for all the indications in our study. We consider that PRC is a promising procedure in correcting wrist flexion deformities. Though there has been significant improvement in all the parameters for all the cases, we consider this procedure is best suited for post-traumatic arthritis group.</p>

1998 ◽  
Vol 23 (3) ◽  
pp. 400-401 ◽  
Author(s):  
F. VANG HANSEN ◽  
H. STAUNSTRUP ◽  
S. MIKKELSEN

In a prospective study of Colles’ fractures, 100 patients with Older type 1 and 2 fractures were randomized in two groups. One group was immobilized for 3 weeks and the other one for 5 weeks. Both groups were immobilized with a below-elbow plaster splint. At 1 year follow-up, there were 73 patients with 74 fractures. Dorsal angulation, radial length, wrist motion, grip strength and pain were measured. There was no significant difference in the measured parameters in the two groups. We found that 3 weeks of immobilization is a satisfactory treatment for Older type 1 and 2 Colles’ fractures.


2021 ◽  
Vol 10 (9) ◽  
pp. 1865
Author(s):  
Stefan M. Froschauer ◽  
Matthias Holzbauer ◽  
Dietmar Hager ◽  
Oskar Kwasny ◽  
Dominik Duscher

High complication rates in total wrist arthroplasty (TWA) still lead to controversy in the medical literature, and novel methods for complication reduction are warranted. In the present retrospective cohort study, we compare the outcomes of the proximal row carpectomy (PRC) method including total scaphoidectomy (n = 22) to the manufacturer’s conventional carpal resection (CCR) technique, which retains the distal pole of the scaphoid (n = 25), for ReMotion prosthesis implantation in non-rheumatoid patients. Mean follow-up was 65.8 ± 19.8 and 80.0 ± 28.7 months, respectively. Pre- and postoperative clinical assessment included wrist flexion-extension and radial-ulnar deviation; Disability of Arm, Shoulder, and Hand scores; and pain via visual analogue scale. At final follow-up, grip strength and satisfaction were evaluated. All complications, re-operations, and revision surgeries were noted. Clinical complications were significantly lower in the PRC group (p = 0.010). Radial impaction was detected as the most frequent complication in the CCR group (n = 10), while no PRC patients suffered from this complication (p = 0.0008). Clinical assessment, grip strength measurements, and the log rank test evaluating the re-operation as well as revision function showed no significant difference. All functional parameters significantly improved compared to preoperative values in both cohorts. In conclusion, we strongly recommend PRC for ReMotion prosthesis implantation.


2013 ◽  
Vol 2 (1) ◽  
pp. 14-20 ◽  
Author(s):  
RR Manandhar ◽  
S Lakhey ◽  
BK Pandey ◽  
RL Pradhan ◽  
S Sharma ◽  
...  

Background: Displaced Colles fractures are generally treated by manipulation and below elbow cast application. Malunion is a common complication resulting in pain, mid carpal instability and post-traumatic arthritis. Fracture stabilization by percutaneous pinning is a simple, minimally invasive technique which helps prevent dislodgment of the fracture thereby minimizing complications. The study aims to assess the amount of collapse after closed manipulation and percutaneous pinning with K-wires and its correlation with the functional outcome of the wrist after union. Methods: A prospective study was conducted from October 2006 to November 2009. Fifty adults (27 female, 23 male) with an average age of 40.72 years with type II fractures underwent closed manipulation and percutaneous pinning with crossed K-wires as the primary procedure. Serial radiographs were taken to document the amount of collapse. The functional outcome was assessed using Mayo Wrist Score. Results: At the final follow up of 6 months the collapse in the mean dorsal angle was 1.15 and mean ulnar variance 0.51. Functionally 25 patients (53.19%) had excellent, 17 patients (36.17%) good and 5 patients (10.63%) had satisfactory or fair outcome. Conclusions: Displaced Colles fractures should be reduced and stabilized with percutaneous K-wires to achieve an excellent functional outcome. DOI: http://dx.doi.org/10.3126/noaj.v2i1.8135 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 14-20


Hand Surgery ◽  
2012 ◽  
Vol 17 (03) ◽  
pp. 341-345 ◽  
Author(s):  
Jacqueline Siau Woon Tan ◽  
Agnes Beng-Hoi Tan

A prospective study of 74 patients who underwent open carpal tunnel releases was conducted, with a follow-up period of six months. We analyzed multiple preoperative variables in order to identify factors that might predict outcomes. These outcomes included improvement in symptom severity and functional severity scores, grip strength as well as patient satisfaction. All the patients showed improvement in symptoms with 72% showing complete symptomatic relief, 74% showing improvement in function and 66% showing improvement in grip strength, and 82% were either completely or very satisfied with the results of surgery. Older patients and patients with weakness were associated with poorer outcomes. Higher preoperative symptom severity and functional severity scores were also associated with less improvement in symptoms and function, respectively. This information would benefit the surgeons and patients during preoperative counseling and help facilitate the decision-making process for both parties.


1998 ◽  
Vol 23 (3) ◽  
pp. 406-409 ◽  
Author(s):  
R. LUCHETTI ◽  
O. SORAGNI ◽  
T. FAIRPLAY

From 1990 to 1994, nine proximal row carpectomies were done through a palmar approach. With an average follow-up of 20 months, seven of the nine patients were completely painfree. Average range of wrist flexion/extension remained unchanged, and average radial/ulnar deviation increased from 25° to 46°. All the patients demonstrated an increase in grip strength in the operated hand. Four cases showed a slight reduction in articular space and subchondral sclerosis in the radiocapitate articulation, in spite of good function. Dynamic studies demonstrated no sign of radiocarpal instability. All the patients were very satisfied with the results and returned to their previous work within 2 months, on average.


1993 ◽  
Vol 18 (6) ◽  
pp. 750-752 ◽  
Author(s):  
W. J. LEACH ◽  
C. ESLER ◽  
T. D. SCOTT

To monitor the effect of open carpal tunnel decompression on grip strength in the hand, a prospective study was made of 25 patients undergoing a total of 31 operations. Hand grip, key pinch and pulp-to-pulp pinch strengths were measured pre-operatively and at regular intervals until 1 year following operation. At that time there was no significant difference in the hand grip and pulp-to-pulp pinch strengths compared to their pre-operative values, but the key pinch in females showed a marginally significant reduction ( P=0.04) compared to the pre-operative value.


2019 ◽  
Vol 65 (3) ◽  
pp. 97-102
Author(s):  
Maximilian Cosma Gliga ◽  
Ionela Maria Pascanu ◽  
Camelia Gliga ◽  
Ancuta Elena Zahan ◽  
Iulian Merlan

AbstractObjective: The purpose of this study was to investigate the benefits of two different Selenium based supplements on patients with chronic autoimmune thyroiditis.Methods: We conducted a prospective study on 50 patients with chronic autoimmune thyroiditis, who were divided into three different treatment groups, one group taking Selenium 100 μg, one Procor T (a combination of Selenium 100 μg and other elements like copper, Zinc and Q10 Conenzyme) and one control group taking Placebo pills. We measured on two follow up visits the antibody levels (anti-thyroidperoxidase- TPO Ab) and offered each patient a standardised questionnaire regarding the thyroid-related quality of life (THYPROro).Results: At the 6 months follow up visit there was a statistically significant decrease in the antibody levels for each treatment group compared to the base levels. The THYPROro questionnaire scores showed an improvement in most aspects regarding the quality of life as well, but there was no significant difference between the placebo and the treated groups in the magnitude of this improvement.Conclusions: Based on our results, we could not identify a certain benefit in improving quality of life with the supplementation of Selenium, as the improvements were at a similar level for the patients who took Placebo pills. Further studies with more patients, as well as taking the Selenium defficiency in consideration (by measuring the basal serum level of Selenium for each patient) would be required to find the target group of patients who could have most benefits of Selenium-based supplementation.


2006 ◽  
Vol 64 (3a) ◽  
pp. 596-599 ◽  
Author(s):  
Roberto S. Martins ◽  
Mario G. Siqueira ◽  
Hougelli Simplício

This prospective study evaluates the possible advantages of wrist imobilization after open carpal tunnel release comparing the results of two weeks immobilization and no immobilization. Fifty two patients with idiopathic carpal tunnel syndrome were randomly selected in two groups after open carpal tunnel release. In one group (A, n=26) the patients wore a neutral-position wrist splint continuosly for two weeks. In the other group (B, n=26) no wrist immobilization was used. Clinical assessment was done pre-operatively and at 2 weeks follow-up and included the two-point discrimination test at the second finger and two questionnaires as an outcome measurement of symptoms severity and intensity. All the patients presented improvement in the postoperative evaluations in the three analyzed parameters. There was no significant difference between the two groups for any of the outcome measurements at the final follow-up. We conclude that wrist immobilization in the immediate post-operative period have no advantages when compared with no immobilization in the end result of carpal tunnel release.


2021 ◽  
Vol 8 (20) ◽  
pp. 1580-1585
Author(s):  
Prathyusha Yakkala ◽  
Rachita Dhurat ◽  
Meghana Phiske

BACKGROUND Diphenylcyclopropenone (DPCP) produces type IV hypersensitivity reaction, immune response being directed against a complex of contact agent hapten bound to proteins of viral origin that enhance wart regression. We wanted to evaluate the efficacy and safety of DPCP in multiple warts along with the various factors affecting DPCP response METHODS A prospective study with 49 patients older than 5 years with 5 or more warts in any area (except genital) was conducted. Patients were sensitized with 2 % DPCP solution and examined after 48 hours. Sensitization was graded as mild, moderate, severe or no sensitization. Patients with mild / moderate sensitization were further applied DPCP; patients with severe sensitization were included after subsidence of reaction and patients with no sensitization were excluded. After sensitization, weekly applications were made on warts. Concentration causing mild reaction was selected as optimal and was applied till lesion clearance. Follow up was for 3 months for recurrences. Response was graded as complete, partial and no response. RESULTS Males outnumbered females. Mean age was 23 years. Mean duration was 12 months. Recurrent and resistant warts were seen in 15 and 6 patients respectively. Mean number of warts was 15.6. 49 patients were tested for sensitization, 1 failed sensitization and 48 were continued with weekly DPCP. 2 developed distant eczematisation and 4 were lost to follow up. Out of 42, complete clearance was seen in 35 (83.3 %), partial in 3 (7.14 %) and no response in 4 (9.52 %). Local eczematisation, lymphadenopathy, hyperpigmentation were the side effects. Response was better with increasing age. Warts less than 6 months had 100 % response. There was no statistically significant difference between site and type of warts and response to DPCP, recurrent and untreated warts in terms of response and response to sensitization and final response. CONCLUSIONS DPCP is an excellent option for multiple / resistant warts with good safety profile. KEYWORDS Diphenylcyclopropenone, Multiple Warts, Safety, Efficacy, Various Factors Affecting Response


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