Solutions to Two Difficult Surgical Problems in Musicians: Modified Surgical Techniques for Basal Thumb Arthritis and Trigger Finger

2008 ◽  
Vol 23 (1) ◽  
pp. 16-19
Author(s):  
R Ragoowansi ◽  
I Winspur
Keyword(s):  
General Population ◽  
Functional Outcome ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
Trigger Finger ◽  
Thumb Carpometacarpal ◽  
Joint Arthritis ◽  
Cmc Joint ◽  
A1 Pulley ◽  
Population Yield

Basal thumb joint arthritis and trigger finger are problems encountered in musicians. Routine surgical procedures to treat these disorders in the general population yield predictable results with good functional outcome. However, in piano players, routine arthroplasty of the thumb carpometacarpal (CMC) joint cannot meet the specific demands of full opposition/rotation and extension/span. In guitar players and string players, standard release of the A1 pulley for trigger finger can compromise fine distal control of the fingertip in extreme flexion. In this paper, we describe modifications of these procedures tailored to meet the functional demands of pianists, violinists, and guitarists.

scholarly journals The Management of Trigger Finger: A 5-Year Retrospective Review

2021 ◽  
Vol 4 (2) ◽  
Keyword(s):  
General Population ◽  
Retrospective Review ◽  
Flexor Tendon ◽  
Age Of Onset ◽  
Ring Finger ◽  
Trigger Finger ◽  
Dominant Hand ◽  
Increased Risk ◽  
Stenosing Tenosynovitis ◽  
A1 Pulley

Stenosing tenosynovitis, generally known as Trigger Finger (TF), is a common hand disorder characterized by pain and locking of the affected digit, which is often found on the dominant hand [1- 3]. This locking occurs when swelling or thickening of the flexor tendon restricts its ability to glide through the A1 pulley during flexion or extension [4, 5]. The general population has a two percent lifetime risk of developing trigger finger, with an average age of onset of 50 years [6, 7]. Women are affected up to six times more than men and diabetics have an increased risk of 10% [8, 9]. Although all digits are susceptible, evidence has shown the ring finger and thumb to be the most affected [10].

scholarly journals Percutaneous Trapeziometacarpal Arthrodesis in Thumb Carpometacarpal Joint Arthritis: A New Surgical Approach

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
D. Mifsut-Miedes ◽  
J. R. Rodríguez-Collell ◽  
A. Valverde-Navarro ◽  
E. M. González-Soler
Keyword(s):  
Minimally Invasive ◽  
Scientific Evidence ◽  
Surgical Techniques ◽  
Invasive Technique ◽  
Carpometacarpal Joint ◽  
Invasive Approach ◽  
Thumb Carpometacarpal Joint ◽  
High Prevalence ◽  
Thumb Carpometacarpal ◽  
Joint Arthritis

The high prevalence of trapeziometacarpal arthritis has resulted in the development of several surgical techniques intended to treat patients failing conservative treatment. However, there is no scientific evidence of the superiority of one technique over others. Open arthrodesis has up to now been successfully used to treat this condition. We believe that performing the technique using a minimally invasive approach with long and short Shannon burrs together with the tapered burr included in the MIS foot instrument set can yield satisfactory results. This article provides a description of this minimally invasive technique performed on a seventy-year-old woman with rhizarthrosis and an anatomical description of the approach in a human cadaver.

scholarly journals Pediatric Trigger Finger due to Osteochondroma

Hand ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 99-105 ◽  
Author(s):  
Ricardo Kaempf de Oliveira ◽  
Pedro J. Delgado ◽  
João Guilherme Brochado Geist
Keyword(s):  
Proximal Phalanx ◽  
Tumor Resection ◽  
Surgical Techniques ◽  
Trigger Finger ◽  
Initial Visit ◽  
Initial Portion ◽  
A2 Pulley ◽  
Finger Motion ◽  
Bone Tumor Resection ◽  
A1 Pulley

Background: The trigger finger is characterized by the painful blocking of finger flexor tendons of the hand, while crossing the A1 pulley. It is a rare disease in children and, when present, is usually located in the thumb, and does not have any defined cause. Methods: We report 2 pediatric trigger finger cases affecting the long digits of the hand that were caused by an osteochondroma located at the proximal phalanx. Both children held the diagnosis of juvenile multiple osteochondromatosis. They had presented at the initial visit with a painful finger blocking. Surgical approach was decided with wide regional exposure, as compared with the trigger finger traditional surgical techniques, with the opening of the A1 pulley and the initial portion of the A2 pulley, along with bone tumor resection. Results: Patients evolved uneventfully, and recovered the affected finger motion. Conclusion: It is important to highlight that pediatric trigger finger is a distinct ailment from the adult trigger finger, and also in children is important to differentiate whenever the disease either affects the thumb or the long fingers. A secondary cause shall be sought whenever the long fingers are affected by a trigger finger.

scholarly journals 208 First and Second Metacarpal Arthrodesis - Salvage Procedure for Failed Thumb Carpometacarpal Joint Arthritis Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Manoharan ◽  
J Edakalathur ◽  
S Pickard
Keyword(s):  
Literature Search ◽  
Ligament Reconstruction ◽  
Salvage Procedure ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Primary Procedure ◽  
Surgical Options ◽  
Thumb Carpometacarpal ◽  
Joint Arthritis ◽  
Cmc Joint

Abstract Aim There are various surgical options for the management of thumb carpometacarpal joint (CMCJ) arthritis. These include first metacarpal osteotomy, trapeziectomy with or without ligament reconstruction, CMCJ arthrodesis and arthroplasty. However, if these operations fail, the options for salvage are limited. The authors aim to offer ‘first and second metacarpal arthrodesis (FSMA)’ as a salvage procedure for failed first CMC joint surgeries. The authors also reviewed the literature on FSMA. Method Literature search Operative Technique Results Literature search Conclusions FSMA is a good salvage option for failed surgical treatment of thumb CMCJ arthritis. FSMA can also be utilised as a primary procedure for various indications.

Osteoarthritis of the Thumb Basilar Joint

2020 ◽  
Author(s):  
Andrew J Straszewski ◽  
Jennifer Moriatis Wolf
Keyword(s):  
Treatment Options ◽  
Treatment Modalities ◽  
Hand Osteoarthritis ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
The Many ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition ◽  
Joint Arthritis ◽  
Cmc Joint

Osteoarthritis of the thumb basilar joint is a common pathology treated by hand surgeons, and this is the leading cause of degenerative pain in the hand. Multi-factorial etiologies, including occupational stresses, gender, hormone milieu, and altered biomechanics, may play roles in the development of thumb carpometacarpal (CMC) joint arthritis.  Patients present with aching pain, synovitis, weakened pinch and grip, and in late disease, adduction deformity and web space contracture. Physical examination and plain radiography are the mainstay of diagnosis, with little utility for advanced imaging.  A multitude of options exists for conservative treatment: physical therapy, splinting, anti-inflammatories, and injections.  With the failure of conservative therapies, surgical management is dictated by disease severity and provider preference.   The thumb CMC joint hosts a variety of treatment options that have evolved over time: arthroscopy, osteotomy, arthrodesis, trapeziectomy alone, or with combinations of ligament reconstruction and tendon interposition.  No superiority has been shown amongst the many base of thumb treatment modalities, though trapeziectomy alone demonstrates a lower complication rate. This review contains 5 tables, 3 figures, and 61 references. Keywords: hand osteoarthritis, base of thumb, anatomy, arthroplasty, silicone, arthrodesis, tendon reconstruction, biomechanics, tendon interposition, outcomes

Trapeziometacarpal narrow pseudarthrosis: a new surgical technique to treat thumb carpometacarpal joint arthritis

2012 ◽  
Vol 38 (8) ◽  
pp. 844-850 ◽  
Author(s):  
M. Rubino ◽  
A. Civani ◽  
D. Pagani ◽  
V. Sansone
Keyword(s):  
Clinical Outcome ◽  
Surgical Techniques ◽  
Pinch Strength ◽  
Dash Score ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Excision Arthroplasty ◽  
Joint Arthritis

We describe a technique that arose from the observation of the clinical outcome of failed arthrodeses of the thumb carpometacarpal joint. In these cases a pseudoarthrosis developed which, surprisingly, rarely lead to a poor clinical outcome. Thus we developed a simple technique which deliberately caused the formation of a narrow pseudoarthrosis in the carpometacarpal joint. We present a retrospective review of 248 consecutive patients treated for Eaton stages II and III osteoarthritis. We observed a statistically significant improvement in mean appositional and oppositional pinch strength, mean DASH score (63.8 pre-operatively to 10.5 at final follow-up), and the mean pain score (8.3 to 0.2). We conclude that trapeziometacarpal limited excision arthroplasty is a simple and reliable alternative to existing surgical techniques for treating Stage II or III thumb carpometacarpal joint arthritis.

Capitolunate Instability and Clinical Outcomes after Resection of the STT Joint in CMC Joint Arthritis

2015 ◽  
Vol 04 (S 02) ◽  
Author(s):  
Mark Ross ◽  
David Gilpin ◽  
Susan Peters ◽  
Bradley Gilpin ◽  
Gregory Couzens
Keyword(s):  
Clinical Outcomes ◽  
Joint Arthritis ◽  
Cmc Joint

Subtotal Pedal Amputations

2001 ◽  
Vol 91 (1) ◽  
pp. 6-12 ◽  
Author(s):  
Christopher Funk ◽  
Gregg Young
Keyword(s):  
Functional Outcome ◽  
Diabetic Foot ◽  
Surgical Techniques ◽  
Surgical Correction ◽  
Proper Treatment ◽  
Review Of The Literature ◽  
Human Foot

Proper treatment for the compromised diabetic foot often requires surgical correction and subtotal pedal amputation. This article discusses various levels of amputation of the human foot, including digital, ray, transmetatarsal, midfoot, and Syme amputations. Surgical techniques and biomechanical considerations are presented in order to assist the surgeon in planning for the most functional outcome of the patient. A review of the literature and the experiences of the authors are presented. (J Am Podiatr Med Assoc 91(1): 6-12, 2001)

FUNCTIONAL OUTCOME OF DISTAL FEMORAL FRACTURES AND THEIR MANAGEMENT

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Raman Shrivastava ◽  
Namita Shrivastava
Keyword(s):  
Functional Outcome ◽  
Surgical Techniques ◽  
Femoral Fractures ◽  
Railway Track ◽  
Distal Femoral Fractures ◽  
Minimally Invasive Surgical ◽  
Fall From Height ◽  
Classification Management ◽  
A Prospective Study ◽  
Jawaharlal Nehru

Background: Fractures of distal end of femur are complex injuries which are difficult to manage. These fractures often are unstable and comminuted. Despite advances in surgical techniques and improvement in implants, treatment of distal femoral fractures remains a challenge in many situations. This study was done to analyse the functional outcome and this management of distal femoral fractures. Material & Methods: This study has been done between August 2008 to March 2010 on patients coming to Orthopaedics Department at Jawaharlal Nehru Hospital and Research Center, Bhilai. It is a prospective study which includes 25 patients with 10 Type A, 7 Type B and 8 Type C fractures of distal femur after fulfilling the inclusion and exclusion criteria. Results: Mean age of 47.08 years with sex incidence of 3.17:1(M:F). Mode of injury was RTA in 16, simple fall in 6, fall from height in 2 and railway track accident in 1 patient. There were 5-A1, 1-A2, 4-A3, 3-B1, 1-B2, 3-B3, 1-C1, 4-C2 and 3-C3 fractures. Results were found to be excellent in 17, good in 1, moderate in 3 and poor in 4 patients. Conclusion: We conclude that minimally invasive surgical techniques and with the availability of locking type of plates distal femoral fractures can now be dealt with more precessions and more satisfactory results can be produced. Keywords: Distal fractures, Muller Classification, Management, Femoral fractures

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