scholarly journals Surgical treatment for persistent second carpometacarpal joint pain

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Taku Hatta ◽  
Hitoshi Goto ◽  
Kazuaki Sonofuchi ◽  
Shingo Nobuta ◽  
Satoshi Toh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pain Relief ◽  
Joint Pain ◽  
Clinical Characteristics ◽  
Stress Test ◽  
Restricted Range ◽  
Carpometacarpal Joint ◽  
Final Followup ◽  
Careful Assessment ◽  
Cmc Joint

The purposes of this study were to demonstrate the clinical characteristics of patients with persistent second carpometacarpal (CMC) joint pain without bony abnormalities known as the carpal boss, and to assess the clinical efficacy of surgical stabilization of the second CMC joint. Eleven patients had persistent wrist pain with characteristic symptoms, including tenderness over the second CMC joint, increased symptoms when the involved hand was placed on the ground or gripped strongly with the involved hand, a positive metacarpal stress test and temporary pain relief with the intra-articular injection of the lidocaine. The patients underwent arthrodesis of the second CMC joint. All cases showed radiologically confirmed fusion of the second CMC joint. At the final followup examination, 10 of 11 patients resulted in satisfactory clinical outcomes, excepting one patient with remnant pain and restricted range of wrist motions. This report highlights the importance of conducting a careful assessment of patients who present with persistent second CMC joint pain without the bony abnormalities, such as carpal bossing. Surgery to stabilize the second CMC joint may be an option to improve their symptoms when conservative treatment fails.

Effect of Extension Osteotomy of the 1st Metacarpal on Laxity of the Thumb Carpometacarpal Joint

2002 ◽  
Author(s):  
Matthew F. Koff ◽  
Niket Shrivastava ◽  
Amy E. Abbot ◽  
Benton E. Heyworth ◽  
Thomas R. Gardner ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hand Function ◽  
Joint Stiffness ◽  
Joint Laxity ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Common Solution ◽  
Clinical Literature ◽  
Thumb Carpometacarpal ◽  
Cmc Joint

Osteoarthritis (OA) of the human thumb carpometacarpal (CMC) joint is a debilitating disease. It has been proposed in the clinical literature that joint ligamentous laxity, or joint looseness, is a major etiological factor in OA of the CMC joint (Figure1) [1–4]. Previous investigations of laxity and stability of the human thumb CMC joint have been performed visually, with no quantitative measures of joint laxity recorded [5–7]. Surgical treatment has been a common solution to reduce the pain associated with CMC OA. One treatment, extension osteotomy of the 1st metacarpal, has been suggested not only to reduce the pain of OA, but also improve hand function [8], however, little is known about its biomechanical effects. A complete description of joint laxity requires that all physiological directions of motion be fully tested. A custom-designed, 4 degree of freedom tester was constructed and instrumented for displacement and load in the distraction-compression, dorsal-volar, pronation-supination, and radial-ulnar directions. The purpose of this study was to use this device to: 1) Measure the joint laxity and compliance of non-OA human thumb CMC joints and 2) Determine the effect that a simulated extension osteotomy has on joint laxity and joint stiffness. This study provides an accurate baseline for future comparisons with osteoarthritic, surgically corrected, and otherwise non-healthy CMC joints.

scholarly journals Surgical Correction of Penoscrotal Web: A Case Series With Literature Review

2020 ◽  
Author(s):  
Volkan Sarper Erikçi
Keyword(s):  
Surgical Treatment ◽  
Clinical Characteristics ◽  
Surgical Techniques ◽  
Case Series ◽  
Scrotal Skin ◽  
Penile Skin ◽  
Surgical Experience ◽  
Postoperative Results ◽  
Pediatric Urologist

INTRODUCTION: Penoscrotal webbing (PSW) is an anomaly of penis and it includes penile and scrotal skin aberration. There are various surgical techniques for repairing PSW with different terminologies. Herein we present our surgical experience of Z-plasty procedure in these cases. METHODS: In this retrospective study, 5 patients with an average age of 46 months who were diagnosed and under follow-up for PSW, between June 2017 and May 2019 were included. Along with demographic and clinical characteristics, treatment and follow-up records were collected. RESULTS: Isolated PSW was observed in 4 patients and one patient had an associated megameatus intact prepuce (MMIP) of a hypospadias variant in addition to PSW. Circumcision and ventral prepuce reconstruction of the penis with the aid of "Z-plasty" solved problem and acceptable postoperative results were obtained. DISCUSSION AND CONCLUSION: PSW is a condition that warrants surgical treatment. During the management of these children, in the case of suspicion of penile skin abnormality at the time of circumcision, it should be deferred and should be consulted to a pediatric surgeon or a pediatric urologist. Gentle surgical treatment is recommended for a favourable surgical and psychological result

Clinical characteristics and surgical treatment outcomes of vallecular cysts in adults

2015 ◽  
Vol 135 (11) ◽  
pp. 1185-1188 ◽  
Author(s):  
Dong Hoon Lee ◽  
Tae Mi Yoon ◽  
Joon Kyoo Lee ◽  
Sang Chul Lim
Keyword(s):  
Surgical Treatment ◽  
Treatment Outcomes ◽  
Clinical Characteristics

scholarly journals The Use of Botulinum Toxin for the Treatment of Chronic Joint Pain: Clinical and Experimental Evidence

Toxins ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 314 ◽  
Author(s):  
Nicole Blanshan ◽  
Hollis Krug
Keyword(s):  
Pain Relief ◽  
Joint Pain ◽  
Peripheral Sensitization ◽  
Long Term Effects ◽  
Neuropeptide Release ◽  
Osteoarthritis Pain ◽  
Catalytically Active ◽  
The Central Nervous System ◽  
The Brain

Chronic osteoarthritis pain is an increasing worldwide problem. Treatment for osteoarthritis pain is generally inadequate or fraught with potential toxicities. Botulinum toxins (BoNTs) are potent inhibitors of neuropeptide release. Paralytic toxicity is due to inhibition at the neuromuscular junction, and this effect has been utilized for treatments of painful dystonias. Pain relief following BoNT muscle injection has been noted to be more significant than muscle weakness and hypothesized to occur because of the inhibition of peripheral neuropeptide release and reduction of peripheral sensitization. Because of this observation, BoNT has been studied as an intra-articular (IA) analgesic for chronic joint pain. In clinical trials, BoNT appears to be effective for nociceptive joint pain. No toxicity has been reported. In preclinical models of joint pain, BoNT is similarly effective. Examination of the dorsal root ganglion (DRG) and the central nervous system has shown that catalytically active BoNT is retrogradely transported by neurons and then transcytosed to afferent synapses in the brain. This suggests that pain relief may also be due to the central effects of the drug. In summary, BoNT appears to be safe and effective for the treatment of chronic joint pain. The long-term effects of IA BoNT are still being determined.

Radiofrequency ablation of the sacroiliac joint

2021 ◽  
pp. 83-92
Author(s):  
Haider M. Ali ◽  
Yashar Eshraghi ◽  
Maged Guirguis
Keyword(s):  
Radiofrequency Ablation ◽  
Pain Management ◽  
Pain Relief ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Positive Response ◽  
Lateral Branch ◽  
Tissue Destruction ◽  
Sacroiliac Joint Pain ◽  
Pain Syndromes

Radiofrequency ablation (RFA) is a revolutionary procedure in the practice of pain management that can be used in the treatment of sacroiliac joint pain syndromes. It is a technology that uses radiofrequency needle probes to create lesions by way of localized tissue destruction. It is indicated for patients with chronic sacroiliac joint pain who have had a positive response to a lateral branch block. This procedure typically provides at least 6 and up to 12 months of significant pain relief and can be repeated. Practitioners should be well versed in the different evolving methods for RFA as well as its evidence, relevant anatomy, the technology used in RFA, and the complications that may occur with this procedure and how to prevent them. This chapter explores these principles and presents the relevant findings from the literature for this innovative procedure for sacroiliac joint pain.

scholarly journals Clinical Characteristics of Patients with Trigeminal Neuralgia Referred to Neurosurgery

2009 ◽  
Vol 03 (03) ◽  
pp. 207-212 ◽  
Author(s):  
Silvia RDT Siqueira ◽  
Manoel J Teixeira ◽  
José TT Siqueira
Keyword(s):  
Surgical Treatment ◽  
Trigeminal Neuralgia ◽  
Clinical Characteristics ◽  
Orofacial Pain ◽  
Cardiac Diseases ◽  
Systemic Diseases ◽  
Pain Questionnaire ◽  
Neurological Findings ◽  
Neurological Abnormalities ◽  
The Right

ABSTRACTObjectives: To investigate the clinical characteristics of patients with trigeminal neuralgia referred to surgery in a center of reference.Methods: We evaluated the general characteristics of 395 patients with trigeminal neuralgia referred to neurosurgery as treatment. They corresponded to 2 samples of 1984 and 2004. The EDOFHC protocol (Orofacial Pain Questionnaire) and the medical profile were used.Results: In the first study (1984), with 290 patients, the higher prevalence was: women (57.3%), white (95.5%), with mean age of 62.5. The most affected trigeminal branches were the maxillary and / or mandibular branches (65.5%), and the right side was the most affected (57.6%). From the second study (2004), with 105 patients, 57.1% were women, 75.2% white, with a mean age of 60.8. The maxillary and / or mandibular branches (79.0%) and the right side (69.5%) were the most affected. Both samples had neurological abnormalities and systemic diseases (mainly cardiovascular).Conclusions: General characteristics of these patients were similar to other samples of trigeminal neuralgia. Neurological findings were also present in patients with no previous surgical treatment for TN. Hypertension and cardiac diseases were also frequent and make the monitoring of the patients during crises necessary. (Eur J Dent 2009;3:207-212)

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