The Journal of hand surgery, European volume
-
J Hand Surg Eur Vol · Aug 2007
Randomized Controlled Trial Comparative StudyTo suspend or not to suspend: a randomised single blind trial of simple trapeziectomy versus trapeziectomy and flexor carpi radialis suspension.
The thumb carpometacarpal joint is the second most common site of osteoarthritis in humans. There are numerous operations for the condition but, perhaps, the commonest is trapeziectomy, sometimes supplemented by a suspension procedure, most commonly using part of the flexor carpi radialis tendon. ⋯ There was increased range of movement in the trapeziectomy alone group, but there was no difference in grip or pinch strength. Measurement of the gap on X-ray left by the trapeziectomy was less when trapeziectomy alone was performed.
-
This study was undertaken to review the outcome of open trigger digit release of 483 digits in 373 consecutive patients over a 1 year period. Parameters were obtained from case records. The patients were followed up for a minimum of 6 months postoperatively. ⋯ There were no recurrences of triggering. Steroid injection is recommended as the first line treatment. Surgical release is recommended for refractory and severe triggering.
-
J Hand Surg Eur Vol · Aug 2007
Comparative StudyAn in vitro biomechanical study comparing the spiral linking technique against the pulvertaft weave for tendon repair.
A new spiral linking technique for tendon repair in which one end of the tendon is spiralled around the other end has been developed. Using pig trotter extensor tendons, the Pulvertaft weave technique was compared with this new technique. Twenty-five repairs using each technique were tested by tensile loading with an Instron testing machine. ⋯ The Pulvertaft weave was stiffer than the spiral linking technique: mean stiffness of 11.1 and 6.7 N/mm, respectively. The spiral linking technique also absorbed considerably more energy: energy absorbed prior to failure to 90% of peak load, 1.75 and 1.13 kN mm, respectively. In conclusion, the spiral linking technique appears as strong as the Pulvertaft weave and we believe it is easier to perform.
-
J Hand Surg Eur Vol · Jun 2007
Scaphoid bone bruising--probably not the precursor of asymptomatic non-union of the scaphoid.
The MRI finding of bone marrow oedema, without fracture, following trauma to the scaphoid has been called a 'bone bruise'. A similar injury is found in the knee, considered benign and managed conservatively. In the scaphoid, there is the concern that this lesion may lead to scaphoid non-union. ⋯ Four of these showed complete resolution of the bruise, the others improvement. At 6 months, 2 of the 8 complained of minor, intermittent discomfort but progressed to resolution of symptoms. This study suggests that the scaphoid bone bruise is a benign injury with predictable recovery and is unlikely to result in long-term morbidity in the form of non-union.