The Journal of hand surgery
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Comparative Study
Precontoured fixed-angle volar distal radius plates: a comparison of anatomic fit.
To compare distal radius volar fixed-angle plates for anatomic fit. ⋯ There was considerable variation in ideal plate location among the 7 plates tested. Total contact was minimal for all plates tested. The Synthes EA pin-subchondral bone distance was significantly greater than those of other plates tested. Joint penetration was relatively common, necessitating use of fluoroscopy and proper plate width.
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Comparative Study
Comparison of neurotization versus nerve repair in an animal model of chronically denervated muscle.
Reinnervation of chronically denervated muscle is clinically unpredictable and poorly understood. Current operative strategies include either direct nerve repair, nerve grafting, nerve transfer, or neurotization. The goal of this study is to compare muscle recovery using microneural repair versus neurotization in a rat model of chronic denervation. ⋯ We demonstrated that neurotization is capable of reinnervating de novo end plates in chronically denervated muscle. Our data do not support the hypothesis that direct muscle neurotization is superior to nerve repair for functional restoration of chronically denervated muscle. However, as the duration of denervation increases, the difference between outcomes of the neurotization and repair group narrows, suggesting that neurotization may offer a viable surgical alternative in the setting of prolonged denervation.
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Comparative Study
Diagnostic comparison of 1.5 Tesla and 3.0 Tesla preoperative MRI of the wrist in patients with ulnar-sided wrist pain.
The diagnostic sensitivity, specificity, and accuracy of 1.5 Tesla (T) and of 3.0T magnetic resonance imaging (MRI) are correlated with wrist arthroscopy findings in patients presenting with ulnar-sided wrist pain. ⋯ The sensitivity, specificity, and accuracy of 3.0T wrist MRI for the TFCC is consistently higher compared with those of 1.5T wrist MRI. The trend suggests that 3.0T wrist MRI provides improved capability for detection of TFCC injuries. Given the available sample size, however, the confidence intervals around the point estimates are wide and overlapping. Further studies are needed to confirm or refute our results of the estimated sensitivity, specificity, and accuracy parameters.
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Carpal tunnel syndrome (CTS) impairs the performance of fine motor tasks of the hand, leading to clumsiness. Precision pinch by the thumb and index finger is a frequent task that requires the fine control of each digit as well as the coordination of the 2 digits. The purpose of this study was to examine the performance of precision pinch movements impaired by CTS. ⋯ Carpal tunnel syndrome impairs the performance of precision pinch movement as indicated by the increased variability. The results correlate with the observed clumsiness or lack of dexterity for patients with CTS.