노인 통증사정을 위한 한국어 판 Short-form McGill Pain Questionnaire [SF-MPQ]의 신뢰도와 타당도

Ulnar midcarpal instability—Clinical and laboratory analysis

ADAPTIVE CARPUS (FIGURE 1)



Fig. 1: 
ADAPTIVE CARPUS-ADAPTIVE DISI: the distal articular surface of the radius is inclined 30° dorsally from an old impacted distal radius fracture. The lunate is tilted dorsally to account for dorsal inclination of the distal radius, while the capitate is in neutral position following the position of the metacarpals with the hand. Changes in the carpal alignment creates a capitolunate angle of approximately 30° and a scapholunate angle of 85°. The increased scapholunate angle creates a DISI (dorsal intercalated segmental instability) configuration.



SYNONYM: none

CLINICAL: NA

RADIOLOGIC: a carpal malalignment usually identified by a dorsal or volar tilt of the lunate caused by an extracarpal osseous abnormality, usually a distal radial malunion without ligament tears

COMMENTS: 1) every carpus must adjust in some way to alterations of the radius articular surface, the ulnar head position, and the shape or size of the carpal bones even if all of its ligaments are intact. Although these alterations of the osseous elements may disrupt the ligament anchorage, may be accompanied by ligament damage, or may secondarily develop ligament attenuation, they often begin as a normal carpus. 2) The carpus may be malaligned between the two rows or remain aligned within itself, while translating at the radiocarpal level to a new position (usually dorsal, sometimes volar, even ulnar or radial). 3) This definition refers to an extracarpal, not an intracarpal, problem. If the malalignment is due to an intracarpal problem, then the case falls into a CID, CIND, or CIC category and would not fit into the category of an adaptive carpus as described here. Any adaptive carpus, by definition, can be solved by an extracarpal intervention that does not require surgery on the carpus. However, with time an adaptive carpus may degenerate to a point that the intrinsic ligaments …

Wrist terminology as defined by the International Wrist Investigators' Workshop (IWIW)

Anaerobic prosthetic joint infection

The lockdown imposed in France to cope with the COronaVIrus Disease 2019 (COVID-19) outbreak has led to major changes in the lifestyle of French citizens. The aim of our study was to study its impact on activity related to emergencies in hand and upper limb trauma in comparison to the same reference period in 2019. All consecutive patients consulting for upper limb injury requiring urgent care at Georges-Pompidou European Hospital (HEGP), France, during the lockdown period (case group) and the equivalent period in 2019 (control group) were included. In each group, the type of accident, the anatomical location of the injury, and the treatment were reported and compared. Two hundred seventy-five patients were included in the case group in comparison to 784 patients in the control group. We observed a two-third decrease in the rate of upper limb emergencies (− 64.9%) in particular a drastic drop in the rate of road, work, and leisure accidents (10.4% vs 14.3%, p = 0.1151; 10.0% vs 22.6%, p < 0.0001; 13.1% vs 30.8%, p < 0.0001, respectively), and a clear increase in domestic accidents (66.5% vs 32.3%, p < 0.0001). The aetiologies were more dominated by lacerations of soft tissues (48.4%, vs 38.3%, p = 0.0034) and infections (8.7% vs 5.1%, p = 0.0299) with an increase in the indications for surgical management (51.2% vs 36.9%, p < 0.0001). Conversely, we observed fewer consultations for joint injuries (20.7% vs 30.7%, p = 0.0015) and fractures (22.2% vs 25.9%, p = 0.2210). The lockdown imposed in France has changes the etiologies and the management of hand and upper limb emergencies.

/pdf/impact-of-the-coronavirus-disease-2019-lockdown-on-hand-and-n5ydj8pfs6.pdf

Impact of the COronaVIrus Disease 2019 lockdown on hand and upper limb emergencies: experience of a referred university trauma hand centre in Paris, France.

The purpose of this retrospective study was to assess the outcome of open surgery for patients with recalcitrant medial epicondylitis following failed conservative management. The clinical results are presented for 15 patients (17 elbows) who were reviewed at a mean follow-up of 66 months. Operative treatment improved patient function significantly with a mean increase in grip strength of 10kg and a mean decrease (improvement) in DASH (Disabilities of the Arm, Shoulder and Hand) score of 25.7. All but one patient experienced little or no residual elbow discomfort and had excellent Mayo elbow performance scores postoperatively. Eleven of the twelve patients who were previously in employment were able to return to work within eight weeks of surgery. This study demonstrates that operative treatment for recalcitrant medial epicondylitis is effective in restoring patient function and strength.

https://publishing.rcseng.ac.uk/doi/pdfplus/10.1308/003588413X13629960048479

Operative treatment improves patient function in recalcitrant medial epicondylitis.

The Authors' Technique for Volar Plating of Scaphoid Nonunion.

Scapular winging secondary to serratus anterior dysfunction: analysis of clinical presentations and etiology in a consecutive series of 96 patients

Purpose We offer collagenase Clostridium histolyticum (CCH) injections to all patients with a Dupuytren contracture and a palpable cord. We assessed whether more severe contractures respond less well or recur more frequently. Methods From a database of 502 CCH injections, 386 (77%) had a complete dataset with minimum 1-year face-to-face follow-up. Contracture severity was assessed using the Tubiana system: grade 1 (27%), grade 2 (49%), grade 3 (19%), and grade 4 (5%). Patients received a single intralesional injection of 0.58 mg CCH followed by manipulation. Finger position was measured at 6 to 12 weeks, 6 months, and 1 year. Failure to break the cord, skin tears, and any adverse events were noted. Recurrence was defined as a failure to maintain any prior correction to within 20°. Results There were 17 failures (4%) and 6 allergic reactions (1%). We found 31% corrected completely, with approximately half remaining corrected at 1 year. We achieved 43° (95% confidence interval, 40°–46°) correction of combined deformity, with 11° (95% confidence interval, 9°–13°) correction attrition over 1 year. Sixteen percent of treated digits experienced a recurrence with no difference between Tubiana grades, and one-third chose further treatment. Following treatment, Tubiana grade 1 contractures improved by 78% in comparison with higher grade contractures (55%–67% relative correction). By 1 year, all grades had a similar mean 46% relative correction. A complete correction was seen in 61% of grade 1 contractures, with more severe contractures less likely to correct completely (9%–24%). A 31% skin tear rate had no impact on outcome, recurrence, or long-term morbidity. Conclusions CCH may treat any Dupuytren cord regardless of severity. Although contracture may recur, few patients pursue further treatment within 1 year. Type of study/level of evidence Therapeutic IV.

Outcomes and Early Recurrence Following Enzymatic (Collagenase) Treatment of Moderate and Severe Dupuytren Contractures.

This study reports the arthroscopic ligament-specific repair of the triangular fibrocartilage complex (TFCC) that anatomically restores both the volar and dorsal radioulnar ligaments into their ind...

Feiran Wu

Papers

Operative treatment improves patient function in recalcitrant medial epicondylitis.

The Authors' Technique for Volar Plating of Scaphoid Nonunion.

Scapular winging secondary to serratus anterior dysfunction: analysis of clinical presentations and etiology in a consecutive series of 96 patients

Outcomes and Early Recurrence Following Enzymatic (Collagenase) Treatment of Moderate and Severe Dupuytren Contractures.

Arthroscopic ligament-specific repair for triangular fibrocartilage complex foveal avulsions: a minimum 2-year follow-up study: