Hand surgery and rehabilitation 

About: Hand surgery and rehabilitation is an academic journal published by Elsevier BV. The journal publishes majorly in the area(s): Medicine & Wrist. It has an ISSN identifier of 2468-1210. Over the lifetime, 1047 publications have been published receiving 3312 citations. The journal is also known as: Hand surgery and rehabilitation.

COVID-19: Initial experience of an international group of hand surgeons.

Abstract: The emergence of the COVID-19 pandemic has severely affected medical treatment protocols throughout the world. While the pandemic does not affect hand surgeons at first glance, they have a role to play. The purpose of this study was to describe the different measures that have been put in place in response to the COVID-19 pandemic by hand surgeons throughout the world. The survey comprised 47 surgeons working in 34 countries who responded to an online questionnaire. We found that the protocols varied in terms of visitors, health professionals in the operating room, patient waiting areas, wards and emergency rooms. Based on these preliminary findings, an international consensus on hand surgery practices for the current viral pandemic, and future ones, needs to be built rapidly.

Nerve conduits for treating peripheral nerve injuries: A systematic literature review

Abstract: Peripheral nerve injuries are a major public health problem. Nerve conduits have been developed in the recent years, although it is still not clear if they should replace nerve grafting and neurorrhaphy. This systematic review aims to gather evidence regarding the use of nerve conduits for peripheral nerve repair. The following electronic databases were searched: MEDLINE, Cochrane Library (CENTRAL) and Embase. Study selection and data extraction followed the PRISMA guidelines. The systematic review of the literature retrieved 6767 articles. Only 27 studies were retained accounting for 1022 patients: 10 randomized controlled trials, 15 case series and 2 cohort studies. Ten different types of tubes were described and a variety of evaluation methods were used to assess outcomes in terms of efficacy (motor and sensory recovery) and complications. The Semmes-Weinstein monofilament test and the static and moving 2-point discrimination test were the most commonly applied tests to evaluate nerve recovery. In general, outcomes showed no significant difference between groups. Synthetic conduits had more complications. Despite major methodological limitations in the studies, we can conclude that use of nerve conduits is preferable over suture repair and nerve grafting, as the functional recovery rates are above 80%. The choice of conduit is based on the surgeon's expertise, but use of synthetic conduits is discouraged due to their higher complication rates.

Pyrocarbon implants for the hand and wrist.

Abstract: Thanks to its remarkable mechanical properties and excellent biocompatibility, pyrocarbon is an ideal material for articular use. Various pyrocarbon implants for the hand and wrist have been developed over the past 25 years, with about 15 currently available for hemi-, total and interposition arthroplasty. This article describes the production methods and mechanical properties of pyrocarbon. The author summarizes the various implants available for each type of joint, their reported results in the literature, as well as his team's experience.

Complications after treating Dupuytren's disease. A systematic literature review.

Abstract: The objective of this study was to review the incidence of complications associated with different treatment options for patients with Dupuytren's disease. In a systematic literature review, the PubMed, EMBASE, Cochrane and Scopus databases were searched for clinical studies reporting complications after collagenase treatment, percutaneous needle fasciotomy (PNF), fasciectomy and dermofasciectomy. The incidence of complications was extracted from each study and stratified by procedure. From a total of 2251 references, 113 studies were analyzed and included with complication incidences varying from 0% to 100%. The highest number of nerve and vessel lesions were reported after fasciectomy, whereas the highest rate of edema was after collagenase injection. Accidental skin tears were mostly associated with collagenase and PNF treatment. Pooled complication incidences were 17.4% (95% CI: 11.7-23.1) for fasciectomy, 78.0% (95% CI: 59.6-96.4) for collagenase treatment, 18.9% (95% CI: -5.5-43.3) for PNF and 11.6% (95% CI: 0.0-23.2) for dermofasciectomy. Due to inconsistencies in reporting complications as well as the lack of a standardized definition, the literature does not provide evidence in favor of a specific procedure for Dupuytren's disease. A standardized definition of complications is required to improve the comparability of published results.

Trapeziectomy and ligament reconstruction tendon interposition after failed trapeziometacarpal joint replacement

Abstract: Total trapeziometacarpal (TMC) joint replacement is increasingly being performed for the treatment of basal joint arthritis. However, complications such as instability or loosening are also frequent with TMC ball-and-socket joint replacement. Management of these complications lacks consensus. The purpose of this study was to report the results of 12 cases of failed TMC joint replacement that were treated by trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty. The follow-up consisted of functional (numerical scale, DASH score, satisfaction), physical (range of motion, strength) and radiological (Barron and Eaton ratio measurement) assessments. At a mean follow-up of 21 months, 11 patients were satisfied or very satisfied after surgery. The mean pain score was 2/10 and the mean DASH score 30/100. Mean thumb palmar and radial abduction was 40°. Thumb opposition measured by the Kapandji technique was 9/10. The height ratio was slightly increased. Trapeziectomy with LRTI after TMC joint replacement appears to be an attractive salvage procedure.