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Kuwahara Y, Hara T, Kurahashi T, Takeshige H, Urata S, Oguchi T. Comparing Clinical and Aesthetic Outcomes of Digital Artery Flap Using Nail Bed Graft for Fingertip Amputation with Replantation. Plast Reconstr Surg 2024; 153:1086-1092. [PMID: 37253041 DOI: 10.1097/prs.0000000000010760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Digital artery flap (DAF) with nail bed graft is a simple method to preserve finger length for fingertip amputations. This study compared the clinical and aesthetic outcomes between replantation and DAF. METHODS Patients who underwent replantation or DAF for a single fingertip amputation (Ishikawa subzone II or III) at the authors' hospital from 2013 to 2021 were retrospectively evaluated. The aesthetic and functional outcomes were finger length and nail deformity at the final follow-up, total active motion, grip strength, Semmes-Weinstein monofilament test, Fingertip Injuries Outcome Score, and Hand20 score. RESULTS Overall, in 74 analyzed cases (40 replantation, 34 DAF), the median operative time and the median length of hospital stay were longer with replantation than with DAF (188 versus 126 minutes; P < 0.01; 15 versus 4 days; P < 0.01). The success rates of replantation and DAF were 82.5% and 94.1%, respectively. The rate of finger shortening with replantation was significantly lower than with DAF (42.5% versus 82.4%; P < 0.01). There were fewer nail deformities with replantation than with DAF (45.0% versus 67.6%; P = 0.06). The proportion of patients who achieved excellent or good Fingertip Injuries Outcome Score and median Hand20 score were not significantly different between the groups (89.5% versus 85.3%, P = 0.61; 8.0 versus 13.5, P = 0.42, respectively). Median postoperative Semmes-Weinstein monofilament test values were similar between the groups (3.61 versus 3.61; P = 0.23). CONCLUSION In this retrospective study, compared with replantation, DAF for fingertip amputations achieved equivalent postoperative functional outcomes and shorter intraoperative time and hospital stays, but resulted in inferior cosmetic outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
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Affiliation(s)
| | | | | | | | - Shiro Urata
- From Orthopedic Surgery, Anjo Kosei Hospital
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2
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Ishii H, Moriya K, Narisawa H, Tsubokawa N, Maki Y, Shimada K. Long-term Follow-up of Hand-degloving Injury Treated by Conventional Methods. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5777. [PMID: 38699283 PMCID: PMC11062683 DOI: 10.1097/gox.0000000000005777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/18/2024] [Indexed: 05/05/2024]
Abstract
Despite medical advances, degloving injury remains one of the most difficult traumatic injuries to treat. The conventional method for treating degloving injury of the hand is reconstruction with a groin flap. However, few reports have described the mid- or long-term functional and aesthetic outcomes after a hand reconstruction with a groin flap. This case report describes a 68-year-old woman with no specific medical history who presented with a severe degloving injury of the right hand, caused by a roller machine. The area of skin loss was covered with a pedicled groin flap that was separated after 3 weeks. Five years after the reconstruction, she had poor functional and aesthetic outcomes. The Japanese Society for Surgery of the Hand version of the Quick Disabilities of the Arm, Shoulder and Hand score was 57.5; the Hand20 score was 60; and the Michigan Hand Outcomes Questionnaire score was 37.5. The static two-point discrimination of the index and middle fingers was more than 15 mm, and Semmes-Weinstein monofilament examination showed that the sensation thresholds of these fingers were purple and blue. The range of motion was 10-degree angle of extension and 60-degree angle of flexion for the metacarpophalangeal joints of the index and middle fingers. Grip strength was 0.0 kg; pulp pinch strength of the index and middle fingers was 1.1 and 0.8 kg, respectively; and side pinch of the index and middle fingers was 0.1 and 0.7 kg, respectively.
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Affiliation(s)
- Hana Ishii
- From the Department of Plastic and Reconstructive Surgery, Kanazawa Medical University Hospital, Ishikawa, Japan
- Niigata Hand Surgery Foundation, Niigata, Japan
| | - Koji Moriya
- Niigata Hand Surgery Foundation, Niigata, Japan
| | | | | | - Yutaka Maki
- Niigata Hand Surgery Foundation, Niigata, Japan
| | - Kenichi Shimada
- From the Department of Plastic and Reconstructive Surgery, Kanazawa Medical University Hospital, Ishikawa, Japan
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Kuwahara Y, Hara T, Kurahashi T, Kitami T, Tatebe M. Comparing clinical and aesthetic outcomes of cross-finger and homodigital reverse digital artery island flap for fingertip injuries: A single-center retrospective cohort study. J Plast Reconstr Aesthet Surg 2024:S1748-6815(24)00219-5. [PMID: 38734540 DOI: 10.1016/j.bjps.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/16/2024] [Accepted: 03/18/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Reverse homodigital artery island flap (RHDI) has been reported to have some postoperative complications. Cross-finger reverse digital artery island flap (CRDI), which is harvested from an adjacent intact finger, has been used to decrease these complications. This study aimed to provide a review of the CRDI procedure and compare the clinical outcomes of CRDI with those of RHDI. METHODS RHDI has been performed for fingertip amputations with deficit of 1.5-2.5 cm before 2018, and CRDI has been performed since 2018. We assessed the functional and aesthetic outcomes, including finger length, nail deformity, finger motion, and Hand20 scores at the final follow-up. RESULTS We identified 22 patients who underwent RHDI and 10 patients who underwent CRDI. The mean follow-up period was 10.3 ± 5.3 months. The median time required for wound healing were 47.0 days (IQR: 34.3-55.8 days) and 34.5 days (IQR: 29.3-44.3 days) in RHDI and CRDI, respectively. The hook nail deformity occurred significantly more frequently in RHDI compared to that in CRDI (40.9% vs. 0.0%, p = 0.03). Flexion contracture of the proximal interphalangeal joint greater than 15º was found to be significantly more in RHDI than in CRDI (36.4% vs. 0.0%, p = 0.04). The median postoperative total active motion of the donor site in CRDI was 278º (IQR: 260-280º). The median postoperative Hand20 scores were similar between the two groups. CONCLUSION CRDI was associated with superior clinical outcomes in terms of lower rates of postoperative flexion contracture and hook nail deformity, potentially making it a better option compared to RHDI.
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Affiliation(s)
- Yutaro Kuwahara
- Anjo Kosei Hospital, Orthopedic surgery, Anjo, Aichi, Japan.
| | - Tatsuya Hara
- Anjo Kosei Hospital, Orthopedic surgery, Anjo, Aichi, Japan
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Saeki M, Yoneda H, Yamamoto M. Clinical and radiographic results of lunate resection and vascularized os pisiform transfer for Kienböck's disease. JPRAS Open 2024; 39:132-141. [PMID: 38259863 PMCID: PMC10801120 DOI: 10.1016/j.jpra.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/10/2023] [Indexed: 01/24/2024] Open
Abstract
Although various treatments for advanced stages of Kienböck's disease have been reported, clinical evidence demonstrating the efficacy of lunate resection and vascularized os pisiform transfer for Kienböck's disease is limited. Herein, we investigated the clinical and radiographic results of this procedure. We retrospectively investigated eight patients who were followed up for ≥1 year. The mean age at the time of surgery was 52 years. The mean follow-up period was 3.4 years. The preoperative and postoperative mean wrist flexion-extension ranges were 84° and 111°, respectively, and grip strengths were 18.5 and 26.3 kg, respectively. Pain decreased in five patients postoperatively. The mean preoperative and postoperative carpal height ratios were 0.47 and 0.46, respectively, and radio scaphoid angles were 63° and 65°, respectively. Osteoarthritic changes were observed in or around the transferred pisiform in all five patients who were surveyed using radiographs. Most patients demonstrated satisfactory clinical results, including pain relief and improved wrist motion and grip strength, regardless of osteoarthritic wrist changes on postoperative radiographs. In summary, this procedure was effective for treating Kienböck's disease, especially in the advanced stages. Level of evidence: Ⅳ.
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Affiliation(s)
- Masaomi Saeki
- Department of Human Enhancement & Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidemasa Yoneda
- Department of Human Enhancement & Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michiro Yamamoto
- Department of Human Enhancement & Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Hirata J, Yoshimura M, Inoue K. Effect of wrist orthoses on upper limb function, activities of daily living, and stress response. J Rehabil Assist Technol Eng 2024; 11:20556683241250307. [PMID: 38680617 PMCID: PMC11047247 DOI: 10.1177/20556683241250307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/12/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction This study examined the effects on upper limb function, activities of daily living, and stress responses when wearing a wrist orthosis made of padded fiberglass or thermoplastic and provided essential information for selecting an orthosis. Methods Thirty-one healthy adults performed two tests while not wearing a wrist orthosis, wearing a padded fiberglass wrist orthosis, and wearing a thermoplastic wrist orthosis. The Purdue Pegboard Test examined upper limb control. In the second test, the actions indicated by the Hand20 questionnaire were performed while wearing a wrist orthosis. An electrocardiogram was obtained before and after each test to identify any changes in sympathetic nervous system activity. Results The Purdue Pegboard Test scores were significantly higher when not wearing a wrist orthosis than when wearing wrist orthosis, and the Hand20 scores for all question were significantly lower. Thermoplastic wrist orthoses had fewer restrictions for upper limb function compared to padded fiberglass wrist orthoses, however activities of daily living were more limited. The low frequency/high frequency ratio and high frequency measures showed no significant differences. Conclusions Pegboard test scores and the Hand 20 scores suggest that a wrist orthosis causes restriction of upper limb function.
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Affiliation(s)
- Junya Hirata
- Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Manabu Yoshimura
- Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Keiko Inoue
- Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
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Yokoi T, Uemura T, Okada M, Saito K, Onode E, Nakamura H. Nerve Grafting for Isolated Injury to the Intrinsic Motor Branch of the Ulnar Nerve due to a Stab Injury: A Case Report. J Hand Microsurg 2023; 15:395-398. [PMID: 38152678 PMCID: PMC10751202 DOI: 10.1055/s-0042-1749442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Isolated injury to the deep motor branch of the ulnar nerve caused by stabbing is sporadic, with only one reported case in the English-language literature. We report one such case treated successfully using nerve grafting. A 33-year-old patient had sustained a stab wound to the right hypothenar eminence and showed a claw hand deformity. Needle electromyography study revealed denervation potentials with no voluntary motor unit action potentials (MUAPs) in the first dorsal interosseous (FDI) muscles. Nerve exploration revealed a neuroma-in-continuity in the intrinsic motor branch of the ulnar nerve. Intraoperative nerve stimulation confirmed the absence of compound muscle action potentials in the FDI. The damaged scarred nerve was resected, and the 15-mm defects were reconstructed with cable autografting. Two years and 5 months after the surgery, voluntary MUAPs were observed in the FDI. The pinch strengths recovered. Laceration of the deep branch of the ulnar nerve caused by stabbing can sometimes remain hidden as the hand sensation remains intact. Pre- and intraoperative electrophysiological examination is essential to assess the severity of the injured nerve and determine an appropriate surgical option. Even nerve grafting can facilitate satisfactory results as target intrinsic muscles are quite close to the repair site.
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Affiliation(s)
- Takuya Yokoi
- Department of Orthopaedic Surgery, Seikeikai Hospital, Sakai, Japan
| | - Takuya Uemura
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - Mitsuhiro Okada
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Kosuke Saito
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Ema Onode
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Hara T, Kurahashi T, Kuwahara Y, Tatebe M, Oguchi T, Urata S. The Results of Hook Plate Fixation for Palmar Fracture Dislocation of the Proximal Interphalangeal Joint. J Hand Surg Am 2023:S0363-5023(23)00496-3. [PMID: 37906242 DOI: 10.1016/j.jhsa.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/30/2023] [Accepted: 09/13/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE This study aimed to present the clinical outcomes of the dorsal plating technique for palmar fracture dislocations of the proximal interphalangeal (PIP) joint. This plating technique minimizes dissection and interference with the finger extensor mechanism. METHODS We treated seven patients (with a mean age of 39.1 years) with dorsal hook plates for palmar fracture dislocations of the PIP joint between April 2018 and August 2022. The little finger was affected in five patients, and ring finger was affected in two. The mean time to surgery was 5.6 days, and the postoperative follow-up period was seven months. On the second postoperative day, all patients were allowed active motion of both the PIP and the distal interphalangeal (DIP) joints. Simultaneously, DIP blocking exercises were started to prevent adhesion of the extensor mechanism. RESULTS The mean active flexion and extension of the PIP joint was 105° and -4°, respectively, whereas those of the DIP joint were 65° and 4°. No patient experienced extension lag in the DIP joint. The mean total active motion (TAM) was 273°, and the %TAM was 96%. The grip strength of the affected hand averaged 90% of that of the unaffected hand. The mean numerical rating scale for pain was 0.3 points, and the mean Hand20 score was 5.1 points. No complications were observed; two patients underwent implant removal at their request. CONCLUSIONS The present study suggests that this hook plate technique, which minimizes interference with the finger extension mechanism, is an effective surgical procedure that allows patients to tolerate early range of motion exercises and obtain satisfactory clinical outcomes in both the PIP and DIP joints. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic V.
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Affiliation(s)
- Tatsuya Hara
- Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan.
| | | | - Yutaro Kuwahara
- Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan
| | - Masahiro Tatebe
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takeshi Oguchi
- Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan
| | - Shrio Urata
- Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan
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Hihara M, Kuro A, Mitsui T, Kakudo N. Twenty-minute harvesting of flow-through type vastus lateralis muscle flap significantly reduces the need for a temporary intravascular shunt in the treatment of severe upper extremity trauma in civilian patients. Medicine (Baltimore) 2023; 102:e33311. [PMID: 36930070 PMCID: PMC10019110 DOI: 10.1097/md.0000000000033311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
For the reconstruction of severe upper extremity trauma involving arterial injury in civilian patients, it is generally recommended that the revascularization time be shortened using a temporary intravascular shunt (TIVS). However, if a flow-through type vastus lateralis muscle (VLm) flap can be harvested in 20 minutes and bypassed at the obstructed ischemic zone within 30 minutes, blood flow can be restored as quickly or more quickly than when using a TIVS, eliminating the need for a TIVS. This procedure was applied in the reconstruction of 3 cases of severe extremity trauma with vascular injury. The mean age was 69.7 years. Surgery was started an average of 2.93 hours from the onset. The average flap harvest time was 0.33 hours. The average time to revascularization from flap harvest was 1.33 hours, the average total operation time was 6.43 hours, and all upper extremities were salvaged. No cases showed ischemia-reperfusion injury or severe muscle contracture. The flow-through-type VLm flap can be applicable as a bypass graft for a 20 cm defect at any region distal to the elbow. In addition, harvesting the flap attached to blood-rich muscle not only controls the infection of contaminated wounds through the filling of dead space, but also has the potential to replace damaged muscle or tendon tissue. Even though TIVS placement is currently used extensively in this field of treatment, its role could be significantly reduced if a flow-through-type VLm flap can be harvested within 20 minutes.
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Affiliation(s)
- Masakatsu Hihara
- Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan
| | - Atsuyuki Kuro
- Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan
| | - Toshihito Mitsui
- Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan
| | - Natsuko Kakudo
- Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan
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Tatebe M, Yamamoto M, Kurimoto S, Iwatsuki K, Yoneda H, Hirata H. Do triangular fibrocartilage complex foveal injuries affect the clinical outcome of ulnar shortening osteotomy for ulnar impaction syndrome? J Orthop Sci 2023; 28:364-369. [PMID: 34922806 DOI: 10.1016/j.jos.2021.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Ulnar shortening osteotomy (USO), as its name implies, is used to shorten the ulna. It subsequently tightens the triangular fibrocartilage complex (TFCC) and ulnar wrist. TFCC foveal insertion is a primary stabilizer of the distal radioulnar joint. It is unclear whether USO is effective in TFCC foveal injuries. The purpose of this study was to review the clinical outcomes of ulnar shortening osteotomies with and without TFCC foveal injuries. METHODS We retrospectively reviewed patients with ulnar wrist pain treated with USO and wrist arthroscopy including the distal radioulnar joint (DRUJ). Sixty-five patients were included in this study. An algorithm was used to guide surgical decision-making. After arthroscopic confirmation of ulnar impaction syndrome, we performed USO with a locking compression plate (mean length of shortening, 2.7 mm; range, 1-7.5 mm). The flattened TFCC disc due to ulnar shortening was confirmed arthroscopically. If the DRUJ was unstable after USO, we repaired the TFCC foveal insertion. RESULTS There were 32 post-traumatic and 33 idiopathic cases. We detected TFCC disc injuries in 34 wrists and TFCC foveal injuries in 33 wrists; both types were found in 15 wrists. TFCC foveal injuries were not significantly correlated with patient age, history of trauma, or clinical outcome. Most patients showed good clinical outcomes; 31 of 65 patients had preoperative DRUJ instability, with a significant number having foveal but not disc injuries. CONCLUSION USO achieved reasonable outcomes, even in patients with TFCC foveal injuries. In cases demonstrating ulnar impaction, USO should be prioritized over TFCC repair.
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Affiliation(s)
- Masahiro Tatebe
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Michiro Yamamoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsuyuki Iwatsuki
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidemasa Yoneda
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Nakano T, Kurimoto S, Ishii H, Iwatsuki K, Yamamoto M, Tatebe M, Hirata H. Mast cell presence in tendon sheaths of trigger fingers: implications on pathogenesis and clinical presentation. J Plast Surg Hand Surg 2023; 57:257-262. [PMID: 35400270 DOI: 10.1080/2000656x.2022.2061498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Trigger finger is a common hand disorder; however, its pathogenesis remains unknown. In this study, we aimed to investigate mast cells, fibroblast activators that synthesize collagen, in the tendon sheaths of trigger fingers. We investigated the presence of mast cells and their association with changes in the collagen content of the tendon sheath and clinical data. We performed a multicenter prospective study of 77 adult patients with trigger finger who had undergone resection of the first annular pulley between August 2012 and January 2020. The tendon sheath was immunostained with an anti-tryptase antibody to confirm mast cell presence. The percentage of collagen in the tendon sheath was determined by picrosirius red staining observed through a polarization microscope. The clinical data, including the duration from symptom onset to surgery, severity, pain numerical rating scale, and Hand20 scores, were evaluated. Tryptase-positive mast cells were recognized in 83.5% of all specimens. The mast cell presence group (Group P) had a significantly higher percentage of type-3 collagen in the tendon sheath than the non-mast cell presence group (Group N) (Group P, 15.6%; Group N, 12.7%; p = 0.03). Moreover, Group P had significantly higher pain numerical rating scale (Group P; 5, Group N; 3, p = 0.04) and Hand20 (Group P; 35.5, Group N; 13.0, p = 0.01) scores than Group N. These findings suggest that mast cell presence in the tendon sheath of the trigger finger is related to the pathology and clinical symptoms of trigger finger.
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Affiliation(s)
- Takahiko Nakano
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hisao Ishii
- Department of Hand Surgery Center, Chutoen General Medical Center, Kakegawa, Japan
| | - Katsuyuki Iwatsuki
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michiro Yamamoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masahiro Tatebe
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Tonak HA, Aydin Y, Ozcanyuz B, Ozcanli H, Uehara K, Morizaki Y. Psychometric Properties of the Turkish Version of the JHand for the Patient-Oriented Outcome Measure for Patients with Hand and Elbow Disorders. Eval Health Prof 2022; 46:152-158. [PMID: 36509709 DOI: 10.1177/01632787221146245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The JHand is an easy-to-understand questionnaire that includes questions that exclude hand dominance. It was developed to evaluate patients with hand and elbow disorders. However, JHand has not been translated and validated in the Turkish language. The aim of this study is to investigate the psychometric properties of the culturally adapted Turkish version of the JHand for Turkish patients. A total of 262 patients were included in the study. JHand, Disabilities of the Arm, Shoulder, and Hand Questionnaire, and Hand20 were used to evaluate patients. Internal consistency and test-retest analyses were applied to determine the reliability of the Turkish version of the JHand. Confirmatory factor analysis and similar scale validity were used to determine its validity. The Turkish version of the JHand showed high levels of internal consistency and excellent test-retest reliability (Cronbach α = 0.907, ICC = 0.923). The model fit indices of the Turkish version of the JHand had good and acceptable fit with reference values. Statistically positive and very strong correlations were found between JHand and DASH (r = .825, p < .001) as well as the JHand and Hand20 (r = .846, p < .001). The Turkish version of the JHand had excellent internal consistency and test-retest reliability as well as a high level of validity.
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Affiliation(s)
- Hasan Atacan Tonak
- Department of Occupational Therapy, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey
| | - Yener Aydin
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Faculty of Medicine, 37502Akdeniz University, Antalya, Turkey
| | - Burc Ozcanyuz
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Faculty of Medicine, 37502Akdeniz University, Antalya, Turkey
| | - Haluk Ozcanli
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Faculty of Medicine, 37502Akdeniz University, Antalya, Turkey
| | - Kosuke Uehara
- Department of Orthopaedic Surgery, 26782The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Morizaki
- Department of Orthopaedic Surgery, 26782The University of Tokyo Hospital, Tokyo, Japan
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Komura S, Hirakawa A, Masuda T, Nohara M, Kimura A, Matsushita Y, Matsumoto K, Akiyama H. Preoperative prognostic factors associated with poor early recovery after trapeziectomy with ligament reconstruction and tendon interposition arthroplasty for thumb carpometacarpal osteoarthritis. Orthop Traumatol Surg Res 2022; 108:103191. [PMID: 34952216 DOI: 10.1016/j.otsr.2021.103191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 06/01/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) is performed for treating thumb carpometacarpal osteoarthritis. However, patients occasionally experience delayed postoperative recovery. Although several prognostic factors associated with long-term outcomes have been identified, the factors associated with delayed recovery after trapeziectomy with LRTI have not been identified. HYPOTHESIS When we define major disability in the early postoperative period at 3 months after LRTI surgery as delayed recovery, some preoperative factors can influence with delayed recovery. Moreover, delayed recovery can influence the long-term therapeutic outcome. PATIENTS AND METHODS Thirty thumbs that underwent trapeziectomy with LRTI (mean follow-up period, 29.3 months) were retrospectively analyzed. Major disability was defined by both DASH and Hand20 scores≥35 after surgery, and patients were divided into groups 1 (major disability; n=9) and 2 (no major disability; n=21) according to the scores at 3 months after surgery. Preoperative data, including age, sex, preoperative symptom duration, dominant hand surgery, concurrent surgery with LRTI, previous orthopedic surgery, employment, stage of osteoarthritis, thickness of the trapezium, metacarpophalangeal hyperextension deformity, DASH score, Hand20 score, visual analogue scale (VAS) scores for pain, grip strength, pinch strength, and range of motion of the thumb were compared between groups to identify the factors indicating a poor prognosis at 3 months after surgery. We also compared the clinical outcomes at the 12-month and final follow-up. RESULTS Dominant hand surgery, previous orthopedic surgery, and preoperative poor DASH score were significantly more frequent in group 1, while the other factors did not show significant intergroup differences. Moreover, group 1 showed significantly poorer DASH score, grip and pinch strength, and active flexion of the thumb metacarpal joint at both the 12-month and final follow-up. This group also showed significantly poorer Hand20 and VAS scores at the final follow-up. DISCUSSION Dominant hand surgery, previous orthopedic surgery, and preoperative poor DASH score were associated with poor recovery at 3 months after trapeziectomy with LRTI. Moreover, major disability at 3 months after surgery influenced poor clinical outcomes at the 12-month and final follow-ups. These data could be useful for counseling patients regarding the expected recovery duration and outcomes after LRTI surgery. LEVEL OF EVIDENCE IV; retrospective therapeutic study.
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Affiliation(s)
- Shingo Komura
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Akihiro Hirakawa
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tomihiro Masuda
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Marie Nohara
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Ayaka Kimura
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Yasuharu Matsushita
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Kazu Matsumoto
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
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13
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Sasaki N, Kawakami R, Toshiki N, Yamada H, Hakozaki M, Konno SI. Fibulo-Scapho-Lunate Arthrodesis With Free Vascularized Fibular Graft for a Japanese Kyudo Archer With Osteosarcoma of the Left Distal Radius: A Case Report. CANCER DIAGNOSIS & PROGNOSIS 2022; 2:489-495. [PMID: 35813006 PMCID: PMC9254103 DOI: 10.21873/cdp.10132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Recent progress in the chemotherapy and surgical procedures for osteosarcoma have enabled the preservation of limb function even when cancer occurs in the distal radius, a rare primary site of osteosarcoma. CASE REPORT We describe a case of osteosarcoma that occurred in an 18-year-old, male Kyudo (Japanese archery) archer's left distal radius. Since the patient desired to resume Kyudo and the left hand was quite important for gripping a bow, we chose partial wrist arthrodesis (fibulo-scapho-lunate arthrodesis) with free vascularized fibular grafting (FVFG) as the reconstruction procedure following wide resection. After the wide resection, the major axis of bone defect was 8 cm. We harvested a free vascularized fibular graft with fascio-cutaneous flap with wide fascia to reconstruct the gliding surface of the extensor tendon. Fibula-proximal radius and fibulo-scapho-lunate fixation was performed by locking plates individually. Vascular anastomosis was performed between the radial artery and peroneal artery in a flow-through manner. Two peroneal veins were anastomosed with the radial vein and cephalic vein. CONCLUSION Fibulo-scapho-lunate arthrodesis with FVFG may provide satisfied stability and function even in a Kyudo archer. The patient obtained sufficient wrist stability and grip strength, and could resume Kyudo.
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Affiliation(s)
- Nobuyuki Sasaki
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ryoichi Kawakami
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
- Department of Traumatology and Reconstructive Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
- Kawakami Orthopaedic Clinic, Fukushima, Japan
| | - Narihiro Toshiki
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
- Department of Hand and Limb Reconstructive Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Yamada
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
- Department of Musculoskeletal Oncology and Metabolic Bone Disease Research, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Michiyuki Hakozaki
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
- Higashi-Shirakawa Orthopaedic Academy, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shin-Ichi Konno
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
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14
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Murayama A, Watanabe K, Ota H, Kurimoto S, Hirata H. Volar plating versus external fixation for unstable dorsal fracture-dislocations of the proximal interphalangeal joint. J Hand Surg Eur Vol 2022; 47:308-313. [PMID: 34812077 DOI: 10.1177/17531934211059300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Average active flexion of the proximal interphalangeal joint was 95° after plate fixation and 87° after external fixation, with an active extension lag of -6° and -9°, respectively. Active flexion at the distal interphalangeal joint averaged 67° in the plate group and 58° in the external fixation group, with active extension lags of 0° and -5°, respectively. We conclude that both methods can obtain a good range of motion at the proximal interphalangeal joint. A limitation of the extension of the distal interphalangeal joint occurred with dynamic external fixation but not with volar buttress plating.Level of evidence: IV.
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Affiliation(s)
- Atsuhiko Murayama
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kentaro Watanabe
- Department of Health Sciences, Aichi Shukutoku University, Nagoya, Japan
| | - Hideyuki Ota
- Department of Orthopaedic Surgery and Hand Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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15
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Hihara M, Takeji K, Mitsui T, Fujita M, Satou A, Himejima T, Kakudo N, Kusumoto K. Reconstruction of extra-large severe punching hole injury in the palm: A case report. Trauma Case Rep 2022; 39:100638. [PMID: 35368722 PMCID: PMC8965141 DOI: 10.1016/j.tcr.2022.100638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/29/2022] Open
Abstract
A 48-year-old man sustained a severe punching hole injury of 8 cm in diameter on the palm of his left hand using a punching instrument (for making the bottom of drink cans), and his middle and ring fingers were almost amputated. A flow-through type immediate ALT (anterolateral thigh) flap was used to bypass the distal blood flow and a titanium plate for mandibular reconstruction and plantar glabrous skin were used to preserve the floating amputated fingers. As there has been no report of reconstruction of a punching hole in the palmar region that exceeds 8 cm in diameter, this report is novel and educational.
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Affiliation(s)
- Masakatsu Hihara
- Corresponding author at: Department of Plastic and Reconstructive Surgery, Kansai Medical University, 2-5-1, Shin-machi, Hirakata, Osaka 573-1010, Japan.
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16
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Tore NG, Tuna Z, Mete O, Gokkurt A, Seven B, Oskay D. Test-retest reliability, convergent validity and cross-cultural adaptation of Turkish version of the Hand10 questionnaire. J Orthop Sci 2022; 27:380-383. [PMID: 33549401 DOI: 10.1016/j.jos.2020.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/24/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Hand10 Questionnaire is composed of 10 short, easy to understand and illustrated questions and was developed to measure upper extremity disorders. Thanks to these features, unlike other questionnaires that assess upper extremity disorders, it can be used in the elderly and children as well as adults. The aim of this study was to cross-culturally adapt the Hand10 into Turkish and to test its reliability and validity. METHODS Translation and back-translation of the Hand10 were performed according to Beaton guidelines. Patients completed the Disabilities of the Arm, Shoulder and Hand Questionnaire once and the final version of the Hand10 Questionnaire twice, with 7-days interval. Test-retest reliability and internal consistency were determined using Intraclass Correlation Coefficient analysis and Cronbach's alpha, respectively. Convergent validity of Hand10 was determined with Disabilities of the Arm, Shoulder and Hand Questionnaire using Pearson Correlation Coefficient analysis. RESULTS One hundred patients participated in the study. Cronbach's alpha value was 0.919, indicating an excellent internal consistency. Intraclass Correlation Coefficient value for test-retest reliability were found to be 0.890 that indicates a high reliability. Hand10 showed very good correlation with Disabilities of the Arm, Shoulder and Hand Questionnaire (r: 0.669). CONCLUSIONS The Turkish version of the Hand10 met set criteria of reliability and validity. As a result of this study, we determined that Hand10 is a useful instrument to measure upper extremity disorders in Turkish-speaking patients. It is recommended to be used in clinical settings and researches.
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Affiliation(s)
- Nurten Gizem Tore
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
| | - Zeynep Tuna
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Oguzhan Mete
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ahmet Gokkurt
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Baris Seven
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Deran Oskay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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17
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Uemura T, Egi T, Okada M, Okano T, Konishi S, Nakamura H. Silicone Implant Arthroplasty for Severe Bony Ankylosis of the Proximal Interphalangeal Joints in Rheumatoid Arthritis. Orthopedics 2022; 45:e53-e56. [PMID: 34734772 DOI: 10.3928/01477447-20211101-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Arthrodesis and prosthetic arthroplasty have been used to treat severe proximal interphalangeal (PIP) joint arthritis. Silicone implant arthroplasty is an established treatment for rheumatoid arthritis (RA) of the fingers. However, few studies have reported the application of silicone implant arthroplasty for the treatment of severe ankylosis of the PIP joint in RA patients. The authors report, for the first time, the case of a 46-year-old woman who presented with severe bony ankylosis of the right fourth and fifth PIP joints at greater than 90° of flexion. Proximal interphalangeal silicone arthroplasty in combination with reconstruction of the extensor mechanism was successfully performed in the affected joints. Four years after surgery, active flexion of the fourth and fifth PIP joints was 55° and 75°, respectively, with an extensor lag of only 5° without pain and joint instability. Proper repair of the extensor mechanism with shortening of the central slips and mobilization of the lateral bands dorsally was most important in maintaining the extended position of the PIP joints. Proximal interphalangeal silicone arthroplasty with intensive reconstruction of the extensor mechanism could become a potential treatment option to maintain joint mobility even in severe ankylosis of the PIP joints in RA patients. [Orthopedics. 2022;45(1):e53-e56.].
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18
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Harada R, Nishida K, Matsuyama Y, Hashizume K, Wada T, Nasu Y, Nakahara R, Horita M, Senda M, Ozaki T. The Japanese Version of the Patient-Rated Elbow Evaluation is a Useful Outcome Measure that Potentially Reflects Hand Function in Patients with Rheumatoid Arthritis who Underwent Total Elbow Arthroplasty. Mod Rheumatol 2021; 32:1041-1046. [PMID: 34791352 DOI: 10.1093/mr/roab100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/03/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We examined the relationship between The Japanese version of Patient-Related Elbow Evaluation (PREE-J) and other established subjective and objective outcome measures in Japanese patients with rheumatoid arthritis (RA) who underwent total elbow arthroplasty (TEA). PATIENTS AND METHODS This study involved 46 elbows of 40 RA patients. We collected clinical data one year after surgery, including the PREE-J, the Mayo Elbow Performance Score (MEPS), Disability of the Arm, Shoulder, and Hand (DASH), and Hand20. The correlation and responsiveness to PREE-J were evaluated compared with other outcome measures pre-and postoperatively. RESULTS Almost all outcome measures were improved significantly after surgery. Preoperative PREE-J was significantly correlated with preoperative DASH, Hand20, and MEPS. Interestingly, postoperative PREE-J did not correlate with postoperative MEPS. Multiple regression analyses revealed that preoperative grip strength (B = -0.09; 95% CI -0.17 to -0.01, p = 0.03) and preoperative Hand20 (B = 0.31, 95% CI 0.03 - 0.58, p = 0.03) were significant factors those might influenced the postoperative PREE-J. CONCLUSIONS The PREE-J was shown to correlate well with other preoperative outcome measures among the RA patients included in the current study. The postoperative PREE-J after TEA was influenced by the preoperative grip strength and function of the hand.
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Affiliation(s)
- Ryozo Harada
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Orthopaedic Surgery, Kurashiki Sweet Hospital, Okayama, Japan
| | - Keiichiro Nishida
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshiyuki Matsuyama
- Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Okayama, Japan
| | - Kenzo Hashizume
- Department of Rehabilitation, Japan Labour Health and Welfare Organization, Okayama Rosai Hospital, Okayama, Japan
| | - Takuro Wada
- Department of Orthopaedic Surgery, Saiseikai Otaru Hospital, Sapporo, Japan
| | - Yoshihisa Nasu
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ryuichi Nakahara
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masahiro Horita
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masuo Senda
- Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Okayama, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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19
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Tajika T, Kuboi T, Endo F, Hatori Y, Chikuda H. Reverse wedge osteotomy for Madelung's deformity in a high school student: A case report. SAGE Open Med Case Rep 2021; 9:2050313X211049898. [PMID: 34616556 PMCID: PMC8488512 DOI: 10.1177/2050313x211049898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/13/2021] [Indexed: 11/17/2022] Open
Abstract
Madelung deformity is a congenital disorder with the malformation of anterior ulnar bowing of radius and a dorsally protruding ulnar head caused by premature growth disturbance at the medial volar aspect of the distal radius. This report describes a bilateral idiopathic Madelung deformity in a 17-year-old woman treated successfully using reverse wedge osteotomy of the distal radius in a symptomatic left wrist. Reverse wedge osteotomy can orient the radial joint surface while correcting the whole radius length by reversely putting the wedge bone removed from the distal metaphysis of radius, the base of which is cut from the surplus of the radial and dorsal cortical bone in the hypotrophic portion. We corrected the palmar subluxation of the carpus, restored her good function, and relieved her wrist pain.
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Affiliation(s)
- Tsuyoshi Tajika
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Takuro Kuboi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Fumitaka Endo
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Yuhei Hatori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
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20
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Daskalakis I, Sperelakis I, Sidiropoulou B, Kontakis G, Tosounidis T. Patient-Reported Outcome Measures (PROMs) Relevant to Musculoskeletal Conditions Translated and Validated in the Greek Language: A COSMIN-Based Systematic Review of Measurement Properties. Mediterr J Rheumatol 2021; 32:200-217. [PMID: 34964024 PMCID: PMC8693298 DOI: 10.31138/mjr.32.3.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/25/2021] [Accepted: 06/10/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The use of patient-reported outcome measures (PROMs) constitutes a valuable tool in evaluating the quality of care offered in orthopaedic surgery. The aim of this review is to identify the PROMs that have been translated into and validated in the Greek language, summarise their measurement properties, and evaluate their methodological quality according to the COSMIN Risk of Bias Checklist. METHODS A structured literature search was conducted using the databases PubMED/MEDLINE, Embase, Scopus, and the Cochrane Library in order to identify PROMs relevant to musculoskeletal conditions translated and validated in the Greek language. The methodological quality of the studies was assessed according to the COSMIN Risk of Bias Checklist, and the quality of measurement properties according to the COMSIN criteria. RESULTS Literature search yielded 6743 articles. After removal of duplicates and screening of the articles, 32 studies including PROMs related to musculoskeletal conditions were identified. The studies included 31 PROMs and reported 171 measurement properties. Methodological quality was adequate for 81 of them (47.3%). The most commonly reported measurement properties were internal consistency, reliability, construct validity and responsiveness. CONCLUSION The majority of PROMs translated into Greek involves the lower extremity and especially knee pathologies. The search revealed that there are areas of Musculoskeletal Medicine such as skeletal trauma, musculoskeletal oncology, and paediatric orthopaedics in which patient reported-outcome measures have not been translated into Greek. Translation and validation of new outcome measures is encouraged, using studies designed in compliance with the COSMIN guidelines, and further validation of the translated instruments.
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Affiliation(s)
- Ioannis Daskalakis
- Department of Orthopaedic Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Ioannis Sperelakis
- Department of Orthopaedic Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece
| | | | - Georgios Kontakis
- Department of Orthopaedic Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Theodoros Tosounidis
- Department of Orthopaedic Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece
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21
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Ajiki T, Murayama A, Hayashi Y, Takeshita K. Validation of a Handprint for Clinical Evaluation of Dupuytren’s Contracture. J Hand Microsurg 2021. [DOI: 10.1055/s-0041-1735347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Objective We have developed a handprint-based method for visualizing and quantifying the palmar contact of patients with Dupuytren’s contracture. The purpose of this study was to examine whether the generated handprint was useful for assessing the severity of flexion contracture of the fingers and for evaluating the therapeutic effects of collagenase clostridium histolyticum (CCH) injection for Dupuytren’s contracture.
Methods The handprint was created by applying medical-grade ethanol-containing hand sanitizer over the entire palmar surface of the affected hand and then pressing it on thermal paper for word processors. The reliability of the handprint was evaluated through test–retest of 10 healthy volunteers at an interval of 10 days, and the validity of the handprint was assessed using a flexion contracture model in which the little finger was fixed in an Alfence splint. In addition, we obtained handprints of the affected hand in 33 patients with unilateral Dupuytren’s contracture both before CCH injection and at the final observation after injection to investigate the contact area of the hand (CAH) and the length of the hand (LH). The relationships between CAH, LH, total extension deficit angle (TEDA), and patient-reported outcome measures (Japanese Society for Surgery of the Hand Version of the Quick Disability of Arm, Shoulder, and Hand Questionnaire [Quick DASH-JSSH] and Hand20) were examined.
Results The test–retest correlation coefficient was 0.9187 (p < 0.001) for CAH and 0.9052 (p < 0.001) for LH, indicating high reliability of the handprint. The ratios of CAH and LH decreased gradually as the contracture angle of the splinted finger increased. The handprint revealed a marked improvement of palmar contact after CCH injection for Dupuytren’s contracture. Furthermore, the ratios of CAH and LH were strongly correlated with TEDA, Quick DASH-JSSH, and Hand20 before treatment.
Conclusion Our handprint-based assessment method was extremely useful for clinical evaluation of CCH treatment for Dupuytren’s contracture.
Type of Study/Level of Evidence Therapeutic.
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Affiliation(s)
- Takashi Ajiki
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
- Department of Orthopedic Surgery, Ishibashi General Hospital, Tochigi, Japan
| | - Akira Murayama
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
| | - Yukinori Hayashi
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
| | - Katsushi Takeshita
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
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22
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Hama S, Okada M, Yokoi T, Uemura T, Nakamura H. Pain and numbness one month after carpal tunnel release predict patient-reported outcome measures at sixth months. J Plast Surg Hand Surg 2021; 56:167-171. [PMID: 34324405 DOI: 10.1080/2000656x.2021.1953041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A number of outcome predictors for carpal tunnel release (CTR) for carpal tunnel syndrome (CTS) have been reported. However, some predictors are controversial, and few studies have referred to the early postoperative outcome prognostic factors after CTR. The aim of this study was to investigate whether pain and numbness at 1 month post-CTR were early postoperative predictors of clinical outcomes 6 months after surgery. Pain and numbness were evaluated using the visual analog scale (VAS) preoperatively and at 1 month post-surgery. Patient-reported outcome measures (PROMs), including the Quick Disabilities of the Arm, Shoulder and Hand (QDASH) measure, the Hand20 questionnaire and the Boston Carpal Tunnel Questionnaire (BCTQ), were recorded for each patient 6 months after surgery. The BCTQ consisted of the Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Multivariable linear regression analysis was performed to investigate the association between the VAS scores and PROMs. We retrospectively identified 93 patients who underwent open carpal tunnel release (OCTR) or endoscopic carpal tunnel release. The mean age of the patients was 67.5 years, and 67 patients (72.0%) were female. Sixty patients were treated by OCTR (65.0%). With multivariable linear regression analysis, we found that pain and numbness, evaluated with VAS 1 month post-surgery had significant correlations with QDASH, Hand20, SSS and FSS 6 months after surgery. In conclusion, pain and numbness 1 month after CTR predict PROMs at 6 months.
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Affiliation(s)
- Shunpei Hama
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mitsuhiro Okada
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuya Yokoi
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuya Uemura
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.,Department of Orthopedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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23
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Komura S, Hirakawa A, Masuda T, Nohara M, Kimura A, Matsushita Y, Akiyama H. Does trapeziectomy with ligament reconstruction and tendon interposition arthroplasty correct the metacarpophalangeal joint hyperextension associated with trapeziometacarpal osteoarthritis? Arch Orthop Trauma Surg 2021; 141:1261-1268. [PMID: 33649913 DOI: 10.1007/s00402-021-03838-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/15/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Trapeziometacarpal osteoarthritis sometimes results in hyperextension of the thumb metacarpophalangeal (MCP) joint, which could negatively impact outcomes following trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty. Although algorithms on performing trapeziectomy with LRTI for the management of this deformity are available, they lack clear evidence. Here, we investigate the function of the thumb MCP joint after trapeziectomy with LTRI and whether this procedure alone corrects preoperative MCP hyperextension, and also analyze clinical factors correlated with MCP hyperextension post-surgery. MATERIALS AND METHODS Twenty-eight patients who underwent trapeziectomy with LRTI and followed up for at ≥ 1 year (mean, 27.2 months) were retrospectively analyzed. No patient had concomitant surgery to the thumb MCP joint at the time of trapeziectomy with LRTI. Patients were divided into the < 30° (n = 19) and > 30° (n = 9) hyperextension groups as per their preoperative passive range of motion (ROM) of the MCP joint. Changes in ROM of the MCP joint post-surgery, clinical factors correlated with postoperative MCP hyperextension, and correlations between clinical outcomes and postoperative MCP extension were analyzed. RESULTS In the < 30° MCP hyperextension group, active and passive extensions of the MCP joint did not significantly change after surgery, and no worsening of postoperative MCP hyperextension was observed. In the > 30° hyperextension group, passive extension of the MCP joint significantly decreased (mean, 49.6°-29.8°). Preoperative MCP hyperextension improved in seven patients, was unchanged in 1, and worsened in 1. Postoperative passive MCP extension was negatively correlated with active/passive radial abduction, MCP flexion, trapezial space height, subjective outcomes, and hand strength post-surgery. CONCLUSIONS Trapeziectomy with LRTI alone could prevent postoperative thumb MCP hyperextension deformity for patients with thumb MCP extension < 30° and improve preoperative thumb MCP hyperextension. However, for patients with loss of radial abduction and MCP flexion due to the contracture, indirect correction of the MCP hyperextension was improbable.
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Affiliation(s)
- Shingo Komura
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, 501-1194, Japan.
| | - Akihiro Hirakawa
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Tomihiro Masuda
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Marie Nohara
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Ayaka Kimura
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Yasuharu Matsushita
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, 501-1194, Japan
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Hosokawa T, Tajika T, Suto M, Chikuda H. The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores in 961 Japanese volunteers. J Orthop Surg (Hong Kong) 2021; 28:2309499020970656. [PMID: 33169638 DOI: 10.1177/2309499020970656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Patient-reported outcomes recently have been used to assess treatment outcomes. The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) is a particularly convenient and useful tools. However, data on the normative values of Japanese population are lacking, so the present study was conducted to gather this information. METHODS We assessed 1098 volunteers over 18 years of age (363 men and 735 women, average 50 years old) who had not received upper limb treatment in a medical facility. These participants included our institution's staff, their family members, and the participants in the group meetings held by institution's staff. Their occupations were also examined. We divided occupations into nonmanual and manual labor. These factors of the participants were then analyzed to clarify which (if any) influenced the QuickDASH. RESULTS Valid answers were obtained from 961 subjects (87.5%). The median score was 2 (mean: 4.8) in the overall population, 0 (mean: 2.6) in men, and 2.5 (mean: 6.0) in women. The scores increased with age and were higher in women than in men. There were no significant differences by manual labor. Female sex and older age were identified as factors that influenced the QuickDASH score in the multiple regression analysis. There were high correlations among QuickDASH, work and sports/music scores. CONCLUSIONS The present study provided QuickDASH scores for Japanese volunteers who had not received upper limb treatment in a medical facility. The scores were associated with older age and female sex. This study helps us to know the degree of potential upper limb impairment in the general population, and will help in populational strategies as primary and secondary preventive medicine for upper limb-related diseases.
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Affiliation(s)
- Takafumi Hosokawa
- Department of Orthopaedic Surgery, Tone Chuo Hospital, Numata, Gunma, Japan.,Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Morimichi Suto
- Department of Orthopaedic Surgery, Tone Chuo Hospital, Numata, Gunma, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
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Uehara K, Miura T, Takashi O, Doi T, Tanaka S, Morizaki Y. Development of a patient-oriented outcome measure for patients with hand and elbow disorder: HandQ. J Orthop Surg (Hong Kong) 2021; 28:2309499020959151. [PMID: 32996436 DOI: 10.1177/2309499020959151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The Disabilities of the Arm, Shoulder, and Hand (DASH) is the most widely used patient-oriented outcome measure for the upper extremities in the world, and high reliability and validity of it has already been confirmed. However, there are several problems with using the DASH, some of which are culturally related. We aimed to (1) develop a patient-oriented disease-specific outcome measure for patients with disorders of the hand and elbow, which we call the HandQ and (2) examine the practical applicability, reliability, and validity of the HandQ for any patient with disorders of the hand and elbow. METHODS A total of 216 patients were surveyed with the HandQ, as well as the Hand20 and the DASH to assess psychometric characteristics. RESULTS There were no considerable floor and ceiling effects regarding the total HandQ score. Test-retest reliability and internal consistency determined using the intraclass correlation coefficient (0.942) and Cronbach's α test (0.961) were excellent. The HandQ was well correlated with the Hand20 and the DASH scores. Scree plot showed unidimensionality of the HandQ, and the graphical model showed the questionnaire items of the HandQ had reasonable correlation among each item. CONCLUSIONS The HandQ has a sufficient reliability and internal consistency, and an excellent validity, and was shown to be able to be practically applicable in all patients with hand and elbow disorders.
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Affiliation(s)
- Kosuke Uehara
- Department of Orthopaedic Surgery, 26782The University of Tokyo Hospital, Tokyo, Japan
| | - Toshiki Miura
- Department of Orthopaedic Surgery, 13622JR General Hospital, Tokyo, Japan
| | - Ohe Takashi
- Department of Orthopaedic Surgery, NTT Medical Center Tokyo, Tokyo, Japan
| | - Tokuhide Doi
- Geriatric Care Facility Narita-tomisato Tokushuen, Tomisato, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, 26782The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Morizaki
- Department of Orthopaedic Surgery, 26782The University of Tokyo Hospital, Tokyo, Japan
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Huang HK, Lee SK, Huang YC, Yin CY, Chang MC, Wang JP. Long-term radiographic outcomes and functional evaluation of ulnar shortening osteotomy in patients with ulnar impaction syndrome and reverse oblique sigmoid notch: a retrospective case series study. BMC Musculoskelet Disord 2021; 22:136. [PMID: 33536011 PMCID: PMC7860176 DOI: 10.1186/s12891-021-04029-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 01/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ulnar shortening osteotomy (USO) is an effective treatment for ulnar impaction syndrome. However, there have been reports of osteoarthritis (OA) at the distal radioulnar joint (DRUJ) when USO was performed on patients with a reverse oblique sigmoid notch. This study aimed to evaluate the radiographic and functional outcomes following USO in patients with a reverse oblique sigmoid notch. METHODS We retrospectively reviewed patients having a reverse oblique sigmoid notch who underwent USO for ulnar impaction syndrome between 2002 and 2013. We evaluated radiographic changes of the DRUJ and functional outcomes of patients. RESULTS We enrolled 22 patients (22 wrists) with an average age of 49.6 years and a mean follow-up of 93.2 (range, 36-179; standard deviation [SD], 38.2) months. We found that there were changes in the inclination angle of the sigmoid notch, from an average reverse oblique of 14.9o (range, 11o-23o; SD, 3.4o) preoperatively to a more parallel 5.1o (range, 0o-11o; SD, 3.2o) at the final follow-up. The functional results at the final follow-up were good, with a mean visual analogue scale for pain of 0.2 (range, 0-1; SD, 0.4) at rest and 1.3 (range, 0-3; SD, 0.9) during activity, QuickDASH of 15.1 (range, 2.3-34.1; SD, 8.8), and modified Mayo Wrist Score of 91.6 (range, 70-100; SD, 6.4). Seven wrists (31.8%) had changes compatible with OA, but the wrists did not exhibit a significantly worse function when compared to wrists without OA changes, except for supination motion and grip strength. CONCLUSIONS For patients with a reverse oblique sigmoid inclination following USO, we observed that the inclination angle had a tendency to become parallel and some patients developed OA at the DRUJ. However, long-term functional outcomes could still be good. The reverse oblique sigmoid inclination does not seem to be an absolute contraindication for USO.
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Affiliation(s)
- Hui-Kuang Huang
- Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopedic Surgery, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.,Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Steve K Lee
- Department of Orthopedic Surgery, Hand and Upper Extremity Service, Hospital for Special Surgery, New York, NY, USA
| | - Yi-Chao Huang
- Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Yu Yin
- Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopedic Surgery, National Yang-Ming University Hospital, Yilan, Taiwan
| | - Ming-Chau Chang
- Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jung-Pan Wang
- Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.
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Iwatsuki K, Yoneda H, Kurimoto S, Yamamoto M, Tatebe M, Hirata H. Osteoid osteoma of the wrist misdiagnosed as de Quervain's tenosynovitis due to normal X-ray at the first visit: A case report. Int J Surg Case Rep 2020; 75:469-472. [PMID: 33076197 PMCID: PMC7527622 DOI: 10.1016/j.ijscr.2020.09.138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/19/2020] [Accepted: 09/19/2020] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION Osteoid osteomas are benign bone tumors that can occur in various bones throughout the body but are mainly found in the long bones. PRESENTATION OF THE CASE We report the case of a patient who had been treated for more than three years for a case of de Quervain's tenosynovitis due to tenderness in the first compartment of the right wrist joint. An X-ray on his first visit to a clinic was normal, but it was eventually discovered that he had an osteoid osteoma of the wrist. DISCUSSION The age of onset and gender proclivity of each disease should be considered. An X-ray should be taken in cases such as this, even to diagnose tendonitis. When any symptom, such as pain, has lingered for a long time and resisted treatment, we must reconsider the diagnosis. In patients with a low risk of tendonitis, it is essential to consider the possibility of other diseases if there is no improvement after treatment. As this patient's tumor was missed on the initial X-ray, it grew to a mature case of osteoid osteoma in three years. CONCLUSION We experienced a very educational case of osteoid osteoma of the wrist misdiagnosed as de Quervain's tenosynovitis.
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Affiliation(s)
- Katsuyuki Iwatsuki
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Japan.
| | - Hidemasa Yoneda
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Michiro Yamamoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Masahiro Tatebe
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Japan
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Tomori Y, Nanno M, Takai S. Recurrent Dislocation of the Extensor Carpi Ulnaris Tendon with Ulnar-Sided Triangular Fibrocartilage Complex Injury in an Ice Hockey Player: A Case Report. J NIPPON MED SCH 2020; 87:233-239. [DOI: 10.1272/jnms.jnms.2020_87-410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Yuji Tomori
- Department of Orthopedic Surgery, Nippon Medical School Musashi Kosugi Hospital
| | - Mitsuhiko Nanno
- Department of Orthopedic Surgery, Nippon Medical School Hospital
| | - Shinro Takai
- Department of Orthopedic Surgery, Nippon Medical School Hospital
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Tomori Y, Nanno M, Takai S. Habitual volar dislocation of the ulnar head with a locked distal radioulnar joint after distal radius fracture: A case report. Medicine (Baltimore) 2020; 99:e21343. [PMID: 32702933 PMCID: PMC7373515 DOI: 10.1097/md.0000000000021343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Habitual volar dislocation of the ulnar head with a locked distal radioulnar joint (DRUJ) is a rare complication after distal radius fracture. We present a case of habitual volar dislocation of the ulnar head in a woman with a dorsally displaced malunited distal radius fracture. PATIENT CONCERNS A 72-year-old woman presented with occasional painful locking of the forearm in full supination. She had fractured the left distal radius in a fall 6 months previously. The fracture had been treated non-surgically with wrist immobilization in a long and short arm cast for 6 weeks. Physical examination showed no swelling of the left hand. The wrist locked when the forearm was fully supinated, and the patient was not able to pronate her forearm without reducing the ulna by pressing the left ulna down toward the DRUJ. She experienced sharp pain during the reduction procedure and pronation of the left forearm. The affected wrist had 91% motion compared with the contralateral wrist. DIAGNOSIS Radiography and computed tomography showed 28° dorsally angulated malunion of the distal radius and ulnar head subluxation with respect to the radius. Magnetic resonance imaging revealed disruption of the ulnar-side triangular fibrocartilage complex (TFCC) from the ulna fovea. INTERVENTIONS The patient desired surgery to address the painful click during full supination of her left wrist and the limitations in her activities of daily living. Corrective osteotomy of the distal radius and arthroscopic repair of the ulnar-side tear of the TFCC were performed. The TFCC was arthroscopically repaired to the ulnar fovea to stabilize the DRUJ. OUTCOMES At 1 year postoperatively, radiography showed complete union of the radius. The affected side had 97% wrist motion compared with the contralateral wrist and a full range of forearm rotation without pain or clicking. The grasp strength was 100% compared with the normal wrist. LESSONS Malunited distal radius fracture with concomitant TFCC injury can result in habitual volar dislocation of the ulnar head due to severely dorsally angulated malunion of the radius and avulsion of the ulnar-side TFCC from the ulna fovea. This condition required corrective osteotomy plus TFCC repair.
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Affiliation(s)
- Yuji Tomori
- Department of Orthopaedic Surgery, Nippon Medical School Musashi Kosugi Hospital, Kanagawa
- Department of Orthopaedic Surgery, Ukima Central Hospital
| | - Mitsuhiko Nanno
- Department of Orthopaedic Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Shinro Takai
- Department of Orthopaedic Surgery, Nippon Medical School Hospital, Tokyo, Japan
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Katayama T, Furuta K, Ono H, Omokawa S. Clinical outcomes of unstable metacarpal and phalangeal fractures treated with a locking plate system: a prospective study. J Hand Surg Eur Vol 2020; 45:582-587. [PMID: 31959035 DOI: 10.1177/1753193419899332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We prospectively assessed clinical and radiological outcomes of locking plate fixation in treating unstable fractures in 11 metacarpals, 15 proximal phalanges, and eight middle phalanges in 34 consecutive patients from October 2011 to December 2016. Median length of follow-up was 14 months (range 12-24). The motion of finger joints, bony union, and complication rates were recorded. The median postoperative range of motion of the two interphalangeal joints and the metacarpophalangeal joint was 82% of the contralateral hands. Fractures in the three locations had significantly different recovery of the finger motion, with the best recovery for the metacarpal fractures. Closer distance between the plate edge and joint line was associated with a more limited range of the finger motion. The clinical outcomes approached an acceptable level at final follow-up. Finger stiffness is unavoidable after locking plate fixation of metacarpal and phalangeal fractures even with early hand therapy, with stiffness occurring in 10 out of 34 cases at the time of final follow-up 1 year after surgery. Level of evidence: II.
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Affiliation(s)
- Takeshi Katayama
- Department of Orthopaedic Surgery, Kokuho Central Hospital, Tawaramoto, Japan
| | - Kazuhiko Furuta
- Department of Orthopaedic Surgery, Kokuho Central Hospital, Tawaramoto, Japan
| | - Hiroshi Ono
- Department of Orthopaedic Surgery, Nishinara Central Hospital, Nara, Japan
| | - Shohei Omokawa
- Department of Hand Surgery, Nara Medical University, Kashihara, Japan
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Komura S, Hirakawa A, Masuda T, Nohara M, Kimura A, Matsushita Y, Akiyama H. Chronological changes in surgical outcomes after trapeziectomy with ligament reconstruction and tendon interposition arthroplasty for thumb carpometacarpal osteoarthritis. Orthop Traumatol Surg Res 2020; 106:357-364. [PMID: 31982383 DOI: 10.1016/j.otsr.2019.11.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/21/2019] [Accepted: 11/13/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Despite satisfactory mid-term and long-term outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) procedures for thumb carpometacarpal osteoarthritis, there is limited literature describing detailed chronological changes in early-phase postoperative outcomes. We investigated chronological changes of subjective, objective, and radiological outcomes within 1 year post-trapeziectomy with LRTI using a longitudinal evaluation and analyzed clinical factors associated with patient-reported subjective outcomes. HYPOTHESIS Some parameters influence patient-reported subjective outcomes during the early postoperative period. PATIENTS AND METHODS Nineteen patients (mean age, 67.3 years) who underwent trapeziectomy with LRTI were evaluated preoperatively and at 3, 6, and 12 months postoperatively to investigate objective (grip strength, pinch strength, range of motion [ROM] of the interphalangeal [IP] joint, metacarpophalangeal [MP] joint, and carpometacarpal [CMC] joint, Kapandji score), subjective (Disabilities of the Arm, Shoulder, and Hand [DASH] score, Hand20 questionnaire score, and visual analog scale [VAS] for pain), and radiological outcomes (trapezial space height and its ratio). Factors affecting DASH and Hand20 scores were analyzed. RESULTS Grip strength and pinch strength were decreased at 3-month follow-up. It required 6 months to recover preoperative strength and 12 months for significant improvement. VAS for pain, DASH, and Hand20 scores were significantly improved at 3-month follow-up, continuing to improve until 12 months. The trapezial space height and its ratio decreased approximately 50% at 3-month follow-up, with no further changes at 6 or 12 months. Both DASH and Hand20 scores were strongly correlated with VAS for pain during activity within 6 months post-surgery and moderately correlated with ROM of the thumb at 3 months post-surgery; however, they were not correlated with grip and pinch strength as well as the trapezial space height ratio within 12 months post-surgery. DISCUSSION Trapeziectomy with LRTI for thumb carpometacarpal osteoarthritis provided early subjective improvements in outcomes as early as 3 months post-procedure. However, more than 6 months are required to determine objective improvements in outcomes. To obtain early patient-reported satisfactory outcomes, we should focus not on improving hand and finger strength, but on treating postoperative surgical site pain and preventing thumb stiffness. LEVEL OF EVIDENCE IV, retrospective therapeutic study.
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Affiliation(s)
- Shingo Komura
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu 501-1194, Japan.
| | - Akihiro Hirakawa
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu 501-1194, Japan
| | - Tomihiro Masuda
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Marie Nohara
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Ayaka Kimura
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Yasuharu Matsushita
- Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu 501-1194, Japan
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Nakagawa Y, Kurimoto S, Maheu E, Matsui Y, Kanno Y, Menuki K, Hayashi M, Nemoto T, Nishizuka T, Tatebe M, Yamamoto M, Iwatsuki K, Dreiser RL, Hirata H. Cross-cultural translation, adaptation and validation of a Japanese version of the functional index for hand osteoarthritis (J-FIHOA). BMC Musculoskelet Disord 2020; 21:173. [PMID: 32178665 PMCID: PMC7333425 DOI: 10.1186/s12891-020-03193-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 03/09/2020] [Indexed: 11/22/2022] Open
Abstract
Background Hand osteoarthritis (OA) has a wide spectrum of clinical presentations and physical function is one of the core domains where patients suffer. The Functional Index for Hand Osteoarthritis (FIHOA) is a leading assessment tool for hand OA-related functional impairment. Our objective was to make a Japanese version of FIHOA (J-FIHOA) and validate it among Japanese hand OA patients. Methods Forward and backward translation processes were completed to create a culturally adapted J-FIHOA. A prospective, observational multicenter study was undertaken for the validation process. Seventeen collaborating hospitals recruited Japanese hand OA patients who met the American College of Rheumatology criteria. A medical record review and responses to the following patient-rated questionnaires were collected: J-FIHOA, Hand20, Health Assessment Questionnaire (HAQ), numerical rating scale for pain (NRS pain) and Short Form 36 Health Survey (SF-36). We explored the structure of J-FIHOA using factor analysis. Cronbach’s alpha coefficients and item-total correlations were calculated. Correlations between J-FIHOA and other questionnaires were evaluated for construct validity. Participants in clinically stable conditions repeated J-FIHOA at a one- to two-week interval to assess test-retest reliability. To evaluate responsiveness, symptomatic patients who started new pharmacological treatments had a 1-month follow-up visit and completed the questionnaires twice. Effect size (ES) and standardized response mean (SRM) were calculated with pre- and post-treatment data sets. We assessed responsiveness, comparing ES and SRM of J-FIHOA with other questionnaires (construct approach). Results A total of 210 patients participated. J-FIHOA had unidimensional structure. Cronbach’s alphas (0.914 among females and 0.929 among males) and item-total correlations (range, 0.508 to 0.881) revealed high internal consistency. Hand20, which measures upper extremity disability, was strongly correlated with J-FIHOA (r = 0.82) while the mental and role-social components of SF-36 showed no correlations (r = − 0.24 and − 0.26, respectively). Intraclass correlation coefficient for test-retest reliability was 0.83 and satisfactory. J-FIHOA showed the highest ES and SRM (− 0.68 and − 0.62, respectively) among all questionnaires, except for NRS pain. Conclusions Our results showed J-FIHOA had good measurement properties to assess physical function in Japanese hand OA patients both for ambulatory follow-up in clinical practice, and clinical research and therapeutic trials.
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Affiliation(s)
- Yasunobu Nakagawa
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Emmanuel Maheu
- Department of Rheumatology, AP-HP, Hospital Saint-Antoine, Paris, France
| | - Yuichiro Matsui
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuri Kanno
- Hand Surgery and Microsurgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Kunitaka Menuki
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masanori Hayashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuya Nemoto
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | | | - Masahiro Tatebe
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Michiro Yamamoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Katsuyuki Iwatsuki
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | | | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Iwatsuki K, Hoshiyama M, Oyama S, Yoneda H, Shimoda S, Hirata H. Electroencephalographic Functional Connectivity With the Tacit Learning System Prosthetic Hand: A Case Series Using Motor Imagery. Front Synaptic Neurosci 2020; 12:7. [PMID: 32184715 PMCID: PMC7058783 DOI: 10.3389/fnsyn.2020.00007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/07/2020] [Indexed: 12/01/2022] Open
Abstract
We previously created a prosthetic hand with a tacit learning system (TLS) that automatically supports the control of forearm pronosupination. This myoelectric prosthetic hand enables sensory feedback and flexible motor output, which allows users to move efficiently with minimal burden. In this study, we investigated whether electroencephalography can be used to analyze the influence of the auxiliary function of the TLS on brain function. Three male participants who had sustained below-elbow amputations and were myoelectric prosthesis users performed a series of physical movement trials with the TLS inactivated and activated. Trials were video recorded and a sequence of videos was prepared to represent each individual's own use while the system was inactivated and activated. In a subsequent motor imagery phase during which electroencephalography (EEG) signals were collected, each participant was asked to watch both videos of themself while actively imagining the physical movement depicted. Differences in mean cortical current and amplitude envelope correlation (AEC) values between supplementary motor areas (SMA) and each vertex were calculated. For all participants, there were differences in the mean cortical current generated by the motor imagery tasks when the TLS inactivated and activated conditions were compared. The AEC values were higher during the movement imagery task with TLS activation, although their distribution on the cortex varied between the three individuals. In both S1 and other brain areas, AEC values increased in conditions with the TLS activated. Evidence from this case series indicates that, in addition to motor control, TLS may change sensory stimulus recognition.
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Affiliation(s)
- Katsuyuki Iwatsuki
- Department of Hand Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Minoru Hoshiyama
- Department of Health Sciences, Faculty of Medicine, Nagoya University, Nagoya, Japan
| | - Shintaro Oyama
- Department of Hand Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hidemasa Yoneda
- Department of Hand Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Shingo Shimoda
- Center of Brain Science (CBS), CBS–TOYOTA Collaboration Center, RIKEN, Nagoya, Japan
| | - Hitoshi Hirata
- Department of Hand Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Long-term disuse of the hand affects motor imagery ability in patients with complete brachial plexus palsy. Neuroreport 2019; 30:452-456. [PMID: 30855560 DOI: 10.1097/wnr.0000000000001229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to examine motor imagery ability in patients with peripheral nerve disorder using the hand mental rotation task. Five patients with left total avulsion brachial plexus palsy (BPP) and 16 healthy age-matched adults participated in this study. The mean±SD time from the injury was 103.6±49.7 months. Participants performed a hand mental rotation task as the motor imagery task; outcome measures included the reaction time from cognizing hand stimuli to the judgment of hand laterality (right or left) and the error rate. Patients also completed the Hand 20 questionnaire to assess the use of their affected limb. Log-transformed reaction times of the affected limb in patients with BPP were significantly higher than those of the unaffected limb and the left-sided limb of the healthy participants. Log-transformed reaction times of the unaffected limb in patients were significantly higher than those of the right-sided limb in healthy participants. Log-transformed error rate did not differ between patients and healthy participants. According to the results of the Hand 20 questionnaire, patients with BPP hardly used their affected limb because of severe sensory-motor dysfunction. Motor imagery ability of the affected and unaffected limbs in patients with complete BPP may be decreased owing to long-term disuse. These findings suggest that long-term disuse in those with severe peripheral nerve disorders could affect motor imagery ability of both the affected and unaffected limbs.
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Uemura T, Takamatsu K, Okada M, Yokoi T, Onode E, Miyashima Y, Konishi S, Nakamura H. A case series of seven patients with recurrent median nerve neuropathy treated by the revision surgery of median nerve neurolysis and wrapping with radial artery perforator adipose flap. J Plast Reconstr Aesthet Surg 2019; 73:453-459. [PMID: 31757685 DOI: 10.1016/j.bjps.2019.09.051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/09/2019] [Accepted: 09/28/2019] [Indexed: 11/19/2022]
Abstract
Adhesion neuropathy of the median nerve with persistent pain can be a challenging problem. Currently, coverage of the median nerve with a well-vascularized soft tissue is deemed necessary after secondary neurolysis. Herein, we reviewed the outcomes of seven patients with a persistent median nerve neuropathy after a primary open carpal tunnel release or a median nerve repair, treated with neurolysis and median nerve wrapping with radial artery perforator adipose flaps. During the revision surgery, after a careful and complete neurolysis of the scarred median nerve, the distally based radial artery perforator adipose flap without its fascia was raised and rotated to wrap the median nerve. The mean size of the perforator flap was 1146 mm2, which was enough to wrap the median nerve in all patients. At 26 months postsurgery, both the visual analog scale score for pain with tingling, and the patient-reported outcome measures improved. There was no recurrence of the median nerve adhesion neuropathy and no major complications were noted. Tinel's sign at the palmar wrist completely disappeared in four patients and was relieved in three patients. The median distal motor latency becomes recordable, and closer to a normal compound motor action potential postoperatively in all patients. Secondary neurolysis and median nerve wrapping with a radial artery perforator adipose flap, which was modified to be softer and thinner than the radial artery perforator adipofascial flap, was a successful treatment for the recurrent median nerve neuropathy in terms of both pain relief and restoration of the hand function.
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Affiliation(s)
- Takuya Uemura
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzakicho, Abeno-ku, Osaka 545-0053, Japan; Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
| | - Kiyohito Takamatsu
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashiyodogawa-ku, Osaka 533-0024, Japan
| | - Mitsuhiro Okada
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Takuya Yokoi
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Ema Onode
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Yusuke Miyashima
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzakicho, Abeno-ku, Osaka 545-0053, Japan
| | - Sadahiko Konishi
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzakicho, Abeno-ku, Osaka 545-0053, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
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Kubo N, Moritomo H, Arimitsu S, Nishimoto S, Yoshida T. Distal Ulnar Metaphyseal Wedge Osteotomy for Ulnar Abutment Syndrome. J Wrist Surg 2019; 8:352-359. [PMID: 31579542 PMCID: PMC6773578 DOI: 10.1055/s-0038-1677494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
Background Ulnar shortening osteotomy of the diaphysis is a common and effective surgical procedure for ulnar abutment syndrome. However, this procedure has some disadvantages, such as a long period until union and a relatively high nonunion rate. To overcome these disadvantages, we have developed distal ulnar metaphyseal wedge osteotomy. The purpose of this article is to describe the technique and to report its clinical results. Patients and Methods Distal ulnar metaphyseal wedge osteotomy consists of resection of the wedge fragment at the distal ulnar metaphysis, compressing the distal fragment of the ulna toward the radial-proximal direction and fixation with a Herbert type headless screw. We performed this procedure for 58 patients with ulnar abutment syndrome, and the clinical data of 43 patients who were followed for > 6 months were analyzed. We evaluated range of motion, grip strength, and HAND20 which is a validated subjective scoring system in Japan. Results All patients experienced relief from their ulnar wrist pain, and bone union was achieved within an average of 2.6 months. The range of dorsiflexion improved from 63° preoperatively to 69° postoperatively, grip strength compared with the contralateral hand improved from 77% preoperatively to 87% postoperatively, and HAND20 improved from 41.3 points preoperatively to 22.4 points postoperatively. Discussion This procedure has advantages especially in early bone union. This procedure should be taken into consideration as one of the options to treat ulnar abutment syndrome.
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Affiliation(s)
- Nobuyuki Kubo
- Department of Orthopaedic Surgery, Kyouritsu Hospital, Kawanishi-shi, hyogo, Japan
| | - Hisao Moritomo
- Osaka Yukioka College of Health Science, Yukioka Hospital Hand Center, Osaka-shi, Osaka, Japan
| | - Sayuri Arimitsu
- Department of Orthopaedic Surgery, Yukioka Hospital, Osaka, Osaka Prefecture, Japan
| | - Shunsuke Nishimoto
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki-shi, Hyogo, Japan
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Töre NG, Oskay D. Validity and reliability study of the Turkish version of the Hand20 questionnaire. Turk J Med Sci 2019; 49:1243-1248. [PMID: 31291708 PMCID: PMC7018235 DOI: 10.3906/sag-1808-168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background/aim This study aimed to translate and validate the Turkish version of the Hand20 questionnaire. Materials and methods Patients who had upper extremity involvement and stable symptoms for the previous 4 weeks in their upper extremities were included in the study. Patients who were illiterate or used a splint during the day were excluded from the study. Participants completed the Turkish version of the Disabilities of the Arm, Shoulder, and Hand (DASH-T) questionnaire once and the final version of the Hand20 questionnaire twice in a 7-day interval. Internal consistency and reliability of the questionnaire was assessed. Moreover, correlations between Hand20 and DASH-T scores were analyzed using Spearman’s correlation coefficient. Results A total of 104 patients participated in the study. The Turkish version of the Hand20 met the set criteria of reliability and validity. Internal consistency (Cronbach’s alpha = 0.93) and test-retest reliability were excellent (r = 0.82). Hand20 showed a positive and statistically significant correlation with DASH-T (r = 0.76, P < 0.001). Conclusion The results showed that the Turkish version of the Hand20 had excellent test-retest reliability and validity. As a result of this study, it was determined that Hand20 was a valid and reliable instrument to measure the upper extremity disabilities of Turkish-speaking patients.
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Affiliation(s)
- Nurten Gizem Töre
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Deran Oskay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Ota H, Iwatsuki K, Kurimoto S, Iida K, Hirata H. Progression from Injection to Surgery for Trigger Finger: A Statistical Analysis. J Hand Surg Asian Pac Vol 2019; 22:194-199. [PMID: 28506159 DOI: 10.1142/s0218810417500241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study was to identify predictive factors of poor response to intra-flexoral sheath corticosteroid injection, as well as to identify factors associated with patients' decisions to undergo surgical treatment. METHODS Data from 112 patients who received steroid injection treatment for trigger finger were reviewed retrospectively. Logistic regression was used to assess the prognostic value of factors assumed to affect prognosis (age, sex, underlying disease, history of illness, presence of carpal tunnel syndrome, multiple digit involvement, and pre- and post-operative disability scores). RESULTS Multiple digits were affected in 42 patients. Associated and underlying conditions were carpal tunnel syndrome (n = 36), hypertension (n = 23), hyperlipidemia (n = 14), and history of malignant tumor (n = 10). Logistic regression analysis showed that multiple digit involvement and Froimson clinical severity score were factors significantly associated with surgical treatment after intra-flexoral sheath corticosteroid injection treatment. These two factors were also found to be associated with the patients' decisions to undergo surgical treatment. CONCLUSIONS Although local corticosteroid injection is useful in most cases, providers need to counsel patients with multiple digit involvement and/or severe cases about the possibility of requiring additional surgical treatment.
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Affiliation(s)
- Hideyuki Ota
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.,† Department of Orthopaedic Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Katsuyuki Iwatsuki
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigeru Kurimoto
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koji Iida
- ‡ Iida Orthopaedic Clinic, Yokkaichi, Japan
| | - Hitoshi Hirata
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Sonoki K, Tomori Y, Obara Y, Nanno M, Kodera N, Takai S. Trans-scaphoid Perilunate Fracture-dislocation with Concomitant Lunotriquetral Ligament Disruption: A Case Report. J NIPPON MED SCH 2018; 85:231-235. [PMID: 30259893 DOI: 10.1272/jnms.jnms.2018_85-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We report a case of trans-scaphoid perilunate fracture-dislocation with concomitant lunotriquetral ligament disruption of the right wrist in a 44-year-old man, sustained from a 10-m fall landing on his outstretched right hand. Open reduction was performed 1 day after injury; at first the palmar dislocation of the lunate was reduced with the palmar approach. Under direct view with the dorsal approach, the scaphoid was comminuted and then treated with open reduction and internal fixation with a double threshold screw using a dorsal approach and a bone graft from the distal radius. Although the scapholunate ligament was intact, the lunotriquetral ligament was disrupted and required repair with metal suture anchors. At the 28-month follow-up evaluation, the patient had no residual pain in his wrist and returned to work. Trans-scaphoid perilunate fracture-dislocations often accompany a comminuted fracture of the scaphoid and disruptions of the intercarpal ligaments, and bone union and ligament healing time is delayed. Prolonged immobilization of the wrist may restrict its range of motion and limit daily activities. Therefore, open reduction and internal fixation with a bone graft for the scaphoid and simultaneous repair of interosseous intercarpal ligaments are essential for satisfactory recovery from perilunate fracture-dislocations.
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Affiliation(s)
- Kentaro Sonoki
- Department of Orthopedic Surgery, Nippon Medical School Hospital
| | - Yuji Tomori
- Department of Orthopedic Surgery, Nippon Medical School Hospital
| | - Yoshinori Obara
- Department of Orthopedic Surgery, Nippon Medical School Hospital
| | - Mitsuhiko Nanno
- Department of Orthopedic Surgery, Nippon Medical School Hospital
| | - Norie Kodera
- Department of Orthopedic Surgery, Nippon Medical School Hospital
| | - Shinro Takai
- Department of Orthopedic Surgery, Nippon Medical School Hospital
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Nishizuka T, Iwatsuki K, Kurimoto S, Yamamoto M, Onishi T, Hirata H. Favorable Responsiveness of the Hand10 Questionnaire to Assess Treatment Outcomes for Lateral Epicondylitis. J Hand Surg Asian Pac Vol 2018; 23:205-209. [PMID: 29734897 DOI: 10.1142/s2424835518500212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of our study was to compare the responsiveness of the Hand10 questionnaire and the Pain visual analogue scale (VAS) for the assessment of lateral epicondylitis. METHODS The standardized response mean and effect size were used as indicators of responsiveness, measured at baseline and after 6 months of treatment. Among the 54 patients enrolled, 28 were treated using a forearm band, compress and stretching, with the other 26 patients treated using compress and stretching. RESULTS The standardized response mean and the effect size were 1.18 and 1.38, respectively, of the Hand10 and 1.39 and 1.75, respectively, for the Pain VAS. CONCLUSIONS The responsiveness of both tests was considered to be large, based on Cohen's classification of effect size, supporting the use of the Hand10 questionnaire to assess treatment outcomes for lateral epicondylitis.
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Affiliation(s)
- Takanobu Nishizuka
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsuyuki Iwatsuki
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigeru Kurimoto
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michiro Yamamoto
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuro Onishi
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hitoshi Hirata
- * Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Yuan C, Zhang H, Liu H, Gu J. Does concomitant ulnar styloid fracture and distal radius fracture portend poorer outcomes? A meta-analysis of comparative studies. Injury 2017; 48:2575-2581. [PMID: 28882374 DOI: 10.1016/j.injury.2017.08.061] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/10/2017] [Accepted: 08/27/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE An ulnar styloid fracture often occur in association with a distal radial fracture. Whether an ulnar styloid fracture interfere with the results of a distal radial fracture still remains controversial. The aim of this study was to analyse the effects of an accompanying ulnar styloid fracture on clinical outcomes in patients with distal radial fractures. METHODS A meta-analysis of published studies comparing outcomes of distal radial fractures with an ulnar styloid fracture versus isolated distal radial fractures was performed. Outcomes of function results, radiological evaluation, and patient reported scores were analyzed. RESULTS Ten studies including 1403 distal radius fractures were identified fitting inclusion criteria. There was no significant difference in wrist motion, grip strength, radial height, volar angle, ulnar variance, pain score, PRWE score, or SF-36 score for distal radial fractures associated with an ulnar styloid fracture versus isolated distal radial fractures. In final follow up, patients with associated an ulnar styloid fracture had lower radial inclination and higher DASH scores. But there was no significant clinical difference. In addition, we found there was no significant difference of outcomes between union and non-union ulnar styloid fractures. CONCLUSIONS Based on this meta-analysis, we suggest that an associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture and clinicians should be caution in electing operative treatment for patients with an ulnar styloid fracture.
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Affiliation(s)
- Chaoqun Yuan
- Department of Hand Surgery, Subei People's Hospital, Address: NO. 98, West Nantong Road, Yangzhou 225000, China.
| | - Hanyu Zhang
- Department of Emergency Medicine, Subei People's Hospital, Address: NO. 98,West Nantong Road, Yangzhou 225000, China.
| | - Hongjun Liu
- Department of Hand Surgery, Subei People's Hospital, Address: NO. 98, West Nantong Road, Yangzhou 225000, China.
| | - Jiaxiang Gu
- Department of Hand Surgery, Subei People's Hospital, Address: NO. 98, West Nantong Road, Yangzhou 225000, China.
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Yamamoto M, Natsume T, Kurimoto S, Iwatsuki K, Nishizuka T, Nolte MT, Hirata H. Patients with benign hand tumors are indicated for surgery according to patient-rated outcome measures. J Plast Reconstr Aesthet Surg 2017; 70:487-494. [PMID: 28153429 DOI: 10.1016/j.bjps.2016.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 12/07/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This study assessed the treatment outcomes of upper extremity benign tumors using the patient-rated outcome measures of Hand20 questionnaire. METHODS In total, 304 patients who underwent surgery for benign bone and soft tissue tumors of the upper limb were included. Tumors were classified into three size groups: <1 cm, 1-3 cm, and >3 cm. Tumors were divided with respect to location: digit, hand, wrist, forearm, elbow, upper arm, or axilla. We prospectively assessed responses to the Hand20 questionnaire that was administered both before and after surgery. RESULTS The mean Hand20 and pain scores significantly improved after surgery in patients with ganglion cysts, giant cell tumors of the tendon sheath, enchondromas, or pyogenic granulomas. For patients with hemangiomas, schwannomas, or glomus tumors, although the mean pain scores improved significantly following surgery, there were no significant changes in the mean Hand20 scores. However, the statistical power for this analysis was low. The mean Hand20 and pain scores improved significantly, regardless of the size grouping. The mean Hand20 scores significantly improved after surgery in patients with finger, thumb, hand, or wrist tumors. Except for elbow to axillary tumors, the mean pain scores significantly improved in all patients. CONCLUSION The results of Hand20 and pain scores suggest that most patients with benign hand tumors are indicated for surgery, but the degree of improvement differs according to tumor pathology and location but not size.
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Affiliation(s)
- Michiro Yamamoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
| | - Tadahiro Natsume
- Department of Orthopaedic Surgery, Kariya Toyota General Hospital, 5-15 Sumiyoshi-cho, Kariya 448-8505, Japan
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Katsuyuki Iwatsuki
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Takanobu Nishizuka
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Michael T Nolte
- University of Michigan Medical School, 1301 Catherine, Ann Arbor, MI 48109, USA
| | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
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Anterior interosseous nerve and posterior interosseous nerve involvement in neuralgic amyotrophy. Clin Neurol Neurosurg 2016; 151:108-112. [DOI: 10.1016/j.clineuro.2016.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/31/2016] [Accepted: 11/01/2016] [Indexed: 11/15/2022]
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Sawada H, Shinohara T, Natsume T, Hirata H. Clinical effects of internal fixation for ulnar styloid fractures associated with distal radius fractures: A matched case-control study. J Orthop Sci 2016; 21:745-748. [PMID: 27511887 DOI: 10.1016/j.jos.2016.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 05/12/2016] [Accepted: 06/29/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Ulnar styloid fractures are often associated with distal radius fractures. However, controversy exists regarding whether to treat ulnar styloid fractures. This study aimed to evaluate clinical effects of internal fixation for ulnar styloid fractures after distal radius fractures were treated with the volar locking plate system. METHODS We used prospectively collected data of distal radius fractures. 111 patients were enrolled in this study. A matched case-control study design was used. We selected patients who underwent fixation for ulnar styloid fractures (case group). Three control patients for each patient of the case group were matched on the basis of age, sex, and fracture type of distal radius fractures from among patients who did not undergo fixation for ulnar styloid fractures (control group). The case group included 16 patients (7 men, 9 women; mean age: 52.6 years; classification of ulnar styloid fractures: center, 3; base, 11; and proximal, 2). The control group included 48 patients (15 men, 33 women; mean age: 61.1 years; classification of ulnar styloid fractures: center, 10; base, 31; and proximal, 7). For radiographic examination, the volar tilt angle, radial inclination angle, and ulnar variance length were measured, and the union of ulnar styloid fractures was judged. For clinical examination, the range of motions, grip strength, Hand20 score, and Numeric Rating Scale score were evaluated. RESULTS There was little correction loss for each radiological parameter of fracture reduction, and these parameters were not significantly different between the groups. The bone-healing rate of ulnar styloid fractures was significantly higher in the case group than in the control group, but the clinical results were not significantly different. CONCLUSIONS We revealed that there was no need to fix ulnar styloid fractures when distal radius fractures were treated via open reduction and internal fixation with a volar locking plate system.
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Affiliation(s)
- Hideyoshi Sawada
- Anjo Kosei Hospital, 28 Higashi Hirokute, Anjio-cho, Anjyo, 446-8602, Japan.
| | - Takaaki Shinohara
- Chunichi Hospital, 3-12-3 Marunouchi, Naka-ku, Nagoya, 460-0002, Japan
| | - Tadahiro Natsume
- Kariya Toyota General Hospital, 5-15 Sumiyoshi, Kariya, 448-8505, Japan
| | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Tatebe M, Iwatsuki K, Hirata H, Oguchi T, Tanaka K, Urata S. Effects of depression and inflammatory factors on chronic conditions of the wrist. Bone Joint J 2016; 98-B:961-8. [DOI: 10.1302/0301-620x.98b7.37152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 03/08/2016] [Indexed: 12/23/2022]
Abstract
Aims Chronic conditions of the wrist may be difficult to manage because pain and psychiatric conditions are correlated with abnormal function of the hand. Additionally, intra-articular inflammatory cytokines may cause pain. We aimed to validate the measurement of inflammatory cytokines in these conditions and identify features associated with symptoms. Patients and Methods The study included 38 patients (18 men, 20 women, mean age 43 years) with a chronic condition of the wrist who underwent arthroscopy. Before surgery, the Self-Rating Depression Scale (SDS), Hand20 questionnaire and a visual analogue scale (VAS) for pain were used. Cytokine and chemokine levels in the synovial fluid of the wrist were measured using enzyme-linked immunosorbent assays and correlations between the levels with pain were analysed. Gene expression profiles of the synovial membranes were assessed using quantitative polymerase chain reaction. Results Older patients had high pre-operative Hand20 scores. One-year post-operative Hand20 and VAS scores and pre-operative VAS scores correlated with SDS scores. Post-operative VAS scores negatively correlated with the expression of nerve growth factor and SDS scores positively correlated with the expression of tumour necrosis factor-alpha and negatively correlated with the expression of tumour necrosis factor-converting enzyme. Conclusion There was a positive correlation between depression and chronic conditions of the wrist. Levels of some cytokines correlate with pain and depression. Additionally, cytokines may be important in the assessment and treatment of chronic conditions of the wrist and depression. Cite this article: Bone Joint J 2016;98-B:961–8.
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Affiliation(s)
- M. Tatebe
- Hand and Microsurgery Center, Anjo Kosei
Hospital, 28 Higashihirokute Anjocho, Anjo, Japan
| | - K. Iwatsuki
- Nagoya University Graduate School of Medicine, 65
Tsurumaicho, Showaku, Nagoya, Japan
| | - H. Hirata
- Nagoya University Graduate School of Medicine, 65
Tsurumaicho, Showaku, Nagoya, Japan
| | - T. Oguchi
- Hand and Microsurgery Center, Anjo Kosei
Hospital, 28 Higashihirokute Anjocho, Anjo, Japan
| | - K. Tanaka
- Hand and Microsurgery Center, Anjo Kosei
Hospital, 28 Higashihirokute Anjocho, Anjo, Japan
| | - S. Urata
- Hand and Microsurgery Center, Anjo Kosei
Hospital, 28 Higashihirokute Anjocho, Anjo, Japan
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Yamamoto M, Murakami Y, Iwatsuki K, Kurimoto S, Hirata H. Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty. BMC Musculoskelet Disord 2016; 17:144. [PMID: 27039373 PMCID: PMC4818897 DOI: 10.1186/s12891-016-0996-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 03/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent advances in imaging modalities have enabled three-dimensional preoperative simulation. A four-dimensional preoperative simulation system would be useful for debridement arthroplasty of primary degenerative elbow osteoarthritis because it would be able to detect the impingement lesions. METHODS We developed a four-dimensional simulation system by adding the anatomical axis to the three-dimensional computed tomography scan data of the affected arm in one position. Eleven patients with primary degenerative elbow osteoarthritis were included. A "two rings" method was used to calculate the flexion-extension axis of the elbow by converting the surface of the trochlea and capitellum into two rings. A four-dimensional simulation movie was created and showed the optimal range of motion and the impingement area requiring excision. To evaluate the reliability of the flexion-extension axis, interobserver and intraobserver reliabilities regarding the assessment of bony overlap volumes were calculated twice for each patient by two authors. Patients were treated by open or arthroscopic debridement arthroplasties. Pre- and postoperative examinations included elbow range of motion measurement, and completion of the patient-rated questionnaire Hand20, Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score, and the Mayo Elbow Performance Score. RESULTS Measurement of the bony overlap volume showed an intraobserver intraclass correlation coefficient of 0.93 and 0.90, and an interobserver intraclass correlation coefficient of 0.94. The mean elbow flexion-extension arc significantly improved from 101° to 125°. The mean Hand20 score significantly improved from 52 to 22. The mean Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score significantly improved from 67 to 88. The mean Mayo Elbow Performance Score significantly improved from 71 to 91 at the final follow-up evaluation. CONCLUSION We showed that four-dimensional, preoperative simulation can be generated by adding the rotation axis to the one-position, three-dimensional computed tomography image of the affected arm. This method is feasible for elbow debridement arthroplasty.
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Affiliation(s)
- Michiro Yamamoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Yukimi Murakami
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Katsuyuki Iwatsuki
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Oda T, Abe Y, Katsumi Y, Ohi H, Nakamura T, Inagaki K. Reliability and Validity of the Japanese Version of the Michigan Hand Outcomes Questionnaire: A Comparison with the DASH and SF-36 Questionnaires. J Hand Surg Asian Pac Vol 2016; 21:72-7. [DOI: 10.1142/s2424835516500119] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The Michigan Hand Outcomes Questionnaire (MHQ) has shown reliability, validity and responsiveness and has been used to assess surgical outcomes mainly in North America. We established a Japanese version of the MHQ and evaluated its reliability and validity compared with both the short-form 36 (SF-36) questionnaire and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire in a Japanese-speaking population. Methods: The MHQ was cross-culturally adapted to a Japanese version according to guidelines. Sixty-eight patients with hand conditions were enrolled in this study and answered the MHQ, DASH questionnaire and SF-36 questionnaire. The MHQ was completed again with an interval of one or two weeks. Reproducibility and internal consistency were statistically assessed by the test-retest method and calculating Cronbach's alpha. Spearman's rank correlation was calculated to assess associations between the MHQ and the SF-36 questionnaire as well as the DASH questionnaire. Results: The intraclass correlation coefficients of MHQ subscales ranged from 0.68 to 0.93. Aesthetics subscale of the left hand showed the lowest intraclass correlation but still a good correlation. Cronbach's alpha values of the MHQ ranged from 0.81 to 0.96 for all subscales. The absolute values of Spearman's rank correlation coefficient between MHQ subscales and DASH function/symptoms scores ranged from 0.49 to 0.82. Spearman's correlation coefficients of the MHQ total score to subscales of the SF-36 questionnaire ranged from 0.42 to 0.68. The strongest correlations were found between work performance of the MHQ and rolephysical of the SF-36 questionnaire. Conclusions: The Japanese version of the MHQ has adequate instrument properties for assessing hand outcomes compared with the SF-36 questionnaire as well as the DASH questionnaire.
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Affiliation(s)
- Takashi Oda
- The Functional Evaluation Committee, The Japanese Society for Surgery of the Hand, Tokyo, Japan
- Department of Orthopedic Surgery, Sapporo Medical University, Sapporo, Japan
| | - Yukio Abe
- The Functional Evaluation Committee, The Japanese Society for Surgery of the Hand, Tokyo, Japan
- Department of Orthopedic Surgery, Saiseikai Shimonoseki General Hospital, Shimonoseki, Japan
| | - Yasukazu Katsumi
- The Functional Evaluation Committee, The Japanese Society for Surgery of the Hand, Tokyo, Japan
- Department of Orthopedic Surgery, Uji Takeda Hospital, Uji, Japan
| | - Hiroyuki Ohi
- The Functional Evaluation Committee, The Japanese Society for Surgery of the Hand, Tokyo, Japan
- Hand and Microsurgery Center, Seirei Hamamatsu Hospital, Hamamatsu, Japan
| | - Toshiyasu Nakamura
- The Functional Evaluation Committee, The Japanese Society for Surgery of the Hand, Tokyo, Japan
- Clinical Research Center, International University of Health and Welfare, Tokyo, Japan
| | - Katsunori Inagaki
- The Functional Evaluation Committee, The Japanese Society for Surgery of the Hand, Tokyo, Japan
- Department of Orthopedic Surgery, Showa University, Tokyo, Japan
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48
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Kurahashi T, Shinohara T, Hirata H. Modified dorsal percutaneous screw fixation through a transtrapezial approach for scaphoid fractures. J Hand Surg Eur Vol 2015; 40:868-9. [PMID: 25588663 DOI: 10.1177/1753193414566553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- T Kurahashi
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Shinohara
- Nagoya Hand Surgery Center, Chunichi Hospital, Nagoya, Japan
| | - H Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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49
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Konzelmann M, Burrus C, Hilfiker R, Rivier G, Deriaz O, Luthi F. Cross-cultural adaptation, reliability, internal consistency and validation of the Hand Function Sort (HFS©) for French speaking patients with upper limb complaints. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:18-24. [PMID: 24839002 DOI: 10.1007/s10926-014-9514-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Functional evaluation of upper limb is not only based on clinical findings but requires self-administered questionnaires to address patients' perspective. The Hand Function Sort (HFS©) was only validated in English. The aim of this study was the French cross cultural adaptation and validation of the HFS© (HFS-F). METHODS 150 patients with various upper limbs impairments were recruited in a rehabilitation center. Translation and cross-cultural adaptation were made according to international guidelines. Construct validity was estimated through correlations with Disabilities Arm Shoulder and Hand (DASH) questionnaire, SF-36 mental component summary (MCS),SF-36 physical component summary (PCS) and pain intensity. Internal consistency was assessed by Cronbach's α and test-retest reliability by intraclass correlation. RESULTS Cronbach's α was 0.98, test-retest reliability was excellent at 0.921 (95 % CI 0.871-0.971) same as original HFS©. Correlations with DASH were-0.779 (95 % CI -0.847 to -0.685); with SF 36 PCS 0.452 (95 % CI 0.276-0.599); with pain -0.247 (95 % CI -0.429 to -0.041); with SF 36 MCS 0.242 (95 % CI 0.042-0.422). There were no floor or ceiling effects. CONCLUSIONS The HFS-F has the same good psychometric properties as the original HFS© (internal consistency, test retest reliability, convergent validity with DASH, divergent validity with SF-36 MCS, and no floor or ceiling effects). The convergent validity with SF-36 PCS was poor; we found no correlation with pain. The HFS-F could be used with confidence in a population of working patients. Other studies are necessary to study its psychometric properties in other populations.
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Affiliation(s)
- M Konzelmann
- Service de réadaptation de l'appareil locomoteur, Clinique romande de réadaptation suvacare, Avenue du grand champsec, 90, 1950, Sion, Switzerland,
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Goula T, Ververidis A, Tripsianis G, Tilkeridis K, Drosos GI. The Greek version of the Hand20 questionnaire: crosscultural translation, reliability and construct validity. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 2015; 20:33-8. [PMID: 25609272 DOI: 10.1142/s0218810415500045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The English version of Hand20 questionnaire was translated into Greek and cultural adaptation was performed. The validity was assessed in 134 patients with a variety of upper limb disorders. A comparison of Hand20 and DASH was also performed. All patients completed EQ-5D, Hand20 and DASH questionnaire. Test-retest reliability was assessed in a subgroup of 37 patients. We assessed the convergent validity of Hand20 by correlating its scores to DASH and EQ-5D scores. We also compared the completeness of Hand20 and DASH. We found no statistically significant differences in Hand20 scores between the 1st and 2nd measurements as well as a strong correlation between Hand20 and the other two questionnaires. There were also better rates of response and fewer missing data even in elderly individuals.
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Affiliation(s)
- Thomais Goula
- University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
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