Interposition Arthroplasty Versus Hematoma and Distraction for the Treatment of Osteoarthritis of the Trapeziometacarpal Joint

Various surgical techniques were reported with excellent result for the treatment of trapeziometacarpal joint arthritis. However, the best treatment option was not defined yet

A new volar plate DiPhos-RM for fixation of distal radius fracture: Preliminary report

We analyzed the efficiency of a new plate DiPhos-RM in CFR-PEEK [carbon-fiber-reinforced poly (etheretherketone)] for the volar fixation of distal radius fractures. The new plate's composition has the advantage of x-ray absolute transparency, therefore allowing to monitor the healing of the fracture. The desired combination of high strength and low rigidity is obtained through the use of the polymer composites CFR-PEEK. In this preliminary study (from March 2012 to June 2012), 10 cases of intra-articular distal radius fractures were treated with DiPhos-RM produced by Lima Corporate (Italy). The fractures were classified according to the AO classification, 4 fractures were type C1, 3 type C2, and 3 were A2. A preoperative computed tomography scan was carried out in all patients. One patient also underwent a postoperative computed tomography scan. Grip strength, range of motion, and DASH score were evaluated at follow-up. There were no cases of hardware failure. Specifically, no loss of position or alignment of fixed-angle locking screws or breakage of the plate were observed. Radiographic union was present at an average of 6 weeks (range, 5 to 8 wk). The overall preliminary experience with this new plate is favorable. The new plate is easy to apply and provides the surgeon dual options of fixed-angle or variable-angle screws. It was rigid enough to maintain the reduction also in AO type C articular fractures. Copyright © 2013 by Lippincott Williams & Wilkins

Schwannomas of the upper extremity: analysis of 34 cases

Schwannomas are the most common benign tumours developing in peripheral nerves. They usually present as a slow-growing mass, sometimes associated with pain and paraesthesia. The aim of this study is to define the correct preoperative diagnosis, to review the surgical treatment employed and to evaluate short- and long-term neurological deficits

Treatment of the ulna non-unions using dynamic compression plate fixation, iliac bone grafting and autologous platelet concentrate

Clinical study of a series of ten patients treated between 2004 and 2009 for non-unions of the ulna. The patients have been treated with osteosynthesis using a dynamic compression plate and biological enhancement of the consolidation using bone graft and autologous platelet injection. The follow-up consisted of clinical and radiographic assessment. Functional scores used were the Visual Analogue Scale (VAS) for pain and the Disability Assessment for the Shoulder and Hand (DASH) questionnaire. The mean time of follow-up was 21 months. Considering both clinical and radiological criteria, bony union was achieved in 9/10 cases on average time of 4 months. According to the system of Anderson, 5 patients provided an excellent result, 2 a satisfactory result, 2 an unsatisfactory result and 1 treatment resulted in failure. At follow-up, the mean VAS score for pain in the upper limb was 1 (range, 0-4) at rest and 2 (range, 0-7) during activities. The physical function and symptoms of the upper limb, evaluated with the DASH questionnaire, scored 17 points. In conclusion, at a mean 21 months follow-up, there was high success regarding both forearm alignment, clinical and functional results. The use of three combined methods provides high success regarding both radiological and clinical results, even if we have no information on the prevalent efficacy of one particular method. © Springer-Verlag 2011

Volar plate fixation for the treatment of distal radius fractures: Analysis of adverse events

OBJECTIVES:: Determining the rate of specific adverse events after volar plating performed for distal radius fractures. DESIGN:: Retrospective. SETTING:: University level I trauma center. PATIENTS:: We searched the electronic database of all surgical procedures performed in our department using the following keywords: distal radius fracture, wrist fracture, and plate fixation. We identified 315 patients, 12 of whom were lost at follow-up. INTERVENTION:: Volar plate fixation for the treatment of distal radius fractures. MAIN OUTCOME MEASUREMENTS:: At an average follow-up of 5 years, 303 patients were evaluated through medical records and clinical and radiographic assessment for specific adverse events after volar plate fixation. RESULTS:: Adverse events were observed in 18 patients (5.9%). Implant-related adverse events, including tendon impairments, intra-articular screws, and screw loosening, were observed in 15 patients (5.0%). Extensor tendon impairments were represented by 5 cases of extensor tenosynovitis and 3 cases of rupture of the extensor pollicis longus due to screws protruding dorsally. Flexor impairments were represented by 2 cases of tenosynovitis and 2 cases of flexor pollicis longus rupture. Screw penetration into the radioulnar joint was observed in 1 case. Loss of reduction was identified in 3 cases. One patient had a deep postoperative infection treated with operative debridement. One patient experienced injury to the median nerve during routine implant removal unrelated to tendon issues. CONCLUSIONS:: The majority of adverse events after volar plate fixation were due to technical errors in implant placement. In our cohort, tendon impairments were the most frequently observed; among these, extensor tendon impairments were the most represented (50% of all adverse events). All 12 tendon-related adverse events were due to technical shortcomings with implant placement. LEVEL OF EVIDENCE:: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited

Adaptive Proximal Scaphoid Implant stability despite a perilunate dislocation: a case report

We present the case of a 22 y.o. male patient suffering from scaphoid non-union with avascular necrosis of the proximal pole and initial degenerative arthritis