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T R C Davis - One of the best experts on this subject based on the ideXlab platform.
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six year outcome excision of the trapezium for trapeziometacarpal joint osteoarthritis is it improved by ligament reconstruction and temporary Kirschner Wire insertion
Journal of Hand Surgery (European Volume), 2012Co-Authors: H Salem, T R C DavisAbstract:This randomized prospective study compared the treatment of trapeziometacarpal joint osteoarthritis with a) trapeziectomy with no ligament reconstruction, no soft tissue interposition and no temporary Kirschner Wire stabilization (Group T); b) trapeziectomy with flexor carpi radialis ligament reconstruction and interposition and temporary K-Wire stabilization (Group T+LRTI). We followed 99 patients with 114 thumbs (59 T and 55 T+LRTI) for a mean of 6.2 (range, 4.2–8.1) years. There were no significant differences between the two treatments in any subjective or objective outcome measure at 6 year follow-up. Eighty-two percent of the thumbs were painless or only ached after use. The DASH (Group T mean, 31; 95% CI, 26–42: Group T+LRTI mean 30; 95% CI, 22–35) and Patient Evaluation Measure (Group T mean, 35; 95% CI, 29–41: Group T+LRTI mean 34; 95% CI, 27–39) scores were significantly better than preoperatively. Thumb key pinch strength did not differ significantly between the two treatment groups (Group T me...
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trapeziectomy for trapeziometacarpal joint osteoarthritis is ligament reconstruction and temporary stabilisation of the pseudarthrosis with a Kirschner Wire important
Journal of Hand Surgery (European Volume), 2009Co-Authors: T R C Davis, Alistair PaceAbstract:This randomised prospective study compared two operations for trapeziometacarpal joint osteoarthritis: trapeziectomy with Flexor carpi radialis ligament reconstruction, tendon interposition and Kirschner Wire insertion followed by splintage for 6 weeks (T+LRTI) and excision of the trapezium with no Kirschner Wire and immobilisation of the thumb in a soft bandage for only 3 weeks (T). Sixty-seven thumbs with trapeziectomy (T) and 61 with trapeziectomy and ligament reconstruction and tendon interposition (T+LRTI) were assessed preoperatively and at 3-months and 1-year after surgery. Forty-seven percent and 73% of patients reported no pain or only aching after use at 3-months and 1-year respectively and the DASH and Patient Evaluation Measure (PEM) outcome scores reduced postoperatively indicating improved function. However the pain, DASH and PEM scores, and also key and tip thumb pinch and all the other clinical outcome measures, did not differ significantly between the two groups at either 3-months or 1-ye...
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trapeziectomy for trapeziometacarpal joint osteoarthritis is ligament reconstruction and temporary stabilisation of the pseudarthrosis with a Kirschner Wire important
Journal of Hand Surgery (European Volume), 2009Co-Authors: T R C Davis, Alistair PaceAbstract:This randomised prospective study compared two operations for trapeziometacarpal joint osteoarthritis: trapeziectomy with Flexor carpi radialis ligament reconstruction, tendon interposition and Kirschner Wire insertion followed by splintage for 6 weeks (T+LRTI) and excision of the trapezium with no Kirschner Wire and immobilisation of the thumb in a soft bandage for only 3 weeks (T). Sixty-seven thumbs with trapeziectomy (T) and 61 with trapeziectomy and ligament reconstruction and tendon interposition (T+LRTI) were assessed preoperatively and at 3-months and 1-year after surgery. Forty-seven percent and 73% of patients reported no pain or only aching after use at 3-months and 1-year respectively and the DASH and Patient Evaluation Measure (PEM) outcome scores reduced postoperatively indicating improved function. However the pain, DASH and PEM scores, and also key and tip thumb pinch and all the other clinical outcome measures, did not differ significantly between the two groups at either 3-months or 1-year after surgery.
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dorsal fracture dislocation of the proximal interphalangeal joint a comparative study of percutaneous Kirschner Wire fixation versus open reduction and internal fixation
Journal of Hand Surgery (European Volume), 2005Co-Authors: A Aladin, T R C DavisAbstract:Nineteen patients with a dorsal fracture–dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner Wire fixation (eight cases) or open reduction and internal fixation, using either one or two lag screws (six cases) or a cerclage Wire (five cases). At a mean follow-up of 7 (range 6–9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more “loss of feeling” in the affected finger and those specifically treated by cerclage Wire fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30°: range 18–38°) and a smaller arc of motion (median, 48°: range 45–60°) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner Wire fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75°; range 60–108°). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal fixation, both of which were technically demanding.
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dorsal fracture dislocation of the proximal interphalangeal joint a comparative study of percutaneous Kirschner Wire fixation versus open reduction and internal fixation
Journal of Hand Surgery (European Volume), 2005Co-Authors: A Aladin, T R C DavisAbstract:Nineteen patients with a dorsal fracture-dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner Wire fixation (eight cases) or open reduction and internal fixation, using either one or two lag screws (six cases) or a cerclage Wire (five cases). At a mean follow-up of 7 (range 6-9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more "loss of feeling" in the affected finger and those specifically treated by cerclage Wire fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30 degrees : range 18-38 degrees ) and a smaller arc of motion (median, 48 degrees : range 45-60 degrees ) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner Wire fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75 degrees ; range 60-108 degrees ). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal fixation, both of which were technically demanding.
A Aladin - One of the best experts on this subject based on the ideXlab platform.
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dorsal fracture dislocation of the proximal interphalangeal joint a comparative study of percutaneous Kirschner Wire fixation versus open reduction and internal fixation
Journal of Hand Surgery (European Volume), 2005Co-Authors: A Aladin, T R C DavisAbstract:Nineteen patients with a dorsal fracture–dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner Wire fixation (eight cases) or open reduction and internal fixation, using either one or two lag screws (six cases) or a cerclage Wire (five cases). At a mean follow-up of 7 (range 6–9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more “loss of feeling” in the affected finger and those specifically treated by cerclage Wire fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30°: range 18–38°) and a smaller arc of motion (median, 48°: range 45–60°) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner Wire fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75°; range 60–108°). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal fixation, both of which were technically demanding.
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dorsal fracture dislocation of the proximal interphalangeal joint a comparative study of percutaneous Kirschner Wire fixation versus open reduction and internal fixation
Journal of Hand Surgery (European Volume), 2005Co-Authors: A Aladin, T R C DavisAbstract:Nineteen patients with a dorsal fracture-dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner Wire fixation (eight cases) or open reduction and internal fixation, using either one or two lag screws (six cases) or a cerclage Wire (five cases). At a mean follow-up of 7 (range 6-9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more "loss of feeling" in the affected finger and those specifically treated by cerclage Wire fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30 degrees : range 18-38 degrees ) and a smaller arc of motion (median, 48 degrees : range 45-60 degrees ) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner Wire fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75 degrees ; range 60-108 degrees ). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal fixation, both of which were technically demanding.
S Pechlaner - One of the best experts on this subject based on the ideXlab platform.
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closed reduction transarticular Kirschner Wire fixation versus open reduction internal fixation in the treatment of bennett s fracture dislocation
Journal of Hand Surgery (European Volume), 2003Co-Authors: M Lutz, M Gabl, R Sailer, Robert Zimmermann, Hanno Ulmer, S PechlanerAbstract:Abstract Thirty two patients with fracture dislocations of the base of the thumb metacarpal with a single large fracture fragment (Bennett's fracture) were either treated by open reduction and internal fixation or closed reduction and percutaneous transarticular Kirschner wiring. All were assessed at a mean follow up of 7 (range 3–18) years. Patients with an articular step off more than 1 mm were excluded. The type of treatment did not influence the clinical outcome or the prevalence of radiological post-traumatic arthritis. The percutaneous group had a significantly higher incidence of adduction deformity of the first metacarpal. This was attributed to Kirschner Wire placement near the fracture line or in the compression zone of the fracture, resulting in loss of reduction. This however did not result in an inferior outcome.
Martin I Boyer - One of the best experts on this subject based on the ideXlab platform.
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volar locking plate and Kirschner Wire fixation did not differ in terms of functional outcomes after dorsally displaced distal radial fracture
Journal of Bone and Joint Surgery American Volume, 2015Co-Authors: Martin I BoyerAbstract:Costa ML, Achten J, Parsons NR, Rangan A, Griffin D, Tubeuf S, Lamb SE; DRAFFT Study Group. Percutaneous Fixation with Kirschner Wires Versus Volar Locking Plate Fixation in Adults with Dorsally Displaced Fracture of Distal Radius: Randomised Controlled Trial. BMJ. 2014 Aug 5;349:g4807. ### Question: In patients with a dorsally displaced fracture of the distal part of the radius, how does volar locking-plate fixation compare with Kirschner-Wire fixation? ### Design: Randomized (allocation concealed), blinded (data collectors and outcome assessors), controlled trial with twelve months of follow-up (Distal Radius Acute Fracture Fixation Trial [DRAFFT]). ### Setting: 18 centers in the United Kingdom. ### Patients: 461 patients ≥18 years of age (mean age, 59 years; 84% women) who had a dorsally displaced fracture of the distal part of the radius within 3 cm of the radiocarpal joint in the past 2 weeks. Exclusion criteria were a fracture extending >3 cm from the radiocarpal joint, open fracture, inability of the fracture to be reduced with indirect techniques, or contraindication to anesthesia. 416 patients (90%) completed follow-up. ### Intervention: Patients were allocated to volar locking-plate fixation (n = 231) or Kirschner-Wire fixation (n = 230). Locking-plate fixation involved an incision over the volar …
Kristin B De Haseth - One of the best experts on this subject based on the ideXlab platform.
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dorsal fracture dislocations of the proximal interphalangeal joint evaluation of closed reduction and percutaneous Kirschner Wire pinning
Hand, 2015Co-Authors: Kristin B De Haseth, Valentin Neuhaus, Chaitanya S MudgalAbstract:Background The purpose of this study is to evaluate the outcome of closed reduction and percutaneous Kirschner Wire pinning in acute dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint.
