Hand Unit, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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Faculty of Life Sciences and Medicine, King’s College London, London, UK
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Introduction Wrist arthritis, either primary or secondary, is a debilitating condition that often leads to significant limitations in the use of the hand due to chronic wrist pain. When conservative treatment fails, surgical intervention is
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evolution of the upper limb and refinement in manipulation. Resection arthroplasties have shown great limitations in producing pain relief and stability of the DRUJ. Studies by Hagert, and Lees and Scheker made it progressively obvious that both the
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within minutes due to tourniquet pressure and ischemia ( 10 ). As a result, surgery time was limited and required sedation. In addition, the surgeon could not adjust the reconstructed parts of the hand during the surgery because of the pain, neuropraxia
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restoring a degree of function to the wrist, while minimizing pain and maximizing motion. The biomechanics of the wrist are substantially altered by all intercarpal arthrodesis procedures. In the unaltered wrist, 20% of axial force is transmitted across the
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destruction of the cartilage. Conventional treatment includes analgesics and non-steroidal anti-inflammatory drugs. Intra-articular visco-supplementation with hyaluronic acid has been shown to be effective in terms of pain relief and improved functionality
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function can be evaluated by examination of light touch, but in patients with an acute injury it may be easier to assess the patient’s ability to feel pain (e.g. that applied by a forceps) in the innervation area of the specific nerve. Two
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Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere, Finland
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Department of Orthopaedics and Traumatology, Tampere University Hospital, Finland
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younger patients, a shortening of the radius of more than 3 mm may cause functional deficit in terms of prolonged pain, reduced range of motion (ROM) and decreased grip strength. 40 , 41 It seems, however, that over 1 mm step-off or gap on the joint
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segment instability (DISI) with a scapholunate angle of approximately 90° (S, scaphoid; L, lunate (red)). SL dissociation is the most common form of CI. Patients with an SLL injury often present with a ‘click’ or ‘pain’ on the dorso-radial aspect
Department of Orthopaedics and Traumatology, Paracelsus Medical University, Nuremberg, Germany
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Institute for Hand- and Plastic Surgery, Oldenburg, Germany
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Introduction Osteoarthritis of the proximal interphalangeal (PIP) joint, either primary or secondary, limits the range of motion and causes pain with or without instability, leading to significant global hand function impairment ( 1 ). Typical
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, 9 , 16 , 17 , 19 However, no uniformity may be found in the assessment of clinical outcomes. The following parameters are evaluated: patient overall satisfaction, pain relief, grip and key-pinch strength, ROM, quick-DASH and Michigan Hand Outcomes
