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Andrea Fidanza, Stefano Necozione, and Lorenzo Garagnani

Purpose

  • Partial wrist denervation can be performed by isolated posterior interosseous nerve (PIN) or combined PIN plus (+) anterior interosseous nerve (AIN) neurectomy procedures.

  • The purpose of the current systematic review is to investigate any differences in clinical outcomes and failures in patients undergoing AIN + PIN vs isolated PIN neurectomy.

Methods

  • A review of the English Literature was performed on Medline, WOS and Scopus according to PRISMA protocol combining ‘wrist denervation’, ‘PIN neurectomy’, ‘AIN neurectomy’, anterior interosseous nerve neurectomy’ and ‘posterior interosseous nerve neurectomy’. Studies were assessed with a modified Coleman Methodology Score (CMS). The primary outcome for meta-analysis was ‘Failures’, including all patients who have required a second surgery or those who are left with pain (defined as ‘bad’).

Results

  • Overall, 10 studies totalling 347 wrists were included in this systematic review, with a ‘moderate’ CMS. The isolated PIN neurectomy technique showed a 15.1% pooled failure rate at a median follow-up of 22 months, while the combined AIN+PIN denervation had a pooled failure rate of 23.6% at a follow-up with a median of 29 months. The combined analysis of both procedures did not show significantly better results in favour of either technique, with a general failure rate of 21.6% (P = 0.0501).

Conclusion

  • Partial denervation for chronic wrist pain is a salvage procedure that leads to an overall success of 78.4% for pain relief, with no substantial complications. Apparently, performing the neurectomy also of the AIN does not offer greater advantages compared to the isolated PIN neurectomy.

Paul Hoogervorst, Peter van Schie, and Michel PJ van den Bekerom

B . Correlation of the degree of clavicle shortening after non-surgical treatment of midshaft fractures with upper limb function . BMC Musculoskelet Disord 2015 ; 16 : 151 . 36. Goudie EB Clement ND Murray IR

Nicolas Gallusser, Bardia Barimani, and Frédéric Vauclair

of shortening have been shown to adequately maintain the upper limb function. 9 , 10 For this reason, fractures that are displaced within these values following immobilization are good candidates for conservative management. Regarding surgical