The Journal of hand surgery
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Comparative Study
Prospective 1-year follow-up study comparing joint prosthesis with tendon interposition arthroplasty in treatment of trapeziometacarpal osteoarthritis.
Osteoarthritis of the thumb basal joint is a common and disabling condition. This clinical follow-up study compares the efficacy of total basal joint replacement surgery with that of tendon interposition arthroplasty. ⋯ This study demonstrates that patients with joint prostheses achieve faster convalescence with better patient comfort and improved strength and range of motion without any increased risk of complications than do patients treated with tendon interposition arthroplasty at 1-year follow up. However, a randomized clinical trial with long-term follow-up is required.
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Randomized Controlled Trial Comparative Study
Comparison of 2 methods of immobilization of fifth metacarpal neck fractures: a prospective randomized study.
The objective of this study was to prospectively compare the effectiveness of 2 methods of cast immobilization for fifth metacarpal neck fractures with respect to the time required for cast application, durability and tolerability of the cast, efficacy of maintaining reduction, and postimmobilization range of motion. ⋯ There was no difference between the 2 groups on maintaining the reduction on final lateral radiographs. Stiffness was not a complication of either group. Advantages of the MCP-ext cast include quicker application and, to a much lesser degree, better tolerability, range of motion, and final grip strength.
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Volar and percutaneous techniques of screw fixation for scaphoid fractures usually do not involve direct visualization of the dorsoproximal scaphoid articular surface. Intra-articular screw penetration may be overlooked if the proper fluoroscopic views are not obtained. The hypothesis of this study is that the pronated oblique fluoroscopic view of the scaphoid is the most sensitive in detecting dorsal articular screw penetration of the scaphoid when compared with other views. ⋯ This study confirms our hypothesis that the pronated oblique view is the most important fluoroscopic image to obtain when evaluating penetration of the proximal scaphoid articular surface.
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Review Meta Analysis Comparative Study
Simple decompression versus anterior subcutaneous and submuscular transposition of the ulnar nerve for cubital tunnel syndrome: a meta-analysis.
Optimal surgical management of cubital tunnel syndrome remains uncertain despite the publication of numerous case series, observational studies, systematic reviews, and, in recent years, randomized controlled studies. The purpose of this meta-analysis was to compare simple decompression to anterior transposition of the ulnar nerve for the treatment of this condition, using comparative trials and randomized controlled trials. ⋯ This report represents the best cumulative evidence to date examining the surgical management of cubital tunnel syndrome. In this study, we found no statistically significant difference, but rather a trend toward an improved clinical outcome with transposition of the ulnar nerve as opposed to simple decompression. Additional prospective, randomized studies that use reproducible preoperative and postoperative objective measures might add statistical power to this finding.