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Mouhib T, Jeudy J, Cast YS, Rabarin F, Bigorre N. Surgical treatment of trigger finger: a comparative study of A1 pulley opening versus ulnar superficialis slip resection. HAND SURGERY & REHABILITATION 2024; 43:101687. [PMID: 38527619 DOI: 10.1016/j.hansur.2024.101687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Abstract
Trigger finger is a common condition. Surgery most frequently involves opening the A0 and A1 pulleys. However, this shows limited effectiveness in correcting proximal interphalangeal joint fixed flexion deformity. The present study aimed to compare clinical outcomes between two surgical techniques for trigger finger treatment. This retrospective study included 127 patients, 72 of whom underwent resection of the ulnar slip of the flexor superficialis, and 55 underwent opening of the pulleys. Study data comprised patient characteristics, range of motion, proximal interphalangeal fixed flexion deformity measurement, Quick-DASH and PRWE scores, and overall satisfaction. There were no significant differences between the two groups in terms of Quick-DASH or PRWE scores. Fixed flexion deformity correction was slightly but not significantly better with resection of the ulnar slip of the flexor superficialis (100%) compared to opening of the pulleys (88%). LEVEL OF EVIDENCE: : Level IV.
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Affiliation(s)
- Taha Mouhib
- Centre de la Main, 47 Rue de la Foucaudiere, 49800 Trelaze, France
| | - Jerome Jeudy
- Centre de la Main, 47 Rue de la Foucaudiere, 49800 Trelaze, France
| | - Yann Saint Cast
- Centre de la Main, 47 Rue de la Foucaudiere, 49800 Trelaze, France
| | - Fabrice Rabarin
- Centre de la Main, 47 Rue de la Foucaudiere, 49800 Trelaze, France
| | - Nicolas Bigorre
- Centre de la Main, 47 Rue de la Foucaudiere, 49800 Trelaze, France.
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Kriener K, Whiting H, Storr N, Homes R, Lala R, Gabrielyan R, Kuang J, Rubin B, Frails E, Sandstrom H, Futter C, Midwinter M. Applied use of biomechanical measurements from human tissues for the development of medical skills trainers: a scoping review. JBI Evid Synth 2023; 21:2309-2405. [PMID: 37732940 DOI: 10.11124/jbies-22-00363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVE The objective of this review was to identify quantitative biomechanical measurements of human tissues, the methods for obtaining these measurements, and the primary motivations for conducting biomechanical research. INTRODUCTION Medical skills trainers are a safe and useful tool for clinicians to use when learning or practicing medical procedures. The haptic fidelity of these devices is often poor, which may be because the synthetic materials chosen for these devices do not have the same mechanical properties as human tissues. This review investigates a heterogeneous body of literature to identify which biomechanical properties are available for human tissues, the methods for obtaining these values, and the primary motivations behind conducting biomechanical tests. INCLUSION CRITERIA Studies containing quantitative measurements of the biomechanical properties of human tissues were included. Studies that primarily focused on dynamic and fluid mechanical properties were excluded. Additionally, studies only containing animal, in silico , or synthetic materials were excluded from this review. METHODS This scoping review followed the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Sources of evidence were extracted from CINAHL (EBSCO), IEEE Xplore, MEDLINE (PubMed), Scopus, and engineering conference proceedings. The search was limited to the English language. Two independent reviewers screened titles and abstracts as well as full-text reviews. Any conflicts that arose during screening and full-text review were mediated by a third reviewer. Data extraction was conducted by 2 independent reviewers and discrepancies were mediated through discussion. The results are presented in tabular, figure, and narrative formats. RESULTS Data were extracted from a total of 186 full-text publications. All of the studies, except for 1, were experimental. Included studies came from 33 countries, with the majority coming from the United States. Ex vivo methods were the predominant approach for extracting human tissue samples, and the most commonly studied tissue type was musculoskeletal. In this study, nearly 200 unique biomechanical values were reported, and the most commonly reported value was Young's (elastic) modulus. The most common type of mechanical test performed was tensile testing, and the most common reason for testing human tissues was to characterize biomechanical properties. Although the number of published studies on biomechanical properties of human tissues has increased over the past 20 years, there are many gaps in the literature. Of the 186 included studies, only 7 used human tissues for the design or validation of medical skills training devices. Furthermore, in studies where biomechanical values for human tissues have been obtained, a lack of standardization in engineering assumptions, methodologies, and tissue preparation may implicate the usefulness of these values. CONCLUSIONS This review is the first of its kind to give a broad overview of the biomechanics of human tissues in the published literature. With respect to high-fidelity haptics, there is a large gap in the published literature. Even in instances where biomechanical values are available, comparing or using these values is difficult. This is likely due to the lack of standardization in engineering assumptions, testing methodology, and reporting of the results. It is recommended that journals and experts in engineering fields conduct further research to investigate the feasibility of implementing reporting standards. REVIEW REGISTRATION Open Science Framework https://osf.io/fgb34.
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Affiliation(s)
- Kyleigh Kriener
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Harrison Whiting
- Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- School of Clinical Medicine, Royal Brisbane Clinical Unit, The University of Queensland, Brisbane, QLD, Australia
| | - Nicholas Storr
- Gold Coast University Hospital, Southport, QLD Australia
| | - Ryan Homes
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Raushan Lala
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Robert Gabrielyan
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
- Ochsner Clinical School, Jefferson, LA, United States
| | - Jasmine Kuang
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
- Ochsner Clinical School, Jefferson, LA, United States
| | - Bryn Rubin
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
- Ochsner Clinical School, Jefferson, LA, United States
| | - Edward Frails
- Department of Chemical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Hannah Sandstrom
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, United States
| | - Christopher Futter
- Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Anaesthesia and Intensive Care Program, Herston Biofabrication institute, Brisbane, QLD, Australia
| | - Mark Midwinter
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
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Rydberg M, Zimmerman M, Gottsäter A, Åkesson A, Eeg-Olofsson K, Arner M, Dahlin LB. Patient Experiences after Open Trigger Finger Release in Patients with Type 1 and Type 2 Diabetes-A Retrospective Study Using Patient-reported Outcome Measures. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5037. [PMID: 37351117 PMCID: PMC10284330 DOI: 10.1097/gox.0000000000005037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/06/2023] [Indexed: 06/24/2023]
Abstract
Trigger finger is overrepresented among patients with diabetes mellitus (DM). Whether DM affects the outcome after open trigger finger release (OTFR) in patients with DM is not known. Our aim was thus to explore outcomes after OTFR in patients with type 1 (T1D) and type 2 DM (T2D). Methods Data included patient-reported outcome measures (PROMs) from all OTFRs performed between 2010 and 2020 registered in the Swedish national registry for hand surgery in individuals over 18 years cross-linked with the Swedish National Diabetes Register (NDR). PROMs included QuickDASH and HQ8, a questionnaire designed for national registry for hand surgery, preoperative and at 3 and 12 months postoperative. HQ8 included pain on load, pain on motion without load, and stiffness. Outcome was calculated using linear-mixed models and presented as means adjusted for age and stratified by sex. Results In total, 6242 OTFRs were included, whereof 496 had T1D (332, 67% women) and 869 had T2D (451, 52% women). Women with T1D reported more symptoms of stiffness (P < 0.001), and women with T2D reported more pain on load (P < 0.05), motion without load (P < 0.01), and worse overall result at 3 months. At 12 months, however, no differences were found in any of the HQ-8 PROMs among men or women. Women with T2D had slightly higher QuickDASH scores at 3 and 12 months. Conclusion Patients with T1D and T2D can expect the same results after OTFR as individuals without DM, although the improvement might take longer especially among women with T2D.
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Affiliation(s)
- Mattias Rydberg
- From the Department of Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine—Hand Surgery, Lund University, Lund, Sweden
| | - Malin Zimmerman
- From the Department of Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine—Hand Surgery, Lund University, Lund, Sweden
- Department of Orthopaedics, Helsingborg Hospital, Helsingborg, Sweden
| | - Anders Gottsäter
- Department of Medicine, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Anna Åkesson
- Clinical Studies Sweden—Forum South, Skåne University Hospital, Lund, Sweden
| | - Katarina Eeg-Olofsson
- National Diabetes Register, Centre of Registers, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Marianne Arner
- Department of Clinical Science and Education, Karolinska Institutet and Department of Hand surgery Södersjukhuset, Stockholm, Sweden
| | - Lars B. Dahlin
- From the Department of Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine—Hand Surgery, Lund University, Lund, Sweden
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Rydberg M, Zimmerman M, Gottsäter A, Eeg-Olofsson K, Dahlin LB. High HbA1c Levels Are Associated With Development of Trigger Finger in Type 1 and Type 2 Diabetes: An Observational Register-Based Study From Sweden. Diabetes Care 2022; 45:2669-2674. [PMID: 36006612 DOI: 10.2337/dc22-0829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/28/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Trigger finger (TF) is a hand disorder causing the fingers to painfully lock in flexion. Diabetes is a known risk factor; however, whether strict glycemic control effectively lowers risk of TF is unknown. Our aim was to examine whether high HbA1c was associated with increased risk of TF among individuals with diabetes. RESEARCH DESIGN AND METHODS The Swedish National Diabetes Register (NDR) was cross-linked with the health care register of the Region of Skåne in southern Sweden. In total, 9,682 individuals with type 1 diabetes (T1D) and 85,755 individuals with type 2 diabetes (T2D) aged ≥18 years were included from 2004 to 2019. Associations between HbA1c and TF were calculated with sex-stratified, multivariate logistic regression models with 95% CIs, with adjustment for age, duration of diabetes, BMI, and systolic blood pressure. RESULTS In total, 486 women and 271 men with T1D and 1,143 women and 1,009 men with T2D were diagnosed with TF. Increased levels of HbA1c were associated with TF among individuals with T1D (women OR 1.26 [95% CI 1.1-1.4], P = 0.001, and men 1.4 [1.2-1.7], P < 0.001) and T2D (women 1.14 [95% CI 1.2-1.2], P < 0.001, and men 1.12 [95% CI 1.0-1.2], P = 0.003). CONCLUSIONS Hyperglycemia increases the risk of developing TF among individuals with T1D and T2D. Optimal treatment of diabetes seems to be of importance for prevention of diabetic hand complications such as TF.
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Affiliation(s)
- Mattias Rydberg
- Department of Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden.,Hand Surgery, Department of Translational Medicine, Lund University, Lund, Sweden
| | - Malin Zimmerman
- Department of Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden.,Hand Surgery, Department of Translational Medicine, Lund University, Lund, Sweden.,Department of Orthopaedics, Helsingborg Hospital, Helsingborg, Sweden
| | - Anders Gottsäter
- Department of Medicine, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Katarina Eeg-Olofsson
- National Diabetes Register, Centre of Registers, Gothenburg, Sweden.,Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars B Dahlin
- Department of Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden.,Hand Surgery, Department of Translational Medicine, Lund University, Lund, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Berlanga-de-Mingo D, Lobo-Escolar L, López-Moreno I, Bosch-Aguilá M. Association between multiple trigger fingers, systemic diseases and carpal tunnel syndrome: A multivariate analysis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2019. [DOI: 10.1016/j.recote.2018.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Berlanga-de-Mingo D, Lobo-Escolar L, López-Moreno I, Bosch-Aguilá M. Association between multiple trigger fingers, systemic diseases and carpal tunnel syndrome: A multivariate analysis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2019; 63:307-312. [PMID: 30795997 DOI: 10.1016/j.recot.2018.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 12/04/2018] [Accepted: 12/16/2018] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Trigger finger (TF) is a frequent pathology depending on several factors. The objective of this study was to assess the relationship between multiple TF and systemic or musculoskeletal disorders in a sample of young patients. MATERIAL AND METHOD A retrospective study was performed of all patients with TF operated in our hospital between 2011 and 2015. Multiple or single TF diagnosis and pathologies such as diabetes mellitus (DM), thyroid dysfunction, carpal tunnel syndrome (CTS), epicondylalgia or DeQuervain's disease were collected. Statistical results included a bivariate analysis and a multiple logistic regression. RESULTS Two hundred and seventy-nine patients with a mean age of 48.45years were included. The dominant hand was affected in 217 cases. There were 59 patients with multiple TF, 21 DM, 55 STC, 16 epicondylalgia and 14 DeQuervains. Prevalence of CTS was 19.7%, significantly higher than the general population (2%-4%). No statistical differences were found in age, sex, hypothyroidism, epicondylalgia or DeQuervain in the multiple TF group. Bivariate analysis detected that DM and CTS patients in the multiple TF group was significantly higher than in the single TF group (P=.007, P<.01). Multiple TF was also more frequent on the dominant side (P<.01). Multivariate logistic regression confirmed these findings, showing a statistically significant association between the multiple TF group and DM (OR: 4.98, P<.01), STC (OR: 2.09, P=.037) and dominant side (OR: 3.76, P=.016). CONCLUSIONS Diabetes, CTS and dominant side are independently associated with multiple TF in young patients.
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Affiliation(s)
- D Berlanga-de-Mingo
- MIR, Hospital Asepeyo de Sant Cugat, Sant Cugat del Vallès, Barcelona, España.
| | - L Lobo-Escolar
- MIR, Hospital Asepeyo de Sant Cugat, Sant Cugat del Vallès, Barcelona, España
| | - I López-Moreno
- Unidad de Mano, Hospital Asepeyo de Sant Cugat, Sant Cugat del Vallès, Barcelona, España
| | - M Bosch-Aguilá
- Unidad de Mano, Hospital Asepeyo de Sant Cugat, Sant Cugat del Vallès, Barcelona, España
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