Rate of clinically significant posttraumatic arthritis after small finger intra-articular carpometacarpal fractures

Intermetacarpal M4-M5 arthrodesis (Dubert procedure) for fifth carpometacarpal joint osteoarthritis: long-term functional outcomes

The goal of this study was to describe the long-term functional outcomes of the procedure described by Dubert (stabilized arthroplasty with intermetacarpal arthrodesis) for painful carpometacarpal impingement of the little finger. Between 2005 and 2017, 8 patients (1 woman and 7 men) were operated on who had a mean age of 38 years (24-53 years). Seven cases were post-traumatic (malunion) and one was due to septic arthritis. A total of 5 patients were available for a retrospective clinical, functional, and radiological follow-up at a mean of 73 months (23-108 months). Clinical parameters included pain on VAS, grip strength, Quick Disability of Arm, Shoulder and Hand questionnaire, Patient-Rated Wrist Evaluation, and a subjective hand value (0-100%). Fusion was achieved in all cases. Of the 8 patients, one developed complex regional pain syndrome and one had persistent pain that required secondary proximal metacarpal resection. At the last follow-up, all patients were satisfied and reported a significant reduction in pain and improvement in strength. Mean Quick Disability of Arm, Shoulder, and Hand questionnaire, Patient-Rated Wrist Evaluation and subjective hand value were 19/100 points, 21/100 points and 75%, respectively. Our study suggests that the stabilized arthroplasty of the fifth finger, as describe by Dubert, is an efficient and reliable method to reduce pain and improve hand function in patients suffering from carpometacarpal impingement of the little finger. LEVEL OF EVIDENCE: retrospective series, IV.

Advances in hand and wrist arthroscopy

Hand and wrist arthroscopy has gained popularity over the past few decades. Arthroscopy is a valuable diagnostic tool in cases where clinical and radiographic findings do not show a clear picture of the patient's pathologic condition. Arthroscopy also allows care providers to perform therapeutic interventions in a less invasive manner than would have been possible with a standard open approach. Over the past three decades, there have been substantial advances in the techniques and outcomes in hand and wrist arthroscopy. With this article, the authors aim to introduce the application of newer arthroscopic techniques in the hand and wrist that may be of diagnostic and/or therapeutic value.