Consolidation rate in ulnar shortening osteotomy with the APTUS Wrist plate

INTRODUCTION

Ulnocarpal impaction syndrome causes pain on the ulnar side of the wrist. Various surgical techniques have been described. Ulnar shortening osteotomy is now a standard treatment. However, it is associated with complications such as non-union of the osteotomy site. The main study objective was to report the rate of radiographic consolidation after ulnar shortening osteotomy with a cutting guide.

MATERIAL AND METHODS

This multicenter retrospective study of 30 cases reported clinical and radiographic criteria at a minimum 6 month's follow-up.

RESULTS

The non-union rate was 3.4%. One case presented non-union of the osteotomy site. 87% of patients were satisfied or very satisfied with the procedure. Mean VAS pain rating was 2.7 ± 2.4. Mean QuickDASH and PRWE scores were 24.7 ± 19.2 and 28.6 ± 25. Mean strength on Jamar dynamometer was 27.4 ± 8.9 kg. One patient developed complex regional pain syndrome. Five patients required plate removal for hardware-related discomfort.

DISCUSSION

Ulna shortening osteotomy with the Aptus Wrist plate provides a standardized approach to the surgical treatment of ulnocarpal impaction syndrome. Compared with other series in the literature, the procedure provided satisfactory consolidation and clinical results.

Management of advanced metacarpal aneurysmal cysts: Surgical technique

The hand is a rare site for aneurysmal bone cysts (ABCs). Depending on their degree of invasiveness, treatment of ABCs ranges from medical therapy to surgical curettage and bone filling. In the most advanced cases, bone resection and reconstruction, with or without adjuvant or neoadjuvant treatment, are indicated. We describe a technique involving segmental bone resection and structural iliac graft reconstruction with carpo-metacarpal plate arthrodesis, for the management of advanced ABC involving the base of the metacarpals. The radio-clinical results of two patients operated on using this technique are presented, at 18 and 36 months. At the last follow-up, the results showed a QDASH of 15 and 10, and a PRWE of 9 and 11. Satisfaction was 10/10 in both cases. Grasp strength was 25 kg and 42 kg versus 28 kg and 40 kg on the opposite side. Pinch strength was 6 kg and 11 kg versus 7 kg and 10 kg. Metacarpophalangeal flexion was 80° and 90°. Extension was complete in both cases. Radiographs showed good graft fusion, with no lysis or signs of ABC recurrence at the last follow-up. Segmental bone resection and iliac autograft reconstruction with carpo-metacarpal plate arthrodesis represents a therapeutic option in the management of advanced ABCs of the metacarpal base.

The role of three-dimensional printing in coronavirus disease-19 medical management: A French nationwide survey

Objectives

Coronavirus disease-19 (COVID-19) has spread worldwide and poses various challenges to healthcare services. The limited supply of medical and personal-protective equipment has affected the ability of many countries to respond to the crisis. Three-dimensional printing (3DP) is well suited to addressing these shortages. We assessed the medical role of 3DP during the COVID-19 outbreak in hospitals in France.

Design

Retrospective survey.

Setting and intervention

We included and questioned all French level-1 and -2 COVID-certified centers.

Participants

One hundred and thirty-eight COVID-certified centers were contacted across France: 38 (27.5 %) level 1 and 100 (72.5 %) level 2 centers. The analysis focused on 133 centers (96.37 %), among which 98 (73.68 %) used 3DP.

Main outcome measures

The primary endpoint was the number of pieces printed in 3D. The secondary endpoints were the mode, type, and benefits of 3DP.

Results

The total number of pieces printed in 3D nationwide was 84,886: 76,000 pieces of individual protective equipment (IPE) (89.53 %), 6335 pieces of biomedical equipment (7.47 %), and 2551 prototypes (3.01 %). In 91 cases (92.85 %), 3DP was performed using external printers. The pieces 3D-printed by the various centers helped around 6109 patients and protected around 41,091 caregivers.

Conclusions

3DP produced more than 84,000 pieces at 98 centers, helped more than 6000 patients, and protected more than 41,000 caregivers. Therefore, 3DP played a major role in medical aid during the COVID-19 outbreak in France.