Major complications after the use of CPSN are not in fact rare. The incidence of severe neuropathy or infection complications is, respectively, 0.50% and 0.25%. However, the insertion of CPSN could be considered effective and is associated with only a few minor complications.
Primary arthritis of the thumb saddle joint is very common. Among the different treatment options, the implantation of a total joint arthroplasty is an alternative. The GUEPAR prosthesis, developed by a group of French surgeons, is mainly used in elderly patients and only in cases with preserved trapezial height. This study reports the mid-term results of the second generation of this implant. The clinical results show good pain relief and good mobility of the thumb. There were a few patients with radiological signs of implant loosening, but none of them had clinical problems. The advantage of a total replacement of the saddle joint, compared to the standard resection arthroplasty, is faster rehabilitation and preservation of the length of the thumb. The new generation of the GUEPAR prosthesis has a more anatomical metacarpal stem and a modularity which allows the fit of the implants according to the anatomical situation.
Dorsal lesions in Dupuytren’s disease are rare and data concerning their epidemiology and management are sparse. We conducted a systematic review to summarize reported cases of dorsal Dupuytren’s disease. Pubmed, Cochrane, and Embase databases were searched from 1893 to 2018, and 17 articles were selected (525 patients). The male to female ratio was 3.8:1. The dorsal disease was bilateral in 225 patients (50%). The index was the most commonly affected finger (48 patients). The proximal interphalangeal joint was the most commonly affected (484 cases). The most frequently reported lesions were knuckle pads (503 patients), dorsal nodules between interphalangeal joints (14 patients), boutonnière deformities (12 patients), and swan-neck deformities (2 patients). Nearly half of the included patients were treated surgically. Postoperative functional result depended on the treated lesion. Most of the included studies had a low level of evidence. Higher-quality studies are necessary to confirm our findings.
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