Metacarpal Osteotomy for Correction of Acquired Phalangeal Rotational Deformity

Bindra, Ranjna; Burke, F. D.

doi:10.1016/j.jhsa.2009.09.005

Cited by 14 publications

(15 citation statements)

References 3 publications

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“…19 To reduce these risks, extra-anatomical correction of intra-articular and phalangeal malunions has been advocated in the past. 3 This goal is achieved by performing osteotomies more proximally, outside the zone of initial trauma. The disadvantage is the obligatory nonanatomic result.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas sagittal deformity is usually well accepted, especially in metacarpals, rotation deformity can lead to significant scissoring of fingers. 3,19,33 As no consensus about the acceptable limits of deformity exists, indication for surgical correction is usually based on clinical findings and following the subjective functional limitation of the patient. 5,10,13 The goal of surgical correction is the restoration of clinical function by correcting the anatomy.…”

Section: Introductionmentioning

confidence: 99%

“…However, for the correction of phalangeal malunions, it is debated whether an extra-anatomic metacarpal or an anatomic phalangeal osteotomy should be performed, and whether intra-articular malunions should be corrected intra-or extra-articularly. 3,7,14,40,44 Available literature about metacarpal and phalangeal corrective osteotomies mainly consists of reports on small cohorts analyzed retrospectively. 13 Satisfactory outcomes in terms of precision of the reduction and improvement of hand function have been described for osteotomies based on conventional x-ray.…”

Section: Introductionmentioning

confidence: 99%

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Corrective Osteotomies of Phalangeal and Metacarpal Malunions Using Patient-Specific Guides: CT-Based Evaluation of the Reduction Accuracy

Hirsiger

Schweizer

Miyake

et al. 2017

Hand (New York, N,Y.)

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BACKGROUND Surgical planning of corrective osteotomies is traditionally based on conventional radiographs and clinical findings. In the past 10 years, 3-dimensional (3D) preoperative planning approaches with patient-specific guides have been developed. However, the application of this technology to posttraumatic deformities of the metacarpals and phalangeal bones has not yet been investigated. Our goal was to evaluate the feasibility of the surgical application to the latter and to evaluate the extent and precision of correction. METHODS We present results of 6 patients (8 osteotomies) treated with phalangeal or metacarpal corrective osteotomy. Deformities were located in the third ray in 1, fourth ray in 3, and fifth ray in 4 cases. Six malunited metacarpal bones (1 intra-articular) and 2 deformed proximal phalanges were treated. Computer-based 3D preoperative planning using the contralateral hand as a template allowed the production of 3D-printed patient-specific guides that were used intraoperatively for navigation. The precision of the reduction was assessed using pre-and postoperative computed tomography by comparing the postoperative bone model with the preoperatively simulated osteotomy. Range of motion and grip strength were documented pre-and postoperatively. RESULTS The mean follow-up time was 6 months (range: 5-11 months). Rotational deformity was reduced from a mean of 10.0°(range: 7.2°-19.3°) preoperatively to 2.3°(range: 0.7°-3.7°) postoperatively, and translational incongruency decreased from a mean of 1.4 mm (range: 0.7-2.8 mm) to 0.4 mm (range: 0.1-0.9 mm). CONCLUSION Preliminary results indicate that a precise reduction for corrective osteotomies of metacarpal and phalangeal bones can be achieved by using 3D planning and patient-specific guides.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Corrective Osteotomies of Phalangeal and Metacarpal Malunions Using Patient-Specific Guides: CT-Based Evaluation of the Reduction Accuracy

Hirsiger

Schweizer

Miyake

et al. 2017

Hand (New York, N,Y.)

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“…In orthopaedic and aesthetic and reconstructive surgery, there is an increasing demand for reliable bone cutting instruments to allow osteotomies of thin and fragile bony segments, which are otherwise prone to fracture [1,2]. A precise and safe bone cutting technique is of the utmost importance for the preservation of vital and delicate bony structures and protection of adjacent soft tissues [3].…”

Section: Introductionmentioning

confidence: 99%

Healing of osteotomy sites applying either piezosurgery or two conventional saw blades: a pilot study in rabbits

Stübinger

Liu

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to compare bone healing of experimental osteotomies applying either piezosurgery or two different oscillating saw blades in a rabbit model. Methods The 16 rabbits were randomly assigned into four groups to comply with observation periods of one, two, three and five weeks. In all animals, four osteotomy lines were performed on the left and right nasal bone using a conventional saw blade, a novel saw blade and piezosurgery. Results All three osteotomy techniques revealed an advanced gap healing starting after one week. The most pronounced new bone formation took place between two and three weeks, whereby piezoelectric surgery revealed a tendency to faster bone formation and remodelling. Yet, there were no significant differences between the three modalities. Conclusions The use of a novel as well as the piezoelectric bone-cutting instrument revealed advanced bone healing with a favourable surgical performance compared to a traditional saw.

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“…The most important intraoperative check is for the unacceptable rotational deformity, which usually affected adjacent ngers and caused signi cant cosmetic or functional problems. When exed, two ngers would overlap to scissors-like interference, and surgical osteotomy could yield an ideal result 23,24 . Patients' subjectively exing and extending the ngers to evaluate the repaired or reconstructed effect is of preference.…”

Section: Discussionmentioning

confidence: 99%

Transient Tourniquet and Electro-cauterization applied for Surgery in Metacarpal Fractures Under Local Anesthesia with Epinephrine

Xie

2021

Preprint

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Background : The purpose of this study is to illustrate whether the electro-cauterization and transient tourniquet enhanced efficiency of local anesthesia with epinephrine in surgery of metacarpal fractures. Methods : Forty-four consecutive cases of metacarpal fractures with estimated major operative time more than 30 minutes were enrolled. Local anesthesia with epinephrine, electro-cauterization and transient tourniquet were performed. Data regarding anesthesia effect, bleeding in the surgical field (with inflating and deflating tourniquet), time when patient felt uncomfortable with tourniquet, inspection of the surgical outcome, and some other surgical tricks were collected and evaluated. Results : All patients felt no pain for whole surgical period in the surgical field. Time when patient felt uncomfortable with tourniquet was about 16 minutes. Mean tourniquet time was about 29 minutes. There was no or less bleeding in the surgical field for whole surgical period. The anatomical structures, such as nerve, tendon and vessel can be easily distinguished and dissected. Outcome of repair and reconstruction could be examined with instructed movement. Postoperative inspection showed no symptom of inflammation. Conclusions : Local anesthesia with epinephrine, electro-cauterization and transient tourniquet for major hand surgery can save time and obtain wide-awake effect, which would satisfy both doctors and patients.

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Metacarpal Osteotomy for Correction of Acquired Phalangeal Rotational Deformity

Cited by 14 publications

References 3 publications

Corrective Osteotomies of Phalangeal and Metacarpal Malunions Using Patient-Specific Guides: CT-Based Evaluation of the Reduction Accuracy

Corrective Osteotomies of Phalangeal and Metacarpal Malunions Using Patient-Specific Guides: CT-Based Evaluation of the Reduction Accuracy

Healing of osteotomy sites applying either piezosurgery or two conventional saw blades: a pilot study in rabbits

Transient Tourniquet and Electro-cauterization applied for Surgery in Metacarpal Fractures Under Local Anesthesia with Epinephrine

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