Prospective Case-Control Study on the Etiopathology of Kienböck Disease

Stahl, Stéphane; Hentschel, P.; Lotter, Oliver; Meisner, Christoph; Manoli, Theodora; Schaller, Hans-Eberhard; Stahl, Adelana Santos

doi:10.1097/01.prs.0000438456.75721.4e

Cited by 10 publications

(6 citation statements)

References 23 publications

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“…For the reconstruction of both skin and bone at the level of the DIP joint, there have been two previous case reports, an iliac crest bone graft and extended DMA flap in one patient and a free metacarpal bone graft and extended DMA flap in another. 12 13 Because bony reconstructions were performed using a nonviable bone graft in the former report, there were concerns with the risk of infection and nonunion. 13 For the latter report, the procedure of a free metacarpal bone graft seemed to be a complicated one, 12 and plain radiography was not presented initially after the surgery.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of a Composite Defect of the Distal Index Finger Using a Chimeric Reverse Flow Second Dorsal Metacarpal Artery Flap: A Case Report

Yano¹,

Kaneshiro²,

Ishiko³

et al. 2023

Journal of Hand and Microsurgery

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The reconstruction for mild tissue loss at the distal part of a finger is challenging. We report about a 29-year-old man presenting with traumatic tissue loss at the distal interphalangeal (DIP) joint of the index finger, including skin, bone, and nerve. Reconstruction using two types of flaps was performed. The dorsal skin flap, nourished by the second dorsal metacarpal artery (SDMA) perforator, was elevated. The vascularized second metacarpal bone, nourished by the SDMA, was also elevated. Using the vascular connection between the DMA and the palmar digital artery (PDA), both flaps were raised to the distal part of the finger, and the pivot point was set at the dorsal proximal phalanx. After arthrodesis of the DIP joint with the vascularized second metacarpal bone, the digital nerve was repaired using the cutaneous nerve in the skin flap, and the skin defect was covered using the perforator flap. The postoperative course, including flap survival and bone union, was uneventful. A good indication for the reconstruction of the distal part of a finger with this technique is when the defect sizes of the skin and bone differ and the vascular connection between the SDMA and dorsal branch of PDA is not injured.

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Section: Discussionmentioning

confidence: 99%

“…11 For reconstruction of both skin and bone at the distal interphalangeal (DIP) joint level, there is no report of reconstruction in such cases with the pedicled compound flap using DMA. 12 13 14…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of a Composite Defect of the Distal Index Finger Using a Chimeric Reverse Flow Second Dorsal Metacarpal Artery Flap: A Case Report

Yano¹,

Kaneshiro²,

Ishiko³

et al. 2023

Journal of Hand and Microsurgery

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“…Clinical study reports were designed involving all members of the team as easy-to-use data collection forms with sufficient and unambiguous data. The self-assessment questionnaire was developed by a multidisciplinary team consisting of two plastic surgeons, one psychiatrist, and a plastic surgery nurse with knowledge and experience in questionnaire design [ 14 , 15 ]. The self-assessment questionnaire included 12 items from the validated international pain outcome questionnaire (IPO) [ 16 ] and 5 items from the modified Brice questionnaire [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Enhanced Recovery After Aesthetic Breast Surgery Under Sedation, Intercostal Block and Tumescent Anaesthesia: A Prospective Cohort Study of the Early Postoperative Phase

Stahl¹,

Stahl²,

Feng

et al. 2022

Aesth Plast Surg

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Background Comfort and recovery are major concerns of patients seeking aesthetic surgery. This study aimed to assess postoperative pain and recovery after outpatient breast surgery under sedation, intercostal block, and local anaesthesia. Methods This prospective cohort study included all consecutive patients who underwent aesthetic breast surgery between April 2021 and August 2022. Epidemiological data, anaesthesia, pain, and patients’ satisfaction were systematically assessed with standardized self-assessment questionnaires. Results Altogether, 48 patients [median (IQR) age: 30 (36–25)] were included. The most frequent surgery was mastopexy. 69% of surgeries involved additional procedures. The mean intercostal block and local anaesthesia time was 15 min. Patients received a median (IQR) of 19 (34–2) mg/kg lidocaine and 2.3 (2.5–2.0) mg/kg ropivacaine. The median (IQR) consumption of propofol and alfentanil was, respectively, 4.89 (5.48–4.26) mg/kg/h and 0.27 (0.39–0.19) µg/kg/min. No conversion to general anaesthesia or unplanned hospital admission occurred. Patients were discharged after a median (IQR) of 2:40 (3:43–1:58) hours. Within the first 24 postoperative hours, 17% required once an antiemetic medication and 38% an opioid. Patients were very satisfied with the anaesthesia and 90% of the patients had not wished more analgesia in the first 24 h. Conclusions Aesthetic breast surgery under sedation, intercostal block, and tumescent anaesthesia can safely be performed as an ambulatory procedure and is associated with minimal intra- and postoperative opioid consumption and high patient satisfaction. These data may be used to inform patients and clinicians and improve the overall quality of care. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Supplementary Information The online version contains supplementary material available at 10.1007/s00266-022-03214-w.

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“…3,4 The etiology is not well understood and remains controversial, but is traditionally thought to be related to trauma or anatomical www.journalchiromed.com factors. 5,6 Stahl et al 5 reported no relationship between the development of Kienbock disease and trauma (although commonly reported), hand-arm vibration, heavy manual labor, and comorbidities. They did, however, report an association with the use of oral corticosteroids.…”

Section: Introductionmentioning

confidence: 99%

“…This is consistent with findings of osteonecrosis in other areas of the skeleton, as prolonged use of corticosteroids is the most common nontraumatic etiology. 5 Anatomical features may be a predisposing factor such as impaired blood supply and anatomical variation that results in increased shear force on the lunate such as negative ulnar variance. 1,3,7 The association with negative ulnar variance is controversial and not consistent worldwide.…”

Section: Introductionmentioning

confidence: 99%

Kienbock Disease: A Complicated Postsurgical Case Study Using Diagnostic Ultrasonography

Yochum

Kettner

2015

Journal of Chiropractic Medicine

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Prospective Case-Control Study on the Etiopathology of Kienböck Disease

Abstract: Risk, III.

Cited by 10 publications

References 23 publications

Reconstruction of a Composite Defect of the Distal Index Finger Using a Chimeric Reverse Flow Second Dorsal Metacarpal Artery Flap: A Case Report

Reconstruction of a Composite Defect of the Distal Index Finger Using a Chimeric Reverse Flow Second Dorsal Metacarpal Artery Flap: A Case Report

Enhanced Recovery After Aesthetic Breast Surgery Under Sedation, Intercostal Block and Tumescent Anaesthesia: A Prospective Cohort Study of the Early Postoperative Phase

Kienbock Disease: A Complicated Postsurgical Case Study Using Diagnostic Ultrasonography

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