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Poncet disease (PD) is a rare form of reactive polyarthritis associated with acute tuberculosis (TB). Multiple TB foci are rare in PD, particularly on the hands. Herein, we describe a case of PD with foci in the trapezium and spine of a 76-year-old man. His medical history included knee arthritis as well as hand and lumbar pain. Radiography and magnetic resonance imaging revealed lytic lesions in the trapezium and spine, which were suspected to be caused by TB infection. An open biopsy of the trapezium and spine was performed. The biopsy results revealed dry necrosis and epithelioid granulation. The diagnosis of PD was made, and the patient was referred to a TB specialty hospital. Our results highlight the importance of considering PD in older patients with multiple TB foci, especially on the hands. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Background: Thumb carpometacarpal (CMC) osteoarthritis (OA) is a common condition. The contribution of surrounding ligaments and tendons to the stability of the CMC joint is likely altered in OA. The flexor carpi radialis (FCR) tendon runs in the trapezial FCR groove and is often noted to be frayed during CMC arthroplasty. We hypothesized that decreased integrity of the FCR tendon is related to FCR groove morphology and is associated with increased severity of CMC OA. Methods: We examined 3-dimensional surface models based on computed tomography (CT) scans of explanted trapezia from patients who underwent thumb CMC arthroplasty. Fraying of the FCR tendon was rated intraoperatively. Measurements were taken of the FCR groove to evaluate its morphology. Preoperative thumb CMC radiographs for each patient were scored using the modified Eaton classification system and the Thumb Osteoarthritis Index. Differences in the tendon groups were examined, and multivariable linear regression models were used to test the association between tendon group and FCR groove measurement. Results: There were 136 patients who were categorized into 4 tendon groups: intact, minor fraying, fraying, and ruptured. There were no differences between the tendon groups on any measures. Conclusions: Our findings do not demonstrate a significant influence of FCR groove morphology on FCR tendon fraying in CMC arthroplasty patients. We also did not find a significant association between the FCR tendon state and degree of radiographic CMC OA. Further studies should investigate the in vivo FCR tendon to evaluate its tearing and inflammation in relation to basilar thumb pain. [ABSTRACT FROM AUTHOR]

The objective of this paper is to explore novel unified continuous and discrete versions of the Trapezium-Jensen-Mercer (TJM) inequality, incorporating the concept of convex mapping within the framework of $ {\mathfrak{q}} $-calculus, and utilizing majorized tuples as a tool. To accomplish this goal, we establish two fundamental lemmas that utilize the $ _{{\varsigma_{1}}}{\mathfrak{q}} $ and $ ^{{{\varsigma_{2}}}}{\mathfrak{q}} $ differentiability of mappings, which are critical in obtaining new left and right side estimations of the midpoint $ {\mathfrak{q}} $-TJM inequality in conjunction with convex mappings. Our findings are significant in a way that they unify and improve upon existing results. We provide evidence of the validity and comprehensibility of our outcomes by presenting various applications to means, numerical examples, and graphical illustrations.

The objective of this paper is to explore novel unified continuous and discrete versions of the Trapezium-Jensen-Mercer (TJM) inequality, incorporating the concept of convex mapping within the framework of q-calculus, and utilizing majorized tuples as a tool. To accomplish this goal, we establish two fundamental lemmas that utilize the 1q and 2q differentiability of mappings, which are critical in obtaining new left and right side estimations of the midpoint q-TJM inequality in conjunction with convex mappings. Our findings are significant in a way that they unify and improve upon existing results. We provide evidence of the validity and comprehensibility of our outcomes by presenting various applications to means, numerical examples, and graphical illustrations. [ABSTRACT FROM AUTHOR]

Osteoid osteoma is a benign bone tumor that usually grows in the long bones of the body and arises from osteoblasts and some components of osteoclasts. It represents the third most frequent type of benign bone tumors, accounting for 11% to 14% of the tumors. The entity usually involves the proximal femur and tibia. It has also been reported in the hand, especially the scaphoid, capitate, and proximal phalanx. The most common symptom is pain, usually during the night, relieved by the use of salicylates and nonsteroidal anti-inflammatory drugs. To date, only 5 cases involving the trapezium have been reported. This article describes a rare case of a large (1.3 cm) osteoid osteoma of the trapezium in a young male patient treated surgically with resection and curettage of the osteoid and provides a review of the existing literature.

Subchondral bone properties are associated with the pathogenesis of osteoarthritis (OA), but this relationship has not been confirmed in the trapeziometacarpal joint (TMCJ). We aimed to evaluate the thickness (SBT) and density (SBD) of three-dimensional (3D) trapezium subchondral bone models derived from computed tomography (CT) images, and their relationships with early-stage TMCJ OA. We reviewed patients with a distal radius fracture who underwent conventional CT scans and such osteoporosis evaluations as bone mineral density (BMD) and bone turnover markers (BTMs). From 3D trapezium subchondral bone models, we measured SBT and SBD according to the OA stage and performed multivariate analyses to evaluate their associations with age, sex, body mass index, BMD, and BTMs. As results, a total of 156 patients (78 men and 78 age-matched women; mean age, 67 ± 10 years) were analyzed. There were 30 (19%) with grade 0, 71 (45%) with grade 1, 13 (8%) with grade 2, and 42 (27%) with grade 3 TMCJ OA. SBT was significantly lower in patients with grade 1 OA than those with grade 0 or grade 3 OA, but SBD generally increased according to the OA severity. Low SBT was associated with low BMD, and low SBD with low BMD, high osteocalcin levels, and severe OA grades. In conclusion, patients with early-stage radiographic TMCJ OA have a lower SBT at the trapezium, which may support the potential role of subchondral bone in OA pathogenesis. This study also shows that subchondral bone properties are associated with BMD and osteocalcin levels. [ABSTRACT FROM AUTHOR]

Osteonecrosis affecting the carpal bones is rare and is mostly seen in the lunate (Kienböck's disease). Osteonecrosis of the scaphoid (Preiser disease) is even rarer. There are only four individual case reports published on patients presenting with trapezium necrosis, none with previous history of corticosteroid injection. This case report is the first presentation of isolated trapezial necrosis in the setting of prior corticosteroid injection for thumb basilar arthritis. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

We report a case series of trans-trapezium carpometacarpal dislocation of the thumb and propose a classification to help with decision-making for this injury., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

We report a case of a 49-year-old patient with an isolated dorsal radial dislocation of the right trapezium that occurred in a context of polytrauma. At first, the lesion went unnoticed. The diagnosis was made 1 month later because of persistent pain in the thumb. An open reduction of the dislocation was carried out, and osteosynthesis using scaphoid-trapezium and trapeziotrapezoid pinning was conducted under fluoroscopic control. The patient was immobilized for 3 months after surgery. After 4 years, the mobility of the thumb was complete and painless.

This study simulated the cross-sectional changes in the distal carpal tunnel resulting from inward rotations of the hamate and trapezium. Rotations which decreased the carpal arch width, increased the carpal arch area. For example, simultaneous rotation of 5 degrees around the hamate and trapezium centroids decreased the carpal arch width by 1.69 ± 0.17 mm and increased the carpal arch area by 6.83 ± 0.68 mm2. Although the bone arch area decreased, decompression of the median nerve would likely occur due to the adjacent location of the nerve near the transverse carpal ligament. [ABSTRACT FROM AUTHOR]

Background: To perform a comprehensive osteologic investigation into trapezium anatomy and investigate the relationship between anatomical factors and osteophyte formation, focusing on sex-specific differences. Methods: This was a cadaveric study involving 1233 trapezia and first metacarpals. Two subgroups ("Control" and "Main Study") were established. The "Control" cohort was used to identify features of the trapezium in specimens devoid of osteophytic change. The prevalence and severity of osteophytic change were investigated in the "Main Study" cohort. Sex differences were specifically assessed. Regression analyses were used to identify factors associated with osteophyte formation. Results: Three discrete surface morphologies exist at the trapezium trapeziometacarpal (TM) facet: heart, quadrilateral, and bean. Controlling for height, men have a larger trapezium TM facet surface area. However, the trapezium assumes the same off-center saddle shape in both sexes. The presence of osteophytes at the basilar joint is a common finding; no differences in osteologic prevalence exist between sexes. The progression of osteophytic change complements the radiographic Eaton-Littler classification system. The trapezium TM facet increases the surface area with incremental osteophyte involvement, with the degree of surface area expansion correlated with increases in the severity of osteophytic change. Increased age, increased surface area, bean morphology, and decreased volar joint depth are associated with more severe osteophyte formation. Conclusions: Anatomical features of the trapezium may contribute to osteophyte development. Although the prevalence of osteophytic disease appears equal between sexes, sex differences exist in some anatomical parameters. These differences may help explain the increased prevalence of symptomatic basilar joint disease in women. [ABSTRACT FROM AUTHOR]

Aims: The objective of this systematic review was to describe trapeziectomy outcomes and complications in the context of osteoarthritis of the base of the thumb after a five-year minimum follow-up. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide study design, and 267 full-text articles were assessed for eligibility. After exclusion criteria application, 22 studies were included, involving 728 patients and 823 trapeziectomies. Outcomes included pre- and postoperative clinical and radiological characteristics. Complications and revisions were recorded. Results: All the studies reported good results regarding pain and range of motion at the last follow-up of 8.3 years (5 to 22); the mean satisfaction rate was 91% (84% to 100%). It was difficult to assess the impact on metacarpophalangeal joint motion in extension with contrary results. The key pinch returned to its preoperative values, whereas tip pinch showed a modest improvement (+14%), with a mild improvement found in grip strength (+25%) at the last follow-up. The mean progressive trapezial collapse was 48% (0% to 85%) and was not correlated with pain, grip strength, or satisfaction. The most represented complications were linked to tendons or nerves affected during additional procedures to stabilize the joint (11.6%; n = 56). Mechanical complications included symptomatic scapho-M1 impingement (3.1%; n = 15/580), leading to nine surgical revisions out of 581 trapeziectomies. Meta-analysis was not possible due to study heterogeneity and limited data. Conclusion: After a minimum five-year follow-up, trapeziectomy achieved high patient satisfaction and pain relief. However, strength seemed to be deteriorating with detrimental consequences, but this did not correlate with trapezial collapse. The issues related to underestimating mechanical complications and varying degrees of success should be highlighted in the information given to patients. Evidence-based analyses should help the surgeon in their decision-making. Cite this article: Bone Jt Open 2021;2(3):141–149.

Background: We investigated whether opportunistic screening for osteoporosis can be done from computed tomography (CT) scans of the wrist/forearm using machine learning. Methods: A retrospective study of 196 patients aged 50 years or greater who underwent CT scans of the wrist/forearm and dual-energy X-ray absorptiometry (DEXA) scans within 12 months of each other was performed. Volumetric segmentation of the forearm, carpal, and metacarpal bones was performed to obtain the mean CT attenuation of each bone. The correlations of the CT attenuations of each of the wrist/forearm bones and their correlations to the DEXA measurements were calculated. The study was divided into training/validation (n = 96) and test (n = 100) datasets. The performance of multivariable support vector machines (SVMs) was evaluated in the test dataset and compared to the CT attenuation of the distal third of the radial shaft (radius 33%). Results: There were positive correlations between each of the CT attenuations of the wrist/forearm bones, and with DEXA measurements. A threshold hamate CT attenuation of 170.2 Hounsfield units had a sensitivity of 69.2% and a specificity of 77.1% for identifying patients with osteoporosis. The radial-basis-function (RBF) kernel SVM (AUC = 0.818) was the best for predicting osteoporosis with a higher AUC than other models and better than the radius 33% (AUC = 0.576) (p = 0.020). Conclusions: Opportunistic screening for osteoporosis could be performed using CT scans of the wrist/forearm. Multivariable machine learning techniques, such as SVM with RBF kernels, that use data from multiple bones were more accurate than using the CT attenuation of a single bone. [ABSTRACT FROM AUTHOR]

As the population ages, symptoms of osteoarthritis in the hand are seen with increasing frequency. It can lead to substantial pain, physical disability and impair the patient's capacity to work in a population with an increasing retirement age. This article gives an overview about the most prevalent forms of osteoarthritis in the hand, its diagnosis and current treatment options, stressing that the multimodal form of therapy is the most effective. [ABSTRACT FROM AUTHOR]

The main objective of this paper is to derive some new fractional analogs of trapezium-like inequalities essentially using the class of preinvex functions and the concepts of tempered fractional integrals. We discuss some special cases that show that our results are unifying. In order to demonstrate the significance of our results, we present some applications to means. To check the validity of our results, we also give some numerical examples.

Background: Osteoarthritis of the thumb base is the second most prevalent arthritis of the hand. Management is primarily conservative, consisting of analgesia, splinting, physiotherapy, and steroid injections. Surgery is considered when conservative measures fail. Methods: The primary objective was to assess the safety and efficacy of the surgical interventions and therein, evaluate whether any superiority exists among the available interventions. Efficacy was evaluated by examining four parameters: pain, function, range of movement and strength of the joint postoperatively. Safety was determined by comparing the rate and severity of postoperative complications. A systematic search of MEDLINE (2014–2019), EMBASE (2014–2019), CINAHL (2014–2019) and CENTRAL (2014–2019) databases was carried out. Abstracts were screened for relevant studies. Randomised controlled trials were only considered. Results: Eight studies were included in the quantitative synthesis. The procedures evaluated are: Trapeziectomy (T), trapeziectomy with ligament reconstruction (T + LR), trapeziectomy with ligament reconstruction and tendon interposition (T + LRTI), trapeziectomy with allograft suspension (T + ALS) and joint arthrodesis (A). Low-moderate quality evidence suggests that T + LRTI yields better range of movement (palmar abduction) when compared with (T) alone; (SMD 0.61, 95% CI 0.22 to 1.00, random-effects, p = 0.002). Comparing adverse events showed that arthrodesis carries a greater risk of adverse events when compared with T + LRTI; (RR 0.33, 95% CI 0.17 to 0.61, random-effects, p = 0.0005). In addition, T + LRTI is preferred over arthrodesis by patients (OR 0.29 95% CI 0.09 to 0.95; p = 0.04). This difference was no seen in the other comparison groups. Conclusions: It is difficult to declare with any degree of certainty which procedure offers the best functional outcome and safety profile. Results suggest T + LRTI yields good postoperative range of movement. Arthrodesis demonstrated an unacceptably high rate of moderate-severe complications and should be considered with careful consideration. [ABSTRACT FROM AUTHOR]

Case: Acrometastasis is extremely rare, accounting for 0.1% of all skeletal metastases. Metastases to the carpus are rarer still. This condition can be the first manifestation of an occult malignancy and generally indicates advanced disease. We present the case of a 53-year-old woman with acrometastasis of squamous cell lung cancer to the trapezium as the initial presentation of her malignancy. Conclusion: The presentation of acrometastasis can mimic infectious or inflammatory processes, leading to an erroneous diagnosis. Although exceptionally uncommon, it is important to consider as a differential diagnosis for a destructive hand lesion. [ABSTRACT FROM AUTHOR]

The aim of this paper is to derive some new fractional analogues of trapezium like inequalities essentially using a new three variable extension of Riemann-Liouville fractional integrals. In order to establish the main results of the paper we use the three variable convexity property of the functions. [ABSTRACT FROM AUTHOR]

Carpal fractures of bones other than the scaphoid occur at a much lower rate than scaphoid fractures. The close relationship between the carpus, intrinsic and extrinsic wrist ligaments, and wrist kinematics makes a thorough history, clinical examination, and interpretation of imaging for carpal malalignment essential. Carpal malalignment should be addressed with reduction and fixation. Nondisplaced fractures are often treated nonoperatively and displaced intraarticular fractures are almost always treatment operatively. The physician should keep in mind the athlete's specific goals and needs. Treatment must be individualized. Options for early return to play should be discussed when possible. [ABSTRACT FROM AUTHOR]

Understanding the loads that occur across musculoskeletal joints is critical to advancing our understanding of joint function and pathology, implant design and testing, as well as model verification. Substantial work in these areas has occurred in the hip and knee but has not yet been undertaken in smaller joints, such as those in the wrist. The thumb carpometacarpal (CMC) joint is a uniquely human articulation that is also a common site of osteoarthritis with unknown etiology. We present two potential designs for an instrumented trapezium implant and compare approaches to load calibration. Two instrumented trapezia designs were prototyped using strain gauge technology: Tube and Diaphragm. The Tube design is a well-established structure for sensing loads while the Diaphragm is novel. Each design was affixed to a 6-DOF load cell that was used as the reference. Loads were applied manually, and two calibration methods, supervised neural network (DEEP) and matrix algebra (MAT), were implemented. Bland-Altman 95% confidence interval for the limits of agreement (95% CI LOA) was used to assess accuracy. Overall, the DEEP calibration decreased 95% CI LOA compared with the MAT approach for both designs. The Diaphragm design outperformed the Tube design in measuring the primary load vector (joint compression). Importantly, the Diaphragm design permits the hermetic encapsulation of all electronics, which is not possible with the Tube design, given the small size of the trapezium. Substantial work remains before this device can be approved for implantation, but this work lays the foundation for further device development that will be required. [ABSTRACT FROM AUTHOR]

Various pathologies of the adult carpus result in clinical scenarios where excision can be considered and even recommended. In the appropriate patient population, isolated carpal excision can alleviate pain and improve mobility. Excisions of the pisiform, trapezium, and trapezoid have abundant literature evidence to support positive long-term functional outcomes. In contrast, isolated excision of the capitate, hamate, and triquetrum has limited support in the literature secondary to compromise of carpal mechanics and lead to recurrent pain. Additionally, isolated scaphoid and lunate excision are best avoided secondary to carpal collapse and should be paired with concomitant stabilizing procedures in the carpus. This article provides a comprehensive literature review of isolated excision of each osseous carpal bone, their indications, and previously assessed outcomes., (© 2024 Published by Elsevier B.V. on behalf of Society for Indian Hand Surgery and Micro Surgeons.)

Background The carpal tunnel is a groove that spans the palm as a 'U.' The ulnar and radial sides of the wrist are made up of the scaphoid tubercle and trapezium while the palmar aspect is made up of carpal bones. Our study aimed to see whether there were differences in carpal tunnel size between men and women. Material and methods The study was conducted on 65 healthy adults, 13 (20%) were males and 52 (80%) were females (both non-pregnant and pregnant). Inclusion criteria were healthy adults and bilaterally symmetrical limbs. Exclusion criteria were chronic disease, diabetes, hypertension, immunological disorders, any visible abnormalities, and a history of upper extremity pain on either side. A high-resolution ultrasound machine with a linear transducer was used to perform an ultrasound scan of the carpal tunnel. The anteroposterior dimension was measured at the midline, or along the axis of the middle finger, and the transverse diameter was measured at the midpoint of the flexor retinaculum. The cross-sectional area of the tunnel was measured at its largest diameter within the carpal tunnel. All the dimensions were measured in centimeters. Results The mean transverse diameter of the right side was 1.824 ± 0.223 cm (p-value 0.002) and of the left side was 1.742 ± 0.197 cm (p-value 0.004). The mean cross-sectional area of the carpal tunnel on the right side was 1.417 ± 0.379 cm 2 (p-value 0.008) and on the left side was 1.306 ± 0.303 cm 2  (p-value 0.004), respectively. Age, sex, weight, and BMI were discussed. The carpal tunnels of females were found to be comparatively squarer and smaller than those of males. Conclusion The transverse diameter and cross-sectional area of the carpal tunnel and their correlation with carpal tunnel syndrome are predicted by age, sex, weight, and BMI. Both sexes had the same wrist ratio., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Rani et al.)

In this article we study a property of trapezia connected with constructions using isometries. The constructions create for each quadrangle another one, which when the starting quadrangle is a trapezium, then the constructed quadrangle is a similar to it trapezium. This property is proved to be characteristic of non-isosceli trapezia. [ABSTRACT FROM AUTHOR]

Purpose: Fractures of the trapezium are rarely diagnosed on plain radiographs after acute wrist trauma. High-resolution cross-sectional imaging identifies fractures of the trapezium as the most common radiographically occult carpal bone fracture. We review the fracture frequency, mechanisms and patterns of trapezium fractures.Methods: Cone beam CT was performed in patients with suspected radiographically occult radiocarpal fracture following acute injury. The frequency of carpal bone fractures was assessed and compared.Results: Ninety-three radiographically occult wrist fractures were identified in 166 patients with acute trauma and negative radiographs. The trapezium was the most frequently fractured carpal bone, making up 20.4% of wrist fractures. Seventy-nine percent of trapezium fractures involved the volar ridge. The scaphoid was the clinically suspected fractured bone at initial assessment in 84% of patients with trapezium fractures.Conclusion: Fractures of the trapezium in acute wrist trauma are much more common than described in the literature. If initial radiographs are negative, a fracture of the trapezium is more likely to be present than one of the scaphoid, despite high levels of clinical suspicion for scaphoid injuries. Awareness of the types and mechanisms of trapezium fracture is important. Cross-sectional imaging should be considered in all cases of post-traumatic wrist pain with negative radiographs. [ABSTRACT FROM AUTHOR]

Objective: The present quantitative study aimed to assess the three-dimensional (3-D) cartilage wear patterns of the first metacarpal and trapezium in the advanced stage of osteoarthritis (OA) and compare cartilage measurements with radiographic severity.Design: Using 19 cadaveric trapeziometacarpal (TMC) joints, 3-D cartilage surface models of the first metacarpal and trapezium were created with a laser scanner, and 3-D bone surface model counterparts were similarly created after dissolving the cartilage. These two models were superimposed, and the interval distance on the articular surface as the cartilage thickness was measured. All measurements were obtained in categorized anatomic regions on the articular surface of the respective bone, and we analyzed the 3-D wear patterns on the entire cartilage surface. Furthermore, we compared measurements of cartilage thickness with radiographic OA severity according to the Eaton grading system using Pearson correlation coefficients (r).Results: In the first metacarpal, the cartilage thickness declined volarly (the mean cartilage thickness of the volar region was 0.32 ± 0.16 mm, whereas that of the dorsal region was 0.53 ± 0.18 mm). Conversely, the cartilage evenly degenerated throughout the articular surface of the trapezium. Measurements of the categorized regions where cartilage thinning was remarkable exhibited statistical correlations with radiographic staging (r = -0.48 to -0.72).Conclusions: Our findings indicate that cartilage wear patterns differ between the first metacarpal and trapezium in the late stage of OA. There is a need for further studies on cartilage degeneration leading to symptomatic OA in the TMC joint. [ABSTRACT FROM AUTHOR]

Background: Trapezium dislocations are rare injuries. Methods: A PubMed search of the term "trapezium dislocation" was conducted. Publications reporting a complete trapezium dislocation were included in the review. Results: The PubMed search resulted in 168 results. Fourteen publications reporting on 16 complete trapezium dislocations met inclusion criteria. A case of delayed diagnosis of a trapezium dislocation is presented. The literature is reviewed for pertinent clinically relevant information with respect to trapezium dislocations. A systematic method for radiographic analysis of trapezium dislocations and classification are described, and a treatment algorithm is presented. Conclusions: Trapezium dislocations are infrequent injuries with few cases reported in the literature. Given the rarity of this injury, diagnosis and appropriate treatment may be delayed due to difficulty in recognition. Using the described method of radiographic analysis, delayed diagnosis may be avoided with implementation of timely treatment. [ABSTRACT FROM AUTHOR]

We investigated whether trapezium bone reaction was different following implantation of a trapeziometacarpal total joint replacement with a hemispheric or a conical cup. Fifty-three Keri Medical Touch implants with hemispheric cup and 53 with conical cup were prospectively followed up radiographically. We compared radiographs taken immediately and one year after surgery for cup subsidence, tilt, heterotopic ossification and loosening. Cup subsidence of at least 1 mm was detected in 4% of cases for both cup types. Additive bone reaction around the cup of more than 1 mm was present in 62% of conical cups and 47% of hemispheric cups. These were minor and there were no large ossifications with risk of impingement. Minor radiolucency was seen superficially at the implant-bone interface of 13% of the hemispheric cups and 9% of the conical cups. None of these bone reactions differed significantly according to cup design., (Copyright © 2023 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

The influence of the anatomy of the proximal articular surface of the trapezium (PAST) and the trapezoidal articular surface of the trapezium (TRAST) on cup placement during trapeziometacarpal arthroplasty was retrospectively evaluated on 56 preoperative anteroposterior radiographs of patients who underwent surgery for trapeziometacarpal osteoarthritis. The percentage coverage of the prosthetic cup by the PAST and the available height of the trapezium were calculated. In 39% of cases, there was a significant difference (up to a mean 4.5 mm, p < 0.001) between the radial height of the trapezium (which is usually considered) and the available height of the trapezium. The anatomy of the PAST and the TRAST has an impact on the placement of the prosthetic cup when trapezium height is low. The results of the present study suggest that these considerations must be known by all operators performing trapeziometacarpal arthroplasty; that lateralization, implant suspension, or surgical alternatives should be considered to prevent several intra- and postoperative surgical complications. Level of evidence: IV., (Copyright © 2024 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

Gastric cancer frequently spreads to the regional lymph nodes, liver and lungs following surgery or late in the clinical course. However, an initial clinical presentation of bone metastasis in gastric cancer patients is relatively rare. The current study presents two cases of gastric cancer diffusely metastasized to the spinal vertebrae and with a single metastasis to the trapezium, respectively. The initial presentations were an increased alkaline phosphatase level without any symptoms associated with bone metastasis in the first case and a swelling in the right carpometacarpal joint of the thumb in the second case. These clinical manifestations are also extremely rare in gastric cancer with bone metastasis. The study emphasizes that a diagnosis of gastric cancer should be considered in patients with increased alkaline phosphatase without clinical symptoms or with a single bone metastasis. [ABSTRACT FROM AUTHOR]

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The behaviour of a contact formed when a flat-faced contact sits in an almost conforming socket is studied. Conditions for the avoidance of all slip are found, and the critical coefficient of friction needed is found. The results derived are of a general nature and apply to many problems of this class, for example, when a dovetail is pulled into a socket having the same angle. [ABSTRACT FROM AUTHOR]

Bone density may influence the primary fixation of cementless implants, and poor bone density may increase the risk of implant failure. Before deciding on using total joint replacement as treatment in osteoarthritis of the trapeziometacarpal joint, it is valuable to determine the trapezium bone density. The aim of this study was to: (1) determine the correlation between measurements of bone mineral density of the trapezium obtained by dual-energy X-ray absorptiometry (DXA) scans by a circumference method and a new inner-ellipse method; and (2) to compare those to measurements of bone density obtained by computerized tomography (CT)-scans in Hounsfield units (HU).We included 71 hands from 59 patients with a mean age of 59 years (43-77). All patients had Eaton--Glickel stage II-IV trapeziometacarpal (TM) joint osteoarthritis, were under evaluation for trapeziometacarpal total joint replacement, and underwent DXA and CT wrist scans. There was an excellent correlation (r = 0.94) between DXA bone mineral density measures using the circumference and the inner-ellipse method. There was a moderate correlation between bone density measures obtained by DXA- and CT-scans with (r = 0.49) for the circumference method, and (r = 0.55) for the inner-ellipse method. DXA may be used in pre-operative evaluation of the trapezium bone quality, and the simpler DXA inner-ellipse measurement method can replace the DXA circumference method in estimation of bone density of the trapezium. [ABSTRACT FROM AUTHOR]

Medical staff hardly recognize fractures of trapezium due to the small size and the complex anatomy of the wrist and the hand. Seventy percent of all carpal fractures are scaphoid's fractures. Only 0.4% of all carpal injuries are trapezial fractures. In this paper, we presented a case of a high speed trauma where there were only trapezial fractures. Origin, diagnosis, differential diagnosis, treatment and complications are evaluated and described.

Trapezium fractures are uncommon injuries. Our case is that of a thumb carpometacarpal joint dislocation associated to a partly comminuted fracture of the body of the trapezium. To the best of the authors' knowledge, this particular variation has not been previously reported in the indexed literature.

The trapezium is rare site of osteoid osteoma development. The diagnostic challenge lies in its rare occurrence, and requires differentiation from various disease entities causing thumb basal joint pain. We report the case of a 29-year-old male who presented with severe thumb basal joint pain. He was initially treated for calcific periarthritis because of concomitant calcifications around the thumb basal joint, but had undiscovered osteoid osteoma. A high index of suspicion to a patient with wrist pain unresponsive to prior treatment is necessary for diagnosis of osteoid osteoma. [ABSTRACT FROM AUTHOR]

Osteochondroma is the most common benign bone tumor. Lesions occurring at the carpal bones are extremely rare. There are very few cases of osteochondroma at the trapezium had been reported in the English literature. We reported a 47-year-old patient with an osteochondroma of the left trapezium presented with painful snapping of abductor pollicis longus tendon. [ABSTRACT FROM AUTHOR]

Solitary metastasis of a carcinoma to carpal bone is extremely rare. Metastases of renal cell carcinoma (RCC) usually occur in a multiple fashion and there has been no report to date of a solitary metastasis to trapezium from RCC. The tumor was excised and reconstructed with iliac bone transplantation. 2 years and 6 months after surgery, there is no local recurrence with minimal functional loss. [ABSTRACT FROM AUTHOR]

In this article, we derive a new fractional estimate for Hermite-Hadamard's inequality via coordinated harmonic convex functions on a rectangle from the plane R². We establish a new fractional integral identity for partially differentiable functions. Utilizing this integral identity, we obtain some more fractional estimates for Hermite-Hadamard's inequality. The ideas of this paper may stimulate further research. [ABSTRACT FROM AUTHOR]

Osteoid osteoma is the most common benign osteogenic bone neoplasm. Osteoid osteomas are typically located in the metaphysis and diaphysis of long bones, especially the tibia and femur. However, less common sites of the skeleton can be affected as well, including carpal bones. Among carpal bones, the scaphoid and the capitate are the most affected. Osteoid osteoma of the trapezium is an extremely rare entity, with only seven cases reported in recent literature. We present a case of a 29-year-old male with persistent left wrist pain who was diagnosed with an osteoid osteoma of the trapezium bone. The diagnosis was based on the patient's history, clinical examination and findings from the CT scan, MRI, and plain radiographs. The patient was treated with an excision biopsy with no additional bone grafting. After a follow-up period of 12 months, no pain or signs of recurrence were present. We conducted a literature review to elucidate the clinical presentation as well as the proper diagnostic tools and therapeutic methods for this rare occurrence., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Koutas et al.)

Objectives: Fractures of carpal bones other than the scaphoid are rare in children. The aim of this study was to analyze results and identify risk factors for an unfavorable outcome., Material and Methods: Children and adolescents up to the age of 16 years who sustained a carpal fracture other than in the scaphoid between 2004 and 2021 were reviewed in this single-center retrospective study., Results: In a series of 209 children and adolescents with carpal fractures, 22 had fractures other than the scaphoid. Mean age was 13 years (range 8-16) years, with a total of 41 fractures, with highest incidences for the capitate (10), trapezium (6), triquetrum (4) and pisiform (4). Twenty-nine of these 41 fractures were missed on initial X-ray. Non-displaced fractures were treated with a short arm spica cast including the thumb. Four patients were operated on for displacement fracture or carpometacarpal subluxation. All fractures united, and patients returned to full activities. At the final consultation at a median 14 months (range 6-89) post-injury, all patients with non-displaced fractures were free of symptoms, with excellent Mayo Wrist Scores (MWS). However, three patients with operated trapezium fractures developed early radiological signs of osteoarthritis, two of them with residual pain and MWS rated only good., Conclusion: Non-displaced pediatric carpal fractures treated by forearm cast have excellent prognosis. Fractures of the trapezium with displacement or first carpometacarpal subluxation incur a risk of osteoarthritis despite anatomical reduction and internal fixation., (Copyright © 2023 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

The tomb G-160, known as the 'Tomb with Cupids', was discovered in 2003, during the excavations at the Pirivoj - Viminacium necropolis. The tomb has a trapezial section, characteristic for Viminacium tombs of the late antique period, and its interior was painted using the fresco technique. Scenes and motives are set on all four walls of the tomb. Since the western wall is damaged, the tomb is named after the depiction of cupids on the eastern wall. The wealth of the iconographic repertoire, together with an analysis of the geometry and symmetry, allowed the reconstruction of the conceptual context and it can be concluded that the tomb was dedicated to Venus, or Dionysus. The tomb painting could be dated to the beginning of the 4th century, owing to the analysis of the style, which combines an eclectic Eastern expressionism, classicism and illusionism of the Constantine era.

OBJETIVO: Avaliar prospectivamente os resultados de uma série de pacientes submetidos ao tratamento cirúrgico da rizartrose, com a técnica de ressecção do trapézio associada à interposição de um novelo do tendão abdutor longo do polegar. MÉTODOS: De maio a agosto de 2005, 10 pacientes foram submetidos ao tratamento cirúrgico da rizartrose. Foram incluídos pacientes com osteoartrose primária da articulação trapézio-metacárpica, estágios II, III, IV da classificação de Eaton, com dor persistente refratária ao tratamento clínico. Para avaliação funcional foi utilizada a escala visual analógica, questionário DASH e o escore de Buck-Gramcko. Na avaliação global do paciente foram mensuradas as forças de preensão palmar, pinça polpa a polpa, pinça lateral, pinça de três pontos, oponência e abduções radial e palmar. Realizou-se, ainda, o índice de migração do primeiro metacarpal na radiografia de repouso e sob estresse. RESULTADOS: Foram considerados bons, no alívio da dor (p = 0,005), com melhora da função na avaliação pelo DASH módulos 2 (p = 0,02) e 3 (p = 0,022) O escore de Buck-Gramcko apresentou um resultado excelente e três ótimos. Houve melhora em quase toda avaliação global, sendo não significante apenas na pinça lateral e abdução. Em todos pacientes houve migração do primeiro metacarpal. CONCLUSÃO: A trapeziectomia associada à interposição de um novelo do tendão abdutor longo do polegar mostrou-se uma técnica de execução relativamente simples e eficaz no alívio da dor e na melhora funcional.OBJECTIVE: To prospectively evaluate the results from a series of patients who underwent surgical treatment for rhizarthrosis using the technique of trapezium resection associated with interposition of yarn from the long abductor tendon of the thumb. METHODS: From May to August 2005, ten patients underwent surgical treatment for rhizarthrosis. Patients with primary osteoarthrosis of the trapezium-metacarpal joint, in stages II, III and IV of the Eaton classification, with persistent pain that was refractory to clinical treatment, were included. For the functional assessment, the visual analogue scale, DASH questionnaire and Buck-Gramcko score were used. For the overall assessment on the patients, strength measurements were made for palm grip, pulp to pulp pinch, lateral pinch, three-point pinch, opposition and radial and palmar abductions. The migration index for the first metacarpal was also determined on radiographs at rest and under stress. RESULTS: The pain relief was considered to be good (p = 0.005), with functional improvements in modules 2 (p = 0.02) and 3 (p = 0.022) of DASH. The Buck-Gramcko score showed one excellent and three very good results. There was an improvement in almost all of the overall assessment and was only non-significant regarding lateral pinch and abduction. For all patients, there was migration of the first metacarpal. CONCLUSION: Trapeziectomy associated with interposition of yarn from the long abductor tendon of the thumb was shown to be a relatively simple and effective technique for pain relief and functional improvement.