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The aim of this study was to develop an automated approach model to define in vivo kinematics of the trapeziometacarpal (TMC) joint using four-dimensional computed tomography. A total of 15 healthy volunteers were included and their TMC joint kinematics were studied during a retropulsion-opposition-retropulsion movement. We used cardan angles estimated from transformation matrices using a ZYX-decomposition and analysed the motion of the thumb metacarpal relative to the trapezium, the thumb metacarpal relative to the index metacarpal, and the trapezium relative to the index metacarpal. The study also included an analysis of the joint hysteresis effect and a joint proximity model that estimated the joint contact area during a retropulsion-opposition-retropulsion movement. The automated approach significantly decreased the time needed to analyse each case and makes this model applicable for further research on TMC kinematics. [ABSTRACT FROM AUTHOR]

The lesions were created arthroscopically and consisted of ventral (VSL), dorsal (DSL), VSL + DSL, VSL + DSL + partial DCSS, and VSL + DSL + complete DCSS. With DSL sectioning, SL diastasis was seen but only in F-E and not in R-U. With sectioning of multiple components, SL diastasis was observed in all movements. I Purpose or Learning Objective: i To study the effect of sectioning the different components of the scapholunate ligament-dorsal scapholunate septum (SL-DCSS) in a cadaveric model and assess the dynamic effects with four-dimensional computed tomography (4D-CT). [Extracted from the article]

The opposable thumb provides both stability and mobility and is needed to accomplish different prehensile tasks. The trapezium is a complex bone, with a distal articular surface that is convex in the sagittal plane of the thumb and concave in the coronal plane of the thumb. The numerous additional articulations with the carpus and the oblique orientation to the main plane of the hand makes it difficult to evaluate the trapeziometacarpal joint using standard hand or wrist radiographic views. This review gives an overview of the different radiological views that have been described for the thumb with an emphasis on their historical origin and positioning during radiography. We also describe different measurements and classifications that can be obtained using different thumb radiographs. [ABSTRACT FROM AUTHOR]

Background: Trapeziometacarpal arthroplasties are designed to restore an adequate level of mobility, stability, and grip strength. In this article, pain and functional and radiographic outcome of Ivory arthroplasty in male patients are investigated. Methods: Between 2005 and 2012, the Ivory arthroplasty was inserted in 21 male patients with degenerative trapeziometacarpal osteoarthritis, of which 14 patients were found eligible for inclusion. Mobility, grip strength, patient self-assessment (pain; Quick Disabilities of the Arm, Shoulder, and Hand [QuickDASH]), and radiographic outcome were measured. Twenty-two female patients who received an Ivory arthroplasty between 2005 and 2007 were included and underwent the same evaluation. Age at primary surgery, survival rate of the implant, and clinical outcome were compared between the 2 groups. Results : In both groups, QuickDASH score and mean pain sensation improved significantly. The improvement in mobility obtained significance in the female group. In the male group, 7 arthroplasties failed (mean follow-up of 65 months). In the female group, 3 of the 24 arthroplasties failed (mean follow-up of 123 months). Kaplan-Meier survival analysis demonstrated a significant lower implant survival in the male group. Conclusions: Decrease in muscle mass and decline in grip strength that postmenopausal women tend to experience might explain the significant difference in implant survival between sexes. In 4 of the 7 failed arthroplasties in the male group, no surgical revision was required. Trapeziometacarpal arthroplasty, even after radiographic failure, still served as a spacer, avoiding collapse of the thumb base. Nevertheless, the failure rate of the Ivory arthroplasty in male patients is high, and an alternative treatment should be considered. [ABSTRACT FROM AUTHOR]

Dear Editor, Periprosthetic fracture after linked total arthroplasty of the distal radioulnar joint (DRUJ) has been reported on several occasions. In both cases, the fracture occurred at the second most proximal screw through the oblong hole of the radial component and caused a flexion deformity at the fracture site. We present two cases of periprosthetic distal radial fracture after total DRUJ arthroplasty with the Scheker prosthesis (Aptis Medical®, Glenview, NY, USA) ([2]) that occurred during our learning curve. [Extracted from the article]

Dear Editor, A 57-year-old cleaning lady presented to our department with a 6-month history of painful trapeziometacarpal (TMC) osteoarthritis. Total joint arthroplasty has become an increasingly popular treatment for symptomatic TMC joint osteoarthritis, although instability with dislocation of the prosthetic head remains a concern ([1]). References 1 Cootjans K, Vanhaecke J, Dezillie M, Barth J, Pottel H, Stockmans F. Joint survival analysis and clinical outcome of total joint arthroplasties with the ARPE implant in the treatment of trapeziometacarpal osteoarthritis with a minimal follow-up of 5 years. [Extracted from the article]

Unlabelled: A strong relationship between congenital pseudarthrosis of the tibia (CPT) and neurofibromatosis type 1 (NF1) has been suggested, but prevalence varies widely throughout the literature and the criteria used for diagnosis are very heterogeneous. Literature focus is mainly on treatment and no specific review on the prevalence of NF1 has been published. Based on our own observations, we hypothesized the prevalence of NF1 in patients with CPT to be higher than what is previously accepted. We conducted a comprehensive literature review on this topic and compared results with our study population. Twenty-one out of twenty-five patients in the study population matched the NIH diagnostic criteria for NF1 (84.0 %, CI95 = 69.6-98.4 %). These results are higher than the prevalence reported in the literature (55.4 %, CI95 = 50.4-60.4 %).Conclusions: The prevalence of NF1 in patients with CPT might be higher than what is reported until now because the criteria of NF1 generally appear only after the diagnosis of CPT. We propose a repeat meticulous examination and a multidisciplinary approach with a clinical genetic counseling in all CPT patients.What Is Known: • Congenital pseudarthrosis of the tibia and neurofibromatosis type 1 are closely related. • Literature focus is mainly on treatment and little epidemiologic research is available. What is New: • Prevalence of neurofibromatosis type 1 in patient with congenital pseudarthrosis of the tibia might be higher than what is reported until now. • A multidisciplinary approach with meticulous clinical examination and genetic counseling might lead to an earlier diagnosis of neurofibromatosis type 1 in patients with congenital pseudarthrosis of the tibia. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop an automated approach model to define in vivo kinematics of the trapeziometacarpal (TMC) joint using four-dimensional computed tomography. A total of 15 healthy volunteers were included and their TMC joint kinematics were studied during a retropulsion-opposition-retropulsion movement. We used cardan angles estimated from transformation matrices using a ZYX-decomposition and analysed the motion of the thumb metacarpal relative to the trapezium, the thumb metacarpal relative to the index metacarpal, and the trapezium relative to the index metacarpal. The study also included an analysis of the joint hysteresis effect and a joint proximity model that estimated the joint contact area during a retropulsion-opposition-retropulsion movement. The automated approach significantly decreased the time needed to analyse each case and makes this model applicable for further research on TMC kinematics., Competing Interests: Declaration of conflicting interestsThe authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The purpose of this study was to analyse the anatomy of the trapezium with regard to cup position in trapeziometacarpal replacement and identify those trapeziums that are at risk of cup perforation through the trapezoid articular surface. The width of the proximal and distal articular surface and the height of the trapezium and second metacarpal facet were measured on 96 peritrapezial views reconstructed from computed tomography scans. The trapezoid articular surface of the trapezium (TRAST) angle was calculated, and four different cup designs were virtually positioned centrally in the trapezium and parallel to the proximal articular surface. Risk of perforation was defined as a cup that exceeds the ulnar border of the proximal articular surface. The mean TRAST angle in our study was 33°. Risk of perforation is higher when the second metacarpal facet is smaller than 5 mm and when the TRAST angle is 35° or more. In these cases, the position of the cup should be more radial or more distal., Competing Interests: Declaration of conflicting interestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JD is a consultant for Kerimedical for teaching activities.