RESUMEN
Five patients with localized little finger carpometacarpal arthritis were treated by excision of the little finger metacarpal base and arthrodesis of the little and ring metacarpals. A dorsal periosteal/capsular flap was used as an interposition graft. All patients achieved significant pain relief, good cosmesis and satisfactory grip strength. All returned to activities of daily living. This procedure, the Dubert procedure, is indicated for localized pathology of the hamate-little finger metacarpal joint. It has theoretical advantages over arthrodesis and resection or interposition arthroplasty as it preserves little finger length, rotation and alignment and maintains some mobility of the transverse carpal arch and the little finger ray.
Asunto(s)
Artrodesis/métodos , Articulación Metacarpofalángica/cirugía , Metacarpo/cirugía , Osteoartritis/cirugía , Actividades Cotidianas , Adulto , Anciano , Tornillos Óseos , Trasplante Óseo , Estética , Femenino , Fuerza de la Mano/fisiología , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
BACKGROUND: There has been considerable debate about the best treatment for acute rupture of the Achilles tendon. At our institution, a well-documented and structured program of nonoperative management of Achilles tendon rupture with use of casts and a removable orthosis was developed. METHODS: We assessed the results in 140 consecutive patients with a complete rupture of the Achilles tendon who had been treated with our nonoperative regimen at our center between 1992 and 1998. Patients were evaluated on the basis of the subjective results and clinically with physiological testing. RESULTS: Overall, 56% of our patients had an excellent result; 30%, good; 12%, fair; and 2%, poor. The overall complication rate was 8%, with three complete and five partial tendon reruptures, two deep vein thromboses, and one temporary dropfoot. CONCLUSIONS: The results of our nonoperative orthotic treatment were better overall than published results of operative repair of acute Achilles tendon rupture. Our patients were quite satisfied with their treatment.