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PURPOSE Basal thumb joint osteoarthritis frequently coexists with carpal tunnel syndrome. The two conditions have traditionally been treated surgically through separate incisions. We sought to determine whether carpal tunnel release using a single incision during basal joint arthroplasty is as effective as a two-incision approach in patients with concomitant carpal tunnel syndrome and basal thumb joint osteoarthritis. METHODS For this purpose, 40 patients were randomly allocated to either a single-incision or double-incision approach, all of whom completed the full follow-up period. The Boston Carpal Tunnel Questionnaire, QuickDASH, and a 10-point visual analog scale pain-severity rating were obtained from patients 3, 6 and 12 months post-operatively. RESULTS The two treatment groups experienced comparable, progressive improvement in all symptom-, function-, and pain-related outcomes, with mean surgery time significantly shorter with the single-incision approach, and four versus zero patients in the double-incision group developing pillar pain (p = 0.035). CONCLUSIONS Concomitant basal thumb joint osteoarthritis and carpal tunnel syndrome might be effectively performed through a single-incision approach, potentially avoiding any morbidity classically associated with a second incision. LEVEL OF EVIDENCE Level II/Therapeutic Study. TRIAL REGISTRATION ClinicalTrials.gov: NCT04391751, 04/29/2020, retrospectively registered.

Objective: To analyse if: forearm rotation modifies the ECRL, ECRB, APL or ECU muscles role on the scapholunate joint stability an SLL-stability exercise regime can be performed in any forearm rotation. Materials and Methods: We assessed the changes in the alignment of both, the scaphoid [for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

Objectives/Interrogation: The development of trigger digit after carpal tunnel syndrome release surgery has been widely reported. Anterior displacement of the flexor tendon has been reported after carpal tunnel release (CTR), causing it to lose its pulley function increasing flexor tendon friction[for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

Objective To evaluate, experimentally in cadavers, the effect of the motor muscles in the wrist in the kinetic behaviour of the carpal, under axial load, and the wrist in a neutral position. Material and method The changes in the spatial orientation of the carpal bones were recorded with a movement trajectory gauge that functions with electromagnetic fields. A total of 30 fresh cadaver wrists were used, in which the principal motor tendons were isolated and subjected to loads proportional to the area of the physiological section of each muscle. The experiment was performed under isometric load conditions of all the tendons, and separately from each tendon. Results The simultaneous load of all the tendons studied caused a three-dimensional change of the carpal bones. The flexor carpi radialis led to supination of the scaphoids and pronation of the pyramidal. Conversely, the isolated load of the flexor carpi ulnaris, abductor pollicis longus and the extensor carpi radialis longus, caused a supination movement of the 2 carpal rows. Only the extensor carpi ulnaris led to a marked pronation of the carpal. Comments and conclusions The forearm muscles, as well as the movements of the wrist, cause pronation/supination/supination, flexion/extension and radial/cubital inclination movements. It is proposed that the most important movements in the dynamic stabilisation of the carpal are the intercarpal pronation and supination movements provoked by these muscles. Depending on the carpal injury mechanism or instability, the stimulating of one muscle group or the other may be beneficial.

Resumen Objetivo Valorar de forma experimental en cadaver el efecto de los musculos motores de la muneca en el comportamiento cinetico del carpo, bajo carga axial y en posicion neutra de la muneca. Material y metodo Se registraron los cambios de orientacion espacial de los huesos del carpo, con un registrador de trayectoria de movimiento que funciona con campos electromagneticos. Se utilizaron 30 munecas de cadaver fresco, cuyos principales tendones motores de la muneca fueron aislados y sujetos a cargas proporcionales al area seccional fisiologica de cada musculo. El experimento se llevo a cabo en condiciones de carga isometrica de todos los tendones, y de forma aislada de cada tendon. Resultados La carga simultanea de todos los tendones estudiados provoco una modificacion de la posicion tridimensional de los huesos del carpo. El flexor carpi radialis provoco supinacion del escafoides y pronacion del piramidal. En cambio, la carga aislada del flexor carpi ulnaris, abductor pollicis longus y extensor carpi radialis longus provocaron un movimiento de supinacion de las 2 filas del carpo. Solo el extensor carpi ulnaris provoco una pronacion marcada del carpo. Comentarios y conclusiones Los musculos del antebrazo, ademas de los movimientos de la muneca, provocan movimientos de pronacion/supinacion, flexion/extension e inclinacion radial/cubital. Proponemos que el movimiento mas importante en la estabilizacion dinamica del carpo son los movimientos de pronacion y supinacion intercarpiana provocados por estos musculos. Segun el mecanismo lesional o inestabilidad carpiana, puede ser beneficiosa la potenciacion de un grupo muscular u otro.

To evaluate, experimentally in cadavers, the effect of the motor muscles in the wrist in the kinetic behaviour of the carpal, under axial load, and the wrist in a neutral position.The changes in the spatial orientation of the carpal bones were recorded with a movement trajectory gauge that functions with electromagnetic fields. A total of 30 fresh cadaver wrists were used, in which the principal motor tendons were isolated and subjected to loads proportional to the area of the physiological section of each muscle. The experiment was performed under isometric load conditions of all the tendons, and separately from each tendon.The simultaneous load of all the tendons studied caused a three-dimensional change of the carpal bones. The flexor carpi radialis led to supination of the scaphoids and pronation of the pyramidal. Conversely, the isolated load of the flexor carpi ulnaris, abductor pollicis longus and the extensor carpi radialis longus, caused a supination movement of the 2 carpal rows. Only the extensor carpi ulnaris led to a marked pronation of the carpal.The forearm muscles, as well as the movements of the wrist, cause pronation/supination/supination, flexion/extension and radial/cubital inclination movements. It is proposed that the most important movements in the dynamic stabilisation of the carpal are the intercarpal pronation and supination movements provoked by these muscles. Depending on the carpal injury mechanism or instability, the stimulating of one muscle group or the other may be beneficial.