Tommy R Lindau - Academia.edu (original) (raw)

Papers by Tommy R Lindau

Journal of wrist surgery, Dec 24, 2021

Background Total wrist arthroplasty can lead to a variation of complications. One of these is th... more Background Total wrist arthroplasty can lead to a variation of complications. One of these is the formation of a pseudotumor. Although this complication is well known after total hip arthroplasty, it is rare in patients with wrist implants. Case Description A 55-year-old man with a Universal 2 (Integra, Plainsboro, NJ) wrist prosthesis was seen with a progressive mass on the radial side of his wrist since 1 year, initially suspicious for a neoplasm. However, after exploration, histopathology confirmed a particle-induced foreign body reaction. Literature Review There is little literature on pseudotumor formation after total wrist arthroplasty. Currently, there is no clear consensus about the etiology of pseudotumors but possible causes may include foreign body reaction, hypersensitivity, and wear debris. Clinical Relevance This case report shows that particle debris-induced pseudotumors should be considered when a patient with a wrist prosthesis presents with a mass suspicious for a neoplasm. In addition, treatment options of pseudotumors after wrist arthroplasty in literature is discussed.

Journal of Hand Surgery (European Volume), Nov 17, 2015

Carpal instability is predominantly caused by trauma and presents as a painful wrist with signs a... more Carpal instability is predominantly caused by trauma and presents as a painful wrist with signs and symptoms of weakness, clicking, clunking and a sense of giving way. Wrist arthroscopy is widely regarded as the ‘gold standard’ in diagnosing and understanding carpal instability. This article is based on an extensive literature search to evaluate the evidence behind the use of wrist arthroscopy in the assessment and management of these patients. There is convincing evidence supporting the role of arthroscopy in diagnosis and assessment of factors involved in the development of carpal instability, but weak evidence for the effectiveness of arthroscopic techniques in the actual treatment of this condition. The article reviews mechanisms behind, and the role for arthroscopy in the management of scapholunate, lunotriquetral, midcarpal and radiocarpal instability. It also presents how the author incorporates the ‘evidence-base’ into an ‘experience-based’ clinical practice.

Springer eBooks, Dec 29, 2005

Hand Clinics, Nov 1, 2017

A fall onto an outstretched hand may cause a wide spectrum of injuries, such as a simple sprain, ... more A fall onto an outstretched hand may cause a wide spectrum of injuries, such as a simple sprain, radial styloid fracture in isolation, or a radial styloid fracture as part of a greater arch injury, thereby forming part of a complete or incomplete perilunate dislocation mechanism. Displaced radius fractures in nonosteoporotic patients have a high incidence of associated soft tissue injuries. Associated injuries affect the long-term outcome, and arthroscopic evaluation is paramount to establish a correct and complete diagnosis and facilitate early treatment. After falls, arthroscopy can diagnose triangular fibrocartilage complex injuries, inter-carpal scapholunate and lunotriquetral ligament tears and chondral lesions. Once evaluated and graded, the appropriate surgical treatment of these lesions can be added to the fracture fixation. Undetected associated injuries may explain the absence of improved outcome in studies comparing volar locking plate fixation and early mobilization versus external fixation. Possibly, further improved outcome may follow if arthroscopy is used in conjunction with volar locking plate fixation. Arthroscopy as an adjunct in the management of distal radius fractures has been available for more than 20 years, but still requires experience and management in expert centers. Successful management of this simple but complex fracture requires: Thorough understanding of the anatomy. Understanding the relevance of individual fracture fragments. Awareness of associated soft tissue injuries.

$Research paper thumbnail of No long-term risk of wrist osteoarthritis due to subchondral haematomas in distal radial fractures$

Journal of Plastic Surgery and Hand Surgery, 2017

Abstract Objective: The objective of this study of distal radius fractures was to determine if a ... more Abstract Objective: The objective of this study of distal radius fractures was to determine if a subchondral haematoma in an unfractured compartment predicts secondary osteoarthritis. Methods: In 1995–1997, 41 patients, 22 women, a median age of 41 years (20–57 years) with a displaced distal radius fracture underwent diagnostic wrist arthroscopy in addition to the fracture treatment. In 12 patients (7/12 women), subchondral haematomas were identified in a joint compartment not involved in the fracture. Results: At 13–15 years, 37 patients were still alive. Twenty-eight patients attended the follow-up and 8/28 had had a subchondral haematoma within an uninjured compartment at the time of arthroscopy. The range of motion at 13–15 years was impaired in the injured wrist, but unrelated to the presence of a subchondral haematoma. The mean grip strength in patients with subchondral haematoma was 80% of the contralateral, compared to 78% in patients without. No correlation was found between the presence of a subchondral haematoma at arthroscopy and the development of radiographic osteoarthritis in the long term. Conclusion: The presence of a subchondral hematoma in an uninjured compartment at the time of fracture did not alter the long-term clinical or radiographic outcome after a distal radius fracture.

$Research paper thumbnail of The management of acute fracture dislocations of proximal interphalangeal joints: a systematic review$

Journal of Plastic Surgery and Hand Surgery, Jul 7, 2020

A systematic review was conducted to identify the best management for acute proximal interphalang... more A systematic review was conducted to identify the best management for acute proximal interphalangeal joint fracture-dislocations. A study protocol was designed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Due to limited data in the primary assessment, the hypothesis was tested in a secondary analysis of articles that marginally met the inclusion criteria (i.e. studies that included patients under 18 years of age). A further tertiary analysis was conducted by dividing the studies into closed reduction techniques, open reduction internal fixation and 'other studies' and a narrative synthesis was performed. The study found a higher rate of complications and arthritis in the closed reduction group compared to open reduction internal fixation, suggesting that operative management should be considered for acute PIP joint fracture-dislocations.

The Journal of Hand Surgery, Oct 1, 2014

Radial-sided wrist pain may be due to an acute fracture or fracture non-union, articular degenera... more Radial-sided wrist pain may be due to an acute fracture or fracture non-union, articular degeneration, ligamentous injury or tendinopathy. Diagnosis is made by obtaining a detailed history and performing a clinical examination with focused attention to provocative tests, followed by directed imaging and, occasionally, wrist arthroscopy. Alan Apley instilled the importance of following the principles of look, feel, move to British and American orthopedic surgeons, a discipline that has proved invaluable for decades.

The Journal of Hand Surgery, Sep 1, 2014

Pain at the ulnar side of the wrist can be attributed to many possible etiologies. 1 The intimate... more Pain at the ulnar side of the wrist can be attributed to many possible etiologies. 1 The intimate relationship between osseous and ligamentous structures imposes difficulties in determining the source of ulnar-sided wrist pain, especially with instability as a result of ligamentous injury (Table 1). Various physical examination maneuvers can aid the hand surgeon to accurately diagnose ulnar-sided wrist pain due to intrinsic and extrinsic carpal ligament injuries.

Journal of Hand and Microsurgery, Jun 22, 2020

Metacarpal joint hyperextension is common cause of postoperative dissatisfaction after trapeziect... more Metacarpal joint hyperextension is common cause of postoperative dissatisfaction after trapeziectomy in the management of basal thumb osteoarthritis. The senior author uses this technique to address this biomechanical problem at the time of trapeziectomy.

Springer eBooks, 2014

Wrist arthroscopy has evolved into a vital tool in the diagnosis, staging and treatment of a rang... more Wrist arthroscopy has evolved into a vital tool in the diagnosis, staging and treatment of a range of pathological conditions. Although not a substitute for a thorough patient assessment, it allows for the direct visualisation of intra-articular pathology. A growing body of evidence highlights its potential advantages over more traditional forms of management for both acute andchronic conditions. We aim to outline the expanding role for wrist arthroscopy, considering both its advantages as well as limitations and possible complications.

Journal of Hand Surgery (European Volume), May 22, 2013

$Research paper thumbnail of Cartilage injuries in distal radial fractures$

Acta Orthopaedica Scandinavica, 2003

Subchondral hematomas have been found with arthroscopy in one third of patients with dislocated d... more Subchondral hematomas have been found with arthroscopy in one third of patients with dislocated distal radial fractures. The aim of the present, prospective study was to determine whether these hematomas might cause radiographic osteoarthrosis. We studied 41 patients (age 20-57 years, 22 women) with a dislocated distal radial fracture. At the time of fracture, 12 patients had subchondral hematomas in a radiocarpal compartment without a fracture line, as defined by arthroscopy. The 1-year follow-up included clinical and radiographic examinations. At follow-up, radiographic subchondral bone plate changes occurred in unfractured compartments in 8 patients, of whom 7 had had a previous arthroscopically diagnosed subchondral hematoma (p = 0.02) in the Copyright O Taylor & Francis 2003. ISSN 00014470, Printed in Swedenall rights reserved.

BMC Musculoskeletal Disorders, Oct 6, 2014

Background: Grip strength correlates with personal factors such as gender, age and nutritional st... more Background: Grip strength correlates with personal factors such as gender, age and nutritional status and has a good inter-rater reliability. It reflects fairly well how much people can use their hands. The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure 3 is a 30-item, self-report, questionnaire that reflects the patients' opinion on their disability due to upper-limb disorders. We assessed if grip strength and grip strength ratio correlate with DASH score. Methods: In 3 groups (20 healthy volunteers, 17 patients after distal radius fractures, 12 patients with different hand/wrist conditions) grip strength and DASH scores (items 1-21, 22-30 and total) were assessed. To exclude personal factors grip strengths in the injured or non-dominant hand and grip strength ratios (grip strength in the injured or non-dominant hand divided by grip strength in the non-injured or dominant hand) were assessed too. Results were analyzed groups using Pearson Correlation Coefficients and with a multivariate ANOVA. Results: Grip strength ratio was 0.97 in healthy volunteers, 0.52 in patients after distal radius fracture and 0.74 in patients with various other hand/wrist disorders. Significant correlations were found between the grip strength ratio and DASH as well as DASH subsections in all groups and between DASH scores and grip strength in some. The correlations between the ratio of the grip strength (GSR) and DASH were much stronger than the correlation between grip strength and DASH. This emphasizes the value of the GSR. Age showed no correlation with grip strength ratio using a multivariate ANOVA. Conclusion: Grip strength ratio correlates well with the DASH score in different hand and wrist conditions. It is a valuable tool to assess patients that speak a different language and have problems with the non-dominant hand and probably easier to follow over time than the DASH score, which is time consuming to fill in and process.

The Journal of Hand Surgery, 2013

Purpose To evaluate long-term efficacy and safety of collagenase clostridium histolyticum (CCH) a... more Purpose To evaluate long-term efficacy and safety of collagenase clostridium histolyticum (CCH) after the third year of a 5-year nontreatment follow-up study, Collagenase Option for Reduction of Dupuytren Long-Term Evaluation of Safety Study. Methods This study enrolled Dupuytren contracture patients from 5 previous clinical studies. Beginning 2 years after their first CCH injection, we re-evaluated patients annually for joint contracture and safety. Recurrence in a previously successfully treated joint (success ϭ 0°to 5°contracture after CCH administration) was defined as 20°or greater worsening in contracture in the presence of a palpable cord or medical/surgical intervention to correct new or worsening contracture. We assessed partially corrected joints (joints reduced 20°or more from baseline contracture but not to 0°to 5°) for nondurable response, also defined as 20°o r greater worsening of contracture or medical/surgical intervention. Results Of 1,080 CCH-treated joints (648 metacarpophalangeal [MCP]; 432 proximal interphalangeal [PIP]; n ϭ 643 patients), 623 (451 MCP, 172 PIP) had achieved 0°to 5°c ontracture in the original study. Of these joints, 35% (217 of 623) recurred (MCP 27%; PIP 56%). Of these recurrences, an intervention was performed in 7%. Of the 1,080 CCH-treated

The journal of hand surgery, Jun 1, 2001

Fifty-three patients with less than 14 day-old, undisplaced fractures of the waist of the scaphoi... more Fifty-three patients with less than 14 day-old, undisplaced fractures of the waist of the scaphoid were randomized to two groups. Twenty-eight patients were treated by immobilisation in a below elbow plaster cast for 10 weeks while 25 were treated by percutaneous insertion of an Acutrak standard screw. There were no statistically significant differences between the two treatment groups with regard to either the rate of union or the time to union. Patients who underwent surgery had a significantly better range of motion at 16 weeks but there were no significant differences for grip strength. Acute percutaneous internal fixation of undisplaced scaphoid waist fractures using the Acutrak screw allows early mobilisation without adverse effects on fracture healing.

Journal of wrist surgery, Sep 29, 2022

Background Pediatric carpal injuries are a clinical challenge due to their non-specific clinical ... more Background Pediatric carpal injuries are a clinical challenge due to their non-specific clinical features and occult nature on plain radiography. We hypothesized that early magnetic resonance imaging (MRI) will allow prompt diagnosis and treatment stratification, and that distal pole fracture of the scaphoid requires a shorter duration of immobilization. This study aims to assess the injury pattern and clinical outcomes of under-16-year-olds treated with acute post-traumatic wrist injuries in accordance with the unit's protocol. Methods All patients under the age of 16 years treated for suspected pediatric wrist injuries in our tertiary pediatric hand and upper limb service were included. Prospectively collected data included patient demographics, radiological findings, treatment and adherence to the unit's protocol. Results There were 151 patients with a mean age of 12 years. The majority (72%) had occult bony injury with radiological evidence of fracture on MRI. The sensitivity and specificity of plain film radiography were 42.7% and 71.4%, respectively. Almost one in four patients benefitted from early MRI demonstrating no injuries, permitting early mobilization and discharge. The scaphoid was the most commonly injured carpal bone. Non-displaced fractures of the distal pole of the scaphoid in patients over 10 years old were treated with 4 weeks' immobilization with no adverse outcome. Conclusion Standardized care in our unit has yielded good results with low complication rate and fewer hospital appointments. Our results support the routine early use of MRI and a shorter duration of immobilization in fracture of the distal pole of the scaphoid at 4 weeks. Level of Evidence This is a level IV, case series study.