Percutaneous needle aponeurotomy: complications and results (original) (raw)
Related papers
International Journal of Medical Reviews, 2020
Aim: Few studies have been published about early surgical treatment of Rheumatoid Arthritis (RA). This article has aimed to describe the main procedures that may be performed in the hands of subjects at early stages of this disease. Methods: This research was a narrative review seeking comparative works in the Medline, LILACs and EMBASE databases. Results: The publications showed good results associated with wrist synovectomy. There was a reduction in pain, greater patient satisfaction, and stabilization of the Larsen score. Synovectomy was indicated in these studies as an alternative procedure after three to four months of unsatisfactory clinical therapy. Another possibility of approaching these patients is the repair or transfer of ruptured tendons. Most studies have described this procedure in patients already with deformities secondary to RA and not in the initial phase of the disease. In this group of patients, the authors observed that the highest number of ruptures was asso...
Results of dorsal wrist synovectomies in the rheumatoid hand
Journal of Hand Surgery-american Volume, 1990
Seventy-eight patients with rheumatoid arthritis had 102 dorsal wrist tenosynovectomies, intraarticular synovectomies, and Darrach resection from 1962 to 1982. Follow-up after surgery averaged 11 years, with a range from 3 to 20 years. Pain was diminished in all but 17 wrists and motion decreased an average of 13 degrees. Synovitis recurred in 16 wrists and x-ray evidence of progressive intraarticular destruction was seen in 45 wrists. Revision surgery was necessary in 28 wrists.
Surgical Management of Rheumatoid Arthritis of the Hand
Rhode Island medical journal, 2020
INTRODUCTION Rheumatoid arthritis (RA) is a painful autoimmune disease that affects about 1% of the population.1 A comprehensive epidemiological study of global disease burden in 2015 found that the prevalence of RA was about 25 million individuals, with an overall increase by 23.8% from 2005.2 RA usually causes bilateral joint pain, stiffness, and swelling, which is typically worse after periods of inactivity or in the morning. While RA is characterized by joint involvement, other inflammatory manifestations include fever, anemia of chronic disease, pericarditis, and pulmonary fibrosis. RA can also be associated with other autoimmune diseases, including systemic lupus erythematosus and psoriatic arthritis. The disease process of RA is a Type III hypersensitivity reaction that involves autoimmune cellular activation and immune complex formation in joints. These deposits lead to thickening of joint capsules, cartilage and bone damage due to inflammatory cascades, and rupture of tendo...
The Journal of rheumatology, 2003
Rheumatoid arthritis (RA) is a common cause of debilitating hand deformities, but management of these deformities is controversial, characterized by large variations in the surgical rates of common RA hand procedures. We conducted a national survey evaluating potential differences in physicians' management of RA hand deformities. We mailed a survey instrument to a random national sample of 500 rheumatologists and 500 hand surgeons in the US. We evaluated physicians' attitudes toward the other specialties' management of common RA hand deformities and toward the indications for performing rheumatoid hand surgery. We found 70% of rheumatologists consider hand surgeons deficient in understanding the medical options available for RA, while 73.6% of surgeons believe rheumatologists have insufficient knowledge of the surgical options for RA hand diseases. However, 66.9% of surgeons and 79.5% of rheumatologists had no exposure to the other specialty during training. The 2 physic...
2021
Background: Scar contractures of the fingers represent a major functional and aesthetic burden to many patients with hand injury. Managing such condition is often challenging and various techniques have been proposed, with flap-based techniques being the conventional options. Percutaneous Needle Aponeurotomy (PNA) combined with lipofilling represent a novel, non-invasive method for managing scar contractures. Methods: This prospective study included 10 patients with scar contractures of the fingers who were managed with PNA and lipofilling at a single center from March 1st, 2015 till March 1st, 2016. Six patients had postburn scars and 4 patients had post-traumatic scarring. Results: All patients had significant improvement in contractures postoperatively at the median follow-up, the mean improvement of contracture was 21 degrees (± 9 degrees) for the MP joint, and 31 degrees (± 12 degrees) for the PIP joint. Functional improvement was recorded in 6 out of 8 patients (75%), and cosm...