Local disruption of the cord that causes contracture of the finger in Dupuytren disease can be achieved either through mechanical division by percutaneous needle fasciotomy (PNF) or through enzymatic digestion by injectable collagenase Clostridium histolyticum (CCH). #JBJS #VisualAbstract
UK epidemiologists presenting at the annual meeting of the British Society for Rheumatology recently reported that X-ray evidence of rapid rheumatoid arthritis (RA) progression during the first 12 months of the disease can help predict the need for later surgery of hand, foot, hip, and knee joints. Lewis Carpenter and colleagues analyzed data from the Early Rheumatoid Arthritis Study and found that a change in the Larsen radiographic score of four units during the first 12 months of RA was associated with an 80% increased risk of subsequent surgery on joints of the hand and foot, and a 50% increase in the risk of later hip or knee surgery. (The 0 to 5 Larsen score includes both joint-erosion and joint-space narrowing components.) Carpenter told MedPage Today that these findings help “build the case for early treatment in rheumatoid arthritis” and support the argument that a “therapeutic window of opportunity” exists with RA.
At a hospital in China, doctors took a very different approach to reattaching an amputated hand. Xiao Wei lost his right hand in an industrial accident, and his arm was severely compromised during the same accident. The dilemma that doctors faced was two-fold; saving the right hand and dealing with severe trauma to the rest of Wei’s arm. Their approach to salvaging his hand was to attach it to his ankle so the arteries and veins in the ankle would continue to supply blood to it. A month later, after his arm injuries healed and blood supply was sufficient, Xiao’s right hand was reattached to his arm. He is expected to regain full use of his hand.