Dataset Information

Little Finger Flexor Tendoscopy, Endoscopy of the Ulnar Bursa and Midpalmar Space.

ABSTRACT: Inflammatory, infectious, and even neoplastic processes can involve the deep subfascial space of the hand. Suppurative deep-space infection is treated primarily with surgical drainage. Open approaches to these deep spaces carry the risk of exposed flexor tendons and nerves without adequate soft tissue coverage. The purpose of this Technical Note is to describe the technical details of little finger flexor tendoscopy, endoscopy of the ulnar bursa and midpalmar space, which will reduce the risk of exposed tendons or nerves associated with open approaches and allow aggressive hand therapy in the early postoperative period because of the minimal surgical trauma and small surgical wounds.

SUBMITTER: Lui TH

PROVIDER: S-EPMC6112227 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Little Finger Flexor Tendoscopy, Endoscopy of the Ulnar Bursa and Midpalmar Space.

Lui Tun Hing TH Lee Cheung Hong CH

Arthroscopy techniques 20180709 8

Inflammatory, infectious, and even neoplastic processes can involve the deep subfascial space of the hand. Suppurative deep-space infection is treated primarily with surgical drainage. Open approaches to these deep spaces carry the risk of exposed flexor tendons and nerves without adequate soft tissue coverage. The purpose of this Technical Note is to describe the technical details of little finger flexor tendoscopy, endoscopy of the ulnar bursa and midpalmar space, which will reduce the risk of ...[more]

PMID: 30167359

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Project description:BackgroundWithout surgical repair, flexor tendon injuries do not heal and patients' ability to bend fingers and grip objects is impaired. However, flexor tendon repair surgery also requires optimal rehabilitation. There are currently three custom-made splints used in the rehabilitation of zone I/II flexor tendon repairs, each with different assumed harm/benefit profiles: the dorsal forearm and hand-based splint (long), the Manchester short splint (short), and the relative motion flexion splint (mini). There is, however, no robust evidence as to which splint, if any, is most clinical or cost effective. The Flexor Injury Rehabilitation Splint Trial (FIRST) was designed to address this evidence gap.MethodsFIRST is a parallel group, superiority, analyst-blind, multi-centre, individual participant-randomised controlled trial. Participants will be assigned 1:1:1 to receive either the long, short, or mini splint. We aim to recruit 429 participants undergoing rehabilitation following zone I/II flexor tendon repair surgery. Potential participants will initially be identified prior to surgery, in NHS hand clinics across the UK, and consented and randomised at their splint fitting appointment post-surgery. The primary outcome will be the mean post-randomisation score on the patient-reported wrist and hand evaluation measure (PRWHE), assessed at 6, 12, 26, and 52 weeks post randomisation. Secondary outcome measures include blinded grip strength and active range of movement (AROM) assessments, adverse events, adherence to the splinting protocol (measured via temperature sensors inserted into the splints), quality of life assessment, and further patient-reported outcomes. An economic evaluation will assess the cost-effectiveness of each splint, and a qualitative sub-study will evaluate participants' preferences for, and experiences of wearing, the splints. Furthermore, a mediation analysis will determine the relationship between patient preferences, splint adherence, and splint effectiveness.DiscussionFIRST will compare the three splints with respect to clinical efficacy, complications, quality of life and cost-effectiveness. FIRST is a pragmatic trial which will recruit from 26 NHS sites to allow findings to be generalisable to current clinical practice in the UK. It will also provide significant insights into patient experiences of splint wear and how adherence to splinting may impact outcomes.Trial registrationISRCTN: 10236011.

Dataset Information

Little Finger Flexor Tendoscopy, Endoscopy of the Ulnar Bursa and Midpalmar Space.

Publications

Little Finger Flexor Tendoscopy, Endoscopy of the Ulnar Bursa and Midpalmar Space.

Similar Datasets

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