scholarly journals Joint Preservation of the Wrist Using Articulated Distraction Arthroplasty: A Case Report of a Novel Technique

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Matt D. A. Fletcher
Keyword(s):  
Functional Outcome ◽  
Therapeutic Option ◽  
Wrist Arthrodesis ◽  
Distraction Arthroplasty ◽  
Novel Technique ◽  
Subjective Pain ◽  
Wrist Fusion ◽  
Functional Outcome Measures ◽  
Orthopaedic Community ◽  
Limited Wrist Fusion

Distraction arthroplasty of the ankle, elbow, and hip has become widely accepted and used within the orthopaedic community with excellent initial results which appear sustained. To date it has not been applied to the wrist in the same manner. A novel technique, drawn upon past success of articulated ankle distraction and static wrist distraction, was devised and evaluated by application of articulated wrist distraction performed over a 12-week period in a patient with poor functional outcome following limited wrist fusion. Posttreatment results showed improvement in range of motion (100-degree arc), subjective pain, and functional outcome measures (DASH 21.7, Mayo Wrist Score 80) comparable or better than either limited wrist fusion or proximal row carpectomy. Articulated wrist distraction initially appears to be a promising therapeutic option for the management of the stiff and painful wrist to maintain maximal function for which formal wrist arthrodesis may be the only alternative.

Modified Instruments for Wrist Fusion

1986 ◽  
Vol 11 (2) ◽  
pp. 245-249
Author(s):  
J. K. STANLEY ◽  
S. R. GUPTA ◽  
M. G. HULLIN
Keyword(s):  
Surgical Procedures ◽  
Operative Time ◽  
Intramedullary Fixation ◽  
Early Mobilisation ◽  
Wrist Arthrodesis ◽  
Wrist Fusion ◽  
New Instruments

A technique and new instruments for intramedullary fixation of the wrist arthrodesis is described, based on the technique of Clayton, popularised by Nalebuff and Millender. This allows early mobilisation, secure fixation and simplicity of the technique. It also allows other surgical procedures to be performed under the same anaesthetic and tourniquet due to the reduction in operative time.

scholarly journals Inducible transgene expression in PDX models in vivo identifies KLF4 as therapeutic target for B-ALL

2019 ◽  
Author(s):  
Wen-Hsin Liu ◽  
Paulina Mrozek-Gorska ◽  
Tobias Herold ◽  
Larissa Schwarzkopf ◽  
Dagmar Pich ◽  
...  
Keyword(s):  
Residual Disease ◽  
Therapeutic Option ◽  
Lymphoblastic Leukemia ◽  
Clinical Model ◽  
Novel Technique ◽  
Pdx Model ◽  
Cell Acute Lymphoblastic Leukemia ◽  
Disease Stages ◽  
Pdx Models

Clinic-close methods are not available that prioritize and validate potential therapeutic targets in individual tumors from the vast bulk of descriptive expression data. We developed a novel technique to express transgenes in established patient-derived xenograft (PDX) models in vivo to fill this gap. With this technique at hand, we analyzed the role of transcription factor Krüppel-like factor 4 (KLF4) in B-cell acute lymphoblastic leukemia (B-ALL) PDX models at different disease stages. In competitive pre-clinical in vivo trials, we found that re-expression of wild type KLF4 reduced leukemia load in PDX models of B-ALL, with strongest effects after conventional chemotherapy at minimal residual disease (MRD). A non-functional KLF4 mutant had no effect in this model. Re-expressing KLF4 sensitized tumor cells in the PDX model towards systemic chemotherapy in vivo. Of major translational relevance, Azacitidine upregulated KLF4 levels in the PDX model and a KLF4 knockout reduced Azacitidine-induced cell death, suggesting that Azacitidine can regulate KLF4 re-expression. These results support applying Azacitidine in patients with B-ALL to regulated KLF4 as a therapeutic option. Taken together, our novel technique allows studying the function of dysregulated genes in a highly clinic-related, translational context and testing clinically applicable drugs in a relevant pre-clinical model.

Functional outcome measures for infantile Charcot‐Marie‐Tooth disease: a systematic review

2018 ◽  
Vol 23 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Melissa R. Mandarakas ◽  
Kristy J. Rose ◽  
Oranee Sanmaneechai ◽  
Manoj P. Menezes ◽  
Kathryn M. Refshauge ◽  
...  
Keyword(s):  
Systematic Review ◽  
Functional Outcome ◽  
Outcome Measures ◽  
Charcot Marie Tooth ◽  
Charcot Marie Tooth Disease ◽  
Functional Outcome Measures ◽  
Tooth Disease

scholarly journals Assessment of Wrist Function After Simulated Total Wrist Arthrodesis

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. 464-468 ◽  
Author(s):  
Richard M. Hinds ◽  
Eitan Melamed ◽  
April O’Connell ◽  
Francoise Cherry ◽  
Monica Seu ◽  
...  
Keyword(s):  
Grip Strength ◽  
Functional Limitation ◽  
Test Duration ◽  
Fusion Model ◽  
Optimal Position ◽  
Wrist Arthrodesis ◽  
Ulnar Deviation ◽  
Radial Deviation ◽  
Wrist Fusion ◽  
Wrist Function

Background: There is poor consensus in the literature regarding associated functional limitation and the preferred wrist position for total wrist arthrodesis. The purpose of the current investigation was twofold: (1) to assess the functional limitations of wrist arthrodesis and (2) to determine the optimal position for wrist arthrodesis using a simulated wrist fusion model. Methods: Twenty healthy volunteers underwent simulated wrist arthrodesis in 6 different positions using custom-molded wrist splints: 15° extension with 0° radio-ulnar deviation, 15° extension with 10° ulnar deviation, 15° extension with 10° radial deviation, 0° extension with 0° radio-ulnar deviation, 0° extension with 10° ulnar deviation, and 0° extension with 10° radial deviation. Each volunteer was independently assessed for wrist function using the Jebsen-Taylor hand function test, grip strength, and satisfaction in the simulated wrist fusion positions. Comparisons between all simulated fusion wrists and the baseline unsplinted wrist as well as among the 6 simulated fusion positions were performed. Results: Turning over a card (5.1 vs 4.3 seconds), picking up small objects (7.1 vs 5.8 seconds), and simulated feeding (8.3 vs 7.1 seconds) as well as total Jebsen-Taylor test duration (41.8 vs 37.9 seconds) was significantly longer in simulated fusion wrists. Both grip strength (55.9 vs 80.7 kg) and satisfaction scores (6.4 vs 9.6) were lower in simulated fusion wrists. Wrists in 0° extension also demonstrated significantly shorter durations in stacking checkers than wrists in 15° extension. Conclusion: Our findings suggest that wrist arthrodesis may only compromise select wrist functions. Among the tested wrist fusion positions, wrists fused in neutral may demonstrate better function than wrist fused in slight extension. However, grip strength and satisfaction seem to be unaffected by wrist fusion position.

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