Katsuji Suzuki

Subcutaneous flexor tendon rupture in patients with rheumatoid arthritis

Abstract Objective: We examined the clinical features and functional outcomes of surgically repaired subcutaneous flexor tendon ruptures in patients with rheumatoid arthritis (RA). Methods: This retrospective study included 41 fingers of 24 RA patients who underwent surgical treatment for flexor tendon ruptures. Evaluations performed at the time of presentation following rupture were C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and disease activity score in 28 joints (DAS28)-ESR, as well as Larsen grading for carpal bone destruction. The ruptured tendon and postoperative active range of motion (ROM) of digits were also examined. Results: The mean CRP was 2.4 mg/dl, ESR was 52 mm/h, and the DAS28-ESR was 4.5. Carpal bone destruction according to Larsen grade IV–V was observed in 18/24 patients. Affected digits were most commonly the thumb (12) and the ring and little fingers (9 each). Tendon ruptures were most common in the carpal tunnel in zone IV. The mean postoperative finger ROM (flexion/extension) was 38°/2° for the interphalangeal (IP) joint of the thumb and 23°/−2° for the distal interphalangeal joint of the other four fingers. Conclusions: Patients with flexor tendon ruptures present with high disease activity and advanced bone destruction. It is important to reduce the risk of progressive bone destruction and subsequent tendon rupture via tight control of disease activity.

Cigarette Smoking Is Associated With Cubital Tunnel Syndrome

The aim of this study was to validate the potential association between cigarette smoking and cubital tunnel syndrome (CubTS).

Sauvé–Kapandji procedure with headless compression screw in patients with rheumatoid arthritis

Abstract Objective: We examined the surgical outcomes of the Sauvé–Kapandji (S–K) procedure using a headless compression screw and a metal cancellous screw in patients with rheumatoid arthritis (RA). Methods: This retrospective study included 41 RA patients who underwent the S–K procedure for distal radioulnar joint disorders with two screws: headless compression screws (HCS group, n = 20) and cannulated cancellous screws (CCS group, n = 21). Clinical and radiographic outcomes were assessed 1 year after surgery. Radiographic outcomes included bony union of the distal radioulnar joint (DRUJ), bone resorption around the screw, a screw back-out, and use of additional K-wire. We investigated any complications related to the screw head. Results: All 20 patients in the HCS group showed bone fusion of the DRUJ. In the CCS group, an asymptomatic non-union was observed in one patient and additional K-wire was needed to stabilize the DRUJ in three patients. No patients complained of any complications related to the screw head in the HCS group, while the CCS group demonstrated the hardware protrusion in two patients who complained of tenderness or discomfort at the screw head. Conclusions: The use of a headless compression screw in the S–K procedure is useful in patients with RA.

Reliability of radiographic measurement of lateral capitellohumeral angle in healthy children

Abstract This retrospective cohort study was designed to validate the reliability of measurement of the lateral capitellohumeral angle (LCHA), an index of sagittal angulation of the elbow, in healthy children. The results were compared to the Baumann angle (BA), which is a similar concept to LCHA. Sixty-two radiographs of the elbow in healthy children (range, 2–11 years) were reviewed by 6 examiners at 2 sessions. The mean value and reliability of the measurement of LCHA and BA were assessed. Intraobserver reliability and interobserver reliability were calculated using intraclass correlation coefficients (ICCs). The mean LCHA value was 45° (range, 22° to 70°) and the mean BA was 71° (range, 56° to 86°). The ICCs for intraobserver reliability of the LCHA measurements were almost perfect for 2 examiners, substantial for 3 examiners, and moderate for 1 examiner with a mean value of 0.77 (range, 0.57–0.95). For BA measurements, the ICCs were almost perfect for 1 examiner and substantial for 5 examiners with a mean value of 0.74 (range, 0.66–0.83). The ICCs for interobserver reliability between the first and second measurements were both moderate for LCHA (0.56 and 0.51) and for BA (0.52 and 0.50). LCHA showed almost the same reliability in measurement as BA, which is the gold standard assessment for coronal alignment of the elbow. LCHA showed moderate-to-good reliability in the evaluation of sagittal plane elbow alignment.

Arthroplasty Using Ball-and-Socket Type Ceramic Prosthesis for the Osteoarthritis of the Trapeziometacarpal Joint of the Thumb

Six patients underwent arthroplasty of the trapeziometacarpal joint of the thumb with our ball-and socket type ceramic prosthesis for the osteoarthritis of Eaton stage 3 or 4. Our prosthesis was made of alumina ceramic and high-density polyethylene. Pain and dislocation or subluxation of the trapeziometacarpal joint were found in all of the patients preoperatively and these symptoms were relieved completely after surgery. The % total active motion of the trapeziometacarpal joint and metacarpophalangeal + interphalangeal joints, the % grip strength and % pinch strength improved postoperatively. The trapeziometacarpal joint function according to Eaton’s criteria after surgery was excellent of 5 patients and good of 1 patient.