Hook of the hamate fractures are frequently underdiagnosed and prone to symptomatic non-union. Internal fixation preserves carpal stability and grip strength. We describe a percutaneous antegrade technique for a stable osteosynthesis.

Aims:Augmented Reality (AR) guidance has demonstrated improved accuracy in glenoid component placement in both in-vitro and in-vivo settings. In cases of severe glenoid wear, structural bone may allow for defect correction. This study evaluates the accuracy of glenoid component positioning and graft incorporation in angled bony-increased offset reverse shoulder arthroplasty (BIO-RSA) assisted by navigated AR. Methods:Fifteen shoulders with severe glenoid erosion underwent angled BIO-RSA between 2021 and 2023. Preoperative computed tomographic (CT) scans facilitated three-dimensional (3D) surgical planning. Intraoperatively, glenoid placement was guided by navigated AR. Postoperative CT scans at six months were analyzed for graft incorporation and compared with preoperative planning to assess implant positioning accuracy. Results:The mean deviation between preoperative planning and postoperative positioning was 4.1° ± 3.4° (range, 0°-11°) in baseplate version and 1.9° ± 2.4° (range, 0°-9°) in inclination. Baseplate entry-point deviation was 1.6 mm ± 1.2 mm (range, 0.5-4.0 mm) in the antero-posterior direction and 1.1 mm ± 1.1 mm (range, 0-4.5 mm) in the superior-inferior direction. The mean deviation in baseplate offset reconstruction was 2.1 mm ± 1.6 mm (range, 0-5.5 mm). Complete graft incorporation was observed in all cases. Conclusion:Navigated AR enhances precision in BIO-RSA, ensuring accurate correction of glenoid wear and adherence to preoperative 3D planning. Level of evidence:Retrospective radiological study.

Boutonnière deformity is characterized by flexion of the proximal interphalangeal (PIP) joint and hyperextension of the distal interphalangeal (DIP) joint, often caused by trauma or rheumatoid arthritis. When the deformity remains supple without fixed contractures, tendon reconstruction techniques such as the Curtis plasty can restore function and correct alignment.

Introduction The supple boutonnière deformity results from central slip disruption at the PIP joint, leading to imbalanced forces across the extensor apparatus. Early intervention with non-surgical methods is preferred using dorsal extensor splint over the PIP joint, but in chronic cases, surgical reconstruction is necessary. Curtis plasty, a tendon-lengthening and rerouting procedure, has shown promising outcomes in restoring finger extension. Surgical Technique Curtis plasty involves reconstructing the central slip and repositioning lateral bands dorsally by sectioning the transverse retinacular ligaments, to restore balanced extension forces. The procedure preserves PIP mobility while preventing DIP hyperextension. Postoperative rehabilitation includes splinting and progressive motion therapy. The result after 3 months is very satisfying. Results and Discussion Studies report improved range of motion and function following Curtis plasty in supple boutonnière deformities. Compared to other techniques, it offers better joint alignment with minimal stiffness. Conclusion Curtis plasty is an effective option for correcting supple boutonnière deformity, restoring hand function with favorable long-term outcomes.

Bennett's fracture, an intra-articular fracture that separates the palmar aspect of the first metacarpal base from the first metacarpal, ais commonly treated with closed reduction and fixation to restore joint congruity and prevent osteoarthritis. Percutaneous cannulated screw fixation is an effective technique that provides stable fixation with minimal soft tissue disruption. Under fluoroscopic guidance, K-wires are inserted percutaneously, followed by cannulated screw insertion (Medartis CCS 1.7) to provide compression at the fracture site. Compared to K-wire fixation, screws offer superior biomechanical stability and early mobilization, reducing stiffness and promoting functional recovery. This technique is particularly beneficial for simple Bennett fractures without comminution. Studies suggest that patients who undergo percutaneous screw fixation achieve faster union and better grip strength than those treated with K-wires. Complications are rare, but may include screw prominence or intra-articular placement, requiring precise technique. Overall, this method is a reliable alternative for the treatment of Bennett fractures.

Background Carpal tunnel release can be performed as open or endoscopic surgery. In WALANT (wide awake local anesthesia no tourniquet) a tourniquet is not used, ensuring less discomfort for the patient. In locoregional distal nerve block, on the other hand, a tourniquet is needed and can be painful. This raises the question as to which method of anesthesia is actually preferred for the patient and the surgeon. Patients undergoing staged bilateral carpal tunnel release present a unique opportunity to study this question. Methods Fifteen patients were included in this prospective study. The primary endpoint was the preference for anesthesia type in patients and surgeons. Surgeon preference was based on the visibility and fluency of the procedure. Secondary endpoints for patients comprised pain scores for performing surgery and anesthesia and pain caused by the tourniquet. Results Baseline demographic and clinical information was collected. There was no significant difference in pain for performing local anesthesia or surgery. Surgeons may find that performing endoscopic release under WALANT is more challenging, as visibility tends to be significantly poorer. The mean pain caused by the tourniquet used during the wrist block procedure was rated as 3.6. In both surgeries, 77% (10/13) of the patients preferred the WALANT anesthesia. Conclusion In general, endoscopic carpal tunnel release was better tolerated under WALANT than locoregional distal nerve block. Although statistical analysis showed no significant difference in visibility and fluency for the surgeon between the two anesthesia techniques, we do not recommend endoscopic release under WALANT due to the consistent report of reduced visibility in the surgical field. This limitation, likely related to the presence of anesthetic fluid, may have failed to reach statistical significance due to small sample size, but is nevertheless a considerable challenge in practice. Level of evidence 1B.

Background: Glenoid rim fractures are uncommon and generally associated with high complication rates. The most common treatment techniques include screw or anchor fixation. Here, we introduce a new fixation method to treat Ideberg type 1A fractures. Methods: A retrospective analysis was performed on patients treated with open reduction and plate fixation for Ideberg type 1A fractures. The active range of motion capacity of both shoulders was recorded postoperatively. Constant-Murley score and Oxford disability index scores were used as outcome tools. Results: Five patients (three men and two women) were evaluated; their mean age was 56 years (standard deviation (SD), 10 years). The mean follow-up period was 25 months (range, 6-69 months); all fractures healed radiologically during the follow-up period. The mean Constant-Murley score was 80.36 (SD 11.01); the mean Oxford disability index was 37 (SD 9). The subsequent flexion and external rotation of the injured shoulders were similar to those of the uninjured side (injured vs. uninjured side: flexion, 176 +/- 5.4 vs. 178 +/- 4.4; external rotation, 48 +/- 10.9 vs. 60 +/- 0). No patient showed signs of osteoarthritis, stiffness, instability, or chronic pain at the last follow-up. Discussion: Open reduction and internal fixation with a plate is suitable for Ideberg type 1A glenoid fractures.

Closed reduction and fixation with elastic intramedullary nails is a popular technique to treat displaced pediatric forearm fractures and has yielded good functional results. Postoperative neurological symptoms can be due to neuropraxia and expectative treatment has been advised for 3 months until further investigation is necessary. We present a case of an 11-year-old boy that presented with median nerve palsy 2 months after a displaced forearm fracture treated with elastic intramedullary nails. Ultrasound and nerve conduction study confirmed the presence of a median nerve entrapped in the callus of the radial fracture. Surgical exploration demonstrated that the nerve was twisted around the intramedullary device. After neurolysis and surgical repair the patient finally recovered 2 years after the operation. This case highlights the possibility of median nerve entrapment after reduction with elastic intramedullary nails. Symptoms should be recognized early, and urgent surgical exploration is needed to prevent irreversible damage.

Bennett’s fractures are the most common fractures around the trapeziometacarpal joint but require specialized radiographs to be correctly diagnosed. If a fracture is missed at initial presentation, it may heal with an intra-articular gap, leading to joint incongruency and a painful trapeziometacarpal joint. We present a new technique to correct the intra-articular gap and restore joint congruency in the event of a symptomatic Bennett malunion with a gap of at least 2 mm. The joint is exposed through an anterolateral approach, and the malunion is marked with K-wires under fluoroscopic control. A closing wedge osteotomy with excision of the malunion site is then performed to restore joint congruency. The osteotomy is fixed with 3 interfragmentary screws, and the joint is immobilized for 2 weeks before passive mobilization is initiated. Hardware can be removed between 3 and 6 months postoperatively after consolidation of the osteotomy. We recommend this technique in active patients without trapeziometacarpal osteoarthritis who present with a painful Bennett malunion. Restoration of the joint congruency reduces pain and may prevent the development of posttraumatic osteoarthritis.

Background: The treatment of glenoid bone deficiencies in primary or revision total shoulder arthroplasty is challenging. This retrospective study evaluated the short-term clinical and radiologic results of a new custom-made patient-specific glenoid implant. Methods: We treated 10 patients with severe glenoid deficiencies with the Glenius Glenoid Reconstruction System (Materialise NV, Leuven, Belgium). Outcome data included a patient-derived Constant-Murley score, a visual analog score (VAS), a satisfaction score, the 11-item version of the Disabilities of the Arm, Shoulder and Hand score, and the Simple Shoulder Test. We compared the postoperative position of the implant with the preoperative planned position on computed tomography scans. Results: At an average follow-up period of 30.5 months, the mean patient-derived Constant-Murley score was 41.3 +/- 17.5 points (range, 18-76 points) with a visual analog scale of 3.3 +/- 2.5 points (range, 0-7 points). The mean 11-item version of the Disabilities of the Arm, Shoulder and Hand score was 35.8 +/- 18.4 (range, 2-71), and the mean Simple Shoulder Test was 47.5% +/- 25.3% (range, 8%-92%). Eight patients reported the result as better (n = 3) or much better (n = 5). One patient had an elongation of the brachial plexus, and 1 patient had a period of instability. The average preoperative glenoid defect size was 9 +/- 4 cm(3) (range, 1-14 cm3). The mean deviation between the preoperative planned and the postoperative version and inclination was 6 +/- 4 (range 1-16) and 4 +/- 4 (range 0-11), respectively. Conclusion: Early results of the Glenius Glenoid Reconstruction System are encouraging. Adequate pain relief, a reasonable functionality, and good patient satisfaction can be obtained in these difficult cases. Further follow-up will determine the bony ingrowth and subsequent longevity of this patient-specific glenoid component. (C) 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Le traitement de la maladie de Dupuytren est en pleine évolution ces dernières années. Les traitements proposés sont divers : la fasciectomie totale, fasciectomie sérielle et l’aponeurotomie à l’aiguille se font petit à petit remplacer par le traitement par collagénose. En Belgique, ce produit est remboursé pour des contractures de 20° au minimum, comportant au maximum deux articulations. La firme pharmaceutique propose pour l’articulation métacarpo-phalangienne d’utiliser 0,58 mg d’enzyme dans un volume de 0,25 mL. Pour l’articulation interphalangienne, il faut prévoir 0,58 mg d’enzyme actif dans un volume de 0,20 mL. Plusieurs études ont prouvé que le rapport coûts-avantages de Xiapex® est favorable comparé aux traitements chirurgicaux. On a voulu augmenter ce rapport coûts-résultats davantage en utilisant tout l’enzyme disponible dans un flacon (0,9 mg), en le diluant dans un volume de 0,6 mL. Ainsi, il devient possible de traiter des contractures pour lesquelles ont utiliserait 2 flacons. Quarante-deux mains chez 36 patients qui avaient au moins 2 articulations atteintes par la maladie de Dupuytren ont été injectés avec la dose décrite précédemment. On les a suivi pendant un période moyenne de 26 mois (12–39 mois). Le taux de contracture (en degrés) a été répertorié avant le traitement, après trois mois et au suivi final. Le taux de récidive, de satisfaction et de force sont rapportés. Parmi les 42 mains traitées, 21 ont maintenu la correction (avec une progression de moins de 20°) obtenu à 3 mois, tandis que 2742 ont progressé vers une récidive de contracture de plus de 20°. Sur ces 27 récidives de contracture, 10 se présentent au niveau de l’articulation interphalangienne proximale du cinquième doigt, et 4 comportent de surcroît une contracture d’une autre articulation des doigts longs. Nous déplorons 9 corrections incomplètes, tous parmi des articulations interphalangiennes proximales. Huit de ces corrections incomplètes de la contracture sont restés stables au suivi final. Le traitement par la collagénase a pris beaucoup d’ampleur et mérite d’être retenu comme traitement valable pour la maladie de Dupuytren. La dilution jusqu’à 0,6 cm3 permet un résultat comparable pour plus d’articulations dans 50 % des cas. Cela est comparable aux résultats obtenus avec deux flacons, tous en étant moins coûteux. L’articulation interphalangienne proximale de l’auriculaire reste néanmoins difficile à corriger complètement.

This study investigated the long term functional outcome after total replacement of the trapeziometacarpal joint with the Ivory prosthesis (Stryker Corporate, Michigan, USA) for trapeziometcarpal joint osteoarthritis in male patients. In this prospective study, range of motion, overall function, pain and radiologic outcome of the trapeziometacarpal arthroplasty were analysed in male patients after a minimum of 5 years of follow-up. The opening of the first web space and metacarpophalangeal flexion and extension were graded. Opposition and retropulsion were graded by Kapandji scores. Key pinch, precision pinch and grip strength were measured using a calibrated hydraulic pinch gauge and a calibrated hydraulic hand dynamometer. To assess overall function, the Quick Disabilities of the Arm, Shoulder and Hand score was used. Pain score was assessed with the Visual Analogue Scale. Radiologic outcome was evaluated using frontal and profile views as described by Kapandji and Eaton views with and without stress. A total of 17 Ivory arthroplasties was evaluated. Out of the 21 male patients eligible, 14 were included in the study. Three had bilateral arthroplasties. The mean age was 63 (range 52–84) years. The mean follow up period was 95 (range 62–125) months. Patient's satisfaction was high in 65 % of the patients, with 35 % of the patients not willingly to repeat surgery. We found no significant improvement in key pinch, precision pinch and grip strength after surgery, nor when comparing preoperative with postoperative strength. Considering thumb mobility, similar conclusions can be drawn. Overall function, according to the Quick Disabilities of the Arm, Shoulder and Hand score had been improved by 37 %. Pain decreased by 83 % with a mean Visual Analogue Scale score of 11/100 at a minimum of 5 years follow-up. Radiologic evaluation revealed collapse of the trapezium in 2 patients. In two other patients, a broken implant was detected. None of these patients needed surgical revision. They are followed in our outpatient clinic. Three patients had a failure of the prosthesis (overall survival of 82 %) and were converted to a trapiezectomy. Cantilever bending loads at the thumb base are larger in males than females. This might explain the high complication rate in the male subgroup. The Ivory arthroplasty for treating advanced trapeziometacarpal osteoarthritis, is associated with an high incidence of complications in the male patient. Nevertheless, there is an improvement in overall function and pain reduction and not every complication requires surgical revision.

This study investigated the long-term functional outcome after total replacement of the trapeziometacarpal joint with the Ivory prosthesis (Stryker Corporate, Kalamazoo, Michigan, USA) for trapeziometcarpal joint osteoarthritis. In this prospective study, range of motion, overall function, pain and radiologic outcome of the trapeziometacarpal arthroplasty were analysed after a minimum of 10 years of follow-up. The opening of the first web space and metacarpophalangeal flexion and extension were graded. Opposition and retropulsion were graded by Kapandji scores. Key pinch, precision pinch and grip strength were measured using a calibrated hydraulic pinch gauge and a calibrated hydraulic hand dynamometer. To assess the overall function, the Quick Disabilities of the Arm, Shoulder and Hand score was used. Pain score was assessed with the Visual Analogue Scale. Radiologic outcome was evaluated using frontal and profile views as described by Kapandji and Eaton views with and without stress. A total of 26 Ivory arthroplasties was evaluated. Out of the 32 patients eligible, 24 patients were included in the study. Two patients had bilateral arthroplasties. The female to male ratio was 22–2 and the mean age was 71 (range 57–83) years. The mean follow-up period was 130 (range 120–142) months. Patient satisfaction was high, with 85 % of the patients willingly to repeat surgery. The mobility of the operated thumb was improved compared to the contralateral thumb, except for metacarpophalangeal extension (78 % less than contralateral). Key pinch deteriorated with 7 % compared to preoperatively, grip strength improved with 3 %. The overall function, according to the Quick Disabilities of the Arm, Shoulder and Hand score improved by 54 %. Pain decreased by 81 % with a mean Visual Analogue Scale score of 13/100 at a minimum of 10 years follow-up. Radiologic evaluation revealed polythene wear with secondary joint instability that needed revision in two patients, and a broken implant that needed revision in another male patient. Three patients had asymptomatic polythene wear that required no revision but remain in follow up. One patient had a failure of the prosthesis and was converted to a trapiezectomy. The 10 year overall survival of the prosthesis was 85 %. These long term results suggest that the Ivory arthroplasty is a reliable option for treating advanced trapeziometacarpal osteoarthritis, since it gives an important improvement in overall function and pain reduction. However, revision of the implant within 10 years after surgery is needed in 15 % of the cases.

Les cals vicieux articulaires des phalanges sont, de par leur taille et l’entourage tissulaire, un défi délicat par rapport à toute chirurgie correctrice. Les moyens de calculs mis à disposition pour préparer la stratégie de correction ont néanmoins évolué. La société Materialise ® développe depuis plus de 25 ans des gabarits de correction 3D pour simplifier la préparation et ainsi le déroulement de la chirurgie. Nous illustrons la technologie proposée au moyen d’un cas précis qui s’est présenté suite à un accident de travail. Cette patiente, inspecteur de police, âgée de 44 ans, droitière, a été victime lors de l’arrestation d’un individu, d’un traumatisme par préhension de son annulaire gauche et hyperextension forcée de la métacarpophalangienne de son doigt. Le diagnostic de fracture par impaction de la surface articulaire du tiers dorsal de la base de la phalange proximale à été retardé compte tenu de la rarité de ce type de lésion. Suite à l’échec du traitement conservateur ainsi que de la persistance des douleurs que suscitait ce cal vicieux intra-articulaire, nous avons proposé un ostéotomie (intra-articulaire) de correction de l’impaction en utilisant la préparation par impression 3D de la société Materialise ®. La lésion, la préparation et le planning préopératoire en 3D virtuels sont illustrés. Le déroulement chirurgical et l’ostéotomie au moyen des gabarits dédiès est filmée. Le tout est synthèsé par plaque et vis à angle stable 1,5 mm (Synthes®). Une allogreffe lyophilisée est utilisée pour combler l’ouverture crée par l’ostéotomie. Le résultat fonctionnel et radiologique est illustré en postopératoire immédiat et à 1 an. Cette patiente à récupéré des amplitudes normales. La douleur qu’elle présentait avant l’ostéotomie à totalement disparu. La force de préhension est passée de 2 kg en preopératoire à 25 kg au dynamomètre de Jamar à 6 mois. Cette technique offre au chirurgien des possibilités de correction intra-articulaire précises permettant un déroulement chirurgical beaucoup plus prévisible grâce au gabarits prévus pour ces petites articulations. Néanmoins, le coût actuel (2500 € TVA incluse) est un frein important à l’utilisation systématique de cet instrument. Toutefois, le résultat permet une baisse substantielle du taux d’invalidité de l’individu, ce qui compense facilement ce coût supplémentaire lors d’accidents du travail.

En 1927, Mauclaire, puis en 1932, Dieterich, furent les premiers à faire un rapport sur une condition de nécrose aseptique des têtes métacarpiennes. Depuis lors, la condition se nomme comme maladie de Dieterich – Mauclaire (ou vice-versa). La plupart des articles qui sont apparus dans la littérature récente, rapportent leurs succès chirurgicaux, tandis que d’autres auteurs décrivent le traitement conservateur. Dans cette catégorie, le suivi dépasse rarement 1 an. Nous vous rapportons l’évolution naturelle de cette condition avec un suivi systématique pendant une période de 8 ans. Ce patient a été victime d’un traumatisme au niveau de sa main droite à l’âge 10 ans. Suite à cet évènement, il développe une douleur persistante. Quatre ans après, il se présente à notre service de chirurgie de la main pour un deuxième avis. Nous l’avons suivi pendant 4 années avec des radiographies et tomodensitométries sérielles. Le traitement à consisté, d’une part, du port d’une attelle de repos (nocturne) de type palette palmaire de support metacarpo-phalangien, ainsi que de la prise d’anti inflammatoires. Par ailleurs, tout travail trop lourd, trop répétitif et intense doit être évité lors des ses activités comme étudiant en à l’école horticole. Cette stratégie a amenuisé rapidement et de façon considérable ses douleurs. À l’examen radiographique et tomodensitométrique évalués annuellement, on a pu apprécier un remodellation étonnante de la surface articulaire ainsi que d’un maintien de l’espace articulaire. Suite à l’analyse de la littérature, notre cas présente le plus long suivi. Les articles sur les traitements chirurgicaux, rapportent un traitement conservateur de 3 mois maximum avant de préférer le parcours chirurgical. Après, les patients sont suivis pendant 6 mois à 4 années. Les articles rapportant le résultat du traitement conservateur, rapportent un suivi moyen variant de 3 mois à 33 mois. Notre cas démontre qu’un traitement conservateur de cette maladie peut donner d’excellents résultats. Il est très important de se rendre compte que dans un monde où les implants et les traitements chirurgicaux les uns plus complexes que les autres se succèdent, que nous ne pouvons oublier l’intérêt du traitement conservateur et un suivi régulier des patients porteurs de cette maladie. Ce cas prouve qu’une attitude conservatrice vis-à-vis de la maladie Dietrich – Mauclaire peut donner des résultats tout à fait satisfaisants.

Background Surgical management of de Quervain's tenosynovitis is based on decompression of the first extensor compartment. A simple release of the first compartment can cause instability of the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons in zone seven of the extensors. The WHAT test (wrist hyperflexion and abduction of the thumb) is very effective in diagnosing this instability. Patients and Methods In this retrospective monocentric study, we analyzed a case series of 10 patients all of whom underwent a reconstruction of the first extensor compartment using a retinacular graft because of symptomatic instability after decompression surgery. The reconstruction was a modified technique of the sixth compartment. Functional outcome and characteristics of the newly reconstructed pulley were examined by physical examination with the aid of ultrasound and internationally validated questionnaires. Results Four patients had a good-to-excellent functional outcome, all of those had a maximum of two surgical procedures performed on the first extensor compartment. Six patients presented poor functional outcome. In four of them, more than two surgical procedures were performed. Minor residual instability was noted in six cases, found in both the groups. Conclusion The reconstruction procedures on the first compartment seemed to be satisfactory in treating instability of the EPB and APL tendons after primary surgical release for de Quervain's disease. Level of Evidence Level IV, observational study without controls.

Background Ulnocarpal abutment is a common condition following distal radius fractures. There are different surgical methods of treatment for this pathology: open and arthroscopic wafer procedure or an ulnar shortening osteotomy. We describe an oblique metaphyseal shortening osteotomy of the distal ulna using two cannulated headless compression screws. We report the results of 10 patients treated with this method.Materials and Methods Out of 17 patients, 10 could be reviewed retrospectively for this study. Patient-rated outcomes were measured using the VAS (visual analogue scale) for pain, PRWHE (patient-rated wrist and hand evaluation) survey, and Quick-DASH (disability of arm, shoulder and hand) survey for functional outcomes. At the review we measured the range of motion (ROM) of the wrist (extension and flexion, ulnar and radial deviation, pronation and supination). Grip strength, pronation, and supination strength of the forearm was measured using a calibrated hydraulic dynamometer. ROM and strength of the affected wrist was compared with ROM and strength of the unaffected wrist.Surgical Procedure Oblique long metaphyseal osteotomy of the distal ulna (from proximal-ulnar to distal-radial), fixed with two cannulated headless compression screws.Results The average postoperative VAS score for pain was 23.71 (standard deviation [SD] of 30.41). The average postoperative PRWHE score was 32.55 (SD of 26.28). The average postoperative Quick-DASH score was 28.65 (SD of 27.21). The majority of patients had a comparable ROM and strength between the operated side and the non-operated side.Conclusion This surgical technique has the advantage of reducing the amount of hardware and to decrease the potential hinder caused by it on medium term. Moreover, the incision remains smaller, and the anatomic metaphyseal localization of the osteotomy potentially allows a better and rapid healing.

La contracture en flexion des doigts longs n’a pas seulement une répercussion sur la fonction des doigts longs, elle diminue la fonction de toute la main. Les patients sont incapables de porter des gants, de mettre leur main dans des espaces étroits et sont souvent embêtés par des accrochages involontaires d’objets. Nous avons revu les résultats d’une technique chirurgicale proposée par Guy Raimbeau, qui consiste en la résection de la phalange moyenne (P2) suivi d’une arthrodèse de la phalange distale (P3) à la phalange proximale (P1) dans le traitement des contractures invétérées des doigts longs. Dix patients furent retenus pour cette étude. Chaque patient ayant subi cette intervention chirurgicale les 7 années précédent l’étude a été invité pour un interview ainsi qu’un examen clinique et contrôle radiographique. La fonction postopératoire de la main a été évaluée utilisant les questionnaires PRWE et Quick Dash, l’échelle visuelle analogique, intolérance au froid et satisfaction personnelle. Les patients ont été examinés sur le plan clinique par rapport à leurs mobilités de l’articulation métacarpo-phalangienne (MCP), force de poigne (Jamar) et force pollicidigale, test de Weber pour la sensibilité pulpaire ainsi qu’une radiographie. Nos résultats démontrent que l’intégrité pulpaire et sa capacité discriminatoire (Weber) sont préservée. Les mobilités des MCP sont préservées. Les mêmes résultats sont retrouvés pour la force de poigne (Jamar) ainsi que la force de pince. Nous avons retrouvé une différence significative entre le score PRWHE préopératoire et celui en postopératoire contrairement au Quick Dash. En comparant la situation préopératoire, 87,5 % des patients s’estimaient satisfait, ou très satisfait concernant le résultat de cette intervention chirurgicale. L’intolérance au froid a été documentée dans 37,5 % des patients. Seul un patient était toutefois déçu par le résultat esthétique, tous les autres étaient satisfaits. Mitz V et al. ont démontré la valeur de la préservation de la pulpe pour les doigts longs en crochet. Ces déformations sont souvent traitées en réséquant tout le rayon ou par amputation. Les bénéfices de cette procédure sont la préservation de la pulpe et sa sensibilité, ainsi qu’un résultat esthétique après la régression du volume de la peau palmaire comprimée. Par ailleurs, des névromes douloureux, complication possible aux amputations digitales sont évités. Cette intervention donne un résultat fiable pour des contractions irréparables des doigts longs sur le versant ulnaire.