The Journal of Hand Surgery - European Volume - April 2018 - 10

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and reporting of complications. Recurrence rate and
follow up ranged from 0- 47% and 24 - 156 months,
respectively.
Conclusion: Due to heterogeneity in the definition of
recurrence and contrasting results between studies,
no definite conclusion regarding the superiority of
dermofasciectomy was possible. In our unit, the
recurrence rate is low at <1%. We emphasise the
use of 1) a minimum data set and 2) both patient
reported- and objective measurements of hand function in future studies.

The Anatomical Relationship Between the Lunate
and Distal Radius: An Analysis of Computed
Tomography Scans of the Normal Wrist
Miss Adeline Clement, Dr Duncan Stickle and
Professor Alan Johnstone
Aberdeen Royal Infirmary
Time in programme: Friday 4th May 2018 09:07

Aim: The aim of the study was to use CT scanning to
determine the anatomical relationship between the
lunate and distal radius as previously identified in
MRI studies, enabling assessment of distal radius
fracture reduction where inadequate radiographs
are taken.
Method: The reformatted images of computed tomography (CT) scans of 19 normal wrists were examined firstly in the central/neutral axis and thereafter
in increments of 5 of the central axis up to 30 in both
directions from the central axis on the true lateral.
To obtain a measurement, a line is drawn continually
from the dorsal cortex of the distal radius to the
carpal region. Then the distance from the superior
pole of the lunate to this line is measured (SL-DC).
The lunate height (LH) is measured and the SL-DC:
LH ratio calculated. The ratios were calculated for
each degree of rotation by two individual observers,
the interobserver reliability calculated using a BlandAltman plot and a repeat-measures ANOVA analysis
applied to the results.
Results: The superior pole of the lunate was always
volar to the dorsal radial line through the range of
Æ30 which is consistent with the previous MRI studies. There was a good degree of interobserver reliability on the full dataset, as well as the isolated data,
with only 4% of the data points outside the limits of
agreement.
Conclusion: The results reaffirm the hypothesis that
the SL-DC relationship is maintained through a range
of rotation up to 30 away from the true lateral view.
In addition, the lunate reliably sits below the dorsal

Journal of Hand Surgery (Eur) 43(Supplement 1)
cortical line of the distal radius, echoing the results
of previous work on the topic. This allows for better
assessment of distal radius fracture reduction in the
presence of poorly obtained lateral plain radiograp.

Association Between Loss of Finger Extension and
Patient Reported Outcome Measures (PROMs) in
Dupuytren's Contracture in the HAND-1 Trial
Mr Wei Tan, Professor Tim Davis, Mrs Trish Hepburn,
Mrs Kirsty Sprange, Mrs Eleanor Harrison,
Ms Amanjeet Dahaley, Mr Gregory McConaghie,
Miss Alexia Karantana, Dr Nicola Mills and
Professor Alan Montgomery
University of Nottingham
Time in programme: Friday 4th May 2018 09:11

Background: Correction of extension deficit is used
to determine the success of Dupuytren's surgery, but
it is uncertain how well this reflects patients' perceptions of outcome.
Aim: To assess the association between changes following treatment in a) linear loss of active finger
extension (LLAE); b) angular finger deformity (AFD);
and c) four patient reported outcome measures
(PROMs).
Methods: Patients with a Dupuytren's contracture
>30 in one or more finger(s) treated by either limited fasciectomy or needle fasciotomy as part of a
randomised trial, underwent linear and angular
measurements of finger extension loss and completed 4 PROMs (URAM, MYMOP, DASH, PEM)
pre-operatively and 6 month post-surgery. LLAE
measurements were assessed via a bespoke device
which maintained the hand in a standard position; the
AFD measurements were obtained using a
goniometer.
Results: Postoperative changes in LLAE and AFD
were moderately correlated (CC ¼ 0.549). Both
change in LLAE and AFD correlated better with the
MYMOP and URAM, than with the DASH and PEM.
Correlation coefficients
LLAE (n ¼ 29-30)
AFD (n ¼ 40-42)

MYMOP
0.580
0.598

URAM
0.526
0.507

PEM
0.378
0.382

DASH
0.255
0.387

Conclusion: Linear loss of extension offers an alternative to angular measurement of finger extension.
Both were associated with changes in PROMs, but
the observed associations were not strong, and may
result from pain, numbness or stiffness not captured
when measuring joint angles.
Trial Registration: SRCTN11164292

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