The Journal of Hand Surgery - European Volume - April 2018 - 13

BSSH Spring meeting abstracts
Minimally Invasive Reconstruction of the Anterior
Oblique and the Dorsoradial Ligaments of the
Painful Subluxated Carpometacarpal Joint of the
Thumb
Professor Ethan Wiesler, Dr David Luo and
Dr Mark Warburton
Wake Forest Univ., Baptist Medical Center
Time in programme: Friday 4th May 2018 09:41

The purpose of this study is to assess the success of
a new minimally invasive surgical technique that
functions to anatomically restore the CMC joint
using palmaris longus (PL) tendon autograft to augment the anterior oblique ligament (AOL) and dorsoradial ligament (DRL).
We retrospectively reviewed 45 patients with subluxated CMC joints of Eaton stage I or II who were
treated with preservation of trapezium andautologous PL tendon transfer. Pre and post op mean
grip and pinch strength were assessed in a standard
manner with Jamar dynamometer, and DASH questionnaire scores recorded. Pre and post-op stress
radiographs were compared to calculate changes in
joint stability as evidenced by the CMC subluxation
ratio. Descriptive statistics including mean values
with standard deviation were performed on all data
collected.
In all 45 patients, grip improvedfrom pre to postop, with measurements increasing from 38 and 11.7
pounds to 55 and 14.7 pounds respectively. CMC subluxation ratios decreased from 0.69 to 0.46 after surgery, showing enhanced stability of the CMC joint. All
patients reported significant subjective improvement
in pain after surgery and were able to return to previous levels of work. A decrease in mean DASH
scores from 42 pre-op to 10.6 post-op were seen
among all patients.
We consider this minimally invasive reconstruction
of the CMC joint to provide satisfactory outcomes in
patients with Eaton stage I or II CMC OA as evidenced
by improved subjective and functional results. Given
its minimally invasive nature, future treatment
options such as a conversion to LRTI or a joint
replacement arthroplasty are still available if
needed.

S13
Antibiotics in Hand Trauma: Cutting Down the Cost
and Maximising Patient Safety
Dr Bismark Adjei, Mr Hazem Alfeky, Miss Lucy Homer,
Miss Salma Mohamed, Mr Irfan Khan, Mr Christian West
and Mr David Bell
Whiston Hospital
Time in programme: Friday 4th May 2018 09:45

Introduction and Aims: The World Health
Organisation recently raised an alarm concerning
moving towards a world without effective antibiotics
(The post-antibiotic era) urging medical specialities
to review their practice and, where appropriate,
change them to stem the tide. Prophylactic antibiotics are frequently used by plastic surgeons in
hand trauma as a prophylaxis. However, there is no
solid evidence for that. The aim of this audit is to
review the current practise and measure it to the
guidelines.
Material and Methods: A review of 300 hand soft
tissue laceration cases were included. All open fractures and complex soft tissue injury were excluded.
The antibiotics prescription was measured against
the guidelines and the recommendations of a two
recent meta-analysis studies to define the role of
prophylactic antibiotics in upper limb lacerations.
Results: In two recent meta-analyses, Jennifer Lane
et al. and Murphy et al, showed that prophylactic
antimicrobial use has no significant effect on the
infection rate compared to placebo or no antibiotics
in patients with small soft hand lacerations. Our current practise shows that there is a trend to prescribe
prophylactic antibiotics where there is no clear
indication.
Conclusion: Not withstanding current evidence, there
is a trend to routinely supply simple hand laceration
patients with prophylactic antibiotics. There is a need
to review our practise and define a clear guidance on
the role of antibiotic prophylaxis in hand trauma
patients.

Rapid Microbial Diagnosis in Hand and Upper Limb
Infections
Dr Andrew McKean, Mr Shakeel Rahman,
Mr Peter Macneal and Mr Maxim Horwitz
Chelsea and Westminster Hospital NHS Foundation Trust
Time in programme: Friday 4th May 2018 09:49

Aims: Microbiology diagnostics have benefited following advancements in multiplex PCR technology,
which is currently available to provide pathogen

Table of Contents for the Digital Edition of The Journal of Hand Surgery - European Volume - April 2018