The Journal of Hand Surgery - European Volume - April 2018 - 5

BSSH Spring meeting abstracts
the change in PROMs at 3 months (EQ5D index
p ¼ 0.92; VAS p ¼ 0.34; PEM p ¼ 0.61); 6 months
(EQ5D index p ¼ 0.15; VAS p ¼ 0.88; PEM p ¼ 0.66) or
at 12 months post-operatively (EQ5D index p ¼ 0.77;
VAS p ¼ 0.66; PEM p ¼ 0.56)
Conclusions: Understanding the distribution of surgical procedures for BTOA through the UKNHR, the
impact of treatment and factors associated with
outcome will benefit the design of future studies
in BTOA.

Use of Thiel Embalmed Cadavers in Elective Hand
Surgery - Exploring Attitudes to Simulated Surgical
Training
Miss Sameena Hassan, Mr Ibrahim Natalwala,
Ms Kirsty Smith, Mr Paul Stanley, Mr Sanjib Majumder
and Mr Richard Pinder
Hull and East Yorkshire Hospitals
Time in programme: Thursday 3rd May 2018 10:08

Aims: To assess the life-like comparability of Thiel
embalmed cadavers in upper limb surgical simulation training. We also explore consultant attitudes in
using simulated training to achieve indicative logbook
numbers.
Methods: Seven consultant plastic surgeons and 11
speciality trainees performed three upper limb procedures [Trapeziectomy & LRTI, radial artery forearm flap (RAFF), and Extensor Indicis (EI) to
Extensor Pollicis Longus transfer (EPL)]. The individual steps in each procedure were assessed using a
Likert scale [1 to 4], as well as trainee confidence in
performing each procedure pre- and post- cadaveric
dissection training using Visual Analogue Score (VAS)
[0 to 10].
Results: Following the training, trainee confidence in
performing the procedures increased by a mean VAS
of 2.6 (p ¼ 0.0005) for trapeziectomy, 4.8 (p ¼ 0.0007)
for RAFF, and 2.6 (p ¼ 0.002) for EI to EPL transfer.
For trapeziectomy, trainees found more than 70% of
the steps (10 of 14) to be either satisfactory or lifelike (overall mean 3.2/4.0). For the RAFF, only 1 of 12
steps (identifying the septocutaneous perforator) was
deemed less than satisfactory by consultants, but the
overall mean was still 3.5/4.0. Both trainees and consultants found every step of EI to EPL transfer to be
satisfactory or life-like with an overall mean of 3.6/
4.0. Interestingly, although consultants were keen on
Thiel cadavers for training, and would welcome
cadaveric training into the curriculum, they did not
feel it was acceptable to use this as an adjunct for
indicative logbook numbers.

S5
Conclusions: Thiel embalmed cadavers allow trainees to readily identify fascial planes, neurovascular
structures, and manipulate tendons and ligaments
and are hence an ideal learning resource.

Arthrodesis for Chronic Carpometacarpal
Instability in Elite Boxers
Mr Feiran Wu, Mr Iain McLaughlin-Symon, Mr Ian Gatt,
Dr Michael Loosemore and Mr Mike Hayton
Wrightington Hospital
Time in programme: Thursday 3rd May 2018 10:15

Aims: Instability of the carpometacarpal joints
[CMCJ] is a common and potentially career ending
hand injury in elite boxers. We present the outcomes
of a cohort of elite boxers who presented with symptomatic chronic CMCJ instability.
Methods@: Twenty-three elite boxers, 13 professional and 10 amateur, who were unable to compete
due to pain and weakness, were treated with primary
CMCJ arthrodesis. A total of 64 joints were fused in
26 hands, with a mean of 2.8 joints per patient. Mean
symptom duration was 14 months. All patients
received non-operative intervention before proceeding to fusion (K-wires: 16 joints, screw fixation: 38
joints, speed staples: 10 joints). Autologous corticocancellous bone graft was used in all cases. All
except two hands required fusion of the index and
middle finger CMCJ. The mean age at surgery was
25 years.
Results: All except 3 patients (5 joints) united at a
mean duration of 10 weeks. Two patients (3 joints)
failed to unite and required secondary iliac crest
bone grafting and fixation (screw: 1, K-wires: 2).
One patient had a partial union that required further
bone grafting without fixation. One patient developed
dysaesthesia in the distribution of the dorsal ulnar
cutaneous nerve that resolved after exploration and
neurolysis. No other complications were seen.
All except two boxers returned to competition at a
mean duration of 33 weeks post-operatively. All professional boxers returned to competition at a mean of
36 weeks, and remain competing 36 months following surgery. Eight amateur boxers returned to competition at a mean of 24 weeks.
Conclusion: Primary arthrodesis is a reliable and
successful treatment for chronic CMCJ instability in
boxers, with a low rate of complications and excellent
return to competition.



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

The Journal of Hand Surgery - European Volume - April 2018 - Cover1
The Journal of Hand Surgery - European Volume - April 2018 - Cover2
The Journal of Hand Surgery - European Volume - April 2018 - 1
The Journal of Hand Surgery - European Volume - April 2018 - 2
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The Journal of Hand Surgery - European Volume - April 2018 - 4
The Journal of Hand Surgery - European Volume - April 2018 - 5
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The Journal of Hand Surgery - European Volume - April 2018 - Cover3
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