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a textbook of engineering physics by rk bansal free download pdfPaired metacarpophalangeal thumb carpometacarpal metacarpophalangeal joint arthrodesis using oscillating saw in patients with hand OA or RA.
To describe the technical aspects of paired metacarpophalangeal thumb carpometacarpal metacarpophalangeal (MP-CMC-MP) joint arthrodesis using oscillating saw in the management of patients with hand OA or RA. A retrospective study of ten cases of paired MP-CMC-MP joint arthrodesis using oscillating saw was done. Mean age was 62.7 years. Twelve treated joints were DIP-PIP or DIP-IP joints and two were MP-CMC-PIP. The mean follow up period was 24 months. All except one patient had greater than 3 years postoperative period. All joints were fixed using lag screws and the fixation can be easily removed after 6 to 8 weeks. There was no nonunion. No major complication occurred. The average range of motion (ROM) of the first MP joint was 31°, CMC joint 12° and MP joint 12° preoperatively and 20°, 28° and 19° postoperatively respectively. The average ROM of the second MP joint was 21° preoperatively and postoperatively. The average DASH score was 32.7. This was satisfactory. Paired MP-CMC-MP joint arthrodesis using oscillating saw could be an option for the management of OA or RA patients with severe restriction of ROM.Reduced oxygen levels in anaerobic granular sludge with minimal metabolic activity.
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