[Results of basal joint arthrosis treatment--comparison of Epping ligament reconstruction with trapeziectomy alone]. / Ergebnisse nach Rhizarthrosebehandlung--Vergleich der Aufhängeplastik nach Epping mit der alleinigen Trapezektomie.

Objective of this study is to compare clinical and radiological results of two different methods of treatment for trapeziometacarpal osteoarthrosis of the thumb. Eighteen patients received operative treatment. An operation according to Epping was performed in eleven cases (collective I), while nine cases were treated with a trapeziectomy only (collective II). The mean follow-up of the first collective was 40 months and 15 months for the second one. The results of the two patient groups were subjected to statistical comparison in a retrospective study. This revealed no significant differences with regard to active range of motion, power, and subjective symptoms, classified according to the Buck-Gramcko score. With a mean of 49 points for the first and 50 points for the second collective, both achieved very good results. However, the mean operating time was significantly shorter in the patients treated with a trapeziectomy only, while the mean distance between the base of the first metacarpal bone and the scaphoid bone was significantly greater in this group. This is surely due to the shorter follow-up of the patients who underwent trapeziectomy only, since further proximalisation has to be expected. We were able to demonstrate that both methods yield equally good results, and hence the simpler technique of trapeziectomy alone should be given preference, at least in the standard situation of a patient, whose intermetacarpal ligaments offer sufficient stability after trapeziectomy.

Relationship of organizational culture and readiness for change to employee commitment to the organization.

OBJECTIVES: A study was undertaken to determine the relationships among organizational culture, organizational commitment, and organizational readiness in a sample of employees participating in a hospital-wide redesign process. METHODS: Employees of an organization undergoing patient-focused redesign were surveyed after a 6-month period of preparation and before the initiation of the new care delivery model. RESULTS: Organizational readiness, a variable rarely described in organizational change literature, was the strongest predictor of employee commitment to the organization. Constructive culture also was predictive, but less so than readiness for change. CONCLUSIONS: Additional research is needed to clarify how an organization's history and culture of change contribute to employee willingness to work for the goals of the organization. Findings suggest that when change is seen as a positive characteristic of the environment, employees are more likely to commit to the work of the institution.