3D-planned corrective osteotomy of metacarpal arch disruption after Motec® wrist prosthesis.

We report two cases of metacarpal arch disruption after Motec® total wrist arthroplasty, with hyperextension of the third metacarpal and dorsal protrusion of the head. Correction osteotomies of the adjacent metacarpals using preoperative 3D surgical planning were successful. This report seeks to shed light on the origin of this deformation and to recommend some operative precautions. It is important that surgeons should be aware of the existence of this complication, as disruption of the transverse metacarpal arch affects both grasp and hand esthetics. LEVEL OF EVIDENCE: IV.

[Is infra-inguinal venous bypass less successful in the woman?]. / Ist der infrainguinale Venenbypass bei der Frau weniger erfolgreich?

In the present study the influence of gender in peripheral arterial reconstructions was evaluated. Between 1986 and 1990 we performed 173 infrainguinal vein bypass procedures in 117 men and 56 women. All procedures were carried out for chronic critical leg ischaemia. Bypasses in men were femoral to popliteal in 68%, and femoral to infragenicular in 32% in cases. The corresponding values in women were 52% and 48%. Perioperative 30-day mortality was 2% in men and 2% in women. Long-term survival at 5 years was 50% in men and 44% in women. Life-table primary 5-year patency rates were 81% for men and 74% for women. Limb salvage results at 5 years were 87% for men and 84% for women. The results indicate that in our experience with autogenous vein longterm graft patency and limb salvage results in women are identical to those obtained in men. Infrainguinal arterial reconstruction can be performed in women with mortality rates similar to those of men.