By Jolie Leung
We are delighted to share Drs. Tom Goetz (PI) and Mikaela Peters’ two new publications, on pisiform excision for pisotriquetral instability or arthritis, and a technical description of an extensile surgical approach to anteromedial coronoid fractures.
As explained by Dr. Peters, pisotriquetral instability is a rare cause of ulnar-sided wrist pain. While treatment, both surgical and nonsurgical, is well described in existing literature, the time for effective pain reduction post-surgery is poorly studied. This study aimed to better understand patient satisfaction after pisiform excision in patients with isolated pisotriquetral pathology.
By studying nine cases of pisiform excision performed by the senior surgeon with Patient-Rated Wrist Evaluation (PRWE), wrist range of motion, grip strength, and QuickDASH scores, the researchers found rapid improvement in the PRWE by three months, which was maintained after twelve months. QuickDASH score also significantly improved after twelve months.
Dr. Peters noted that information from this study could be used to better manage patient expectations towards surgery, and hopefully allow them to make a better-informed decision to opt for surgical or nonsurgical treatment.
In a retrospective review describing outcomes from an extensile surgical approach to anteromedial coronoid fractures, the investigators, also led by Dr. Goetz, sought to provide a detailed and photographically illustrated guideline for orthopaedic surgeons who may not frequently operate on the coronoid.
Already well researched by the group at St. Paul’s Hospital in Downtown Vancouver, subtle elbow instability can lead to early arthritis. This article is intended to describe an effective approach to fixing these fractures, and includes six patient cases, all of whom achieved a stable elbow. By offering a detailed review, Dr. Peters hopes to help both community orthopods and upper extremity subspecialty orthopaedic surgeons expand their options for approaches to the elbow.
The full article “Patient Satisfaction with Pisiform Excision for Pisotriquetral Instability or Arthritis: A Prospective Review” is available online from Thieme at https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0042-1758708.
The full article “Anteromedial coronoid fractures: technical description of an extensile surgical approach and outcomes from a small series using this technique” is available online from the Journal of Shoulder and Elbow Surgery at https://www.jsesreviewsreportstech.org/article/S2666-6391(22)00109-2/fulltext.
Dr. Tom Goetz is an Orthopaedic Surgeon at St. Paul’s Hospital and a Clinical Associate Professor in the UBC Department of Orthopaedics. Dr. Mikaela Peters is a UBC Orthopaedics Resident.
