Free Palmaris Longus Graft Tenodesis Effectively Treats Swan Neck Adduction Collapse Secondary to Thumb Basilar Joint Arthritis
Bibliographic record
Abstract
BACKGROUND: Compensatory thumb metacarpophalangeal joint hyperextension may occur with basilar joint arthritis and subluxation. Instability at the metacarpophalangeal joint must be corrected when the basilar joint is operated on. The authors use a simple surgical procedure that provides correction of thumb metacarpophalangeal joint hyperextension by a free palmaris longus graft to provide volar tenodesis across the metacarpophalangeal joint. METHODS: Twelve patients (14 extremities) were evaluated at a minimum of 11 months postoperatively. Outcome analysis was performed using the Disability of the Arm, Shoulder, and Hand Questionnaire, the McGill Pain Questionnaire, and a patient satisfaction survey. Clinical assessments evaluated thumb appearance, range of flexion and extension at the metacarpophalangeal joint, opposition, span, and cylindrical grip strength and pinch strength. Special attention was devoted to stability of the metacarpophalangeal joint while maintaining range of motion and strength. RESULTS: The average score on the Disability of the Arm, Shoulder, and Hand Questionnaire was 13.0 (good return of function), and the McGill Pain Questionnaire revealed mild to no postoperative pain. Overall postoperative patient satisfaction was high. There was good range of motion at the metacarpophalangeal joint (mean flexion, 44 degrees), and assessment of thumb strength revealed a mean tip pinch strength of 6.8 pounds and a mean key pinch strength of 8.7 pounds. Firm thumb stability was demonstrated during these strength measurements. CONCLUSIONS: Thumb metacarpophalangeal joint tenodesis can be an alternative to arthrodesis in patients who have swan neck deformity of the thumb secondary to basilar joint arthritis. It has the advantage of retaining useful motion. The procedure provides high patient satisfaction and good thumb function, strength, and range of motion. It is easily performed simultaneously with trapezial resection arthroplasty without complications.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".