{'fraction_non_alphanumeric': 0.028761061946902654, 'fraction_numerical': 0.016224188790560472, 'mean_word_length': 4.951754385964913, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
[Joint denervation, a simple response to complex problems in hand surgery].

STUDY AIM
In patients with preserved mobility and stability a painful joint remains a difficult problem, especially in elderly patients. All operations, including intracarpal arthrodesis, reduce an already limited mobility, require prolonged immobilization and have a high rate of complications. Denervation could be proposed in such cases.


MATERIALS AND METHODS
In our study denervation was performed on 132 wrists, 36 first carpo-metacarpal joints and 32 proximal inter-phalangeal joints.


RESULTS
We have been disappointed in the past by partial wrist denervations. Fifty cases of complete and isolated wrist denervation were reviewed with a mean 5-year followup. Strength and mobility were only marginally improved but pain was decreased by a mean 75% (on a visual analog scale) in 74% of patients. At the proximal inter-phalangeal joint level, the mean pain improvement was 88% in 85% of patients. At the first carpo-metacarpal joint level, results of denervation were less predictable and the mean pain improvement was 67% in 81% of patients, with a mean 17-month follow-up.


CONCLUSION
Joint denervation is a simple but precise operation performed under local anesthesia and on an outpatient basis. It provides good results in elderly patients, with few complications.