Background Wrist tuberculosis is a rare disease, easy to cause misdiagnosis, delay treatment and lead to poor prognosis. In this study, the clinical manifestations, diagnosis, treatment and prognosis of 18 cases of wrist tuberculosis were analyzed retrospectively. Methods We conducted a retrospective study investigating tuberculosis of the wrist, diagnosed in 18 patients from August 2013 to November 2018. Puncture biopsy confirmed the diagnosis. The study includes 11 males and 7 females, and 8 left and 10 right wrists. The average age was 53.5 ± 18.3 years and ranged from 15 to 81 years. The disease course was 1 to 42 months, with an average of 15.1 ± 11.3 months. Eighteen patients were treated with surgery and chemotherapy, 3 patients with severe bone defect were treated with wrist fusion, and 15 patients were treated with focus removal. The Gartland and Werley score, DASH score, the range of motion (ROM), grip strength, and imaging examinations were used to evaluate the postoperative recovery of the patients. Results Eighteen patients were followed up for 15 to 77 months, with an average follow up of 39.7 ± 15.3 months. The ESR and CRP levels were normal for all patients after chemotherapy. No recurrence of tuberculosis was observed in any of the patients. Among the 15 focus removal, the Gartland and Werley scores at admission, two weeks of chemotherapy, 1 month after surgery, and the last follow-up were 21.73 ± 4.33, 18.60 ± 3.16,11.27 ± 2.79, and 5.07 ± 2.28, respectively; and DASH scores were 45.87 ± 5.58, 39.47 ± 4.72,22.67 ± 6.54, and 6.73 ± 2.94, respectively. The wrist range of motion (ROM) and grip strength improved significantly compared to those at admission. Among the three cases of wrist fusion, 2 were fixed with a steel plate and the fixation position of wrist joint was good. One case was fixed with Kirschner wire and resulted in a slightly deformed wrist joint. Conclusion For the patients with wrist tuberculosis, early diagnosis, preoperative and postoperative chemotherapy, thorough focus removal, and appropriate fixation of the affected limb can help restore the function of the affected wrist, reduce the recurrence rate, and improve the quality of life.

BackgroundThis study evaluated the effectiveness of a newly revised pivot knee prosthesis in patients with peri-knee malignant bone destruction tumors.MethodsMedical records of patients who were admitted to our hospital from January 2014 to February 2020 and underwent the newly revised pivot knee prosthesis operations were retrospectively collected and analyzed. Visual analogue scale (VAS), hospital special surgery (HSS) knee score, American knee society knee score (KSS), and ROM for pre-operation, discharge, and last follow-up were applied to assess the effectiveness of this surgery. Meanwhile, the results of musculoskeletal tumor society system (MTSS) and radiographs were observed and analyzed at last follow-up.ResultsThe average operation time was 174.0 ± 35.5 min, and intraoperative bleeding volume was 271.2 ± 127.3 ml. The follow-up time was 33.8 ± 14.9 months. The scores of VAS, HSS, and KSS at pre-operation, discharging, and last follow-up were all comparable (p༜0.05), ROM was only comparable between discharging and last follow-up (p༜0.05), while ROM between preoperative and discharging had no significance (p༞0.05). MTSS at last follow-up was22.6 ± 2.4. All patients were alive with their prosthesis in good condition except for one patient who underwent revision surgery for misalignment of prosthesis and two patients who died of systemic metastasis.ConclusionThe newly revised pivot knee prosthesis is a good alternative limb-salvage strategy for patients who suffered from bone destruction tumors, although patient tumor stage and health condition should be fully assessed before surgery to reduce the mortality rate of patients who are not eligible.