Surgical Treatment of Hand and Foot Gout Stone and Influence Factors on Prognosis

Abstract

Purpose. To explore the technique of surgical treatment of hand and foot gout stone by using 3D CT reconstruction images and influence factors on prognosis. Method. 48 cases of hand and foot gout were treated surgically and retrospective analyzed. Before operation, we used 3D CT reconstruction images to check the accurate site and amount of uric acid (white chalk foam) deposition. Different surgical methods were applied depending on the different deposition site of urine acid stone. The frequency of gout attack and blood uric acid was compared before and after surgery. Patients were followed up to observe the recovery and recurrence and then analyzed the reason of unsuccessful healing. Result. Sutures were removed 2 weeks after operation in all cases. The frequency of gout attack and blood uric acid of patients 3 months after operation was lower than those before operation, and the differences were statistically significant. Follow-up ranged from 1 to 3 years, with an average of 1.8 years. Three cases were not followed up. The remaining 45 cases were healed in the first stage. 40 cases had improved joint function, increased range of motion, and relieved discomfort after movement. 5 cases had no improvement in joint function after operation, and 3 of them had gout stone recurrence (nonoperative area) and were treated by second hospital operation. Conclusion. Surgical treatment of gout stone in hand and foot under the guidance of three-dimensional CT reconstruction image can effectively alleviate the local symptoms of gout stone and improve the function of hand and foot. Deep tissue can be thoroughly washed by the pressure of pulse gun after resection of the lesion, which can reduce the incidence of gout stone. Malnutrition, hypoproteinemia, and residual urine acid in the wound are the main reasons for unsuccessful healing.

Comparative study of trimming and resection of diseased finger superficial flexor tendons in gouty carpal tunnel syndrome

“…In the second method, the eroded superficial flexor tendon of the finger is excised, and the wrist is rinsed with normal saline. The doctors who choose this method believe that lost postoperative function of the superficial flexor tendon of the affected finger can be compensated by the deep flexor tendon of the affected finger, and there may be no dysfunction of hand activity [ 9 ]. Based on the results of this study, the author believes that for carpal tunnel syndrome caused by tophi, selective resection of the superficial flexor tendon of the affected finger will not have a great impact on the postoperative function of the affected finger.…”

“…However, in recent years, due to the improvement of quality of life, gouty carpal tunnel syndrome caused by hyperuricaemia is also increasing year by year and becoming more prevalent in younger age groups [ 8 ]. The clinical treatment of gouty carpal tunnel syndrome is divided into medical treatment and surgical treatment; medical treatment can control the gout attack and relieve the disease but cannot eliminate the deposited gout stones [ 7 , 9 , 10 ]. Gouty carpal tunnel syndrome can occur with carpal osteonecrosis, rupture of the intercarpal ligament, wrist instability and carpal stiffness.…”

“…Some scholars believe that to preserve the postoperative function of the affected finger, it is sufficient to trim the superficial flexor tendon and remove the gout stone deposits in the carpal tunnel without removing the superficial flexor tendon. Other scholars believe that when the gout stone invades the superficial flexor tendon, the superficial flexor tendon can be removed during gout stone removal, and the deep flexor tendon will compensate for the loss of function after surgery [ 9 , 13 ].…”

Retracted: Surgical Treatment of Hand and Foot Gout Stone and Influence Factors on Prognosis

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process: Discrepancies in scope Discrepancies in the description of the research reported Discrepancies between the availability of data and the research described Inappropriate citations Incoherent, meaningless and/or irrelevant content included in the article Peer-review manipulation …”

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [1]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process:…”