Abstract 3145 Conclusions: This study indicates that an Instagram account can be a valuable adjunct to traditional teaching methods. Respondents were generally pos- itive, and the majority thought more courses should use Instagram in a similar way. 48-0942 Techniques for Continuous Irrigation of Septic Metacarpophalangeal Joint Wang Qiao, Duncan Angus McGrouther and Robert Yap Tze-Jin Department of Hand and Reconstructive Hand Surgery, Singapore Generat Hospital, Singapore Introduction: Septic arthritis of metacarpophalan- geal joint [MCPJ} is uncommon condition however it may cause serious consequence if not treated prop- erly. Open debridement and drainage is the conven- tional way of surgical management, Repeated surgical debridement and secondary closure are commonly required. Continuous catheter irrigation allows primary closure of the wound at the initial surgical procedure, facilitate drainage of purulent fluid, help to significantly reduce symptoms, and allows early mobilization and functional. return. Most importantly, it dilutes the infected joint fluid and inflammatory mediators, which helps to pre- serve the cartilage of the joint. Better clinical out- come has been observed. Surgical technique Surgical procedure for MCPJ septic arthritis is often done under general anaesthesia with tourni- quet control, Excisional debridement of surrounding subcutaneous debris and necrotic tissue is also undertaken before catheter irrigation. The sagittal band is then fully exposed with both the distal and proximal margin well visualised. The distal and prox- imal margin of sagittal band are then carefully dis- sected and opened to create a tunnel underneath. A &-French Gauge (FG) infant feeding tube is then inserted into the tunnel, The distal tip was tied into fa tight knot to black the distal orifice. One stab hole is made with size 15 blade longitudinally at the centre of the segment of the tube positioned under the sagittal band. After successful placement of the tubes, intraoperative irrigation with 500ml 0.9% normal saline was done. Wound is primarily closed around the catheter. Post-operative care The irriga- tion tube is connected to a bag of 0.9% normal saline delivered through @ pump driver for continuous irri- gation at arate of 10 mL/h in the ward for normally at 2 to 5 days postoperatively. In most cases, there is no need for secondary suture because of primary clo- sure of the wound, Case example Patient was 2 25 years old female with no past medical history. She presented to our center for dth MCPJ septic arthritis land subcutaneous abscess as a result of cat bite injury. She was brought to emergency operating the- atre for above-described surgery. Catheter was inserted into the éth MCPJ, under the sagittal band, for continuous irrigation. Wound was closed over the catheter, The joint was continuously irrigated by the above-described technique, and the patient complied well with active and passive motion exercises, There was anather catheter inserted into the subcutaneous plane as well for continuous irrigation. The pain and swelling resolved after 4 days and the catheters were removed at that stage. No secondary suture was required for this patient. Her duration of hospital stay was 4 days and her 4th MCPJ range of motion was full without pain upon discharge. Her stitches were removed 14 days after surgery in the clinic with no further issues. Conclusion: Continuous catheter irrigation is an effi- cient way to treat MCP septic arthritis with better preservation of the joint cartilage, better functional ‘outcome and requires less surgical procedures with shorter inpatient stay. ‘4-0949 Revised Dellon's modification of Moberg pick-up test ~ Pick-up3, standardized protocol with normative data ‘Marisa Nikkonen’ and Kaarina Pirila® "ila Manus oy, Vantaa, Finland “Metropolia University of Applied Sciences, Helsinki Finland Objective: Home based therapies are more common, than before, Therapist may notice something in patients hand function and need to give numeric value on it. This is to correspond on demand of mea- suring findings instead of just describing them. Functional sensory testing was introduced by Erik Moberg and in the 1980's A. Lee Dellon developed his own version of the test. Far modern day use this test lacked a standardized test protocol and test items were in USA measurements. Despite of its shortcomings, the test felt useful and practical by the therapist that participated in Hand Speciality course, Our aim was to update and develop an easy dexterity and sensory test to all therapists that is also easy to carry around as part of their home Visit kit. Methods: With the kind permission of Dr Dellon we wrote detailed standardized instructions and proto- col with items of metric system [2013]. Peer reviews, and pilot study showed that therapists perceived this test as practical, quick and easy to use [2015].14s Journal of Hand Surgery [Eur] 47(Supplement 1 Research is continued to cover intra- and inter-rater reliability and normative data for reference values for hhealthy subjects age from 20 to 71 and above. Results are classified according to age, gender and dexterity Results: For test-retest 30 healthy adults, were tested twice within few days. Part 1 [Pick-up] had good test-retest rate and Part 2 (recognition) was good or excellent when both hands were tested twice (2020). Values for inter-rater reliability (N=40} and normative data (N =800) is ongoing in September 2021. The pilot study showed that thera- pists perceived this test as practical. quick and easy to use. 96% felt that the test instructions were clear ‘and easy to fallow. The Test kit was considered com- pact and easy to carry around to client appointments. The Test was commented to be relevant, and it sup- ported findings from other functionality/dexterity tests, Conclusions: Results/preliminary results from fur- ther reliability studies, normative data and useful- ness of the test will be presented. Keywords: Evaluation, Sensory, Dexterity, Pick-up test, Moberg, Dellon. ‘4-0950 Periprosthetic osteolysis following a total wrist replacement ~ a case series of 11 Universal 2 Implant (Integral Rumina Begum, Matthew Brovin, lan Trail, Mike Hayton, Sumedh Talwalkar, Raj Murali and Ashley Newton Wrightington Hospital, Wigan, UK Aims: Periprosthetic osteolysis (PPO) after third generation total wrist arthroplasty [TWAl, with sub- sequent loosening of the implant components, has previously been reported inthe literature and symp- toms may warrant further surgery. The purpose of this study was to analyse the lacation, and natural history of PPO following a total wrist replacement ‘and to determine whether this was associated with excessive polyethylene [PE] wear. Patients and Methods We reviewed all revision TWA undertaken at our hospital in the last 7 years and identified 10, patients (total of 11 wrists] who had undergone revi- sion for PPO. All of these cases involved the Universal 2 Implant (Integral. Results 9 patients were female and 1 male with an average age of 67 [range 43 to 83. The mean time from primery to revision replacement was 7.8 years (range 5 to 13} The poly size for the primary TWA included 7 small, 3 ‘medium and 1 large component. 4 TWA survived less than 6 years, 3 of which included small PE liners AIL 11 wrists underwent revision surgery which included 3 wrist arthrodesis, & single stage revision of poly liner +/~ bone graft, 1 2-stage revision and 1 excision arthoplasty. Preoperatively, significant peri- prosthetic radiolucency [>2mm in width) was noted around 9 radial components and in only 2 carpal implants. However, intraoperatively, loosening of carpal and radial implants was found in 5 and 3 cases respectively. The most common finding was PE wear in 81% [9 out 11 wrists} and metalosis. The clinical presentation and histology will be presented together with the clinical outcome. Conclusion Periprosthetic loosening is a recog- nised long- term complication of total wrist replace- ment. In our series of patients who underwent revision surgery a clinical and radiological pattern has been identified which may lead to earlier recog- nition and as a consequence less invasive interven- tion. Preventative measures will also be presented. Level of Evidence Therapeutic IV Keywords: wrist, arthroplasty, radiolucency. osteolysis, ‘A-0951 Results of arthroscopic hemitrapeziectomy ‘with suture button suspensionplasty for thumb ‘carpometacarpal arthritis Ryosuke Ikeguchi, Takashi Noguchi, Maki Ando, Koichi Yoshimoto, Daichi Sakamoto and Shuichi Matsuda Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan Objective: We hypothesized that arthroscopic partial trapezium resection combined with suture button suspensionplasty is an effective surgical option. Methods: Eighteen cases af thumb carpometacarpal arthritis in which conservative treatment had been ineffective were included (mean age 65.1 years, 48 to 81 years old]. Eleven patients were female and seven were male. The surgical method is partial resection of the distal trapezium articular surface under carpometacarpal arthroscopy and suture button suspensionplasty between the first metacar pal base and the second metacarpal shaft. Postoperative treatment is one week of immobiliza- tion followed by active range of motion exercise. Results: Preoperative VAS scores {mean 76.7) were significantly Ip <0,001] reduced after the operation [mean 13.8]. Range of motion of the thumb carpome- tacarpal joint {mean preoperative palmar abduction 583° and radial abduction 45.7°) was significantly improved [mean postoperative palmar abduction 70.7" p<0.05 and radial abduction 61.0°p<0.05)