Delayed manipulation after collagenase clostridium histolyticum injection for Dupuytren contracture
Conclusions
Delaying manipulation to day 2 or 4 following CCH injection for MCP joint contractures does not increase adverse events or result in loss of efficacy.
Level of Evidence: Therapeutic, Level II. (Source: Hand)
Source: Hand - December 2, 2014 Category: Surgery Source Type: research
Carpal tunnel syndrome secondary to an accessory flexor digitorum superficialis muscle belly: case report and review of the literature
Abstract
Anomalous muscles usually do not cause symptoms but are of academic interest mainly discovered during cadaveric dissection. An aberrant muscle belly arising from the index finger flexor digitorum superficialis tendon causing carpal tunnel syndrome is rare. The management of such an anatomical variant is dependent on whether the median nerve compression is associated with a palpable mass. A brief case highlighting important management principles along with a complete literature review is reported. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Treatment preferences for trigger digit by members of the American Association for Hand Surgery
Conclusions
Variation exists between the treatment algorithms of hand surgeons when managing a trigger digit. Some of these differences may be attributable to the type of training or the duration of clinical practice. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
A quantitative study of vibration injury to peripheral nerves—introducing a new longitudinal section analysis
Conclusion
The amount of damage to the myelin sheath directly correlated with vibration duration. When vibrated for longer than 7 days, nerve recovery was limited. This study also demonstrated that light microscopy of longitudinal slices is a simple yet effective method of quantifying the nerve damage. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Curvatures of the DIP joints of the hand
Conclusion
The purpose of this study is to gain better insight into the DIP joints of the hand. The asymmetry between the distal phalanx grooves and the middle phalanx condyles suggests that there may be a translational component to DIP joint motion. Our understanding of morphology may lend insight into the biomechanics and disease progression within the DIP joints. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Upper Extremity Orthoses Use in Amyotrophic Lateral Sclerosis/Motor Neuron Disease: Three Case Reports
Conclusions
Upper extremity orthotic use can be a beneficial adjunct contributing to the quality of life for individuals with ALS/MND. We have observed positive responses in pain control, contracture management, functional positioning, and increased independence with the use of orthoses. Designing appropriate means of studying effects of orthosis intervention is deficient in the current scientific literature. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Anomalous first thoracic rib as a cause of thoracic outlet syndrome with upper trunk symptoms: a case report
Conclusion
Identification of a rare congenital anomaly allowed for a precise surgical treatment of the condition. The importance of careful selection of modality and review of imaging in diagnosis and operative planning is discussed. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Median nerve compression at the fibrous arch of the flexor digitorum superficialis: an anatomic study of the pronator syndrome
Conclusions
A longer surgical release is needed with indistinct FDS arches. Overlying muscle during dissection may be indicative of an indistinct arch. Dissection along the ulnar side of the median nerve can possibly decrease the chance of injury to the AIN during decompression. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Anomalous muscles within the first dorsal extensor compartment of the wrist
Abstract
A 73-year-old woman presented with a 12-month history of a tender first dorsal extensor compartment of her right wrist along with swelling which extended proximally. Caring for her grandchildren exacerbated her pain, and rest relieved it. Over a 2-month period, two injections and splint immobilization failed to provide pain relief and swelling reduction. An ultrasound showed anomalous muscles within the first dorsal extensor compartment. Surgical release of the first compartment showed the abductor pollicis longus and extensor pollicis brevis tendons flanked by muscles within an inflamed sheath...
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Volar locking plate fixation of distal radius fractures: use of an intra-operative ‘carpal shoot through’ view to identify dorsal compartment and distal radioulnar joint screw penetration
Conclusions
Using the hand and carpus to minimise the contrast in X-ray penetration, the dorsal cortex of the distal radius may be imaged intra-operatively and dorsal compartment screw penetration detected in cases with significant multifragmentation when screw measurement is difficult. This view potentially reduces the risk of post-operative pain and extensor tendon injury and also provides excellent visualisation of the DRUJ. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Surgical management of the wrist in children with cerebral palsy and traumatic brain injury
(Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Intraoperative evaluation of dorsal screw prominence after polyaxial volar plate fixation of distal radius fractures utilizing the Hoya view: a cadaveric study
Conclusions
This study supports the intraoperative use of the Hoya view to evaluate screw length and dorsal cortical screw penetration in volar plate fixation of distal radius fractures. However, this view may be difficult to obtain in patients with limitations in elbow or shoulder range of motion. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
The treatment of extensor lag of the middle finger following crushing–penetrating injuries of the metacarpophalangeal joint: case series
Abstract
We aimed to introduce a surgical option for crushing–penetrating injuries around the metacarpophalangeal (MP) joint of the middle finger with extensor reconstruction of the interphalangeal (IP) joints. We also assessed the outcomes of patients using this surgical protocol. First, MP joint reconstruction was performed early (mean, 1.2 weeks after injury) using free autogenous cartilage or bone graft. We next performed a tendon transfer using a modified Brand method (M. Brand) at the same setting of extensor tendon tenolysis (mean, 4.7 months after injury) in order to extend the IP joints as ...
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Evidence for safe tourniquet use in 500 consecutive upper extremity procedures
Conclusion
In this series of more than 500 operations, there were no immediate or delayed tourniquet-related events using parameters determined perioperatively by the attending surgeon. Tourniquet pressures of 250 mmHg or less in adult patients with less than 2 h of ischemic time appear to be safe, even in the elderly and patients with multiple medical comorbidities. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
Integra® dermal regenerative template application on exposed tendon
Conclusion
Neovascularization of Integra® over exposed tendon occurs from the peripheral tissue. Ingrowth proceeds from the dermis–Integra interface toward the center of the graft. Four weeks after application to the denuded tendon, Integra has the histological appearance of native dermis. (Source: Hand)
Source: Hand - November 15, 2014 Category: Surgery Source Type: research
