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Journal of Hand Surgery

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https://www.readbyqxmd.com/read/28318742/a-mobile-based-surgical-simulation-application-a-comparative-analysis-of-efficacy-using-a-carpal-tunnel-release%C3%A2-module
#1
Kamil M Amer, Taha Mur, Kamal Amer, Asif M Ilyas
PURPOSE: The utilization of surgical simulation continues to grow in medical training. The TouchSurgery application (app) is a new interactive virtual reality smartphone- or tablet-based app that offers a step-by-step tutorial and simulation for the execution of various operations. The purpose of this study was to compare the efficacy of the app versus traditional teaching modalities utilizing the "Carpal Tunnel Surgery" module. We hypothesized that users of the app would score higher than those using the traditional education medium indicating higher understanding of the steps of surgery...
March 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28318741/neonatal-magnetic-resonance-imaging-without-sedation-correlates-with-injury-severity-in-brachial-plexus-birth-palsy
#2
Andrea S Bauer, Peter Y Shen, Anna E Nidecker, Paul S Lee, Michelle A James
PURPOSE: Which infants with brachial plexus birth palsy (BPBP) should undergo microsurgical plexus reconstruction remains controversial. The current gold standard for the decision for plexus reconstruction is serial clinical examinations, but this approach obviates the possibility of early surgical treatment. We hypothesize that a new technique using 3-dimensional volumetric proton density magnetic resonance imaging (MRI) without sedation can evaluate the severity of BPBP injury earlier than serial clinical examinations...
March 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28318740/upper-limb-dimelia
#3
Takehiko Takagi, Ayano Nojiri, Atsuhito Seki, Shinichiro Takayama, Masahiko Watanabe
A patient with upper limb dimelia including a double scapula, humerus, radius, and ulna, 11 metacarpals and digits (5 on the superior side, 6 on the inferior side) was treated with a simple amputation of the inferior limb resulting in cosmetic improvement and maintenance of range of motion in the preserved limb. During the amputation, the 2 limbs were found to be anatomically separate except for the ulnar nerve, which, in the superior limb, bifurcated into the sensory branch of radial nerve in the inferior limb, and the brachial artery, which bifurcated into the radial artery...
March 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28284457/the-accuracy-of-the-scratch-collapse-test-performed-by-blinded-examiners-on-patients-with-suspected-carpal-tunnel-syndrome-assessed-by-electrodiagnostic-studies
#4
Jeremy Simon, Kevin Lutsky, Mitchell Maltenfort, Pedro K Beredjiklian
PURPOSE: A diagnostic maneuver known as the "scratch-collapse test" (SCT), to aid in the diagnosis of compressive upper limb neuropathies such as carpal tunnel syndrome (CTS), has been described. There is a wide variability in the sensitivity and specificity values reported to date, and the reason for this discrepancy is unclear. The purpose of this study was to evaluate the utility of the SCT performed by examiners blinded to the meaning of the examination. METHODS: Forty consecutive patients referred to a single physiatrist for electrodiagnostic testing for the evaluation of suspected CTS were included in the study...
March 8, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28284456/carpal-coalitions-on-radiographs-prevalence-and-association-with-ordering-indication
#5
Bastiaan T van Hoorn, Taylor Pong, Wouter F van Leeuwen, David Ring
PURPOSE: Carpal coalitions are common and usually incidental to the indication for wrist radiographs. It is not clear if, or when, carpal coalitions cause pain. The aim of this study was to assess the prevalence of incidental carpal coalitions by evaluating radiographs taken for various indications and to test the association of demographic variables and ordering indications with the finding of a carpal coalition. METHODS: We reviewed 1,119 posteroanterior wrist radiographs for the presence of carpal coalition...
March 8, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28274605/the-outcomes-of-extension-block-pinning-and-nonsurgical-management-for-mallet%C3%A2-fracture
#6
Jun O Yoon, Hyungki Baek, Jae Kwang Kim
PURPOSE: We aimed to compare the clinical and radiographic results of patients with a mallet fracture involving more than one-third of the articular surface, but without a high degree of distal interphalangeal (DIP) joint subluxation, treated with extension block pinning or nonsurgical management. METHODS: Forty-nine patients with a mallet fracture involving more than one-third of the articular surface were reviewed. Twenty-six cases were treated using extension block pinning (surgery group) and 23 were treated nonsurgically (nonsurgical group)...
March 5, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28262383/nerve-transfer-versus-nerve-graft-for-reconstruction-of-high-ulnar-nerve-injuries
#7
Asser A Sallam, Mohamed S El-Deeb, Mohamed A Imam
PURPOSE: To assess the efficacy of nerve transfer versus nerve grafting in restoring motor and sensory hand function in patients with complete, isolated high ulnar nerve injuries. METHODS: A retrospective chart review was performed, at a minimum 2 years of follow-up, of 52 patients suffering complete, isolated high ulnar nerve injury between January 2006 and June 2013 in one specialized hand surgery unit. Twenty-four patients underwent motor and sensory nerve transfers (NT group)...
March 2, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28259566/delayed-onset-digital-ischemia-after-local-anesthetic-with-epinephrine-injection-requiring-phentolamine-reversal
#8
Andy F Zhu, Brandon R Hood, Mark S Morris, Kagan Ozer
The use of low-dose epinephrine in hand surgery has made it possible to perform a wide range of surgical procedures in the office setting. Low-dose epinephrine use is safe, and its vasoconstrictive effects are reversible with phentolamine. In this report, we present late-onset finger ischemia beginning 3 hours after an ipsilateral carpal tunnel and A1 pulley release of the middle finger anesthetized with local anesthetic and low-dose epinephrine (1:100,000). Finger ischemia lasted 14 hours until rescued with phentolamine injection...
March 1, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28259565/3-dimensional-printing-assisted-percutaneous-fixation-for-acute-scaphoid-fracture-1-shot-procedure
#9
REVIEW
Hua-Wei Yin, Jing Xu, Wen-Dong Xu
Scaphoid fractures are the most common carpal fractures. Percutaneous fixation is a popular treatment option for nondisplaced or minimally displaced scaphoid fractures. Placement of the guidewire in the percutaneous fixation procedure often requires several attempts and adjustments with the help of intraoperative fluoroscopy. This article describes a 1-shot procedure of percutaneous fixation for acute scaphoid fracture with patient-specific guiding templates made by computer reconstructions and 3-dimensional printing technique...
March 1, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28259564/modified-mccash-technique-for-management-of-dupuytren-contracture
#10
REVIEW
Alex C Lesiak, Nicole J Jarett, Joseph E Imbriglia
Despite recent advancements in the nonsurgical treatment for Dupuytren contracture, a number of patients remain poor nonsurgical candidates or elect for surgical management. The traditional McCash technique releases contractures while leaving open palmar wounds. Although successful in alleviating contractures, these wounds are traditionally large, transverse incisions across the palm. A modification of this technique has been performed that permits the surgeon to utilize smaller wounds while eliminating debilitating contractures...
March 1, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28259563/propionibacterium-acnes-infection-of-a-metacarpophalangeal-joint-arthroplasty
#11
Guillaume Bacle, Sheena K Sikora, Eugene T H Ek
Neglected and underestimated in the past, Propionibacterium acnes is currently the most prevalent organism associated with deep prosthetic infections around the shoulder. Surprisingly, it has never been reported as a cause of infection in the hand. Here we report a case of a late presentation of a P. acnes infection in a metacarpophalangeal joint replacement, resulting in chronic low-grade pain with movement. The patient underwent a 2-stage revision, with initial removal of the prosthesis. Positive cultures for P...
March 1, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28258869/comparative-skin-evaluation-after-split-thickness-skin%C3%A2-grafts-using-2-different-acellular-dermal-matrices%C3%A2-to-cover-composite-forearm-defects
#12
Myung Chul Lee, Yong Jun Jang, In Sik Yun, Dae Hyun Lew, Won Jai Lee
PURPOSE: The combination of acellular dermal matrix (ADM) and split-thickness skin graft (STSG) has been widely adopted to overcome functional and cosmetic limitations of conventional STSG. In this study, we evaluated the efficacy of this combination using 2 types of ADM: cadaveric acellular dermal matrix (CDM) and bovine acellular dermal matrix (BDM). METHODS: We recruited 72 patients undergoing autologous STSG to cover radial forearm free flap donor sites. They were included in 1 of 3 therapeutic groups: group 1, STSG using CDM (n = 29); group 2, STSG using BDM (n = 20); and group 3, STSG only (n = 23)...
February 28, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28258868/rates-of-complications-and-secondary-surgeries-after-in%C3%A2-situ-cubital-tunnel-release-compared-with-ulnar-nerve-transposition-a-retrospective-review
#13
Dafang Zhang, Brandon E Earp, Philip Blazar
PURPOSE: The purpose of this study was to contrast the rate and types of complications and secondary surgeries for in situ cubital tunnel release and ulnar nerve transposition. METHODS: A retrospective cohort study was performed by query of hospital billing records for all patients who underwent cubital tunnel surgery from August 2008 to July 2013, yielding 421 patients. Exclusion criteria were acute trauma, revision surgery, neoplasm, age younger than 18 years, incomplete records, and postoperative follow-up less than 3 months...
February 28, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28258867/radial-artery-pseudoaneurysm
#14
Rick Tosti, Sezai Özkan, Robert M Schainfeld, Kyle R Eberlin
PURPOSE: To review the causes, clinical course, and management of patients with catheter-associated radial artery pseudoaneurysm (PSA). METHODS: We reviewed all patients diagnosed with radial artery PSA resulting from arterial line placement or radial artery access for cardiac procedures from 2010 to 2015. RESULTS: We identified 11 cases: 5 caused by arterial lines and 6 by cardiac procedures. The diagnosis was confirmed by duplex ultrasound in all cases; PSA size ranged from less than 1 cm to 5 cm in diameter...
February 28, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28249791/an-evaluation-of-forearm-deformities-in-hereditary-multiple-exostoses-factors-associated-with-radial-head-dislocation-and-comprehensive-classification
#15
Ah Reum Jo, Sung Taek Jung, Myung Sun Kim, Chang Seon Oh, Byung Ju Min
PURPOSE: This study attempted to evaluate a series of patients with hereditary multiple exostoses (HME) who could not be categorized according to the widely accepted Masada classification and to identify radiographic variables such as radial bowing, ulnar shortening, ulnar variance, radial articular angle, and carpal slip predictive of deformity. METHODS: We retrospectively reviewed data on 102 upper limbs of 53 pediatric patients with HME. Demographics, site of forearm involvement, and radiographic parameters were documented...
February 27, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28249792/alpha-lipoic-acid-after-median-nerve-decompression-at-the-carpal-tunnel-a%C3%A2-randomized-controlled-trial
#16
Filippo Boriani, Donatella Granchi, Giulia Roatti, Luciano Merlini, Tania Sabattini, Nicola Baldini
PURPOSE: The postoperative course of median nerve decompression in carpal tunnel syndrome may be associated with complications. The aim of this study was to explore the possible effects of alpha-lipoic acid (ALA) in the postoperative period after surgical decompression of the median nerve at the wrist. METHODS: We conducted a double-blind prospective, randomized, controlled trial. A total of 64 patients with proven carpal tunnel syndrome were enrolled and randomly assigned into 1 of 2 groups: group A (n = 32) patients had surgical decompression of the median nerve followed by ALA for 40 days, and group P (n = 32) patients had surgical decompression followed by placebo...
February 26, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28249790/free-functioning-gracilis-muscle-transfer-with-and-without-simultaneous-intercostal-nerve-transfer-to-musculocutaneous-nerve-for-restoration-of-elbow-flexion-after-traumatic-adult-brachial-pan-plexus-injury
#17
Andrés A Maldonado, Michelle F Kircher, Robert J Spinner, Allen T Bishop, Alexander Y Shin
PURPOSE: After complete 5-level root avulsion brachial plexus injury, the free-functioning muscle transfer (FFMT) and the intercostal nerve (ICN) to musculocutaneous nerve (MCN) transfer are 2 potential reconstructive options for restoration of elbow flexion. The aim of this study was to determine if the combination of the gracilis FFMT and the ICN to MCN transfer provides stronger elbow flexion compared with the gracilis FFMT alone. METHODS: Sixty-five patients who underwent the gracilis FFMT only (32 patients) or the gracilis FFMT in addition to the ICN to MCN transfer (33 patients) for elbow flexion after a pan-plexus injury were included...
February 26, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28249789/hand-transplantation-evolution-of-a%C3%A2-personal-outlook
#18
REVIEW
W P Andrew Lee
The field of vascularized composite allotransplantation-combining advances in reconstructive surgery, transplantation, and immunology-offers great promise for patients with heretofore unsolvable problems. In the last 30 years, hand transplantation has progressed through the phases of being a research subject, a controversial clinical procedure, a more widely accepted and expanding field, and now a promising endeavor undergoing refined indications. Although many lessons have been learned, few procedures in the author's experience have been as life-transformative in restoring the body image, motor and sensory functions, activities of daily living, and personal autonomy as successful hand transplantation...
February 26, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28242243/effect-of-the-optimal-asymmetry-on-the-strength-of-six-strand-tendon-repair-an-ex%C3%A2-vivo-biomechanical-study
#19
Naoya Kozono, Takamitsu Okada, Naohide Takeuchi, Takeshi Shimoto, Hidehiko Higaki, Yasuharu Nakashima
PURPOSE: To evaluate the mechanical properties of a 6-strand core suture repair with asymmetric purchase in the 2 tendon ends, in comparison with a repair with symmetric suture purchases. METHODS: Under cyclic loading of the tendons, we recorded the fatigue strength (Forces × Cycles) of a 6-strand flexor tendon repair with different symmetry in the lengths of suture purchase in 60 porcine tendons. The symmetric repair was made with 3 groups of parallel Kessler repairs of equal suture purchase (10 mm from the cut end) in the 2 tendon stumps...
February 24, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28242242/simple-assessment-of-global-bone-density-and-osteoporosis-screening-using-standard-radiographs-of-the-hand
#20
Joseph J Schreiber, Robin N Kamal, Jeffrey Yao
PURPOSE: Osteoporosis and fragility fractures have consequences both at the individual level and to the overall health care system. Although dual-energy x-ray absorptiometry (DXA) is the reference standard for assessing bone mineral density (BMD), other, simpler tools may be able to screen bone quality provisionally and signal the need for intervention. We hypothesized that the second metacarpal cortical percentage (2MCP) calculated from standard radiographs of the hand or wrist would correlate with hip BMD derived from DXA and could provide a simple screening tool for osteoporosis...
February 24, 2017: Journal of Hand Surgery
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