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Journal of Hand Surgery

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https://www.readbyqxmd.com/read/28040299/reimplantation-of-a-large-extruded-segment-of-bone-in-an-open-fracture
#1
REVIEW
Ahmadreza Afshar
Replacing an extruded segment of bone in an open fracture imposes a challenging decision concerning the best and safest patient management. There are numerous advantages to restoring the patient's own extruded bone segment to its original location, particularly when the bone segment is of structural importance. However, reimplantation of contaminated and avascular extruded bone segments can potentially result in serious infection or nonunion. There is no conclusive evidence regarding the best decontamination protocol for the safest use of the recovered bone segment as an autologous graft...
December 28, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28027846/pediatric-scaphoid-proximal-pole-nonunion-with-avascular-necrosis
#2
Edward W Jernigan, Brandon S Smetana, J Megan M Patterson
A 13-year-old, right hand-dominant, otherwise healthy boy presented with left wrist pain 19 months after a nonmotorized scooter injury. Radiographs and magnetic resonance imaging at presentation demonstrated proximal pole scaphoid nonunion with avascular necrosis of the proximal fragment. Operative and nonsurgical treatment options were discussed and the family elected for an attempt at nonsurgical management. The patient was placed in a short-arm thumb spica cast, with a window for a bone stimulator, for 14 weeks...
December 24, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28027845/differences-in-the-treatment-of-distal-radius-fractures-by-hand-fellowship-trained-surgeons-a-study-of-abos-candidate-data
#3
Sean Childs, Tobias Mann, Jason Dahl, John Ketz, Warren C Hammert, Peter M Murray, John Elfar
PURPOSE: The management of distal radius fractures differs based on the nature of the fracture and the experience of the surgeon. We hypothesized that patients requiring surgical intervention would undergo different procedures when in the care of a surgeon with subspecialty training in hand surgery as compared with surgeons with no subspecialty training in hand surgery. METHODS: We queried the ABOS database for case log information submitted for part II of the ABOS examination...
December 24, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28027844/effect-of-hospital-volume-on-success-of-thumb-replantation
#4
Elham Mahmoudi, Kevin C Chung
PURPOSE: Hospital volume-outcome association has been examined for many high-risk surgical procedures. Little is known about this association for thumb replantation, a complex but essential surgical procedure to restore hand function. We aimed to determine patient and hospital characteristics that are associated with increased probability of replanted thumb survival and to examine volume-outcome association among hospitals that performed thumb replantation. METHODS: We used data from 2008 to 2012 from the National Trauma Data Bank...
December 24, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28027843/phaeoacremonium-tenosynovitis-of-the-wrist
#5
Tetsushi Aizawa, Takashi Domoto, Shimpo Aoki, Ryuichi Azuma, Tomoharu Kiyosawa
A 79-year-old man presented with a painless, soft, subcutaneous mass lesion of the right volar wrist that had been slowly growing for 3 years. A cloudy, yellow serous effusion was aspirated from the punctured mass, from which Phaeoacremonium spp., an extremely rare cause of tenosynovitis, was isolated in culture. Total synovectomy was performed without the use of antifungal agents. No recurrence or complications occurred as of 6 months after surgery. Fungal infection is rare but should be considered in the differentiation of chronic tenosynovitis...
December 24, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28011035/proximalization-of-the-vascularized-toe-joint-in-finger-proximal-interphalangeal-joint-reconstruction-a-technique-to-derive-optimal-flexion-from-a-joint-with-expected-limited-motion
#6
REVIEW
Raja Mohan, Victor W Wong, James P Higgins, Ryan D Katz
When used to reconstruct a finger proximal interphalangeal joint, a free toe interphalangeal joint, without modification, cannot meet the motion demands of the finger to allow palm touchdown. This limitation is the direct result of the toe interphalangeal joint having an intrinsic arc of motion that delivers less flexion than that of a normal functioning finger proximal interphalangeal joint. By modifying the inset of the transferred joint to an extra-anatomical more proximal position, this limitation can be overcome...
December 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28011034/interosseous-ligament-and-transverse-forearm-stability-a-biomechanical-cadaver-study
#7
Christina J Gutowski, Kurosh Darvish, Asif M Ilyas, Christopher M Jones
PURPOSE: The interosseous ligament (IOL) is known to be an important longitudinal stabilizer of the forearm. We hypothesize that it may also contribute to transverse stability, with pronosupination tensioning of the radius relative to the ulna. Therefore, when injured, we predict the interosseous space should widen in the transverse plane, enough to be appreciable on plain radiographs. A measurable difference in interosseous space, comparing an injured with an uninjured forearm, can potentially be of diagnostic and clinical value...
December 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28011033/cost-savings-and-patient-experiences-of-a-clinic-based-wide-awake-hand-surgery-program-at-a-military-medical-center-a-critical-analysis-of-the-first-100-procedures
#8
Peter C Rhee, Michelle M Fischer, Laura S Rhee, Ha McMillan, Anthony E Johnson
PURPOSE: Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. METHODS: A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon...
December 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28011032/a-rare-diagnosis-recognizing-and-managing-fungal-tenosynovitis-of-the-hand-and-upper-extremity
#9
Maureen A O'Shaughnessy, Aaron J Tande, Shawn Vasoo, Mark J Enzler, Elie F Berbari, Alexander Y Shin
PURPOSE: Fungal infections involving the tenosynovium of the upper extremity are uncommon and are often misdiagnosed. This study evaluates the epidemiology, diagnosis, treatment, and outcomes of patients with fungal tenosynovitis of the upper extremity over a 20-year period. METHODS: A retrospective review of all culture-confirmed cases of fungal tenosynovitis of the upper extremity treated between 1990 and 2013 at a single institution was performed. Clinical data included patient and epidemiologic risk factors, causative fungal organism, surgical management, antimicrobial regimen, recurrence rates, and outcomes...
December 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27964900/zone-ii-flexor-tendon-repairs-in-the-united-states-trends-in-current-management
#10
Peter D Gibson, Garret L Sobol, Irfan H Ahmed
PURPOSE: The repair of zone II flexor tendon injuries is an evolving topic in hand surgery with current literature suggesting the use of a 4-strand repair; 3-0 or 4-0 braided, nonabsorbable sutures; and an epitendinous repair. It was hypothesized that variability would exist within the hand surgeon community in treatment of zone II flexor tendon repairs in surgical material used, surgical technique, and postoperative rehabilitation protocol. METHODS: An online single-answer multiple-choice survey was distributed to the American Society for Surgery of the Hand members' database...
December 10, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27964899/reversed-palmaris-longus-muscle-causing-volar-forearm-pain-and-ulnar-nerve-paresthesia-a-case-report
#11
Abhiram R Bhashyam, Carl M Harper, Matthew L Iorio
A case of volar forearm pain associated with ulnar nerve paresthesia caused by a reversed palmaris longus muscle is described. The patient, an otherwise healthy 46-year-old male laborer, presented after a previous unsuccessful forearm fasciotomy for complaints of exercise exacerbated pain affecting the volar forearm associated with paresthesia in the ulnar nerve distribution. A second decompressive fasciotomy was performed revealing an anomalous "reversed" palmaris longus, with the muscle belly located distally...
December 10, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27955967/digital-necrosis-after-lidocaine-and-epinephrine-injection-in-the-flexor-tendon-sheath-without-phentolamine-rescue
#12
Jacques X Zhang, Jason Gray, Donald H Lalonde, Nicholas Carr
The literature generally supports the safety of epinephrine injection in the digits, but recent case reports describe ischemic adverse events associated with the use of lidocaine and epinephrine in which phentolamine rescue was not performed. We present a case of finger necrosis and subsequent amputation in a patient after 1% lidocaine with 1:100,000 epinephrine was injected in the fat and flexor sheaths in the palm for a 3-finger trigger release. Phentolamine rescue was not performed. All surgeons who use epinephrine in the finger should be prepared to reverse vasoconstriction with phentolamine rescue if there is persistently inadequate perfusion of the fingertip...
December 9, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27955966/reticular-perineurioma-of-the-hand-diagnosis-and-treatment-of-a-rare-case-of-hand-mass
#13
Patrice Zaugg, Benoit Maeder, Antoine Nobile, Wassim Raffoul, Christof Bollmann, Pietro G di Summa
Reticular perineurioma is a rare and recently delineated morphologic variant of benign perineurioma of skin and soft tissues. Because of its nonspecific gross appearance, varying histologic patterns, and potential range of cellularity, perineurioma of the hand is likely to be confused with more commonly encountered tumor or tumor-like conditions such as schwannoma, neurofibroma, fibromyxoid tumors, and giant tumor of tendon sheath. We report the case of a 20-year-old woman who presented with a slowly growing mass of the hand, which was eventually identified as a reticular perineurioma...
December 9, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27955965/unusual-presentation-of-infantile-myofibroma-in-the-deep-palm-of-a-child-a-case-report-and-discussion-of-the-differential-diagnosis
#14
Matthew S Brown, Amer Heider, Kevin C Chung
Infantile myofibroma or myofibromatosis is a myofibroblastic and fibroblastic proliferation that is most commonly reported in children younger than 2 years of age. It is a benign process composed histologically of a biphasic pattern of spindle-shaped cells surrounding a zone of less differentiated cells in a hemangiopericytoma-like pattern. We report this tumor in a unique presentation in the deep palm of a 2-year-old child without skin ulceration and with an intimate association with the median nerve. The well-circumscribed nature of the tumor facilitated complete excision with neural preservation...
December 9, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27889093/removal-of-a-contraceptive-implant-from-the-brachial-neurovascular-sheath
#15
Christopher Belyea, Justin Ernat, Rey Gumboc
Subdermal implantable devices are commonly used for long-acting contraception in the United States and Europe. Although relatively safe in nature, their implantation and removal may be associated with potential complications, some of which may require surgical intervention. Complications may include infection, incorrect implantation, migration, or difficulty with removal. Proximal migration has been reported; however, there are no reports of devices that have migrated within the brachial neurovascular sheath...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#16
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27881244/negotiation-how-to-be-effective
#17
REVIEW
Arnold-Peter C Weiss
The art of successful negotiation is not as random or difficult as it might seem at first glance. Most negotiations end up with both sides receiving something of value as well as giving up something valuable in return. It has been said that the best negotiated outcomes occur when both parties walk away a bit disappointed or just a little bit happy. The goal of this short primer is to give some hints as to how to get a slightly better deal than the other party most of the time. There are several points to remember to be able to achieve such an outcome frequently...
November 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27863829/the-effect-of-carpal-tunnel-release-on-typing-performance
#18
Justin W Zumsteg, Matthew J C Crump, Gordon D Logan, Douglas R Weikert, Donald H Lee
PURPOSE: To describe the effect of carpal tunnel release (CTR) on typing performance. METHODS: We prospectively studied 27 patients undergoing open CTR. Patient demographics and clinical characteristics including nerve conduction studies, electromyography results, and duration of symptoms were collected. Before surgery and at 8 time points after surgery, ranging from 1 to 12 weeks, typing performance for an approximately 500-character paragraph was assessed via an on-line platform...
November 15, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27856099/a-reconstructive-stabilization-technique-for-nontraumatic-or-chronic-traumatic-extensor-tendon-subluxation
#19
REVIEW
Jae Hoon Lee, Jong Hun Baek, Jung Seok Lee
Subluxation of the extensor tendon results from a disruption to the sagittal band at the metacarpophalangeal joint. When conservative treatment fails to correct the subluxation, surgical treatment may be necessary. Surgical techniques for chronic cases vary in graft source and graft pathway. We present a surgical technique to recentralize and stabilize the extensor tendon using a residual ruptured sagittal band. This technique is simple and effective without donor site morbidity and seems to provide potential biomechanical advantages by restoring nearly normal anatomy...
November 14, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27838209/distal-interphalangeal-joint-arthrodesis-complicated-by-postoperative-infection-a%C3%A2-rare-presentation-of-disseminated-herpes-simplex-virus
#20
Meredith N Osterman, Michael P Gaspar
Postoperative infection after elective arthrodesis of the interphalangeal joint is an uncommon complication often necessitating urgent debridement. We present the rare case of a female patient with a history of oral herpetic lesions, who underwent elective arthrodesis of the middle and index fingers for treatment of erosive osteoarthritis and subsequently developed a postoperative herpetic infection at the surgical site.
November 9, 2016: Journal of Hand Surgery
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