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Journal of Hand Surgery

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https://www.readbyqxmd.com/read/28412189/mean-5-year-follow-up-for-suture-button-suspensionplasty-in-the-treatment-of-thumb-carpometacarpal-joint-osteoarthritis
#1
Jeffrey Yao, Andre Eu-Jin Cheah
PURPOSE: Suture button suspensionplasty (SBS) has been used to treat thumb carpometacarpal joint osteoarthritis (CMC joint OA). Although promising short-term outcomes have been reported, no outcomes beyond 4 years have been published. The aim of this article is to report intermediate outcomes of SBS. METHODS: We reviewed the charts of 14 patients who underwent 16 SBS procedures for symptomatic thumb CMC joint OA. We recorded demographic data, preoperative Eaton stage, length of follow-up, Quick-Disabilities of the Arm, Shoulder, and Hand questionnaire scores, as well as pinch strength, grip strength, range of motion, and metacarpal subsidence...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28412188/patterns-of-brachial-plexus-stretch-palsy-in-a-prospective-series-of-565-surgically-treated-patients
#2
Jayme A Bertelli, Marcos F Ghizoni, Francisco Soldado
PURPOSE: To report the distribution of the different patterns of stretch brachial plexus injuries (BPIs) in a retrospective cohort of patients operated at our institution during an 11-year period. METHODS: From September 2002 to June 2012, we evaluated and operated on 565 patients with traction injuries of the brachial plexus. Average age was 26.8 years (SD ±9.3 years); the interval between the injury and surgery was 5.4 months (SD ±2.8 months). The pattern of injury was defined based on data obtained from a standardized clinical examination, preoperative helical computed tomography myelography after intradural contrast injection, surgical findings, and intraoperative electric stimulation...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28412187/restoring-volar-tilt-in-ao-type-c2-fractures-of-the-distal-radius-with-unilateral-external-fixation
#3
Kenneth F Taylor, David Gendelberg, Michael B Lustik, Matthew L Drake
PURPOSE: To determine whether unilateral external fixation using a staged multiplanar reduction technique restores anatomic volar tilt in a distal radius fracture model. METHODS: We used radiographic images to obtain baseline measurements in 20 fresh-frozen cadaveric wrists. Through a standard dorsal approach to the radius, we performed osteotomies to simulate displaced AO/ASIF type C2 fractures. After placement of a unilateral external fixator, a stepwise technique of applying longitudinal traction followed by a volar translational maneuver was performed...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28410939/acute-hand-ischemia-following-elective-venous-sclerotherapy-for-dorsal-hand-varicose-veins
#4
Steven M Andelman, Amanda L Walsh, Todd A Rubin, Michael R Hausman
Venous sclerotherapy is an emerging cosmetic treatment option for dorsal hand varicose veins. Although venous sclerotherapy is considered a safe and effective procedure for treatment of venous malformations and varicosities in both the upper and lower extremities, inadvertent injection of the sclerosing agent into the arterial system has led to reported instances of acute ischemic events and distal limb necrosis. This is a rare but well-documented complication of lower-extremity venous sclerotherapy. Only 2 cases have been reported in upper-extremity venous sclerotherapy, both of which occurred during treatment of complex vascular malformations...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28410938/preservation-of-devitalized-bone-in-necrotic-digits-following-crush-injury-with-free-tissue-transfer
#5
Fei Song, Yongwei Pan, Zhe Zhao, Jiuzheng Deng, Changjiao Sun
Traditional management of necrotic digits has been to allow demarcation between viable and nonviable tissues to occur, and thus to indicate the level of amputation required. In this case report, the phalangeal length of the necrotic thumb was maintained in 2 patients who had sustained crush injury. After nonviable soft tissues were debrided, the devitalized bones were covered with soft tissue flaps. All wounds healed without infection. Both cosmetic and functional results of the reconstructed thumbs were satisfactory...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28410937/proximal-row-carpectomy-and-4-corner-arthrodesis-in-patients-younger-than-age%C3%A2-45-years
#6
Eric R Wagner, Jean-David Werthel, Bassem T Elhassan, Steven L Moran
PURPOSE: To examine the long-term outcome of patients aged less than 45 years who underwent either proximal row carpectomy (PRC) or 4-corner arthrodesis (4CA) for wrist arthritis. METHODS: We reviewed a retrospective cohort of 89 patients aged less than 45 years who underwent either 4CA (n = 51) or PRC (n = 38) for wrist arthritis. Mean follow-up was 11 years in the 4CA group and 18 years in the PRC group. RESULTS: Overall, there were no differences between groups in the need for revision surgery...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28410936/radiographic-and-clinical-analysis-of-lateral-epicondylitis
#7
Matthew Shillito, Maximillian Soong, Nicholas Martin
PURPOSE: The literature suggests that radiographs may be unnecessary in the initial evaluation of lateral epicondylitis because treatment is rarely altered as a result of the radiographic findings. The most commonly reported radiographic finding is calcification at the lateral epicondyle. Our goal was to perform a quantitative and qualitative analysis of this finding to determine its importance and possible relationship with various clinical factors and patient-reported measures. METHODS: All patients diagnosed with lateral epicondylitis by a single surgeon during a 5-year period were retrospectively reviewed...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28392088/single-stage-treatment-of-osteomyelitis-for-digital-salvage-by-using-an-antibiotic-eluting-methylmethacrylate-joint-spanning-spacer
#8
REVIEW
Victoria L Aimé, John T Kidwell, Leland H Webb
Osteomyelitis of the digit is a challenging problem that can result in amputation. We describe 13 cases of osteomyelitis involving bones of the hand managed with a novel technique. We reviewed records of 12 patients (13 digits) who had joint-spanning, antibiotic-eluting (tobramycin or vancomycin), methylmethacrylate spacers placed as definitive, single-stage treatment for digital osteomyelitis. The primary outcome was digit salvage. Secondary outcomes were infection eradication (no recurrence at 3 months) and spacer removal...
April 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28389082/distal-humerus-external-rotation-osteotomy-for-hand-position-in-arthrogryposis
#9
Lindley B Wall, Valeri Calhoun, Summer Roberts, Charles A Goldfarb
PURPOSE: In the amyoplasia type of arthrogryposis, a reverse pronated grasp pattern is often seen. We hypothesized that repositioning the hands, through distal humerus external rotation osteotomies (DHO), would allow for palm-to-palm grasp without arm cross-over and would improve function and parent/patient satisfaction. METHODS: The medical records of all patients treated surgically for arthrogryposis were reviewed at the Shriners Hospital for Children, St. Louis, MO...
April 4, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28389081/the-use-of-residual-collagenase-for-single-digits-with-multiple-joint-dupuytren-contractures
#10
Louis C Grandizio, Anil Akoon, Janice Heimbach, Jove Graham, Joel C Klena
PURPOSE: Standard 0.58 mg (0.25 mL) collagenase Clostridium histolyticum (CCH) preparations result in unused CCH that is often discarded. Our purpose was to assess the results on Dupuytren contractures affecting both the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints in the same digit utilizing an injection containing the maximum CCH volume that can be withdrawn from a single vial. METHODS: A consecutive series of patients with MCP and PIP cords in the same digit received a single treatment with 2 injections totaling 0...
April 4, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28385291/management-of-myositis-ossificans-of-the-hand-a-case-report-and-a-review-of-the-literature
#11
Mohammad M Al-Qattan, Lenah Al-Fahdil, Haifa M Al-Shammari, Amin I Joarder
Myositis ossificans is a rare form of self-limiting heterotopic ossification of muscles. Most cases are seen in the thigh; the standard approach to these cases has been nonsurgical management awaiting spontaneous resolution. We report on a rare case of myositis ossificans of the hand with severe symptoms treated with early marginal excision without a trial of nonsurgical management.
April 3, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28365148/outcomes-after-flexor-tendon-repair-combined-with-the-application-of-human-amniotic-membrane-allograft
#12
Olli V Leppänen, Teemu Karjalainen, Harry Göransson, Annika Hakamäki, Jouni Havulinna, Jyrki Parkkinen, Jarkko Jokihaara
PURPOSE: Clinically proven methods to prevent adhesion formation after flexor tendon repair have not yet been established. The aim of this pilot study was to assess the feasibility of amniotic membrane allograft as a mechanical barrier to decrease adhesion formation. METHODS: Ten patients having flexor tendon injuries were planned to be recruited to the pilot study. The operative treatment consisted of tendon repair and fixation of amniotic membrane allograft around the repaired tendon...
March 29, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28365147/the-bare-area-of-the-proximal-ulna-an-anatomic-study%C3%A2-with-relevance-to-chevron-osteotomy
#13
Rongguang Ao, Xu Zhang, Dejian Li, Fancheng Chen, Jianhua Zhou, Baoqing Yu
PURPOSE: A chevron osteotomy of the ulna is widely used to obtain intra-articular access to the elbow in the treatment of type C distal humerus fractures. The trochlear notch of the proximal ulna is divided into 2 articular parts by the "bare area." Ideally, the olecranon osteotomy should be centered on the bare area to minimize damage to the joint cartilage. The goals of this study were to describe the anatomy of the bare area and design an ideal chevron-shaped osteotomy. METHODS: We dissected 38 cadaver elbows and measured the width of the bare area, the distance between the tip of the triceps insertion and the area on the olecranon cortex corresponding to the bare area...
March 29, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28365146/in%C3%A2-vivo-scaphoid-motion-during-thumb-and-forearm-motion-in-casts-for-scaphoid-fractures
#14
Yohei Kawanishi, Kunihiro Oka, Hiroyuki Tanaka, Kazuomi Sugamoto, Tsuyoshi Murase
PURPOSE: In nonsurgical treatment for acute undisplaced or minimally displaced scaphoid waist fractures, immobilization of both wrist and thumb can be an option. However, in vivo scaphoid motion during forearm and thumb motion with the wrist immobilized in a cast has not been measured. Therefore, we examined the in vivo kinematics of the scaphoid during forearm and thumb motion with cast immobilization. METHODS: Ten healthy right wrists of 10 male volunteers were included...
March 29, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28365145/the-double-thenar-flap-a-technique-to-reconstruct-2-fingertip-amputations-simultaneously
#15
REVIEW
Daniel B Polatsch, Remy V Rabinovich, Steven Beldner
Fingertip injuries are a common problem. There may be pulp loss and exposed bone. Various techniques have been described to reconstruct function as well as aesthetics; yet it is still unclear which treatment options should be chosen for each specific injury. Evidence-based treatment strategies are limited because there are no prospective randomized clinical trials evaluating one method with another. Fingertip injuries are usually variable in their presentation, and therefore treatment decisions are often dictated by the knowledge and expertise of the treating physician combined with the patient's unique injury...
March 29, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28359641/prospective-evaluation-of-sleep-improvement-following-carpal-tunnel-release-surgery
#16
Jacob E Tulipan, Nayoung Kim, Jack Abboudi, Christopher Jones, Frederic Liss, William Kirkpatrick, Jonas Matzon, Michael Rivlin, Mark L Wang, Asif M Ilyas
PURPOSE: Sleep disturbance due to nighttime awakening is a well-documented symptom of carpal tunnel syndrome. While relief of nighttime waking following carpal tunnel release (CTR) has been demonstrated, the effect of CTR on overall sleep quality has not been fully investigated. We hypothesized that CTR would result in significant improvement in overall sleep quality as well as patients' overall satisfaction with their sleep habits. METHODS: Cases of carpal tunnel syndrome with positive nerve studies, and treated with CTR, were prospectively enrolled...
March 27, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28359640/headless-compression-screw-versus-kirschner-wire-fixation-for-metacarpal-neck-fractures-a-biomechanical-study
#17
Daniel M Avery, Stephen Klinge, Felix Dyrna, Leo Pauzenberger, David Lam, Mark Cote, Jessica DiVenere, Elifho Obopilwe, Augustus Mazzocca, Craig Rodner
PURPOSE: This study aimed to determine the biomechanical stability of headless compression screws in the fixation of metacarpal neck fractures and to compare them with another common, less invasive form of fixation, K-wires. The hypothesis was that headless compression screws would show higher stiffness and peak load to failure than K-wire fixation. METHODS: Eight matched-paired hands (n = 31), using the ring and little finger metacarpals, had metacarpal fractures simulated at the physeal scar...
March 27, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28359639/lateral-para-olecranon-approach-for-the-treatment-of-distal-humeral-fracture
#18
Takuji Iwamoto, Taku Suzuki, Noboru Matsumura, Masaya Nakamura, Morio Matsumoto, Kazuki Sato
PURPOSE: To assess the outcomes of the lateral para-olecranon triceps-splitting approach for the treatment of distal humeral fracture. METHODS: Ten patients (3 males, 7 females) with a mean age of 59 years were retrospectively reviewed. There were 2 A2, 3 C1, and 5 C2 fractures according to the AO/ASIF classification. Types B3 and C3 fractures were excluded from this study because the olecranon osteotomy approach was indicated to visualize the anterior fragment...
March 27, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28359638/indications-and-predictors-for-reconstructive-surgery-after-hand-burns
#19
C H van der Vlies, S de Waard, J Hop, M K Nieuwenhuis, E Middelkoop, M E van Baar, P P M van Zuijlen
PURPOSE: The objective of this study was to analyze the prevalence, indications, and type of reconstructive surgery and predictors of the outcomes of reconstructive surgery after hand burns. METHODS: A retrospective cohort study was conducted that included all patients admitted with acute hand burns in the Dutch burn centers from January 1998 through December 2002. The details of reconstruction including frequency, timing, indication, and techniques were collected over a 10-year follow-up period...
March 27, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28341070/severe-hand-injuries-from-fireworks-injury-patterns-%C3%A2-outcomes-and-fireworks-types
#20
Brinkley K Sandvall, Kari A Keys, Jeffrey B Friedrich
PURPOSE: The purpose of this study was to characterize injury patterns and outcomes of fireworks-related hand injuries and determine if there was an association with certain fireworks types. METHODS: A retrospective cohort study was conducted on patients treated at a trauma center between 2005 and 2015. A total of 105 patients sustaining operative hand injuries due to fireworks were identified. Medical records were reviewed to identify injury patterns, treatment outcomes, and fireworks types...
March 21, 2017: Journal of Hand Surgery
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