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Journal of Hand Surgery

Sean M McNary, Nasser Heyrani, Ido Volk, Robert M Szabo, Christopher O Bayne
PURPOSE: To determine the effects of motion-increasing modifications to radioscapholunate (RSL) arthrodesis on capitolunate contact pressure in cadaveric wrist specimens. METHODS: Ten fresh-frozen cadaveric wrists were dissected of all superficial soft tissue, potted in polymethyl-methacrylate, and the carpus exposed via a ligament-sparing capsulotomy. An RSL arthrodesis was simulated using 2 2.4-mm distal radius plates with locking screws. The distal scaphoid pole and triquetrum were removed with an osteotome and rongeur, respectively...
September 18, 2018: Journal of Hand Surgery
Ryan A Caldwell, Peter L Shorten, Nathan T Morrell
Eponyms, whereas commonly used in hand surgery, are perhaps misused as often as they are used correctly. Many commonly used eponyms, such as Colles fracture, Barton fracture, Smith fracture, and Bennett fracture, were actually described decades before the development of radiographs. The goal of this article is to revisit the original descriptions of commonly used eponymous terms for distal radius and first metacarpal base fractures to provide clarity and enhance understanding of what these eponyms actually mean...
September 18, 2018: Journal of Hand Surgery
Lauren Elisabeth Wessel, Danielle Christine Marshall, Jeffrey Gei-Hun Stepan, Hayley Anne Sacks, Ogonna Kenechi Nwawka, Theodore T Miller, Duretti Teferi Fufa
PURPOSE: The purpose of this study was to identify associations between the clinical manifestations of carpal tunnel syndrome (CTS) and the sonographic measurements of the median nerve in the carpal tunnel. We hypothesized that sonographic changes in the median nerve from proximal to distal along the carpal tunnel would be associated with symptom severity scores. METHODS: We report on 38 patients with clinical signs and symptoms of CTS in a prospective investigation...
September 18, 2018: Journal of Hand Surgery
Shannon Ahmad, Matthew Delarosa, William Kleinman, Rasheed Ahmad
Erythema elevatum diutinum (EED) is a rare skin disease caused an Arthrus-type immunological reaction to antigen with immune complex deposition in the cutaneous microvasculature, which leads to tissue damage secondary to the effects of complement and leukocytes. It presents as brown or red cutaneous nodules, papules, or plaques, often on the extensor surfaces of the hands, knees, or elbows. Onset usually occurs in the fourth to sixth decades but possibly younger in patients with human immunodeficiency virus...
September 18, 2018: Journal of Hand Surgery
Sebastian Siebenlist, Andreas Schmitt, Andreas B Imhoff, Andreas Lenich, Gunther H Sandmann, Karl F Braun, Chlodwig Kirchhoff, Peter Biberthaler, Arne Buchholz
PURPOSE: The aim of this retrospective study was to evaluate the clinical outcome and complication rate of intramedullary cortical button repair for distal biceps tendon rupture (partial and complete tears). METHODS: Between 2010 and 2014, a total of 28 patients with an acute distal biceps tendon rupture underwent intramedullary cortical button repair. Twenty-four patients (mean age, 49 years) with a mean follow-up of 28 months were included in the study. Twenty patients were examined clinically and by maximum isometric strength testing in flexion (at 90°) and supination of both arms...
August 31, 2018: Journal of Hand Surgery
Kathryn Schultz, Jennifer Moriatis Wolf
Osteoporosis is a disease defined by diminished bone mass, often resulting in debilitating fragility fractures. As hand surgeons who care for patients with fractures of the distal radius and proximal humerus often related to osteoporosis, it is critical to understand the diagnostic modalities used in the workup of decreased bone density. Although the current reference standard for diagnosing osteoporosis is dual x-ray absorptiometry, this technique has notable drawbacks such as the inability to provide a 3-dimensional image or information about bone microstructure...
August 31, 2018: Journal of Hand Surgery
Justin P Chan, Jennifer Uong, Nima Nassiri, Ranjan Gupta
In light of the World Health Organization's push to accelerate progress toward a leprosy-free world by 2020, it is fitting to look back on the evolution of progress in treating lepromatous neuropathy and limb deformities. To date, no surgeon has had as great an impact on the understanding and treatment of this disease as Dr Paul Brand. Before Dr Brand's accomplishments, few surgeons participated in the management of the deformed leprous patient. By challenging conventional beliefs, Dr Brand revealed that many of the deformities associated with leprosy were in fact caused by nerve damage and subsequent limb anesthesia...
August 31, 2018: Journal of Hand Surgery
Jonathan Isaacs, Gaurangkumar Patel, Satya Mallu, Obinna Ugwu-Oju, Anish Desai, Gregory Borschel, Dylan David, Omar Protzuk, Shalin Shah, Rachel Semus
PURPOSE: Processed acellular nerve allograft (PNA) has been suggested as a convenient tool for overcoming short and medium nerve defects. Although the clinical implications are unclear, animal data suggest that PNA becomes less effective at longer lengths. Although reverse or supercharging end-to-side nerve transfer may improve the neurotrophic potential in chronically denervated nerve tissue, the application of this strategy to long acellular nerve allograft has not been previously investigated...
August 29, 2018: Journal of Hand Surgery
Martin Jose Pastrana, Ezequiel Ernesto Zaidenberg, Dante Palumbo, Fernando Juarez Cesca, Carlos Rodolfo Zaidenberg
PURPOSE: To describe the innervation of the proximal interphalangeal (PIP) joint of the fingers as well as the anatomical relations of the articular branches. METHODS: In this anatomical study, 52 fresh-frozen index, long, ring, and little fingers of 6 male and 4 female cadavers were dissected after injection of a colored latex composite. The anatomical dissections were performed under ×3.5 and ×6.0 magnifications. The numbers of articular nerve branches that penetrated the PIP joint on both sides of the fingers were quantified and patterns of innervation were established...
August 29, 2018: Journal of Hand Surgery
Ugochi C Okoroafor, William Gerull, Melissa Wright, Jason Guattery, Brinkley Sandvall, Ryan P Calfee
PURPOSE: Although social deprivation is acknowledged to influence physical and mental health in adults, it is unclear if and how social deprivation influences perceived health in children. This study was conducted to evaluate the impact of social deprivation on Patient-Reported Outcomes Measurement Information System (PROMIS) scores in children presenting for treatment of upper extremity fractures. METHODS: This cross-sectional evaluation analyzed data from 975 new pediatric patients (8-17 years old) with upper extremity fractures presenting to a tertiary orthopedic center between June 1, 2016, and June 1, 2017...
August 28, 2018: Journal of Hand Surgery
Rinze L Zwanenburg, Duncan A McGrouther, Paul M N Werker
PURPOSE: Grayson ligament has been described as a common pathway for digital contracture in Dupuytren disease. Its anatomical descriptions in the literature are, however, inconsistent. METHODS: We have performed a microsurgical dissection study in 20 fresh-frozen and thawed digits to revisit the anatomy of Grayson ligaments. We also performed dissections in Thiel-preserved hands to be able to study the changes in tension of the ligaments during flexion and extension of the finger...
August 28, 2018: Journal of Hand Surgery
Nathalie Mobargha, Susanne Rein, Elisabet Hagert
PURPOSE: The dorsoradial ligament (DRL) is essential for stability of the first carpometacarpal joint (CMC1) and is innervated with nerve endings and mechanoreceptors known to contribute to joint proprioception. The influence of these nerve endings on the neuromuscular stability of CMC1 is not yet known. This study investigated whether a ligamento-muscular reflex pathway is present between the DRL and CMC1 muscles. METHODS: Ten healthy subjects (5 women and 5 men, mean age 28 years; range, 24-37 years) were included...
August 26, 2018: Journal of Hand Surgery
Timothy T Fei, Evan Chernoff, Nathan A Monacco, David E Komatsu, Samantha Muhlrad, Steven P Sampson, Lawrence C Hurst, Alexander B Dagum
PURPOSE: To explore the efficacy of injectable collagenase Clostridium histolyticum (CCH) in distal interphalangeal (DIP) joint contractures in Dupuytren disease. METHODS: A retrospective review was conducted for patients with DIP joint contractures treated with CCH. Baseline contracture and posttreatment residual contracture were recorded. The primary end point was achievement of 0° to 5° of residual contracture 30 days postmanipulation. Recurrence and adverse events are also reported...
August 23, 2018: Journal of Hand Surgery
Matthew Walker, Behnam Sharareh, Scott A Mitchell
PURPOSE: The Masquelet technique is a procedure increasingly utilized for addressing segmental bone defects. The technique involves staged procedures consisting of bone debridement and temporary spacer placement to induce membrane formation, followed by delayed bone grafting. This report summarizes our center's experience with the Masquelet technique to reconstruct bone loss exclusively in the forearm. METHODS: We reviewed all cases in which the Masquelet technique was used to reconstruct segmental bone defects in the forearm resulting from acute trauma or nonunion, with or without infection, between 2014 and 2017 at a level-1 trauma center...
August 23, 2018: Journal of Hand Surgery
Gregory Schmidt, Hristo Piponov, Donald Chuang, Mark Gonzalez
Physicians are increasingly caring for immunocompromised individuals owing, in part, to the improved treatments and the increased life expectancy in these patients. Presentation of a patient with hand infection can vary greatly depending on the patient's underlying immune status. It is important to recognize and treat the infections quickly and effectively owing to the higher morbidity and mortality that may result from ineffective or delayed treatment in this patient population. The purpose of this article is to provide an outline of the most common and some of the more exotic organisms causing hand infections in patients with human immunodeficiency virus/acquired immunodeficiency syndrome, diabetes, and patients on immunosuppressive treatment...
August 22, 2018: Journal of Hand Surgery
Zhong Gang Yin, Ke Tong Gong, Jian Bing Zhang
PURPOSE: To provide a summary of the relevant evidence on outcomes of transaxillary first rib excision (TAFRE), supraclavicular first rib excision with scalenectomy (SCFRE), and supraclavicular release leaving the first rib intact (SCR) for patients with neurogenic thoracic outlet syndrome (TOS), and interpret the treatment effects from a Bayesian perspective. METHODS: A systematic literature search and review were performed. Random-effects meta-analyses were conducted to estimate success rate and complete relief rate of each procedure...
August 16, 2018: Journal of Hand Surgery
Claudia Antoinette Bargon, Emily L Zale, Jessica Magidson, Neal Chen, David Ring, Ana-Maria Vranceanu
PURPOSE: The purpose of this study was to survey the attitudes and beliefs about opioids and opioid prescribing policies among patients presenting to an orthopedic hand surgery practice. METHODS: Patients (n = 118; median age, 49 years) who presented to their regularly scheduled appointment at a major urban university medical center completed surveys assessing their sociodemographic and clinical characteristics, beliefs about prescription opioids, beliefs about opioid prescribing policies, and perceived importance of opioid prescribing policies in the department...
August 16, 2018: Journal of Hand Surgery
Junya Hojo, Shohei Omokawa, Akio Iida, Hiroshi Ono, Hisao Moritomo, Yasuhito Tanaka
PURPOSE: To assess the wrist joints of healthy volunteers in extended and loaded states versus the unloaded state by using computed tomography (CT) to analyze the in vivo 3-dimensional movements in the distal radioulnar joint (DRUJ). METHODS: The dominant arms of 9 volunteers with healthy wrists were studied. We mounted a compression device onto the elbows in an inverted position. A 0-kg and 7-kg load each was applied during low-dose radiation CT imaging and a bone model was produced...
August 14, 2018: Journal of Hand Surgery
Teemu Karjalainen, Kaisa Jokinen, Sandeep J Sebastin, Toni Luokkala, Olli-Pekka Kangasniemi, Aleksi Reito
PURPOSE: Any loss of range of motion of the finger after flexor tendon repair is an impairment of function, but to what extent it causes disability is not properly understood. The aim of this study was to assess the correlation between perceived function (disability) and objectively measured loss of function (impairment), to understand what impairments are meaningful to patients. METHODS: We assessed 49 patients who underwent flexor tendon repair an average of 38 months after repair...
August 13, 2018: Journal of Hand Surgery
Jill G Putnam, Ryan M DiGiovanni, Sean M Mitchell, Paulo Castañeda, Scott G Edwards
PURPOSE: Currently, there is no consensus on the optimal treatment for scaphoid nonunion with avascular necrosis (AVN). Various techniques, often involving vascularized corticocancellous bone grafting, have been proposed. The authors hypothesized that similar outcomes might be possible with volar plate fixation augmented with autogenous pure cancellous graft. METHODS: The authors performed a retrospective chart review of 13 cases of scaphoid nonunions with AVN in 12 patients treated with plate fixation and pure cancellous bone grafting...
August 10, 2018: Journal of Hand Surgery
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