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Techniques in Hand & Upper Extremity Surgery

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https://www.readbyqxmd.com/read/29975230/a-novel-technique-for-correcting-radial-length-and-translation-in-distal-radius-fractures
#1
William L Wang, Rick Tosti
We describe a novel technique in correcting distal radius fractures deformed with significant shortening or coronal plane translation in both the acute or chronic setting. The technique involves using a modified push-pull device to assist the surgeon in correcting length and/or translation of the articular block without the use additional hardware outside of the volar plate.
July 2, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29965949/triceps-repair-and-restoration-of-triceps-footprint-with-anchorless-suture-fixation
#2
Matthew Steffes, Samantha Tayne, Feroz Osmani, Gary Edwards, Kyle MacGillis, Walter Kim, Benjamin Goldberg
Triceps tendon rupture is an uncommon yet potentially devastating injury affecting patients over a broad demographic. Surgical treatment is essential to restore upper extremity functional status, and a vast array of techniques has been implemented with different fixation devices including suture buttons, intraosseous anchors, and suture repairs. Outcomes of distal triceps tendon repair have demonstrated nearly full return of functional capacity. Complications include infection, ulnar nerve neuropathy, arthrofibrosis, flexion contracture, hardware irritation, and most commonly, repair failure...
June 30, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29912805/obtaining-a-reliable-scaphotrapeziotrapezoid-radiograph-pronation-ulnar-deviation-and-thumb-abduction
#3
Brent R DeGeorge, Nicholas Pulos, Alexander Y Shin
A simple, reproducible technique for assessing the scaphotrapeziotrapezoid joint radiographically is described. In addition to its diagnostic value, the technique is simple to perform with a minifluoroscopy unit, allowing for image-guided injections of the scaphotrapeziotrapezoid joint.
June 16, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29912029/a-novel-algorithmic-approach-to-chronic-forearm-longitudinal-instability
#4
Todd A Rubin, Matthew J Gluck, Michael R Hausman
Essex-Lopresti Lesions are rare injuries that are often missed in the acute setting. Delayed intervention may lead to chronic wrist and elbow pain and overall poor outcomes. The literature currently supports treatments that involve shortening of the ulna to reduce the relative degree of ulnar impaction, followed by attempted reduction of the distal radioulnar joint. Although such techniques may help to temporarily reduce wrist pain secondary to ulnar impaction, they do not address the proximal migration of the radius and ipsilateral radial head dislocation at the elbow...
June 14, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29894391/dorsolateral-biplane-closing-radial-osteotomy-and-lunate-fixation-for-stage-iiic-kienb%C3%A3-ck-disease-a-new-surgical-approach
#5
Sergi Barrera-Ochoa, David Campillo-Recio, Tryno Muñoz-Perdomo, Ignacio Esteban-Feliu, Gerardo Mendez-Sanchez, Xavier Mir-Bullo
The treatment of advanced-stage Kienböck disease (KD) remains highly controversial. Particularly important is stage IIIC KD, which includes patients with a lunate coronal fracture. The purpose of this paper was to describe a new approach to KD in patients with Lichtman stage IIIC KD, and our results using it. The procedure combines a dorsolateral biplane closing radial osteotomy and lunate fixation. A total of 11 patients from January 2002 through December 2016 with documented KD who underwent this technique were included...
June 11, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29889155/antegrade-percutaneous-intramedullary-fixation-technique-for-metacarpal-fractures-prospective-study-on-150-cases
#6
Lorenzo Rocchi, Gianfranco Merendi, Luigi Mingarelli, Francesco Fanfani
OBJECTIVES: The aim of our study was to assess the results of antegrade percutaneous intramedullary Kirschner wire (K-wire) fixation, for the treatment of unstable displaced metacarpal fractures in a large number of cases, in order to support the usage of this mini-invasive technique in the largest variety of fractures as possible. MATERIAL AND METHODS: Every patient meeting the inclusion criteria was treated with closed reduction and antegrade intramedullary fixation with 1 or 2 K-wire from January 2013...
June 7, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29782446/minimally-invasive-proximal-interphalangeal-joint-arthrodesis-using-headless-screw-surgical-technique
#7
Elizabeth A Newman, Maria C Orbay, Fiesky A Nunez, Fiesky Nunez
Proximal interphalangeal (PIP) joint arthritis causes debilitating hand pain and instability leading to significant functional impairment. Arthrodesis remains the gold standard for treatment of PIP arthritis. We present a minimally invasive PIP arthrodesis that provides rigid fixation with a headless compression screw. Seven patients who presented to the senior author with PIP joint arthritis underwent PIP arthrodesis by minimally invasive technique. A 1 cm transverse incision is made over the PIP joint, incising skin, central band, and articular capsule...
June 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29683963/outside-the-ivory-towers
#8
Alexander Y Shin
No abstract text is available yet for this article.
June 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29664804/temporary-bridge-plate-stabilization-of-unstable-elbow-fractures-and-dislocations
#9
David Edelman, Asif M Ilyas
Unstable fracture-dislocations of the elbow, and in particular the "terrible triad" injury consisting of an elbow dislocation with a fracture of the radial head and coronoid, are complex injuries that can be plagued and complicated by persistent instability. Acute and chronic instability is a difficult problem and is best managed early by avoidance and restoration of stability. A number of treatment options have been proposed to manage acute postfixation instability of the elbow joint. Traditional stabilization options include immobilization with splinting or casting, cross-articular pinning, and external fixation (hinged or static), followed by early physical therapy...
June 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29664803/posterior-shoulder-dislocation-associated-with-the-head-splitting-and-humeral-neck-fracture-impact-of-understanding-radiologic-signs-and-experience-with-an-extended-deltopectoral-approach
#10
Kemal Gokkus, Ergin Sagtas, Hasan Kara, Ahmet T Aydin
In this paper, our main objective was to emphasize the competency of extended deltopectoral exposure, enforced with the supraspinatus and subscapularis detachment, to gain access to the entire head. The second important point in this paper was to underline the importance of the knowledge that is necessary for interpreting classic radiologic signs of posterior fracture-dislocation of the shoulder. A 47-year-old woman fell down directly onto her shoulder while she was skiing. She was diagnosed with posterior shoulder dislocation, associated with fracture of the head (head splitting) and humeral neck fracture, with the aid of plain radiographs and computed tomographic results...
June 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29664802/free-thoracoacromial-artery-perforator-flap-for-skin-defects-of-the-dorsal-hand
#11
Satoshi Kodaira, Keizo Fukumoto, Naoki Kato
Various flaps are used for skin defects of the dorsal hand and fingers. A sensory flap is not essential, but a thin and good color-matched flap is suitable, and donor site mobility of the flap should be considered. A reverse or free posterior interosseous artery perforator flap is one of the standard flaps. This flap requires no major arterial sacrifice, but direct closure of the donor site is difficult when the width of the flap is >3 cm, and there is also the risk of posterior interosseous nerve injury, especially the motor branch of the extensor carpi ulnaris muscle...
June 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29642118/revisiting-the-elastic-band-tourniquet-in-pediatric-upper-limb-surgery
#12
Yong Chiang Kang, Mahadev Arjandas, Lam Chuan Teoh
Pediatric upper limb surgery requires fine tissue handling in a bloodless surgical field. Standard pneumatic tourniquets are often ineffective in the very young, as they do not fit all limb circumferences. We describe a simple and effective elastic band tourniquet technique and report our experience of safety with 113 cases.
June 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29505436/intramedullary-percutaneous-fixation-of-extra-articular-proximal-and-middle-phalanx-fractures
#13
Nebojsa Jovanovic, Ehab Aldlyami, Basem Saraj, Mohamed Fm Seidam, Hamed Badawi, Ahmed Shaat, Khalid Alawadi, Chaitanya Dodakundi
Multiple methods have been described for treating unstable proximal and middle phalangeal fractures. Irrespective of using an open or closed technique of fixation, stiffness and extensor lag at the proximal/distal interphalangeal joint almost always occur. This issue can be avoided by allowing the patients to mobilize the fingers out of plaster or splint as early as possible from the day of surgery. We describe a technique of intramedullary percutaneous fixation of extra-articular proximal and middle phalanx fractures allowing immediate mobilization of fingers, concurrent stabilization with progressive healing and thus preventing such complications...
June 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29356719/transfer-of-a-radial-nerve-branch-to-the-brachialis-nerve-for-restoration-of-elbow-flexion
#14
Kyle J Chepla, Blaine T Bafus
Nerve transfers for brachial plexus reconstruction and the treatment of peripheral nerve injury have demonstrated excellent clinical outcomes and may be superior to nerve grafting. Previously described nerve transfers for restoration of elbow flexion include the Oberlin (ulnar to musculocutaneous) and double fasicular (median to biceps and ulnar to brachialis) transfers. However, these transfers cannot be performed in patients with loss of elbow flexion and concomitant high median and ulnar nerve injury. Other transfers utilizing the thoracodorsal or intercostal nerves have been described; however, this requires sacrifice of the latissimus dorsi muscle or potential nerve donors for a free, functioning gracilis muscle transfer...
June 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29466278/interlocking-k-wires-followed-by-immediate-mobilization-for-fractures-of-the-hand
#15
Efrain Farias, Mayron Lichterman, Mark Yuhas, Sunil M Thirkannad
We describe a technique of interlocking Kirschner wires to improve stability after fixation of fractures of the hand. This enables immediate mobilization of the injured fingers thus reducing the need for prolonged postoperative physical therapy and consequently diminishing chances of posttraumatic stiffness. This study analyzes outcomes in 83 fractures in 70 patients including 26 metacarpal and 57 phalangeal fractures. The technique has proven to be simple, versatile, and cost-effective. Patient compliance and satisfaction has been high and results have been gratifying...
March 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29462074/radial-shaft-convergence-in-distal-radius-fractures-diagnosis-and-treatment
#16
Daniel Tordjman, Richard M Hinds, S Steven Yang, John T Capo
Radial shaft convergence in distal radius fractures is often misdiagnosed. This common deformation is often associated with a radial translation of the distal fragment. This parameter has to be corrected because of the increased risk of distal radioulnar joint instability due to detensioning of the distal interosseous membrane if there is an associated triangular fibrocartilage complex lesion. A new radiologic sign for diagnosis of proximal radius convergence during distal radius fracture is presented as well as technical tips for correction of this deformity...
March 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29369124/are-we-too-quick-to-alter-our-practice-patterns-because-of-the-results-of-a-randomized-controlled-trial
#17
Jesse Jupiter
No abstract text is available yet for this article.
March 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29360674/reconstruction-of-a-circumferential-upper-extremity-soft-tissue-defect-with-a-dermal-regeneration-template-and-skin-grafting
#18
Ji H Son, Blaine Bafus, Anjay Khandelwal, Kyle J Chepla
Extensive degloving injuries of the upper extremity are rare and pose unique reconstructive challenges. Circumferential loss of soft tissue coverage over the elbow treated by skin grafting is often complicated by elbow contracture and decreased range of motion, requiring secondary contracture release and free-flap reconstruction to restore function. As an alternative approach, we report a good outcome after the use of a dermal regenerative template and subsequent split-thickness skin grafting. A 38-year-old right hand dominant man presented with circumferential degloving injury of the entire right upper extremity to the level of the chest wall after an industrial accident...
March 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29360673/the-weakest-point-of-the-shepherd-s-crook-technique-suture-tension
#19
LETTER
Bulent Karslioglu, Ali C Tekin, Ersin Tasatan
No abstract text is available yet for this article.
March 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29356718/suture-fixation-using-polyblend-polyethylene-sutures-with-hydroxyapatite-block-for-an-intra-articular-depression-fracture-of-the-pisiform-bone
#20
Toshiyuki Kataoka, Kohji Kuriyama, Yukihiko Yasui
Few cases in which open reduction and internal fixation was performed for displaced pisiform fractures have been reported. We present a new surgical technique for the treatment of depressed intra-articular pisiform fractures. First, the depressed fragment was reduced by pushing the bone tamp. Then, the fracture void resulting from the reduction of the depressed fragment was filled with a shaped hydroxyapatite block. Finally, the fragments were sutured using braided polyblend polyethylene sutures. The postoperative radiography could achieve a well-reduced articular facet, and this procedure had a good clinical outcome...
March 2018: Techniques in Hand & Upper Extremity Surgery
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