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Techniques in Hand & Upper Extremity Surgery

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https://www.readbyqxmd.com/read/27824736/free-functional-muscle-transfer-tendon-insertion-secondary-advancement-procedure-to-improve-elbow-flexion
#1
Sreedharan Sechachalam, Anne O'Byrne, Anthony MacQuillan
One method of restoring elbow flexion in patients with brachial plexus injuries is through the use of free functional muscle transfer. Most of our patients achieve good outcome, resulting in improved usefulness of the affected limb. However, a minority of our patients have successful reinnervation of the transferred muscle but with a suboptimal strength and range of motion (ROM) of elbow flexion. In this subset of patients, we perform a secondary procedure to improve the moment arm of the muscle on the elbow joint...
November 7, 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27824735/surgical-treatment-of-chronic-essex-lopresti-lesion-interosseous-membrane-reconstruction-and-radial-head-prosthesis
#2
Prospero Bigazzi, Letizia Marenghi, Marco Biondi, Maura Zucchini, Massimo Ceruso
The Essex-Lopresti lesion, or radioulnar longitudinal dissociation, results from an axial load to the forearm with lesion to the radial head, interosseous membrane and distal radioulnar joint. The lesion is rarely diagnosed early, therefore treatment is often subacute or chronic. In these cases, procedures such as radial head replacement, ulnar shortening and/or wafer procedures should be combined with reconstruction of the interosseous membrane central band to restore longitudinal stability of the forearm...
November 7, 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27811625/internal-bone-grafting-for-the-treatment-of-scaphoid-nonunions
#3
Utkan Aydin, Sunil M Thirkannad
Scaphoid fracture is the most common carpal fracture of the upper extremity and a significant proportion of these can eventually progress to nonunion. Excision of pseudoarthrosis and fibrous scar tissue at the nonunion site is regarded as one of the important steps in management of scaphoid nonunions. We describe a technique of internal bone grafting, where curettage of the nonunion site was performed through a drill hole in the scaphoid and bone graft was packed through this same hole before fixation with a headless compression screw...
November 2, 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27849675/brachioradialis-tendon-coverage-in-volar-distal-radius-plating
#4
Nicholas B Jew, John W Karl, Evan Trupia, Robert J Strauch, James H Calandruccio
Volar plate fixation of unstable distal radius fractures has become the preferred technique by most surgeons for the operative treatment of displaced distal radius fractures. Flexor tendon rupture is a rare but serious complication associated with this operation that is thought to be due to irritation of the flexor tendons over the prominent distal edge of the plate. We describe a novel technique of using the brachioradialis tendon to cover the distal edge of the plate to help prevent tendon irritation and rupture...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27824734/targeted-muscle-reinnervation-for-transradial-amputation-description-of-operative-technique
#5
Emily N Morgan, Benjamin Kyle Potter, Jason M Souza, Scott M Tintle, George P Nanos
Targeted muscle reinnervation (TMR) is a revolutionary surgical technique that, together with advances in upper extremity prostheses and advanced neuromuscular pattern recognition, allows intuitive and coordinated control in multiple planes of motion for shoulder disarticulation and transhumeral amputees. TMR also may provide improvement in neuroma-related pain and may represent an opportunity for sensory reinnervation as advances in prostheses and haptic feedback progress. Although most commonly utilized following shoulder disarticulation and transhumeral amputations, TMR techniques also represent an exciting opportunity for improvement in integrated prosthesis control and neuroma-related pain improvement in patients with transradial amputations...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27811626/the-technology-hype-curve-and-success-through-failure
#6
Alexander Y Shin
No abstract text is available yet for this article.
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27801774/the-efcr-approach-and-the-radial-septum-understanding-the-anatomy-and-improving-volar-exposure-for-distal-radius-fractures-imagine-what-you-could-do-with-an-extra-inch
#7
Jorge L Orbay, Robert Gray, Lauren L Vernon, Scott M Sandilands, Anthony R Martin, Sofia M Vignolo
Locked volar plating is the most common surgical procedure to address distal radius fractures. The extended flexor carpi radialis approach continues to be an excellent method for visualizing distal radius fractures and applying a volar plate. A new understanding of the anatomy allows for better visualization and reduction of the many different distal radius fracture patterns surgeons commonly see. Within the extended flexor carpi radialis approach, we describe the radial septum in further detail including the anatomy which comprises the radial septum triangle...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27776006/arthroscopic-assisted-acromioclavicular-and-coracoclavicular-ligaments-reconstruction-for-chronic-acromioclavicular-dislocations-surgical-technique
#8
Achilleas Boutsiadis, Laurent Baverel, Hubert Lenoir, Philippe Delsol, Johannes Barth
Chronic acromioclavicular (AC) instability is a rare posttraumatic shoulder condition that can lead to undesirable symptoms like persistent pain, muscle fatigue, loss of strength, or even scapular dyskinesis. It is well known that in these cases the superior functional results depend on the restoration of the anatomy and stability of the AC joint in both vertical and horizontal planes. Considering the ligaments degeneration and atrophy in chronic AC joint dislocations, we present an arthroscopic-assisted reconstruction of both the coracoclavicular and AC ligaments using autograft augmentation...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27776005/the-use-of-a-simple-dynamic-external-fixator-for-the-treatment-of-volar-fracture-subluxation-of-proximal-interphalangeal-joints-of-the-fingers
#9
Mohamed M Abou Elatta, Foad Assal, Hussam M Basheer, Mazen Mohamed Ibrahim
Volar fracture dislocation is very uncommon, with few series reported in the literature. Patients with such injuries were treated by modified dynamic external fixators. The mean follow-up was 18 months (range, 6 to 92 mo). The mean range of interphalangeal (proximal interphalangeal) joints and distal interphalangeal joints were 90 and 74 degrees, respectively. The total active range of motion (TAM) was excellent (256 degrees). The mean quick disabilities of the arm, shoulder and hand score was 1.2. The advantages of our external fixators are that they are simple, cheap, adjustable, and allow immediate range of motion...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27741054/surgical-treatment-of-symptomatic-congenital-type-i-lunotriquetral-coalition-technique-and-a-report-of-4-cases
#10
Daniel Tordjman, Mohamed K Barry, Richard M Hinds, S Steven Yang
Lunotriquetral (LT) synchondrosis is an uncommon variant of congenital LT coalition. Unlike complete LT fusions, this incomplete pseudoarthrosis-like coalition can become symptomatic. Surgical LT arthrodesis is a described treatment for this variant of LT coalition (Minnaar type I). We report 4 patients who underwent LT fusion with a second-generation headless compression screw and distal radius cancellous autograft. Fusion was achieved in all cases at an average of 2.5 months postoperatively. All the patients were satisfied with complete pain relief in 2 patients and minimal pain in 2 patients, and all improved their range of motion...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27575583/distal-radius-bone-graft-from-the-second-extensor-compartment-a-safe-and-effective-technique
#11
Oleksandra Vyrva, Sunil M Thirkannad
We describe a technique for harvesting cancellous bone graft from the floor of the second extensor compartment that is both easy and effective. It confines surgery to a single operative field under the same regional anesthesia and tourniquet as the primary hand surgical procedure while at the same time allowing wide visualization for harvesting bone graft. It provides cancellous bone of sufficient quality and quantity for use in most hand surgical cases. The technique has so far been used in 80 patients and has proven to be very safe...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27551832/endobutton-fixation-technique-for-multifragmented-coronoid-fractures
#12
Egemen Altan, Omer Ozel, Mehmet U Ozbaydar, Taner Bekmezci
Coronoid fractures commonly occur in a part of unstable elbow fractures. Stable coronoid fracture fixation is important for early elbow motion. It may be difficult to fix multifragmented coronoid process fractures with loose capsular attachment. Thus, we demonstrated the endobutton suspensory technique to fix the anterior coronoidal fragments due to its suspensory effect providing capsular attachment. This technique allows stable fixation to the small multifragmented coronoid fractures with early range of motion...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27438528/double-v-y-flap-to-cover-the-fingertip-injury-new-technique-and-cases
#13
Luis C Díaz, Enrique Vergara-Amador, Lina M Fuentes Losada
The volar V-Y flap is used in transverse or dorsal oblique amputations in fingertip injuries; however, its use is contraindicated in patients with volar oblique amputations and cannot advance distally enough to cover the defect. The aim of this report is to describe a technique of double V-Y flap to cover fingertip defects in which a simple V-Y flap is not enough. This technique allows advancement between 30% and 50% farther than the original, simple V-Y flap. Report of cases a series of fingertip amputation covered with this technique...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27466049/technique-for-3-dimesional-3d-modeling-of-osteoarticular-medial-femoral-condyle-vascularized-grafting-to-replace-the-proximal-pole-of-unsalvagable-scaphoid-nonunions
#14
Matthew T Houdek, Jane M Matsumoto, Jonathan M Morris, Allen T Bishop, Alexander Y Shin
This study describes a novel technique for the preoperative surgical planning for an osteoarticular medial femoral condyle (MFC) graft to replace the proximal pole of a scaphoid. In cases of proximal pole scaphoid nonunion or in Preiser disease, fragmentation of the articular surface can occur, leading to significant pain and disability. Osteoarticular MFC bone grafting can be used to treat these injuries by providing a vascularized osteoarticular surface. Using 3-dimensional imaging and printing we are able to precisely model the injured scaphoid, and also accurately plan the harvest of MFC osteoarticular graft...
September 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27415161/arthroscopic-classification-of-the-lesions-of-the-dorsal-capsulo-scapholunate-septum-dcss-of-the-wrist
#15
Luc Van Overstraeten, Emmanuel J Camus
The dorsal capsulo-scapholunate septum (DCSS) is an anatomic structure linking the scapholunate ligament and the dorsal capsule of the wrist. It should be a predynamic scapholunate stabilizer. The authors, using their experience for the extrinsic ligaments testing, suggest an arthroscopic testing of the DCSS. The status could be graded in 4 stages according to the trampoline aspect and to the fiber attachment. They report a preliminary study on a series of 53 arthroscopies made between January 2014 and December 2015 with evaluation of scapholunate ligament instability and DCSS laxity...
September 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27415160/published-articles-on-surgical-techniques-are-they-set-in-stone
#16
Vijay Patil, Lorenzo Garagnani
No abstract text is available yet for this article.
September 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27328424/survivorship-of-trabecular-metal-anchored-glenoid-total-shoulder-arthroplasties
#17
Joseph F Styron, Patrick G Marinello, Sebastian Peers, William H Seitz
Trabecular metal anchored glenoids (TMAGs) were developed to counter the pervasive problem of component loosening at the bone-cement interface in total shoulder arthroplasty. Increased failure rates associated with the glenoid component have been previously reported due to increased rates of glenoid failures. Our hypothesis was that in our patients, the failure rate of TMAG implants is similar to or less than reported failure rates of traditional all polyethylene glenoid components. A medical chart review of 66 consecutive patients treated with a TMAG total shoulder replacement was conducted including clinical and radiographic follow-up...
September 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27280754/a-novel-technique-for-correcting-extensor-lag-in-vascularized-toe-pip-joint-transfers
#18
Yu-Te Lin, Charles Yuen Yung Loh
The use of the vascularized second-toe proximal interphalangeal joint (PIPJ) for vascularized joint transfers (VJTs) allows for restoration of powerful pinch/grasp and range of movement of a PIPJ in the hand. However, because of the lack of central slip formation in the majority of toes, the reconstructed PIPJ often results in extension lag. Extension lag associated with poor central slip formation in the lesser toes can be corrected using central slip reconstruction methods such as the Stack method. However, such methods are often cumbersome and involve extensive dissection and soft tissue manipulation...
September 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27280753/osteochondral-autograft-transfer-for-treatment-of-metacarpophalangeal-and-interphalangeal-cartilage-defects
#19
Alan J Micev, Michael P Gaspar, Randall W Culp
There is no general consensus regarding the optimal surgical treatment for cartilage defects of the metacarpophalangeal and interphalangeal joints in active patients who wish to preserve motion and functionality. We describe our technique of arthroscopically harvested femoral osteochondral autograft for treatment of metacarpophalangeal and interphalangeal cartilage defects.
September 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27280752/a-novel-surgical-approach-to-coracoid-based-eosinophilic-granuloma-and-the-technical-trick
#20
Kemal Gökkuş, Mehmet B Unal, Ahmet T Aydin
The coracoid base is a very rare location for tumors. It is difficult to diagnose and approach, but easy to dismiss. In this case, the tumor (eosinophilic granuloma of the scapula) was located at the base of the coracoid, and the posterior cortex was eroded by the tumor. Accessing this lesion through the deltopectoral approach with coracoid osteotomy without penetrating the supposed tumor extending posterior soft tissue will be discussed. This approach gives a wider and safer access to the surgeon than the posterior approach...
September 2016: Techniques in Hand & Upper Extremity Surgery
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