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Techniques in Hand & Upper Extremity Surgery

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https://www.readbyqxmd.com/read/28221245/an-articulating-antibiotic-cement-spacer-for-first-stage-reconstruction-for-infected-total-elbow-arthroplasty
#1
Kanishka E Williams, Simon MacLean, Jesse Jupiter, Gregory I Bain
Management of an infected total elbow replacement is a significant clinical challenge. Although preservation of the prosthesis is ideal, a 2-stage revision is often necessary. Unlike lower limb arthroplasty, antibiotic spacers are not commercially available. Monoblock cement spacers do not allow elbow movements and are therefore associated with severe stiffness and scarring, leading to poor clinical outcomes. In our paper we present a simple and novel technique for constructing an articulating antibiotic-impregnated spacer for use as an implant for a 1-stage revision of an infected elbow arthroplasty...
February 17, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28027078/back-to-basics
#2
Jesse Jupiter
No abstract text is available yet for this article.
March 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28009702/volar-dorsal-and-lateral-locking-plate-fixation-for-pilon-fractures
#3
Mark Henry
The more common dorsal fracture subluxations at the base of the middle phalanx have an intact dorsal buttress of articular surface in continuity with the shaft. Capitalizing on this foundation, various fixation methods have met with relatively equivalent success including Kirschner wires, screws only, nonlocking plate and screws, and external fixation. Pilon fractures are complete articular fractures, where the comminuted articular fragments lack any structural connection to the more distal shaft of the middle phalanx, and have largely relied upon external fixation traction systems...
March 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27984361/dorsal-distraction-plating-and-lunate-decortication-for-stage-iii-kienb%C3%A3-ck-disease-a-novel-technique
#4
Michael D Wigton, Omar F Nazir, Benjamin R Graves, Peter J Apel, Zhongyu Li
Kienböck disease (KD) is a progressive condition and difficult to manage. A number of treatment algorithms exist but there is no clear consensus as to which method produces the best outcome, particularly for Lichtman stage III disease. The majority of the current treatment options for KD emphasize lunate unloading and restoration of biology with bone graft. However, less attention has been given to the protection of the lunate during revascularization process. We report a novel technique of lunate decompression and bone grafting, combined with wrist distraction with or without radial shortening osteotomy via dorsal wrist bridge plating for the treatment of stage II-IIIa/b KD...
March 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27824736/free-functional-muscle-transfer-tendon-insertion-secondary-advancement-procedure-to-improve-elbow-flexion
#5
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...
March 2017: 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
#6
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...
March 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27811625/internal-bone-grafting-for-the-treatment-of-scaphoid-nonunions
#7
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...
March 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27849675/brachioradialis-tendon-coverage-in-volar-distal-radius-plating
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
Vijay Patil, Lorenzo Garagnani
No abstract text is available yet for this article.
September 2016: Techniques in Hand & Upper Extremity Surgery
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