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Techniques in Hand & Upper Extremity Surgery

journal
https://www.readbyqxmd.com/read/28777157/has-the-contemporary-electronic-medical-record-emr-made-the-comprehensive-hand-examination-obsolete
#1
Jesse B Jupiter
No abstract text is available yet for this article.
August 3, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28777156/deep-transverse-metacarpal-ligament-reconstruction-using-suture-button-and-a1-pulley
#2
Joshua Piercey, Paul McEniery, Nicholas Green
Rupture of the deep transverse metacarpal ligament (DTML) can result in pain, impaired grip strength, and undermine functional performance of the hand. We describe the case of a patient whose right hand came into contact with a boat propeller. He sustained a complete disruption of the DTML between the second and third ray in addition to soft tissue injury and open metacarpal fractures. Although other techniques describe a reconstruction of the DTML, our technique describes an adjunctive technique that strongly augments the A1 pulley reconstruction and nullifies the requirements of palmaris longus graft...
August 3, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28727585/closed-continuous-irrigation-with-lidocaine-and-immediate-mobilization-for-treatment-of-pyogenic-tenosynovitis
#3
Rebecca Knackstedt, Joyce Tyler, Steven Bernard
Pyogenic flexor tenosynovitis treatment consists of either closed continuous irrigation with sterile saline or antibiotic solution, or open debridement and irrigation. These treatment approaches serve to resolve the infection, but are extremely painful and residual stiffness can be devastating to the patient. We describe herein our approach to managing pyogenic flexor tenosynovitis. To provide continuous irrigation, a butterfly catheter with needle removed is utilized with irrigation holes cut into the tubing...
July 19, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28708756/anatomic-reconstruction-of-distal-radioulnar-ligaments-with-tendon-graft-for-treating-distal-radioulnar-joint-instability-surgical-technique-and-outcome
#4
Daniela Meyer, Andreas Schweizer, Ladislav Nagy
Among the various reasons for chronic posttraumatic ulnar-sided wrist pain, instability of the distal radioulnar joint (DRUJ) has recently received major attention and finally achieved fundamental progress in understanding thanks to anatomic and biomechanical studies. This has resulted in more physiological and successful treatment methods compared with the historic options. One and the most dramatic surgical technique consists in the replacement of the main ligamentous stabilizer of the DRUJ, the so-called triangular fibrocartilage, with a tendon graft...
July 13, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28671904/a-sandwich-method-using-kapandji-intrafocal-pinning-to-facilitate-palmar-plating-of-displaced-distal-radius-fractures
#5
Hui-Kuang Huang, Yi-Chao Huang, Jung-Pan Wang, Ming-Chau Chang
The use of palmar plating in the treatment of dorsally displaced distal radius fracture is very common, and can result in a good functional outcome. We present an easy "sandwich method" to reduce the fracture and to facilitate osteosynthesis. Firstly, the dorsal Kapandji intrafocal wire was applied to achieve the reduction of the dorsally displaced fracture and provide a volar-directed force. Then the intra-articular fractures were reduced or the metaphyseal defect is stuffed with bone graft if necessary. Finally, the anatomical plate is used to buttress and push back the distal fragment to complete the osteosynthesis...
June 30, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28614277/the-pull-out-k-wire-anchorage-the-shepherd-s-crook-technique
#6
Daniele De Spirito, Dario Giunchi
Traditional pull-out techniques for tendon and ligament repair are still widely used in hand surgery, despite constant refinements and the development of other methods of fixation. We propose a modification of the classic technique which utilizes a K-wire as an external strut instead of the classic button. This fixation system can be usefully applied in the fixation of extensor and flexor tendons and reinsertions. It is particularly applicable in situations where a transarticular K-wire is to be used anyway, in situations of temporary joint immobilization and in other situations...
June 13, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28614276/wrist-arthrodesis-with-femoral-head-structural-allograft-after-failed-total-wrist-arthroplasty
#7
Louis C Grandizio, Steven Maschke
The failed total wrist arthroplasty represents a challenging reconstructive problem for the upper extremity surgeon. Bone loss, poor bone quality, and soft tissue defects all present technical challenges when considering revision procedures. Our purpose is to describe a technique for wrist arthrodesis after failed total wrist arthroplasty utilizing fresh-frozen femoral head allograft and dorsal plate fixation. We describe a simple method of allograft preparation for this procedure, as graft preparation and implantation can be time consuming and technically challenging...
June 13, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28614275/indocyanine-green-angiography-a-helpful-tool-for-intraoperative-assessment-of-upper-extremity-perfusion
#8
Paul A Ghareeb, Thomas M Neustein, Robert C Fang, Diane E Payne
Assessment of tissue perfusion can be a challenge for the hand surgeon. Indocyanine green (ICG) angiography has been shown to be a valuable adjunct to physical examination and clinical judgment when there is a concern for tissue perfusion. The use of this technology has risen sharply in recent years in reconstructive surgery. Applications of ICG angiography have been developed throughout the field of surgery, including breast surgery, free tissue transfer, bowel surgery, neurosurgery, and lymphatic reconstruction...
June 13, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28614274/corrective-osteotomy-for-symptomatic-clavicle-malunion-using-patient-specific-osteotomy-and-reduction-guides
#9
Mathias Haefeli, Matthias Schenkel, Ralf Schumacher, Karim Eid
Midshaft clavicular fractures are often treated nonoperatively with good reported clinical outcome in a majority of patients. However, malunion with shortening of the affected clavicle is not uncommon. Shortening of the clavicle has been shown to affect shoulder strength and kinematics with alteration of scapular position. Whereas the exact clinical impact of these factors is unknown, the deformity may lead to cosmetic and functional impairment as for example pain with weight-bearing on the shoulder girdle...
June 13, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28614273/fat-grafting-for-esthetic-correction-of-the-muscle-atrophy-secondary-to-ulnar-nerve-lesion
#10
Samuel Ribak, André L Vasconcelos, Ricardo K Oliveira
Patients with hand muscular atrophy due to damage of the ulnar nerve could be stigmatized for their appearance. Unsatisfactory results in the attempt to correct the atrophy are reported in the literature. Fat grafting is an autologous and easily obtainable graft, antigenic response is very unlikely, it does not require any special material, and the procedure has a low cost. The technique of autologous fat grafting by using fat block, to remodel the first interdigital space, is useful and safe in correcting muscle atrophy of the first interdigital space caused by the injury of the ulnar nerve...
June 13, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28525521/what-is-surgical-grit
#11
Nicholas Pulos, Alexander Y Shin
No abstract text is available yet for this article.
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28448306/open-glenohumeral-joint-reduction-and-latissimus-dorsi-and-teres-major-tendon-transfers-for-infants-and-children-following-brachial-plexus-birth-palsy
#12
Joshua M Abzug, Scott H Kozin, Peter M Waters
Glenohumeral dysplasia can occur in brachial plexus birth palsy due to an imbalance of muscle forces. Most commonly this occurs in C5-C6 injuries where the shoulder external rotators are weak compared with the shoulder internal rotators. Treatment of the dysplasia with open reduction of the glenohumeral joint in combination with rebalancing the muscles can improve the development of the joint. Furthermore, the tendon transfer can improve shoulder function by decreasing the internal rotation forces about the shoulder while increasing the external rotation forces...
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28441305/step-by-step-technique-for-segmental-reconstruction-of-reverse-hill-sachs-lesions-using-homologous-osteochondral-allograft
#13
Hassanin Alkaduhimi, Michel P J van den Bekerom, Derek F P van Deurzen
Posterior shoulder dislocations are accompanied by high forces and can result in an anteromedial humeral head impression fracture called a reverse Hill-Sachs lesion. This reverse Hill-Sachs lesion can result in serious complications including posttraumatic osteoarthritis, posterior dislocations, osteonecrosis, persistent joint stiffness, and loss of shoulder function. Treatment is challenging and depends on the amount of bone loss. Several techniques have been reported to describe the surgical treatment of lesions larger than 20%...
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28437364/a-technique-for-the-management-of-concomitant-scaphotrapezoid-arthritis-in-patients-with-thumb-metacarpotrapezial-arthritis-interposition-arthroplasty-with-a-capitate-suture-anchor
#14
Tibor Warganich, Alexander Y Shin
Scaphotrapezoid (ST) arthritis is a common source of pain and disability that typically presents with concomitant basilar thumb arthritis. ST arthritis is often under recognized and under diagnosed as a source of continued pain after successful basilar thumb arthroplasty. Untreated, symptomatic ST arthritis can cause failure of an otherwise successfully executed thumb carpometacarpal arthroplasty due to persistent pain, which is frustrating to the patient and surgeon. Although multiple surgical treatment options have been described for basilar thumb carpometacarpal joint arthritis, there is no gold standard for the treatment of ST arthritis...
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28394872/a-technique-for-treating-dorsal-instability-of-the-distal-radioulnar-joint
#15
Madi El-Haj, Carter Baughman, Sunil M Thirkannad
We describe a technique for the treatment of chronic dorsal instability of the distal radioulnar joint by creating a strong dorsal radioulnar restraint using opposing flaps from the extensor retinaculum and dorsal capsule of the radioulnar joint. This technique has been used in 18 patients and has proven to be very easy and reliable with all patients demonstrating good stability of the distal radioulnar joint at final follow-up.
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28394871/triplanar-humeral-osteotomy-for-restoration-of-midline-function-in-patients-with-brachial-plexus-birth-palsy
#16
John D Jennings, Dustin A Greenhill, Scott H Kozin, Dan A Zlotolow
Brachial plexus birth palsy resolves spontaneously in a majority of patients, however, others may have serious permanent dysfunction. Although nerve transfers or grafts are early options for treatment, many children have residual deficits or present too late for such procedures. In these patients, rotational osteotomy of the humerus may restore improved function and motion. Unfortunately, traditional humeral osteotomies only provide correction in a single plane, therefore appropriate correction of the typical residual deformity is incomplete...
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28383356/-hills-plains-and-valleys-a-topographical-concept-in-the-treatment-of-dupuytren-s-contracture-with-needle-aponeurotomy
#17
Roshin Thomas, Emmett O'Flaherty
Needle aponeurotomy is emerging as a preferred choice of treatment for patients with Dupuytren's contracture keen on a quick, minimally invasive procedure that enables a rapid return of hand function. This article describes a unique topographical concept in the treatment of Dupuytren's contracture with needle aponeurotomy. This concept guides portal placement in a planned manner to achieve better correction and avoid potential complications.
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28338524/chronic-boutonniere-deformities-supple-or-stiff-a-new-surgical-technique-with-early-mobilization-in-11-cases
#18
Elodie Dubois, Frederic Teboul, Thomas Bihel, Jean-N Goubier
Injuries to the central slip of the extensor mechanism can lead to a Boutonniere deformity with important functional consequences. We report a series of 11 patients treated by lengthening-dorsalizing the lateral bands and tightening the central slip with early mobilization. The average age of the patients was 42 years (14;52). The extension defect of the proximal interphalangeal (PIP) joint was 64 degrees (80;55) and the hyperextension of the distal interphalangeal joint was 10 degrees (15;5). The surgery was performed with peripheral nerve block (sensitive), allowing dynamic adjustment of the tendinous sutures...
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28221245/an-articulating-antibiotic-cement-spacer-for-first-stage-reconstruction-for-infected-total-elbow-arthroplasty
#19
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...
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28383357/radiopaque-element-to-evaluate-adequacy-of-debridement-of-bony-lesions
#20
Nicholas Pulos, Alexander Y Shin
A technique for using an x-ray detectable radiopaque element from a surgical sponge to assess the adequacy of debridement of carpal bone cysts, Kienböck disease (lunate avascular necrosis), enchondroma of the digits, and scaphoid nonunions is described. The technique is simple to perform, inexpensive, and presents minimal additional risk to the patient. The technique has been used over the past 16 years and has enabled adequate debridement of these hand and wrist maladies by radiographically demonstrating the adequacy of the debridement to be bone grafted...
April 21, 2017: Techniques in Hand & Upper Extremity Surgery
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