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Techniques in Hand & Upper Extremity Surgery

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https://www.readbyqxmd.com/read/29369125/derotational-pronation-producing-osteotomy-of-the-radius-and-biceps-tendon-rerouting-for-supination-contractures-in-neonatal-brachial-plexus-palsy-patients
#1
Casey M DeDeugd, Alexander Y Shin, William J Shaughnessy
Forearm supination contractures can occur as a result of neurological derangement of the upper extremity. Primarily, this is observed in patients with neonatal brachial plexus birth palsy. The contractures develop slowly over time and become problematic in childhood as the patients begin requiring forearm pronation for activities of daily living including typing on a keyboard and writing. Although supination contracture is a well-described sequelae of neonatal brachial plexus birth palsy, there is a paucity of literature describing techniques and outcomes for reconstruction and restoration of forearm pronation...
January 23, 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
#2
Jesse Jupiter
No abstract text is available yet for this article.
January 23, 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
#3
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...
January 23, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29360673/the-weakest-point-of-the-shepherd-s-crook-technique-suture-tension
#4
Bulent Karslioglu, Ali Cagri Tekin, Ersin Tasatan
No abstract text is available yet for this article.
January 22, 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
#5
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...
January 19, 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
#6
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...
January 19, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29315135/percutaneous-blunt-needle-reduction-pbnr-needs-stable-fixation
#7
(no author information available yet)
No abstract text is available yet for this article.
January 8, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29239972/modified-suzuki-technique-with-cable-ties-for-unstable-fracture-dislocations-of-the-proximal-interphalangeal-joint
#8
Marco Guidi, Olivier Herrison, Stefan Luchian, Isidro Jimenez, Priscilla Di Sette, Amirouche Dahmam, Patrick Lorea
No abstract text is available yet for this article.
December 12, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29466278/interlocking-k-wires-followed-by-immediate-mobilization-for-fractures-of-the-hand
#9
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
#10
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/29145347/fingertip-winding-suture-pull-out-suture-technique-for-flexor-tendon-repair-in-zone-i
#11
Mostafa Mahmoud, Motaz Elian, Abdalah Seif Elnasr
Injuries to flexor tendons in zone I has always been challenging during repair. Over the time several techniques were developed and modified to achieve the highest repair strength and thus the best functional outcome. These techniques vary from pull-out sutures with internal and external fixation to the use of bone anchors. All techniques were accompanied with advantages and disadvantages as well as postoperative morbidities related to certain techniques. In the present technique we introduce a subperiosteal pull-out suturing technique...
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29064953/the-emperor-s-new-surgery
#12
Alexander Y Shin
No abstract text is available yet for this article.
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28953168/bipedicle-flaps-for-posterior-elbow-reconstruction
#13
Kyle J Chepla, Shirley Shue, Bram R Kafuman
Chronic posterior elbow soft tissue defects often require soft tissue reconstruction because of exposure of the underlying triceps tendon and proximal ulna. Current options for soft tissue coverage require sacrifice of a local muscle or microsurgery. The purpose of this study is to evaluate patient and surgical outcomes after reconstruction of small-sized to medium-sized (<50 cm) posterior elbow defects with bipedicle advancement flaps. A retrospective chart review was performed for 3 patients who underwent posterior elbow reconstruction with bipedicle flaps...
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28930949/the-blocking-flap-for-ulnar-nerve-instability-after-in-situ-release-technique-and-a-grading-system-of-ulnar-nerve-instability-to-guide-treatment
#14
Peter Tang
In situ ulnar nerve release has been gaining popularity as a simple, effective, and low-morbidity procedure for the treatment of cubital tunnel syndrome. One concern with the technique is how to manage the unstable ulnar nerve after release. It is unclear how much nerve subluxation will lead to problems and surprisingly there is no grading system to assess ulnar nerve instability. I propose such a grading system, as well as a new technique to stabilize the unstable ulnar nerve. The blocking flap technique consists of raising a rectangular flap off the flexor/pronator fascia and attaching it to the posterior subcutaneous flap so that it blocks the nerve from subluxation/dislocation...
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28914668/minimally-invasive-palmaris-longus-abductorplasty-for-severe-carpal-tunnel-syndrome
#15
Sze-Ryn Chung, Robert Tze-Jin Yap, Andrew Yam Kean Tuck
Camitz abductorplasty is the most commonly used tendon transfer in patients with severe carpal tunnel syndrome with significant muscle wasting and loss of opposition. This procedure requires a long incision in the palm to harvest a strip of palmar aponeurosis to lengthen the palmaris longus tendon, allowing it to reach the abductor pollicis brevis insertion. Several complications have been attributed to this extensive dissection in the palm. We describe a minimally invasive palmaris longus abductorplasty using a strip of free flexor carpi radialis tendon graft to achieve the necessary length...
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28902098/repair-of-the-thumb-ulnar-collateral-ligament-with-suture-tape-augmentation
#16
Anthony F De Giacomo, Steven S Shin
One of the most commonly injured structures of the thumb metacarpophalangeal (MCP) joint is the ulnar collateral ligament (UCL). An acute injury of this ligament is often amenable to primary repair. Despite the favorable outcomes of primary repair, the thumb is often restricted during initial healing of the ligament with immobilization and delayed rehabilitation. We present a novel technique to augment the repair of the UCL with suture tape to provide immediate biomechanical support and strength during the critical time of ligament healing...
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28885384/a-new-stem-guide-and-a-tuberosity-anchoring-lasso-system-for-shoulder-hemiarthroplasty-in-the-treatment-of-complex-proximal-humerus-fractures
#17
Philippe Valenti, Davide Aliani, Charbel Maroun, Jean-David Werthel
Hemiarthroplasty implantation for proximal humerus fracture is challenging. In case of young demanding patients with functional rotator cuff, humeral head replacement is an option if open reduction internal fixation is not a viable solution. The criteria for success in terms of clinical outcomes and longevity are anatomic healing of the tuberosities and stem positioning (restoring correct height, version, and axis). The purpose of this article is to describe a technique including a new stem guide and a tuberosity anchor "lasso" system for the implantation of hemiarthroplasty in complex proximal humerus fractures...
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28885383/application-of-a-modified-pedicled-adipofascial-lateral-arm-flap-in-the-prevention-and-treatment-of-radial-nerve-injuries
#18
Steven M Koehler, Andrew P Matson, Suhail K Mithani
The fasciocutaneous lateral arm flap is a workhorse flap in upper extremity reconstruction. However, its adipofascial variant is not widely used. The technique can be used in various clinical scenarios. The adipofascial flap can be transposed to circumferentially wrap the radial nerve with a pliable, vascularized fat and fascial envelope, mimicking the natural fatty environment of peripheral nerves. This technique has the advantage of providing a scar tissue barrier, a barrier to hardware irritation and a milieu for vascular regeneration of the nerve...
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28777156/deep-transverse-metacarpal-ligament-reconstruction-using-suture-button-and-a1-pulley
#19
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...
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29189597/ultrasonic-percutaneous-tenotomy-of-common-extensor-tendons-for-recalcitrant-lateral-epicondylitis
#20
Christopher T Battista, Matthew A Dorweiler, Michael L Fisher, Bernard F Morrey, Matthew P Noyes
Tennis elbow is a common musculoskeletal condition affecting middle-aged patients with symptoms usually lasting from 6 months to 2 years. The vast majority of individuals will respond to conservative therapy; however, some will require surgical intervention. A new treatment system has been developed for use with ultrasound guidance in the ultrasonic microresection of tendinopathic tissue. This technology has been implemented in the TX1 Tissue Removal System and is used to treat various tendinopathies by debridement using targeted ultrasonic energy...
November 16, 2017: Techniques in Hand & Upper Extremity Surgery
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