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Hand: Official Journal of the American Association for Hand Surgery

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https://www.readbyqxmd.com/read/28082855/morel-lavallee-lesion-in-the-upper-extremity
#1
Grant K Cochran, Kathryn H Hanna
Background: The Morel-Lavallee lesion (MLL) is a closed internal degloving injury that results from shearing of the skin and subcutaneous tissue from the underlying fascia. Disruption of the perforating blood vessels and lymphatics results in a lesion filled with serosanguinous fluid and necrotized fat. MLLs are most commonly described in association with pelvic and lower extremity trauma, and there are limited reports of these lesions in other locations. Methods: This case report describes a 58-year-old male referred from his primary care physician with a soft tissue mass in the upper arm...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082854/iatrogenic-injury-to-the-median-nerve-during-palmaris-longus-harvest-an-overview-of-safe-harvesting-techniques
#2
Joshua Choo, Bradon J Wilhelmi, Morton L Kasdan
Background: A rare and disastrous complication of harvesting a tendon graft is the misidentification of the median nerve for the palmaris longus. Methods: The authors report a referred case in which the median nerve was harvested as a free tendon graft. Results: Few reports of this complication are found in the literature despite the frequency of palmaris longus tendon grafting and the proximity of the palmaris tendon to the median nerve. Given the obvious medicolegal implications, the true incidence of this complication is difficult to assess...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082853/gouty-tenosynovitis-of-the-distal-biceps-tendon-insertion-complicated-by-partial-rupture-first-case-and-review-of-the-literature
#3
Rick J Fairhurst, Arnold M Schwartz, Leo M Rozmaryn
Background: Given the appreciable prevalence of gout, gout-induced tendon ruptures in the upper extremity are extremely rare. Although these events have been reported only 5 times in the literature, all in patients with a risk factor for or history of gout, they have conspicuously never been diagnosed in the shoulder or elbow. Methods: A 45-year-old, right-hand-dominant man with a history of gout presented with pain in his right anterior elbow and weakness in his forearm after a trivial injury. Results: Here, we report the first case of gouty tenosynovitis of the distal biceps tendon insertion complicated by partial rupture, a composite diagnosis supported by both intraoperative and histological observations...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082852/pediatric-trigger-finger-due-to-osteochondroma-a-report-of-two-cases
#4
Ricardo Kaempf de Oliveira, Pedro J Delgado, João Guilherme Brochado Geist
Background: The trigger finger is characterized by the painful blocking of finger flexor tendons of the hand, while crossing the A1 pulley. It is a rare disease in children and, when present, is usually located in the thumb, and does not have any defined cause. Methods: We report 2 pediatric trigger finger cases affecting the long digits of the hand that were caused by an osteochondroma located at the proximal phalanx. Both children held the diagnosis of juvenile multiple osteochondromatosis. They had presented at the initial visit with a painful finger blocking...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082851/comments-on-the-article-non-surgical-treatment-of-lateral-epicondylitis-a-systematic-review-of-randomized-controlled-trials
#5
Dimitrios Stasinopoulos
No abstract text is available yet for this article.
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082850/the-lateral-proximal-phalanx-flap-for-contractures-and-soft-tissue-defects-in-the-proximal-interphalangeal-joint-an-anatomical-and-clinical-study
#6
Aldo G Beltrán, Camilo J Romero
Background: The management of contractures and soft tissue defects in the proximal interphalangeal (PIP) finger joint remains a challenge. We report a transposition flap from the lateral skin of the proximal phalanx that is based on perforating branches of the digital arteries and can be used safely for both palmar and dorsal cover defects. Methods: We first completed an anatomic study, dissecting 20 fingers in fresh cadavers with arterial injections and made the new flap in patients with dorsal or palmar defects in PIP joints...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082849/biceps-to-triceps-transfer-in-tetraplegic-patients-our-experience-and-review-of-the-literature
#7
José Medina, Alberto Marcos-García, Isidro Jiménez, Gustavo Muratore, José Luis Méndez-Suárez
Background: Management and indications for surgery in the tetraplegic patient are highly complex because of the substantial functional deficits that they present and their effect on their daily activity. Our purpose was to evaluate the functional outcome in tetraplegic patients who underwent biceps-to-triceps transfer surgery according to Zancolli's modified technique. Methods: This is a retrospective study of 6 biceps-to-triceps transfers using Zancolli's modified technique in 4 patients. Mean follow-up was 45 months...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082848/biomechanical-and-dimensional-measurements-of-the-pulvertaft-weave-versus-the-cow-hitch-technique
#8
Nanette L A Vincken, Thomas M A S Lauwers, Rene R W J van der Hulst
Background: In this study, biomechanical strength and bulkiness of the cow-hitch technique and Pulvertaft weave were compared. Our goal was to investigate whether the cow hitch can withstand equal strength in comparison with the Pulvertaft and to see if there is a difference in bulk, which could enhance gliding function and reduce friction and adhesion formation. Methods: Sheep tendons were used to perform 10 cow-hitch and 10 Pulvertaft repairs. Tensile strength was obtained with a cyclic loading tensile testing machine and tendon width and height measurements were obtained through digital analysis by photographs of the repairs...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082847/optimized-repopulation-of-tendon-hydrogel-synergistic-effects-of-growth-factor-combinations-and-adipose-derived-stem-cells
#9
Simon Farnebo, Lovisa Farnebo, Maxwell Kim, Colin Woon, Hung Pham, James Chang
Background: Tendon-derived extracellular matrix (ECM) hydrogel has been shown to augment tendon healing in vivo. We hypothesized that reseeding of the gel with adipose-derived stem cells (ASCs) could further assist repopulation of the gel and that combinations of growth factors (GFs) would improve the survival of these cells after reseeding. Methods: A tendon-specific ECM solution was supplemented with varying concentrations of basic fibroblast growth factor (bFGF), insulin-like growth factor-1 (IGF-1), and platelet-derived growth factor-BB (PDGF-BB)...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082846/muscle-atrophy-at-presentation-of-cubital-tunnel-syndrome-demographics-and-duration-of-symptoms
#10
Matthew L Drake, Dana T Hensley, Wei C Chen, Kenneth F Taylor
Background: The purpose of this study is to describe the demographics and duration of symptoms of patients with cubital tunnel syndrome who present with muscle atrophy. Methods: We identified 146 patients who presented to the hand surgery clinic at a single institution over a 5-year period with an initial diagnosis of cubital tunnel syndrome based on history and physical examination. Medical records were retrospectively reviewed to determine if there was a difference in demographic data, physical examination findings, and duration of symptoms in patients who presented with muscle atrophy from those with sensory complaints alone...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082845/frequency-of-incidental-median-thenar-motor-nerve-branch-visualization-during-mini-open-and-endoscopic-carpal-tunnel-release
#11
Kevin F Lutsky, Christopher M Jones, Nayoung Kim, Juana Medina, Jonas L Matzon, Pedro K Beredjiklian
Background: Clinical studies using extensile approaches for carpal tunnel release (CTR) report a fairly high incidence of thenar motor branch (TMB) variants. As mini-open and endoscopic CTRs have become commonplace, the likelihood of encountering one of these variants in current practice is unknown. The purpose of the present study was to assess prospectively the frequency with which TMB variants are encountered during routine surgery. Methods: All patients who underwent a primary CTR between August 2014 and April 2015 by 11 hand fellowship-trained, orthopedic surgeons were prospectively evaluated...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082844/a-preliminary-assessment-of-the-utility-of-large-caliber-processed-nerve-allografts-for-the-repair-of-upper-extremity-nerve-injuries
#12
Jonathan Isaacs, Bauback Safa
Background: Cabled sensory nerve autografts are the historical gold standard for overcoming gaps in larger diameter nerves as repair utilizing large-diameter autograft risks central graft necrosis. Commercially available processed nerve allograft (PNA) is available in diameters up to 5 mm but represents an acellular 3-dimensional matrix as opposed to viable tissue. The purpose of this study is to specifically evaluate whether similar concerns regarding the use of large-caliber PNA are warranted. Methods: The RANGER Registry is an active database designed to collect injury, repair, safety, and outcomes data for PNAs (Avance® Nerve Graft; AxoGen, Inc, Alachua, Florida) according to an institutional review board-approved protocol...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082843/brachial-plexus-blockade-causes-subclinical-neuropathy-a-prospective-observational-study
#13
Donato J Perretta, Matthew Gotlin, Kenneth Brock, Nader Paksima, Michael B Gottschalk, Germaine Cuff, Michael Rettig, Arthur Atchabahian
Background: The objective of this study is to determine subclinical changes in hand sensation after brachial plexus blocks used for hand surgery procedures. We used Semmes-Weinstein monofilament testing to detect these changes. We hypothesized that patients undergoing brachial plexus nerve blocks would have postoperative subclinical neuropathy detected by monofilament testing when compared with controls. Methods: In total, 115 hand surgery adult patients were prospectively enrolled in this study. All patients undergoing nerve-related procedures were excluded as well as any patients with preoperative clinically apparent nerve deficits...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082842/a-clinical-scoring-system-for-distinguishing-patients-with-coincident-cubital-tunnel-syndrome-among-patients-with-carpal-tunnel-syndrome
#14
Justin Koh, Kodi K Azari, Prosper Benhaim
Background: Coincident carpal and cubital tunnel syndromes present a diagnostic challenge, exacerbated by the limitations of nerve conduction study (NCS) for confirming cubital tunnel syndrome. This study develops a diagnostic scoring system, the Koh-Benhaim (KB) score, to identify patients with coincident compression neuropathies. Methods: A retrospective review of 515 patients was performed from patients surgically treated for carpal and/or cubital tunnel release. These patients were divided as patients with isolated carpal tunnel syndrome (n = 337) or coincident carpal and cubital tunnel syndromes (n = 178), then characterized according to demographics, medical history, physical examination, and NCS results...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082841/prospective-evaluation-of-opioid-consumption-following-carpal-tunnel-release-surgery
#15
Talia Chapman, Nayoung Kim, Mitchell Maltenfort, Asif M Ilyas
Background: Postoperative pain management and opioid consumption following carpal tunnel release (CTR) surgery may be influenced by many variables. To understand factors affecting opioid consumption, a prospective study was undertaken with the hypothesis that CTR performed under local anesthesia (wide awake local anesthesia with no tourniquet [WALANT]) would result in increased opioid consumption postoperatively compared with cases performed under sedation. Methods: All patients undergoing open CTR surgery were consecutively enrolled over a 6-month period...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082840/a-survey-of-the-use-of-ultrasound-by-upper-extremity-surgeons
#16
William L Wang, Kevin Kruse, John R Fowler
Background: Ultrasound is a versatile imaging modality that can be used by upper extremity surgeons for diagnostic purposes and guided injections. The perceptions of ultrasound for diagnosis and treatment among upper extremity surgeons and its barriers for adoption have not been formally surveyed. The purpose of this study is to determine the current usage of musculoskeletal ultrasound for diagnostic purposes and guided injections by upper extremity surgeons and their reasons for using it or not using it in practice...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082839/long-term-outcomes-of-scaphoid-malunion
#17
Blake P Gillette, Peter C Amadio, Sanjeev Kakar
Background: The optimal treatment of patients with a scaphoid malunion remains controversial. The long-term outcomes of operative and nonoperative management have not been established. Methods: We conducted a retrospective review of the outcomes of all scaphoid malunions treated at single institution over a 30-year period. This included patients who underwent corrective osteotomy, salvage procedures (ie, dorsal cheilectomy, radial styloidectomy, and scaphoidectomy with midcarpal fusion), and those who refused operative intervention...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082838/hand-surgery-and-fluoroscopic-eye-radiation-dosage-a-prospective-pilot-comparison-of-large-versus-mini-c-arm-fluoroscopy-use
#18
Mark L Wang, C Edward Hoffler, Asif M Ilyas, William H Kirkpatrick, Pedro K Beredjiklian, Charles F Leinberry
Background: The purpose of this study is to (1) perform a prospective pilot comparison of the impact of large versus mini C-arm fluoroscopy on resultant eye radiation exposure and (2) test the hypothesis that the use of either modality during routine hand surgery does not exceed the current recommended limits to critical eye radiation dosage. Methods: Over a 12-month period, eye radiation exposure was prospectively measured by a board-certified hand surgeon using both large and mini C-arm fluoroscopy. For each modality, accumulated eye radiation dosage was measured monthly, while fluoroscopic radiation output was recorded, including total exposure time and dose rate...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28082837/trends-in-the-treatment-of-dupuytren-disease-in-the-united-states-between-2007-and-2014
#19
REVIEW
Marc D Lipman, Samuel Evan Carstensen, Dylan Nicole Deal
Background: Dupuytren disease is a common fibroproliferative disorder. Multiple procedural treatment options are available, with Collagenase Clostridium Histolyticum (CCH) injection being introduced in 2010. The purpose of this study was to investigate trends in the treatment of Dupuytren disease in the United States between 2007 and 2014. Methods: The PearlDiver Humana database was queried using International Classification of Diseases, Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) codes for patients with Dupuytren disease that received percutaneous needle aponeurotomy (PNA), fasciotomy, fasciectomy, and CCH injection...
January 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28149225/case-report-35-year-follow-up-for-nonvascularized-toe-phalangeal-transfer-for-multiple-digit-symbrachydactyly
#20
Sanjay Naran, Joseph E Imbriglia
Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
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