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Hand: Official Journal of the American Association for Hand Surgery

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https://www.readbyqxmd.com/read/27698646/pleomorphic-hyalinizing-angiectatic-tumor-arising-in-the-hand-a-case-report
#1
Patrick M Kane, Michael P Gaspar, Benjamin B Whiting, Randall W Culp
Background: Background: Pleomorphic hyalinizing angiectatic tumors (PHATs) are extremely rare, non-metastasizing tumors of uncertain origin that are typically seen in the lower extremities. To date, it is estimated that less than 100 cases have been reported worldwide since first described in 1996. Methods: The case of a 35-year-old male with a several-year history of a dorsal hand mass is presented. Although the patient was initially asymptomatic, in the months prior to presentation, the patient complained of pain with power grasp and direct pressure over the mass...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698645/bilateral-legg-calve-perthes-disease-and-kienbock-s-disease-in-a-child-with-factor-v-leiden-thrombophilia-a-case-report
#2
Heather L Baltzer, Scott Riester, Steven L Moran
Background: The etiology of multifocal osteonecrosis is not definitively known; however, hypercoagulable state is a very plausible cause. Methods: We present an unusual case of a 12-year-old boy with a history of Legg-Calve-Perthes disease presenting with right wrist pain who was subsequently diagnosed with Kienbock's disease. The finding of multifocal osteonecrosis prompted testing for a hypercoagulable state that was positive for Factor V Leiden thrombophilia. A thorough literature review using Medline database was conducted to investigate associations between inherited hypercoagulable states and multifocal osteonecrosis...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698644/proximal-interphalangeal-joint-fibromatosis-after-pyrocarbon-implant-insertion-a-case-report
#3
Jacob Rinkinen, Matthew D Chetta, Kevin C Chung
Background: Pyrocarbon implants represent an increasingly popular method to treat proximal interphalangeal joint dysfunction. To this point, no association has been shown between pyrocarbon biomaterials and fibromatosis. We present a potentially serious and destructive complication associated with pyrocarbon arthroplasty. Methods: We demonstrate a clinical case involving pyrocarbon arthroplasty and subsequent fibromatosis development in an otherwise healthy 23-year-old female. To present this association, we illustrate the diagnostic workup involved in a rapidly expanding soft tissue mass of the hand and explain the appropriate treatment...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698643/foreign-body-reaction-and-osteolysis-in-dorsal-lunate-dislocation-repair-with-bioabsorbable-suture-anchor
#4
Ezequiel Ernesto Zaidenberg, Pablo Roitman, Gerardo Luis Gallucci, Jorge Guillermo Boretto, Pablo De Carli
Background: In recent years the use of biodegradable suture anchors for treating tendon and ligament pathology in hand surgery became popular. These materials are biocompatible, radiolucent, and load sharing, as they incrementally transfer load to surrounding bone during the resorption process. Despite these numerous advantages, polyglycolic (PGA) and poly-L-lactic acid (PLLA) have become a problem because of the potential risk for foreign body reactions. Methods: This article presents a case of an intraosseous foreign body reaction and massive osteolysis of the proximal carpal after dorsal lunate dislocation repair with bioabsorbable suture anchors...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698642/impact-of-long-flexor-versus-intrinsic-dominance-in-the-generation-of-arc-of-finger-flexion
#5
James R Seaward, Fiona Peck, Vivien C Lees
Background: Finger flexion is a composite movement involving both long flexors and intrinsic hand muscles. Previous studies have characterized this but have not investigated differences within the normal population. Were discrete finger motion patterns identified, this could guide rehabilitation programs following flexor tendon surgery. Methods: Twelve volunteers repeatedly flexed and extended at a comfortable speed, resting their hand on a horizontal surface. Video was recorded perpendicular to the little finger flexion plane, and the little finger tip position was identified frame by frame to create a composite curve...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698641/the-radial-artery-s-sacrifice-in-the-chinese-flap-is-not-deleterious-to-patients
#6
Antonio C Costa, Leandro Viecili, Marina T C Sambuy, Marcelo R Rezende, Ivan Chakkour
Background: A widely discussed subject, albeit with few associated studies and publications, centers on whether sacrifice of the radial artery to perform the radial forearm flap (RFF) is deleterious to the patient. The objective of this study was to assess, by questionnaire, the complications reported at the donor site, particularly those related to sacrifice of the radial artery. Methods: During the 2014 Symposium of the Brazilian Society of Reconstructive Microsurgery, surgeons were asked to answer a questionnaire on RFF cases and complications...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698640/baseline-characteristics-of-the-median-nerve-on-ultrasound-examination
#7
Tiffany J Pan, Richard J White, Caiyan Zhang, William C Hagberg, Joseph E Imbriglia, John R Fowler
Background: Previous studies using ultrasound for diagnosis of carpal tunnel syndrome have reported on relatively small series of patients, leading to large standard deviations and/or confidence intervals for the mean cross-sectional area of the median nerve. The purpose of this study is to define the CSA of the median nerve in a large cohort of patients. Methods: Patients (n = 175) without history of carpal tunnel release were recruited. All participants were evaluated using the Carpal Tunnel Syndrome-6 questionnaire, a validated clinical diagnostic tool, with a score of 12 or greater considered positive for CTS...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698639/geographic-and-age-based-variations-in-medicare-reimbursement-among-assh-members
#8
Michael P Gaspar, Patrick M Kane, Grace B Honik, Eon K Shin, Sidney M Jacoby, A Lee Osterman
Background: The purpose of this study was to investigate how American Society for Surgery of the Hand (ASSH) members' Medicare reimbursement depends on their geographical location and number of years in practice. Methods: Demographic data for surgeons who were active members of the ASSH in 2012 were obtained using information publicly available through the US Centers for Medicare and Medicaid Services (CMS). "Hand-surgeons-per-capita" and average reimbursement per surgeon were calculated for each state. Regression analysis was performed to determine a relationship between (1) each state's average reimbursement versus the number of ASSH members in that state, (2) average reimbursement versus number of hand surgeons per capita, and (3) total reimbursement from Medicare versus number of years in practice...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698638/results-of-operative-intervention-for-finger-stiffness-after-fractures-of-the-hand
#9
Kevin F Lutsky, Jonas L Matzon, Joseph Dwyer, Nayoung Kim, Pedro K Beredjiklian
Background: Posttraumatic finger stiffness can occur as a result of hand fractures. The purpose was to assess and quantify the improvement in range of motion (ROM) after surgical management of the stiff finger in patients who developed loss of motion following treatment for a metacarpal or phalangeal fracture. In addition, an aim was to identify possible risk factors for suboptimal improvement in ROM postoperatively. Methods: A retrospective review was performed on 18 patients who underwent surgery to improve finger stiffness following metacarpal or phalangeal fracture...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698637/extensor-indicis-proprius-tenodesis-to-correct-finger-ulnar-drift-deformity-in-rheumatoid-arthritis
#10
Ricardo Monreal
Background: The most frequent deformity of the hand occurring in patients with RA affects the metacarpophalangeal (MCP) joint and it is characterized by a volar subluxation of the proximal phalanges and ulnar drift of the fingers. Methods: The Extensor Indicis Proprius (EIP) tenodesis for correction of ulnar deviation of fingers (II to V) was performed in 10 hands (40 fingers and 5 patients). Results: There was complete correction of the subluxation or dislocation and almost complete correction of the ulnar drift of the metacarpophalangeal joints at the initial postoperative evaluation (three to four months after surgery)...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698636/a-cross-sectional-study-of-musculoskeletal-health-literacy-in-patients-with-carpal-tunnel-syndrome
#11
Andrew J Rosenbaum, Andrew Dunkman, Daniel Goldberg, Richard L Uhl, Michael Mulligan
Background: Approximately 33% of Americans have inadequate health literacy, which is associated with infrequent use of preventative services, increased hospitalization and use of emergency care, and worse control of chronic diseases. In this study, the Literacy in Musculoskeletal Problems (LiMP) questionnaire was used to evaluate the prevalence of limited musculoskeletal literacy in patients undergoing carpal tunnel release (CTR), as these individuals may be at increased risk of inferior outcomes. Methods: This cross-sectional study included individuals older than or equal to 18 years of age who were scheduled for elective CTR...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698635/distal-inside-out-epineural-sliding-technique-to-repair-segmental-nerve-defects
#12
Toni Luokkala, Jorma Ryhänen, Juha Näpänkangas, Teemu V Karjalainen
Background: The repair of a segmental peripheral nerve injury is a clinical challenge. Several studies have been performed to determine superior methods for overcoming nerve gaps. The purpose of this study was to investigate if the inside-out slided epineurium of the distal segment of an injured nerve can serve as a conduit to bridge a short nerve defect (10 mm). Methods: Nineteen sciatic nerves in Sprague-Dawley rats were transected, and a 10-mm gap was left between the ends. A section of distal epineurium was pulled inside out to bridge the gap...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698634/linking-of-the-american-academy-of-orthopaedic-surgeons-distal-radius-fracture-clinical-practice-guidelines-to-the-international-classification-of-functioning-disability-and-health-international-classification-of-diseases-and-icf-core-sets-for-hand-conditions
#13
Saravanan Esakki, Joy MacDermid, Saipriya Vajravelu
Background: American Academy of Orthopaedic Surgeons (AAOS) distal radius fracture (DRF) clinical practice guidelines (CPG) are readily available to clinicians, patients, and policymakers. International Classification of Functioning, Disability, and Health (ICF) provides a framework for describing the impact of health conditions. The International Classification of Diseases-10th Revision (ICD-10) is a classification system to classify health conditions as specific disease or disorders. The aim of this study is to analyze and describe the scope and focus of the AAOS DRF CPG using the ICF and ICD-10 as a basis for content analysis, and to compare the content of the CPG with the ICF hand core sets as the reference standard...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698633/efficient-construction-of-volar-wrist-splints-a-biomechanical-study-comparing-splints-of-different-material-thickness-and-design
#14
Clifton Meals, Nathan J Castro, David Moss
Background: The aim was to test the null hypothesis that splint material, thickness, or longitudinal ridging does not affect the strength of a wrist splint. Methods: Ten splints were made according to each of 7 different splint designs (resulting in 7 groups of 10 splints each). All splints were the same length and were molded to approximate the contour of the volar hand, wrist, and forearm with the wrist in neutral. Three groups consisted of plaster splints of different thicknesses (8, 10, and 12 ply). Three additional groups included splints of the same thicknesses but with a longitudinal ridge...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698632/long-term-outcomes-of-primary-repair-of-chronic-thumb-ulnar-collateral-ligament-injuries
#15
Thomas Christensen, Shumaila Sarfani, Alexander Y Shin, Sanjeev Kakar
Background: The purpose of this study is to evaluate long-term outcomes of ligamentous repair rather than reconstruction for chronic thumb ulnar collateral ligament (UCL) injuries. Methods: Patients at least 15-years status-post repair of a chronic (greater than 6 weeks) UCL tear were contacted for clinical evaluation, radiographs, and postoperative outcome questionnaires, including the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analog scale (VAS) pain scale, and study-specific questions...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698631/the-association-of-complementary-health-approaches-with-mood-and-coping-strategies-among-orthopedic-patients
#16
Casey O'Connor, Yvonne Braun, Sjoerd P F T Nota, Timothy Baloda, David Ring
Background: Variation in pain intensity and magnitude of disability among patients with musculoskeletal illness is largely accounted for by variations in symptoms of depression, catastrophic thinking, and heightened illness concern. It is possible that patients with greater stress, distress, and less effective coping strategies might be more likely to seek the use of Complementary Health Approaches (CHA). This study addressed the primary null hypothesis that there are no demographic, illness-related, or psychological factors associated with CHA use among patients with upper extremity illness...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698630/longitudinal-outcomes-following-a-randomized-controlled-trial-of-dynamic-splint-stretching-for-carpal-tunnel-syndrome
#17
F Buck Willis, Brook Fowler
Background: The incidence of carpal tunnel syndrome (CTS) is 48 million patients in the United States. The purpose of this longitudinal study was to determine whether Dynasplint stretching (immediately after diagnosis) had an effect on a patient's decision to seek surgical treatment for CTS. Methods: Fifty patients (10 men, 40 women, mean age 51.2 ± 12 years) were recruited for this randomized, controlled, longitudinal trial. Patients were diagnosed with CTS by physical examination and nerve conduction studies...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698629/malignant-glomus-tumors-of-the-hand
#18
REVIEW
Joseph F Woodward, Neil F Jones
Background: Glomus tumors are uncommon vascular tumors of the hand. Malignant glomus tumors, known as glomangiosarcomas, are very rare and offer management challenges. Methods: A review of the diagnosis and treatment of malignant glomus tumors is presented in along with a report of the largest malignant glomus tumor of the hand to date. Results: The review illustrates the management of glomangiosarcomas. Only 6 previous such cases have been reported. Conclusion: The rare nature of malignant glomus tumors mandates case presentation and longitudinal analysis to help guide surgical management an optimize outcomes...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698628/hand-surgeon-reporting-of-tendon-rupture-following-distal-radius-volar-plating
#19
REVIEW
Nathan A Monaco, C Liam Dwyer, Alex J Ferikes, John D Lubahn
Background: Volar plate fixation with locked screws has become the preferred treatment of displaced distal radius fractures that cannot be managed nonoperatively. This treatment, however, is not without complication. The purpose of this study was to determine what percentage of hand surgeons, over a 12-month period, have experienced a tendon complication when using volar plates for the treatment of distal radius fractures. Methods: A total of 3022 hand surgeons were e-mailed a link to an online questionnaire regarding their observation and treatment of tendon injuries associated with volar plating of distal radius fractures...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27698627/carpal-coalitions-and-metacarpal-synostoses-a-review
#20
REVIEW
Michael B Gottschalk, Maxim Danilevich, Hilton P Gottschalk
Background: Carpal coalition and metacarpal synostosis are uncommon congenital anomalies of the carpus and hand. Methods: A comprehensive review of the literature was performed to help guide surgical and non-surgical treatment of carpal coalition and metacarpal synostosis. Results: The embryology, epidemiology, medical and surgical management, and associated outcomes are detailed. Conclusions: Most patients with these disorders will likely benefit from conservative measures. Surgery should be considered in patients with pain and limitations in wrist and hand function...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
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