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Hand Surgery and Rehabilitation

A Toffoli, R Gamain, C Lazerges, M Chammas
We report the case of a 28-year-old man with a septic forearm non-union treated with minocycline for 3 months. At the time of reconstructive surgery, the radius and ulna were entirely black. Surgical debridement until bleeding of both bone extremities resulted in a 5-cm defect that was filled with a cement spacer. Histology confirmed poorly vascularized bone with focal areas of acute inflammatory infiltrate at the non-union sites (highly suggestive of infection) and normal structure of the remaining diaphyseal bones, although black in color...
November 3, 2018: Hand Surgery and Rehabilitation
T-W Kang, J-H Lee, D-H Park, H-S Cynn
Hand osteoarthritis reduces a person's ability to perform work activities and return to their occupation. We investigated the effects of a finger exercise program on hand grip strength, pain, physical function, and stiffness in automobile manufacturing workers with hand osteoarthritis. This randomized controlled trial was conducted on 29 subjects. Fifteen experimental subjects received a finger exercise program with paraffin baths, while 14 control subjects received only paraffin baths. Hand grip strength, pain, physical function, and stiffness were assessed at baseline and 8 weeks later...
November 3, 2018: Hand Surgery and Rehabilitation
J A Bertelli, K E Tavares
We aimed to evaluate the abduction and adduction of the little finger based on a new clinical test in the context of ulnar nerve lesions. We tested little finger abduction and adduction in 34 patients with an isolated ulnar nerve injury and 20 patients with cubital tunnel syndrome. With their forearms supinated, patients were asked to fully abduct their little finger. Then, the examiner held the patients' index, middle, and ring fingers in extension and maximal radial deviation, and then asked the patients to touch their little finger to their radially deviated ring finger...
October 22, 2018: Hand Surgery and Rehabilitation
J Guillou, C Pougès, M Limousin, G Strouck, C Fontaine
Lateral epicondylitis is a condition whose pathophysiology is poorly understood and whose optimal treatment divides physicians. Arthroscopy has proven its worth, with results similar to or better than open surgery. The purpose of this study was to look for prognostic factors for the outcomes of arthroscopic treatment of lateral epicondylitis. This was a retrospective, single-center study involving 39 cases (36 patients). Patients were split into two groups based on the Mayo Elbow Performance score (MEPS). A good result was defined as a score of 75 or better...
October 20, 2018: Hand Surgery and Rehabilitation
C Huttin, J J Hidalgo Diaz, P Vernet, S Facca, Y Igeta, P Liverneaux
Radiolucent foreign bodies of the hand are frequent and may lead to pain, infection, hematoma and/or migration. Their diagnosis and removal can be difficult. The goal of this study was to assess the usefulness of intraoperative ultrasound imaging for detecting translucent foreign bodies in the hand to facilitate their removal. Our single-center retrospective study included 19 patients with preoperatively radiolucent but echogenic foreign bodies. An intraoperative ultrasound was performed to assist with and confirm the removal of the foreign body...
October 19, 2018: Hand Surgery and Rehabilitation
M Le Hanneur, A Cambon-Binder, Z Belkheyar
Our aims were to study the anatomical feasibility of triceps brachii long head (TBLH) transfer to the extensor digitorum communis (EDC) and extensor pollicis longus (EPL) tendons through a medial route, and to report on its first clinical application. Dissections were conducted on 10 fresh-frozen cadaver specimens. Using a posteromedial approach, the TBLH was separated from the remaining triceps and extended distally with a fascia lata strip. This strip was then tunneled through a medial route and secured distally to the EDC and EPL tendons...
October 18, 2018: Hand Surgery and Rehabilitation
F Vigouroux, C Choufani, A Grosset, O Barbier, S Rigal, L Mathieu
The purpose of this report was to analyze sequential management of patients with combat-related hand injuries in the Kabul International Airport Combat Support Hospital and to identify principles of hand damage control orthopedics (DCO). A retrospective study was conducted using the French Opex data system that included all the patients who received sequential treatment for combat-related hand injuries from 2009 to 2013. Demographics, mechanism, injury pattern, reasons for DCO application and surgical procedures performed during initial and definitive treatment were described...
October 14, 2018: Hand Surgery and Rehabilitation
G Dautel
Vascularized toe joint transfers are used for proximal interphalangeal (PIP) or metacarpophalangeal reconstruction of the fingers in children or young adults, as an alternative to joint arthroplasty. In children, this reconstruction aims to restore range of motion (ROM) and the growing capacities. The typical donor sites are the PIP or metatarsophalangeal joints of the second toe. These transfers are performed with short vascular pedicles in order to simplify the surgical technique and reduce the overall morbidity...
October 14, 2018: Hand Surgery and Rehabilitation
W Duan, X Zhang, Y Yu, Z Zhang, X Shao, W Du
We aimed to describe the treatment of comminuted fractures of the base of the thumb metacarpal using a cemented bone-K-wire frame. Between March 2010 and January 2016, 41 fractures of the base of the thumb were treated using a cemented bone-K-wire frame. The mean age of the patients was 34 years. The patients' history included a fall onto the hand in 7 cases, direct trauma in 31 cases, and polytrauma with an unclear mechanism of injury in 3 cases. At the final follow-up, hand grip and pinch strength were measured using a dynamometer...
October 11, 2018: Hand Surgery and Rehabilitation
F Loisel, I Pluvy, H Kielwasser, M Panouilleres, L Obert, D Lepage
Rib cartilage grafts are widely used in maxillofacial surgery, but not in orthopedic surgery. The aim of this technical note is to describe the technique used to harvest this graft and to report on donor site complications in the 136 cases we have published on up to now. Harvesting is carried out at the osteochondral junction of the eighth rib. The osteochondral junction is located under the external oblique muscle and a perichondrium layer, which is retracted to allow safe harvesting. The amount of cartilage harvested depends on the size of the area being grafted...
September 25, 2018: Hand Surgery and Rehabilitation
L Amsallem, J Pierrart, J-D Werthel, D Delgrande, T Bihel, J Sekri, D Zbili, T Lafosse, E H Masmejean
Out of 100,000 inhabitants, 700 to 4000 suffer a hand wound each year. Numerous hand wounds that may not have a clinically evaluated deficit, actually have damage to a major structure after surgical exploration in the operating room (OR). The aim of our study was to evaluate the incidence of major structure damage within a population of patients presenting a hand wound with no deficit on the clinical examination. Every patient older than 12 years, consulting for a wound deeper than the dermis with no clinical signs of major structure damage underwent surgical treatment and exploration of the wound under regional anesthesia in the OR...
September 21, 2018: Hand Surgery and Rehabilitation
J Rimokh, H Najjari, V Rotari, C Maes, N Lebeau, M Moughabghab
Intraosseous cysts of the carpus are relatively common benign tumors. They are often discovered by chance and can cause wrist pain thereby requiring appropriate management. While conventional open surgical treatment leads to good results, it has certain disadvantages, the main one being postoperative stiffness. Arthroscopic treatment has been proposed as an alternative for lunate cysts. The present study consisted in evaluating the feasibility and outcomes of arthroscopic treatment for lunate and scaphoid cysts...
September 14, 2018: Hand Surgery and Rehabilitation
M-C Sapa, Y Igeta, S Gouzou, S Facca, C Pizza, J J Hidalgo Díaz, P Liverneaux
The aim of this retrospective study was to compare the results of arthroscopic dorsal capsulodesis performed with or without temporary K-wiring to treat patients who had sustained scapholunate ligament injuries. Our case series included 30 patients with an average age of 37 years (range: 19-55) of whom 12 were female. Dorsal scapholunate capsulodesis was carried out in all patients. In 15 patients, splint immobilization only was used (group I). For the remaining 15 patients, supplementary scapholunate and scaphocapitate K-wiring was performed (group II)...
September 13, 2018: Hand Surgery and Rehabilitation
M Kiran, I Guisasola, J-J George-Malal
Hand preference for perineal hygiene is not a commonly recorded data unlike hand dominance. Ability to reach the perineum is essential for a good functional outcome. There is no evidence in orthopaedic literature regarding its variability. The aim of this study was to examine hand preference for perineal hygiene in a cohort of hospital staff and enumerate possible factors that may associate with this preference. One hundred hospital staff in two NHS hospitals were asked questions regarding dominance of hand and hand preference for personal hygiene, ethnicity and gender...
August 30, 2018: Hand Surgery and Rehabilitation
S Barrera-Ochoa, J H Nuñez, X Mir
No abstract text is available yet for this article.
August 30, 2018: Hand Surgery and Rehabilitation
G Silk, N Vetharajan, H Nagata
A case of an isolated volar dislocation of the second and third carpometacarpal (CMC) joints in an 18-year-old man is described. He presented following a game of rugby unable to move his hand or wrist. He was managed by manipulation and K-Wire fixation. Hand function was excellent following wire removal and mobilization. This is an extremely rare injury, easily missed. The mechanism of injury described leads to comparison with the Lisfranc injury of the foot.
August 28, 2018: Hand Surgery and Rehabilitation
S Roulet, G Bacle, J Guéry, B Charruau, E Marteau, J Laulan
The goal of this study was to assess the recurrence of Dupuytren's disease and the stability of the functional result after fasciectomy combined with the McCash open-palm technique. From 1989 to 1999, 56 consecutive patients were surgically treated for Dupuytren's disease. In 2003, 40 of these operated patients were reviewed by an independent evaluator; 12 patients were Tubiana stage 1, 16 stage 2, 9 stage 3 and 3 stage 4. Twenty-one of them were reviewed again in 2016 by a second evaluator who was unaware of the clinical results in 2003...
August 2, 2018: Hand Surgery and Rehabilitation
M C Sozbilen, A E Dastan, H Gunay, L Kucuk
Angle grinders are powerful tools used for cutting, shaving and polishing metal, stone, concrete and many hard surfaces in the work and hobby context. The aim of this study was to evaluate the acute hand injuries caused by angle grinders and to identify risk factors. Out of 742 acute hand and forearm injuries presenting in our emergency department between March 2016 and March 2017, 82 cases of injury due to angle grinder were included in the study. The age, gender, occupation, experience and education level of the injured patients were recorded...
August 2, 2018: Hand Surgery and Rehabilitation
O Grobnicu, F Vinée, Y Igeta, F Xavier, T Bourcier, P Liverneaux
The purpose of this work was to determine whether the Cochet-Bonnet (CB) corneal sensitivity test has a lower cutaneous pulp sensitivity threshold than the Semmes-Weinstein (SW) monofilament test. Tactile sensitivity thresholds for the radial hemi-pulp of the index finger of 25 healthy adult subjects aged 30 years on average were measured using SW and CB esthesiometers. The sensitivity threshold of the radial hemi-pulp of the index was lower with the CB test than with the SW test. The sensitivity and specificity of the CB test on palm wounds still needs to be determined to rule out nerve damage...
August 2, 2018: Hand Surgery and Rehabilitation
M Le Hanneur, A Walch, T Gerosa, A Grandjean, E Masmejean, T Lafosse
We aimed to assess the rate and type of postoperative motor deficits that might be encountered following elbow flexion reanimation using ulnar- and/or median-based side-to-end nerve transfers in patients with brachial plexus injuries. All patients who underwent elbow flexion reanimation between November 2015 and October 2017 at our facility by nerve transfer based on partial harvests of the median and/or ulnar nerves were included. Postoperative clinical assessment was conducted the day after surgery to identify motor deficits in the territory of the harvested nerves...
August 2, 2018: Hand Surgery and Rehabilitation
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