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Hand Surgery and Rehabilitation

M Cegarra-Escolano, C Jaloux, O Camuzard
Rice bodies are very unusual lesions, generally encountered in chronic synovitis due to rheumatoid diseases or tuberculosis. A 31-year-old right-handed man presented with a 15-year history of progressively growing "sausage-like" swelling of the 4th finger and palm of his right hand. There was an immovable, painless mass with restriction of the finger's ROM without local or general associated signs. Imaging showed a large non-aggressive mass within the tendon sheath. Complete excision of the mass was performed...
May 18, 2018: Hand Surgery and Rehabilitation
G Meyer Zu Reckendorf, A Dahmam
Damage to the hand in patients suffering from gout is rare and is often detected at an advanced stage. The main clinical manifestations are the appearance of subcutaneous tophi at the finger joints. Other clinical manifestations of osteoarticular, tendinous or neurological lesions have been described in the hand and are often difficult to diagnose. In the majority of cases, surgery and adequate medical care with a suitable anti-gout treatment will allow the patient to recover normal hand function. However, surgical treatment is rare and is only performed after several months of carefully adapted medical treatment...
May 17, 2018: Hand Surgery and Rehabilitation
A Zemirline, C Taleb, K Naito, P Vernet, P Liverneaux, F Lebailly
Distal radius fractures (DRF) may trigger, reveal or decompensate acute carpal tunnel syndrome (CTS) in 0.5-21% of cases. Internal fixation and median nerve release must then be carried out urgently. Less invasive approaches have been described for both the median nerve release using an endoscopic device and for the DRF fixation using a volar locking plate. We assessed the feasibility of DRF fixation and median nerve release through a single, minimally-invasive 15mm approach on a series of 10 cases. We reviewed retrospectively 10 consecutive cases of DRF associated with symptomatic CTS in 8 women and 2 men, aged 57 years on average...
May 17, 2018: Hand Surgery and Rehabilitation
S Roner, P Fürnstahl, A Schweizer, K Wieser
Nonoperative treatment of an injured ulnar collateral ligament of the thumb metacarpophalangeal (MCP) joint (skier's thumb without a Stener lesion) is managed by immobilization. A splint is applied on the radial side with the thumb in slight flexion to immobilize the MCP joint and allow motion in the interphalangeal joint. Thermoplastic splints are mainly used for daily activities with the advantage of custom fabrication for optimal comfort. To immobilize the thumb during surgical procedures performed by an orthopedic surgeon, splints made of sterilizable materials are needed but not yet available to our knowledge...
May 17, 2018: Hand Surgery and Rehabilitation
B Karslıoğlu, M Uzun, C Tetik, E Tasatan, A C Tekin, C D Buyukkurt
Mallet fracture is an avulsion of the extensor tendon and fracture of the dorsal rim of the articular surface of distal phalanx at the same time. If a part of the mallet fracture is angled or rotated to such a degree that prevents full anatomic reduction, malunion and deformities may occur as a result. The objective of this study was to describe a new surgical technique to provide derotation of the mallet fracture. A 22G or 21G needle is used like a joystick to reduce the mallet fracture with small, gentle movements...
May 14, 2018: Hand Surgery and Rehabilitation
G Pomares, C Duysens, C Camps, A Durand, A Falcone, T Jager
No abstract text is available yet for this article.
May 14, 2018: Hand Surgery and Rehabilitation
G Prunières, Y Igeta, J J Hidalgo Díaz, S Gouzou, S Facca, F Xavier, P Liverneaux
The usefulness of ultrasound for making the diagnosis of pyogenic flexor tenosynovitis (PFTS) has been demonstrated. The primary goal of this study was to show that the diameter of the flexor sheath near the A2 pulley was larger when PFTS was present compared to the healthy contralateral finger. The secondary goal was to determine the reproducibility of these ultrasound measurements. Our series included 20 patients (12 men and 8 women) operated due to PFTS. The average age was 41.7 years old. The average diameter of the digital sheath measured near the A2 pulley on transverse and longitudinal ultrasound sections was 5...
May 11, 2018: Hand Surgery and Rehabilitation
C Demirdover, F A Ozturk, H S Yazgan, N Yogurtcu, M Sevindik, H Vayvada
The aim of this study was to emphasize the importance of early surgical treatment of multicomponent soft tissue injuries of the wrist. A retrospective review was performed on 156 patients with multicomponent soft tissue injuries of the wrist who were treated between July 2007 and July 2015. All the patients included in the study were operated within the first 36hours of the injury and were hospitalized after the surgery based on the extent of their injury. The patients were evaluated in terms of age, gender, etiology, injured structures, total number of damaged structures, mean follow-up time, complications and reoperation...
April 28, 2018: Hand Surgery and Rehabilitation
P Bellemère
Thanks to its remarkable mechanical properties and excellent biocompatibility, pyrocarbon is an ideal material for articular use. Various pyrocarbon implants for the hand and wrist have been developed over the past 25 years, with about 15 currently available for hemi-, total and interposition arthroplasty. This article describes the production methods and mechanical properties of pyrocarbon. The author summarizes the various implants available for each type of joint, their reported results in the literature, as well as his team's experience...
April 6, 2018: Hand Surgery and Rehabilitation
R Imai, M Osumi, T Ishigaki, S Morioka
We investigated the relationship between pain and hesitation during movement initiation among 11 adult female patients who had undergone surgery for a distal radius fracture. Data on the patients' pain at rest, pain during movement and score on the Pain Catastrophizing Scale were analyzed. Movement characteristics were assessed by the administration of a finger tapping (FT) task using the thumb and index finger, with the movement repeated 10 times, recorded and analyzed to determine the patient's hesitation when opening or closing her thumb/forefinger during the task...
March 23, 2018: Hand Surgery and Rehabilitation
Z Al-Amin, S A Senyürek, E M M Van Lieshout, M M E Wijffels
The aim of this study was to determine the rate of carpal tunnel syndrome (CTS) in patients with a volar plated distal radius fracture (DRF), with or without prophylactic carpal tunnel release (CTR). The PubMed database was searched for studies reporting on CTS in patients with a DRF fixed by a volar plate. Selected patients were those who underwent prophylactic CTR versus patients who did not. Pooled rates of CTS were calculated using inverse - variance weighting assuming a random effects model. Tests for heterogeneity were applied...
March 23, 2018: Hand Surgery and Rehabilitation
C Gengler, N Pauchard
Dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint of the long fingers are in most cases unstable. They require surgery, whose primary aim is to restore and maintain articular congruency. While numerous techniques exist to treat these injuries, none have been shown to be superior to any of the others in terms of outcomes and complications. The least invasive techniques should be used as much as possible. We report here a rare case of incarceration of the flexor tendons in the PIP fracture which required open surgery...
March 20, 2018: Hand Surgery and Rehabilitation
C K Goorens, K Van Royen, S Grijseels, S Provyn, J De Mey, T Scheerlinck, J F Goubau
Flexor tendon injury after volar plating of distal radius fractures is due to friction against the plate. To assess this risk, the distance between the flexor pollicis longus (FPL) and the volar prominence of the plate was measured with ultrasonography under various conditions: a standard plate fixed proximal or distal to the watershed line and a low-profile volar rim plate, with and without transection of the pronator quadratus (PQ). Distance from the FPL to the volar prominence of the plate decreased significantly when the PQ was cut and when a standard plate was placed distal to the watershed line, with the tendon often bulging over the plate...
March 19, 2018: Hand Surgery and Rehabilitation
V Matter-Parrat, F Severac, F Xavier, S Facca, J J Hidalgo Diaz, P Liverneaux
Repair of the nail bed and plate after distal phalanx trauma remains controversial. The aim of this study was to determine whether simple approximation of the nail bed flaps maintained by tension band suture of the nail plate is sufficient to prevent nail dystrophies. Our series gathered 27 fingers in 25 patients with a mean age of 36 years. In 15 cases (Group I), the nail plate was fixed in a single layer by a point in a frame, and in 12 cases (Group II), the bed and the plate were fixed layer-by-layer using the wound adhesive, 2-octylcyanoacrylate...
March 19, 2018: Hand Surgery and Rehabilitation
C Bouvet, S Bouddabous, J-Y Beaulieu
Hand aneurysms are a rare entity only described as case reports in the literature. The aim of our study was to describe a series of four cases and the surgical technique using an arterial bypass. We also wanted to define an algorithm for the imaging of this pathology. We have operated on four patients with hand aneurysms in the past decade or so. One patient had an aneurysm in the thumb proper palmar digital artery, one in the superficial palmar arch and the two others in the ulnar artery. All patients had an excision surgery with direct arterial bypass; no patient had a venous graft...
March 19, 2018: Hand Surgery and Rehabilitation
B Degeorge, R Coulomb, P Kouyoumdjian, O Mares
The purpose of this study was to determine the time needed to return to personal and professional activities after bilateral simultaneous endoscopic carpal tunnel release. During a retrospective, single-center study, we included a cohort of 30 patients (60 wrists). Patients were evaluated clinically (pain, paresthesia) and functionally (QuickDASH score) pre- and postoperatively. At the last follow-up, patients completed a questionnaire regarding the time needed to resume personal activities using the ADL scale (feeding, personal hygiene and dressing) and return to work...
March 19, 2018: Hand Surgery and Rehabilitation
D Jann, M Calcagni, P Giovanoli, T Giesen
We analyzed the results of 20 unstable metacarpal fractures in 15 patients treated with a cannulated compression screw and no immobilization. All fractures healed within 6 weeks. One patient with multiple fractures and a flexion deficit required arthrolysis of two metacarpophalangeal joints. Another patient had an extension lag. There were no other complications. This fast and easy technique results in good outcomes for unstable metacarpal fractures. The advantages are early active motion without immobilization and stable fixation...
April 2018: Hand Surgery and Rehabilitation
B Le Glédic, J J Hidalgo Diaz, P Vernet, S Gouzou, S Facca, P Liverneaux
No study has compared the QuickDASH score after Swanson implant arthroplasty performed by dorsal versus volar approaches. This study compared the outcomes of PIP arthroplasties through a volar approach as described by Schneider versus a dorsal approach as described by Chamay by determining the QuickDASH score, pain and range of motion. Our series included 21 Swanson implant arthroplasty cases in 17 patients aged 62 years on average, among which 12 were females. A volar approach was performed in 9 cases (group I) and a dorsal approach was performed in 12 cases (group II)...
April 2018: Hand Surgery and Rehabilitation
A Marzouki, B Soumare, A S Diarra, K Lahrach, F Boutayeb
The aim of this study was to evaluate the results of percutaneous screw fixation of scaphoid waist fractures in our surgery unit by comparing them with recent data from the literature. This was a retrospective, descriptive study conducted between January 2010 and September 2016. Patients operated due to a recent scaphoid fracture and treated by percutaneous anterograde screw fixation with a Herbert screw were included in this study. Our cohort was a sub-set from a scaphoid fracture group; other fracture sites, other treatment techniques and fractures associated with scapholunate ligament lesions were excluded...
April 2018: Hand Surgery and Rehabilitation
L K Head, R Bradley, M Momtazi
We report a case of synovial chondromatosis of the wrist that manifested as acute carpal tunnel syndrome. The patient successfully underwent carpal tunnel release, tenosynovectomy and resection of dorsal and volar ossified bodies embedded in the tenosynovium overlying the wrist. Final histopathology confirmed the diagnosis of synovial chondromatosis. The patient's symptoms of pain, numbness, and paresthesia in a median nerve distribution resolved completely and the patient resumed full-time work in the service industry 4-weeks postoperatively with no functional limitations...
April 2018: Hand Surgery and Rehabilitation
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