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Journal of Hand Surgery Asian-Pacific Volume

Hiroshi Yamazaki, Toshiysasu Sakurai, Shigeharu Uchiyama, Hiroyuki Kato
BACKGROUND: There are several methods for measuring edema of the hand. While the volumetric techniques, finger circumference measurement, and figure-of-eight techniques have undergone extensive psychometric testing, alternative methods of measuring hand size, such as circumferential finger size determination using a ring gauge (ring gauge method; RGM) and tape measurement of hand girth taken along the distal palmar crease (metacarpal head tape measure method; MHTM), have not. This study's aim is to examine the reliability and validity of the RGM and the MHTM...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Helen M A Ingoe, Jonathan F O'Hare, Alan Middleton
BACKGROUND: Arthrodesis of the distal interphalangeal (DIP) joint reliably improves symptomatic arthritis. A range of successful surgical techniques including tension band wiring, plate fixation and headless compression screws have been described and produce stable painless unions. For best functional outcome, the fusion angle should be between 10 and 61 degrees. In the past, it has been difficult to achieve more than 10 degrees of flexion with a headless compression screw. Higher fusion angles have been reported using tension band wiring techniques...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Koji Sukegawa, Kazuki Kuniyoshi, Takane Suzuki, Yusuke Matsuura, Kenji Onuma, Tomonori Kenmoku, Masashi Takaso
BACKGROUND: This study aimed to investigate whether the distance between the radial nerve and rotational center of the elbow joint when observing from the lateral surface of the humerus changes according to passive elbow joint flexion for safe external fixation with a hinged fixator of the elbow joint. METHODS: Twenty fresh-frozen cadaveric arms were dissected. The points where the radial nerve crosses over the posterior aspect of the humerus, crosses through the lateral center, and crosses over the anterior aspect of the humerus were defined in the lateral view of the elbow joint, using fluoroscopy, as R1, R2, and R3, respectively...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Hideki Okamoto, Isato Sekiya, Jun Mizutani, Nobuyuki Watanabe, Takanobu Otsuka
BACKGROUND: Arthroscopy is a widely used minimally invasive technique. Nevertheless, no report describes the arthroscopic anatomy of the proximal interphalangeal (PIP) joint for portal creation. To facilitate arthroscopy, this study elucidated the anatomy of the lateral bands of the extensor mechanism and collateral ligaments of PIP joints. METHODS: A total of 39 fingers from the right hands of 10 cadavers (4 males, 6 females) were evaluated in this study. We defined the extension line from the proximal interphalangeal volar crease as the C-line...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Andrew K Sefton, Belinda J Smith, David A Stewart
BACKGROUND: Dupuytren's disease results in contracted cords in the hand that lead to deformity and disability. Current treatment options include fasciectomy and an injectable, collagenase clostridium histolyticum. No cost comparison studies have been published within the Australian health care environment. METHODS: A retrospective review of all patients treated for Dupuytren's disease in a major teaching hospital was undertaken to compare the costs of treatment by fasciectomy or collagenase injection...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Michael Lonne, David S Sparks, Carl Stephan, Michael Wagels, Anthony Berger
BACKGROUND: The Extensor Pollicis Brevis (EPB) is an extrinsic thumb muscle whose main function is extension of the first metacarpophalangeal joint (MCPJ). It is subject to significant anatomical variation and may be absent, vestigial or have an anomalous distal attachment. Clinical examination of EPB is notoriously difficult and no reliable test has yet been described. We propose a novel test for the accurate examination of EPB. We sought to clarify the anatomical variations of EPB and to validate our clinical test using human cadaveric anatomical tests...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Suresh K Nayar, Anne M Kuwabara, José M Flores, Greg M Osgood, Dawn M LaPorte, Babar Shafiq
BACKGROUND: Venous thromboembolism (VTE) has been studied in lower extremity fractures but little is known of its relation with upper extremity (UE) fractures. As an often overlooked but serious complication, VTE may compromise patient outcomes. METHODS: Using data on inpatients (aged ≥ 18 years) at a level-I trauma center and patients in the National Surgical Quality Improvement Program database who sustained UE fractures (clavicle, humerus, or radius/ulna) and VTE in the same hospitalization between 2007 and 2014, the authors analyzed data on demographic characteristics, fracture type, VTE location (pulmonary embolism, lower extremity, or UE), VTE onset, polytrauma, operative or nonoperative management, comorbidities, and mortality...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Jae-Hwi Nho, Sang-Woo Lee, Mi-Ae Nam, Byung-Sung Kim, Ki Jin Jung
Avulsion fracture of the volar base of the distal phalanx is a rare injury. Zone 1 flexor tendon injuries can be treated with either internal or external fixation techniques. Pull-out suture repairs are often used for FDP tendon avulsion injuries. However, the pull out suture technique is associated with a number of well documented complications including nail bed injury and pressure necrosis. Despite the variety of techniques available for the repair of acute distal zone 1 flexor tendon injuries, no one technique has proven to be superior to all others...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Takako Kanatani, Issei Nagura, Yoshifumi Harada
We describe our injection method for Collagenase Clostridium Histolyticum using a medical silicone tube after determining the optimal depth by ultrasonography. This procedure adjusts the exposed needle length to the planned injection depth by placing a sterilized silicone tube over the needle. The restricted depth provides not only precise injection into the middle of the cords but also avoids needle tip migration through the cord and into the vital structures, which prevents possible complications. This method is safe and simple...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Shingo Komura, Akihiro Hirakawa, Yasuharu Matsushita, Tomihiro Masuda, Marie Nohara, Haruhiko Akiyama
A 16-year-old man sustained a minor penetrating injury to his forearm, resulting in pseudoaneurysm formation that caused acute compartment syndrome with muscle contracture. Surgical treatment, including fasciotomy, evacuation of the hematoma and aneurysmectomy, followed by intensive hand therapy provided a successful outcome. Traumatic pseudoaneurysm after penetrating injury is a rare cause of acute forearm compartment syndrome. Although minor penetrating injuries tend to be underestimated, this type of injury can cause subsequent serious pathological conditions...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Seung Hoo Lee, Ki Ho Lee, Hye Jin Yoo
A 20-year-old male has presented with mild numbness and tingling sensation at 4, 5th finger of his left hand. Simple radiograph and MRI images revealed bony mass at medial joint space of ulno-humeral joint. After surgical exploration, we found that there were two cause of ulnar nerve irritation symptom. Fixed ulnar nerve position at anterior aspect to medial condyle with deficiency of nerve gliding was one cause, and friction irritation around bony mass was another. It is rarely reported that ulnar nerve always travels to the anterior side of the medial condyle of the elbow, and there are no cases involving skeletal variation...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
L Giwa, A Siddiqui, G Packer
BACKGROUND: The Motec cementless modular metal-on-metal ball-and-socket wrist arthroplasty is an implant with promising intermediate results. An alternative to primary wrist fusion, total wrist arthroplasty is an option for active patients, who wish to retain their wrist function. It is indicated in cases of degenerative osteoarthritis, post-traumatic arthritis and rheumatoid (inflammatory) arthritis. METHODS: A prospective review of patient demographics, pre and post-operative Disabilities of the Arm Shoulder and Hand (DASH), MAYO scores, range of movements and grip strengths...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Seung-Han Shin, Il-Kyu Park, Jin-Woo Kang, Yong-Suk Lee, Yang-Guk Chung
BACKGROUND: Purulent musculoskeletal infections often require surgical debridement and drainage. However, when the infection is extensive or involving multiple layers of tissues, maintaining drainage of the involved spaces can be difficult, even with the application of vacuum-assisted closure (VAC) therapy. Wide exposure and aggressive debridement is often required for such cases, which in turn may complicate wound coverage. METHODS: A retrospective review was performed for 16 patients with musculoskeletal infections treated surgically...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Panai Laohaprasitiporn, Saichol Wongtrakul, Torpon Vathana, Roongsak Limthongthang, Panupan Songcharoen
BACKGROUND: The finding of pseudomeningocele from cervical myelogram is widely accepted as a pathognomonic sign for diagnosing root avulsion in brachial plexus injury. In general, motor power in this setting should be absent. However, in clinical practice, we observed that motor power in some patients was still preserved. The objective of this study is to evaluate the accuracy of pseudomeningocele from cervical myelogram for predicting root avulsion in brachial plexus injury. METHODS: We retrospectively reviewed 201 patients with brachial plexus injury from 2007-2011...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Konrad Mende, Michael A Tonkin
In severe carpal tunnel syndrome a continuum of neural changes takes place depending on the degree and duration of the compression, beginning with breakdown of the blood-nerve barrier, followed by endoneurial oedema and, subsequently, perineurial thickening and ischemia. Persisting chronic compression will eventually result in axonal degeneration. We report a case of longstanding carpal tunnel syndrome with amyloid deposits and the unusual intraoperative 'Austrian flag' sign.
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Rashad H Usmani, Samuel S Abrams, Gregory A Merrell
BACKGROUND: To identify the time course for efficacy of corticosteroid injections in the treatment of trigger finger. METHODS: A prospective single-center observational study was conducted, consisting of 38 patients with 41 trigger digits that were injected. Enrolled patients completed an initial Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire to determine the severity of their symptoms. Following the injection, patients were contacted at scheduled time points for up to 12 weeks to determine if, and when, objective resolution of symptoms occurred...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Ryan A Odgers, Ghazi M Rayan
BACKGROUND: The objective was to quantify joint laxity in healthy volunteers by measuring the passive axial rotation of the trapeziometacarpal joint using the axial rotation test. METHODS: Eighty volunteers (34 men and 46 women) were subjected to the axial rotation shear test and the degree of total rotational motion (TRM) was assessed. Volunteers were divided into Group I with a range of 18-50 years old and Group II for 51 years and older. Statistical analysis was performed...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Deepak Samson, Manish Gupta
BACKGROUND: The terminal phalanx of the fingers carries the attachment of the Flexor Digitorum Profundus (FDP) on the volar surface and the extensor on the dorsal surface. Avulsion of these tendons has traditionally been repaired with pull-through sutures. Recently, bone anchor sutures have been found to be of comparable biomechanical strength but with the added advantage of technical ease and fewer complications. However, the dimensions of the bone, at the site of insertion of the anchors, have never been studied...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Ines C Lin, Alexander Y Shin, Allen T Bishop
Arthroscopic dorsal wrist ganglionectomy is demonstrably a safe procedure with recurrence rates comparable to open surgery. We present a patient with wrist pain following arthroscopic ganglion excision. MRI and arthroscopic findings showed a large dorsal capsular defect, synovial fistula to the fourth extensor compartment, and dorsal radiocarpal ligament resection. Ligament reconstruction and capsular imbrication resolved her symptoms. We postulate that this complication resulted from a large capsular resection...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Sakiko Mizuno, Kensuke Ochi, Jun Miyauchi, Itsuo Watanabe, Hiraku Hotta, Ukei Anazawa
A liposarcoma is extremely rare in the digits. A 73-year-old woman was diagnosed with a lipoma in her middle finger 10 years ago. As this tumor increased in size and presented with imaging findings that were atypical of lipomas, careful marginal resection biopsy outside the pseudo-capsule was performed, and the tumor was diagnosed as a well-differentiated liposarcoma. At the 5-year follow-up, the patient showed no evidence of local recurrence or metastasis, with no loss of hand function. The findings from this case suggest that even for a lipomatous tumor in the digits, further imaging examination and resection biopsy should be considered if the tumor presents with features that are atypical of lipomas...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
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