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hand injury tendons

Nicholas Pulos, Sanjeev Kakar
Injuries to the hands and wrist are common in athletes. Injuries include acute fractures, dislocations, ligamentous, and tendon injuries, as well as more chronic injuries such as sprains and strains. Complications in the treatment of sports injuries of the hand and wrist may be divided into 2 categories: incorrect or delayed diagnosis and iatrogenic injury related to treatment. This article highlights common sports injuries of the hand and wrist and their complications, and includes tips for successful management...
April 2018: Clinics in Sports Medicine
Marta Kierzkowska, Piotr Pędzisz, Ireneusz Babiak, Jakub Janowicz, Mateusz Kulig, Anna Majewska, Anna Sawicka-Grzelak, Grażyna Młynarczyk
Most Clostridium species are part of saprophytic microflora in humans and animals; however, some are well-known human pathogens. We presented the challenges in identifying the Clostridium species isolated from a patient with an infected open dislocation of the proximal interphalangeal joint of the fourth digit of the right hand. The clinical materials were intraoperative samples collected from a patient diagnosed with an injury-related infection, with soft tissue loss and tendon sheath involvement. The available biochemical, molecular, and genetic techniques were used in identifying the isolated bacteria...
March 9, 2018: Folia Microbiologica
N Alnaif, S Alrobaiea, Alain J Azzi, S Thibaudeau, M H Martin
Isolated avulsion fracture of the extensor carpi radialis longus (ECRL) tendon is a rare and poorly understood injury. We present a unique case of a 45-year-old male who fell on his flexed right hand. He presented with a subtle but extremely painful mass on the dorsum of his wrist. Ultrasound (U/S) imaging of the mass revealed an avulsed bone fragment attached to the ECRL tendon, confirming the clinical suspicion of an ECRL avulsion injury. Computed tomography and magnetic resonance imaging are well-documented imaging modalities to detect tendon avulsions...
March 7, 2018: Skeletal Radiology
Jason Silvestre, Joseph Upton, Benjamin Chang, David R Steinberg
BACKGROUND: Hand surgery fellowship programs in the United States are predominately sponsored by departments or divisions of orthopaedic surgery or plastic surgery. This study compares the operative experiences of hand surgery fellows graduating from orthopaedic or plastic surgery hand surgery fellowships. METHODS: Operative case logs of 3 cohorts of hand surgery fellows graduating during the academic years of 2012-2013, 2013-2014, and 2014-2015 were analyzed. The median case volumes were compared by specialty via Mann-Whitney U tests...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Michael P Gaspar, Julie E Adams, Ralph C Zohn, Sidney M Jacoby, Randall W Culp, A Lee Osterman, Patrick M Kane
BACKGROUND: The purpose of this study was to report our long-term outcomes following reconstruction of the forearm interosseous membrane (IOM) with bone-patellar tendon-bone (BPTB) graft for treatment of chronic Essex-Lopresti injuries. METHODS: We identified 33 patients who underwent IOM reconstruction with BPTB graft for chronic Essex-Lopresti injuries over a 20-year treatment interval. Twenty male and 13 female patients, with a mean age of 42.1 years (range, 19 to 73 years) and a minimum follow-up interval of 5 years, were included...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Enqi Guo, Qingping Xie, Ziguan Zhu, Peihong Jin, Peihong Jin, Liang Wang
Management of hand and foot defects with exposed tendons is a big challenge for plastic surgeons. Thin vascularized tissue offers an ideal surface for tendon excursion. OBJECTIVE: This study examines the reconstructive benefits of a laparoscopy-assisted chimeric peritoneal-deep inferior epigastric artery perforator (DIEP) flap in the treatment of hand and foot injury defects. MATERIALS AND METHODS: A retrospective review was performed on 8 patients (6 men, 2 women) that received hand or foot reconstruction with laparoscopy-assisted chimeric peritoneal-DIEP flap...
February 2018: Wounds: a Compendium of Clinical Research and Practice
G Rahmani, J Martin-Smith, P Sullivan
Accidental self-inflicted knife injuries to digits are a common cause of tendon and nerve injury requiring hand surgery. There has been an apparent increase in avocado related hand injuries. Classically, the patients hold the avocado in their non-dominant hand while using a knife to cut/peel the fruit with their dominant hand. The mechanism of injury is usually a stabbing injury to the non-dominant hand as the knife slips past the stone, through the soft avocado fruit. Despite their apparent increased incidence, we could not find any cases in the literature which describe the "avocado hand"...
December 18, 2017: Irish Medical Journal
F Unglaub, M F Langer, J M Unglaub, L P Müller, P Hahn, C K Spies, S Löw
Due to the exposure of the hands in the daily routine, defect wounds of the hand are common. The injury severity varies and ranges from small fingertip defects to large soft tissue lesions with exposed tendons, nerves and vessels. The complete extent of the soft tissue defect is often only recognizable after meticulous debridement. A considerable variety of techniques for defect coverage are available to the surgeon but the actual challenge is to select the most appropriate procedure which will result in the smallest possible residual defect...
February 20, 2018: Der Unfallchirurg
Haroldo Junior Fiorini, Marcel Jun Tamaoki, Mário Lenza, Joao Baptista Gomes Dos Santos, Flávio Faloppa, Joao Carlos Belloti
BACKGROUND: Trigger finger is a common clinical disorder, characterised by pain and catching as the patient flexes and extends digits because of disproportion between the diameter of flexor tendons and the A1 pulley. The treatment approach may include non-surgical or surgical treatments. Currently there is no consensus about the best surgical treatment approach (open, percutaneous or endoscopic approaches). OBJECTIVES: To evaluate the effectiveness and safety of different methods of surgical treatment for trigger finger (open, percutaneous or endoscopic approaches) in adults at any stage of the disease...
February 20, 2018: Cochrane Database of Systematic Reviews
K Yammine, M Erić
Agenesis, functional deficiency and the common type of the flexor digitorum superficialis of the little finger are reported in the literature to be highly variable with significant discrepancy between clinical and cadaveric frequencies. The aim of this systematic review was to generate overall clinical and cadaveric weighted frequencies, along with ancestry-based, side-based, sex-based and laterality-based frequencies. A systematic literature search identified 34 studies including 12,213 forearms/hands that met the inclusion criteria...
February 12, 2018: Hand Surgery and Rehabilitation
Lina Bunketorp Käll, Robert J Cooper, Johanna Wangdell, Jan Fridén, Malin Björnsdotter
BACKGROUND: Tendon transfer is a surgical technique for restoring upper limb motor control in patients with cervical spinal cord injuries (SCI), and offers a rare window into cortical neuroplasticity following regained arm and hand function. OBJECTIVE: Here, we aimed to examine neuroplasticity mechanisms related to re-established voluntary motor control of thumb flexion following tendon transfer. METHODS: We used functional Magnetic Resonance Imaging (fMRI) to test the hypothesis that restored limb control following tendon transfer is mediated by activation of that limb's area of the primary motor cortex...
2018: Restorative Neurology and Neuroscience
Paweł Reichert, Aleksandra Królikowska, Jarosław Witkowski, Łukasz Szuba, Andrzej Czamara
BACKGROUND Although iatrogenic posterior interosseous nerve (PIN) palsy is an uncommon complication of ruptured distal biceps brachii tendon surgical anatomical reinsertion, it is the most severe complication leading to functional limitation. The present study investigated possible types of PIN palsy as a postoperative complication of anatomical distal biceps tendon reinsertion, and aimed to clinically assess patients at 2 years after its surgical treatment. MATERIAL AND METHODS The studied sample comprised 7 male patients diagnosed with an iatrogenic PIN palsies after anatomical reinsertion of the distal biceps tendon, who were referred to the reference center for management of a peripheral nervous system injury...
February 7, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Khalid Al-Hourani, David Gamble, Paul Armstrong, Greg O'Neill, James Kirkpatrick
BACKGROUND: Fast and accurate diagnosis of conditions of the hand and wrist is essential in guiding management. We aimed to analyse the predictive value of ultrasound in identifying different pathologies in the hand and wrist by correlating pre-operative ultrasound findings with per-operative surgical findings. METHODS: We retrospectively reviewed the case notes of all patients under the care of the senior author on whom a hand/wrist ultrasound had been performed between January 2007-May 2013...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Vinícius Alexandre de Souza Almeida, Carlos Henrique Fernandes, João Baptista Gomes Dos Santos, Francisco Alberto Schwarz-Fernandes, Flavio Faloppa, Walter Manna Albertoni
Objective: To measure the reliability of Albertoni's classification for mallet finger. Methods: Agreement study. Forty-three radiographs of patients with mallet finger were assessed by 19 responders (12 hand surgeons and seven residents). Injuries were classified by Albertoni's classification. For agreement comparison, lesions were grouped as: (A) tendon avulsion; (B) avulsion fracture; (C) fracture of the dorsal lip; and (D) physis injury-and subgroups (each group divided into two subgroups)...
January 2018: Revista Brasileira de Ortopedia
Narayanamurthy Sundaramurthy, Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj
Background: Fingertip injuries that are complicated by pulp loss, bone or tendon exposure will need a flap cover. Cross finger flap is commonly used to cover such defects. However, patients are apprehensive about injuring the uninjured finger as a donor site. Reverse homodigital artery flap (RHAF) can provide reliable vascularised cover to such defects. Aims: This study aims to assess the functional and aesthetic outcomes along with the patient satisfaction of RHAFs done for fingertip defects...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Mohit Sharma, Subramania Iyer, P Kishore, Jimmy Mathew, Raghuveer Reddy, Janarthanan Ramu, Sundeep Vijayaraghavan, Abhijeet Wakure, S M Mali Chetan, Visakh Varma, Ashish Chaudhari, Swapnil Dhake, Akshay Omkumar, Jerry Paul, Sunil Rajan, Ayyappan Nair, Druvan Shaji
Introduction: This article deals with two patients who underwent bilateral hand transplantation following amputation of both upper limbs at the distal third of the foream. Materials and Methods: The first patient had a history of loss of hands in a train accident , with possiblity of a run over element during the injury. The second patient lost his both hands in a mine blast. The preoperative work up included detailed clinical and psychological evaluation. The donor retrieval was similar in both the cases and the donors were housed in our own instittution...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Julie A Neumann, Christopher M Klein, Carola F van Eck, Hithem Rahmi, John M Itamura
Background: Avoiding delay in the surgical management of pectoralis major (PM) ruptures optimizes outcomes. However, this is not always possible, and when a tear becomes chronic or when a subacute tear has poor tissue quality, a graft can facilitate reconstruction. Purpose: The primary aim was to evaluate the clinical outcomes of PM reconstruction with dermal allograft augmentation for chronic tears or for subacute tears with poor tissue quality. A second aim was to determine patient and surgical factors affecting outcome...
January 2018: Orthopaedic Journal of Sports Medicine
Christopher S Klifto, John T Capo, Anthony Sapienza, S Steven Yang, Nader Paksima
Flexor tendon injuries of the hand are uncommon, and they are among the most challenging orthopaedic injuries to manage. Proper management is essential to ensure optimal outcomes. Consistent, successful management of flexor tendon injuries relies on understanding the anatomy, characteristics and repair of tendons in the different zones, potential complications, rehabilitation protocols, recent advances in treatment, and future directions, including tissue engineering and biologic modification of the repair site...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
Y M Shen, C X Ma, F J Qin, C Zhang, C Wang, X H Hu
Objective: To explore the methods and effects of wound repair and functional reconstruction of high-voltage electrical burns in wrists. Methods: From January 2009 to June 2016, 71 patients with high-voltage electrical burns in wrists were hospitalized, with 118 wrist wounds including 21 of type Ⅰ, 69 of type Ⅱ, 9 of type Ⅲ, and 19 of type Ⅳ. According to the wrist injuries, different surgical operations were performed. Forearm amputation was conducted in 20 wrists with necrosis in the distal end. On the basis of fasciotomy for decompression, early debridement was performed on the other 98 wrist wounds...
December 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
A Duprat, L-E Gayet, C Breque, M Freslon
Tendon grafts are a component of the therapeutic arsenal for managing chronic flexor tendons injuries in the hand, especially during two-stage Hunter reconstruction. The purpose of this anatomical study was to compare the strength of the Pulvertaft weave versus the step-cut suture used for flexor tendon reconstruction to determine their role in early active mobilization. We performed a biomechanical study with cadaver specimens. Thirty-four hands were randomized and the tendons from both hands were equally assigned to each group...
February 2018: Hand Surgery and Rehabilitation
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