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Background Definitive diagnosis of occult scaphoid fractures remains difficult. We tested the null hypothesis that, for diagnosis of true fractures among suspected scaphoid fractures, computed tomography (CT) reformations along the long axis of the scaphoid have the same accuracy as reformations made relative to the anatomical planes of the wrist. Methods In a prospective trial, 34 patients with...
Metacarpal fractures comprise between 18–44 % of all hand fractures. Non-thumb metacarpals account for around 88 % of all metacarpal fractures, with the fifth finger most commonly involved [19]. The majority of metacarpal fractures are isolated injuries, which are simple, closed, and stable. While many metacarpal fractures do well without surgery, there is a paucity of literature and persistent controversy...
Background Over the past five decades, microsuturing has been established as the “gold standard” for nerve repair. Alternative techniques such as fibrin glue, protein “welds”, and nerve connectors have been met with variable enthusiasm. While advancements in this area continue, there is little data on surgeon attitude and acceptance of these new techniques. Methods A short questionnaire was electronically...
Purpose The purpose of this experiment was to determine the effect of A2 pulley reconstruction on gliding coefficient (GC), bowstringing, and proximal interphalangeal (PIP) joint maximum flexion angle after zone II repair of flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) lacerations. Methods Fresh frozen cadaver forearms were mounted, and the wrist and MCP joints fixed...
Background When performed alone, endoscopic carpal tunnel release and endoscopic cubital tunnel release are safe and effective surgical options for the treatment of carpal and cubital tunnel syndromes, respectively. However, there is currently no literature that describes the performance of both procedures concomitantly. We describe the results of 17 cases in which dual endoscopic carpal and cubital...
Background MRI has been shown to be highly accurate in assessing collateral ligament injuries of the metacarpophalangeal joint (MPJ) of the thumb. The purpose of this study is to evaluate the accuracy of MRI for diagnosing collateral ligament tears of the MPJ of the fingers. Our hypothesis is that MRI would accurately detect complete tears of collateral ligaments of the lesser digit MPJs. Methods...
Background This study investigated the effects of a series of four hypertonic dextrose injections on the subsynovial connective tissue (SSCT) and median nerve within the carpal tunnel of a rabbit model. Methods Twenty New Zealand white rabbits were used. One forepaw carpal tunnel was randomly injected with 0.1 ml of 10 % dextrose solution. The contralateral forepaw was injected with a similar amount...
Background The authors report the use of a single slip of the flexor digitorum superficialis (FDS) as a hemitenodesis through the A2 pulley in treating swan neck deformities after previous unconstrained proximal interphalangeal joint (PIP) arthroplasty. Methods A retrospective chart review was undertaken to identify non-constrained PIP joint arthroplasties that underwent a subsequent soft tissue...
Background Patient expressions reflect disability and psychological factors. The aim of this study was to list common phrases and feelings in hand surgery practice and to prospectively study the correlation of these phrases and to correlate them with possible associated feelings and disability. Methods Eighty-three patients completed the short version of the disabilities of arm, shoulder and hand...
Background We examined the fellowship experience of hand surgeons in the USA to identify gaps and variations in exposure to essential skills and knowledge during hand fellowship. Methods We conducted a web-based survey of the entire American Society for Surgery of the Hand and American Association for Hand Surgery membership. We inquired about the level of exposure received to 170 knowledge topics...
Background Socioeconomic factors have been found to be predictors of outcome for other ailments. The purpose of this study was to evaluate the association of patient education level on pain and disability after distal radius fracture. Methods A series of patients with distal radius fractures (n = 335) were enrolled into a prospective research registry. Standard demographic information was obtained...
Background This review article critically examines the current literature for Dupuytren's disease. Methods Five procedures are considered: dermofasciectomy, limited fasciectomy, segmental aponeurectomy, needle aponeurotomy, and collagenase injection. Studies regarding the efficacy of these treatments focus primarily on the initial degree of correction, rate of recurrence, and complications...
Purpose The A2 and A4 pulleys have been shown to be important in finger flexor tendon function. Other authors have suggested either reconstruction or venting of portions of these pulleys in an attempt to preserve finger function in certain clinical situations. This study examines the effects of partial incision of these pulleys on finger flexion kinematics and biomechanics. Methods The index and...
Background Carpal tunnel syndrome (CTS) is the most commonly diagnosed and treated entrapment neuropathy. There is no consensus regarding the optimal technique for carpal tunnel release. The objective of this study is to demonstrate the surgical treatment of CTS by a small palmar incision and utilization of Paine retinaculotome to divide the transverse carpal ligament. Methods In this technical...
Background This study aims to evaluate the incidence of forearm soft tissue abnormalities associated with radial head fracture severity based on the Mason classification system. Methods Eighteen patients (age 18–45 years) were prospectively evaluated with elbow radiographs and magnetic resonance imaging (MRI) following longitudinal forearm trauma. MRI was performed within 10 days of the initial...
Background This study analyzes both the subjective and objective symptom and functional outcomes of patients who underwent either traditional single-incision or two-incision carpal tunnel release (CTR). Methods From 2008 to 2009, patients with isolated carpal tunnel syndrome were randomized to undergo either single-incision or two-incision CTR by a single surgeon at a university medical center....
The human fingernail contributes to the precise dexterity of the fingers, enhances sensibility, allows manipulation of fine objects, and shields the fingertip from traumatic injury. Nail abnormalities are a common incidental finding in the course of a hand surgeon’s daily practice. These abnormalities may be clues to systemic, dermatologic, traumatic, and infectious processes that would benefit from...
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