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A patient presenting with acute carpal tunnel syndrome and swelling and pain in the wrist and thumb is presented. An open carpal tunnel release and tenosynovectomy were performed with biopsy specimen revealing infection with Histoplasma capsulatum . The case is discussed in context of the prior scant literature of tenosynovitis of the wrist and hand caused by histoplasmosis. ...
Background Peripheral nerve transfers are being used to improve upper extremity function in cervical spinal cord injury (SCI) patients. The purpose of this study was to evaluate feasibility and perioperative complications following these procedures. Methods Eligible SCI patients with upper extremity dysfunction were assessed and followed for a minimum of 3 months after surgery. Data regarding...
Background Our purpose was to compare the outcomes of patients with severe basilar thumb osteoarthritis treated with trapeziectomy and suspensionplasty using abductor pollicis longus (APL) tendon versus a suture button device. Methods A retrospective study was performed for patients undergoing trapeziectomy and suspensionplasty with APL tendon or suture button fixation. Outcome measures...
Purpose Complications in metacarpal fracture treatment increase in proportion to the severity of the initial injury and the invasiveness of the surgical fixation technique. This manuscript evaluates the feasibility of minimizing internal fixation construct size and soft tissue dissection, while preserving the advantages of stable internal fixation in a biomechanical model. We hypothesized that...
Background Fingertip injuries are common in the pediatric population. Composite grafting is a frequently used technique for distal amputations in children given the reported success rate. We sought to study the early clinical results of composite grafting for fingertip injuries in the pediatric population. Methods A retrospective review was performed over a 5-year period at a tertiary...
Fibrokeratoma is a benign fibrous tumor which usually arises in fingers and toes. Tumor size is usually small, around 3–5 mm. We report a giant acquired periungual fibrokeratoma of the thumb in this study. The size of the tumor is 40 × 25 × 21 mm 3 . Clinical and histopathological characteristics of acquired fibrokeratoma are also reviewed.
Although airbags are designed to save lives and protect victims from serious injuries, airbag deployment can cause unwanted lesions. In this case report, two cases are presented of young women who sustained an important fracture dislocation of the first carpometacarpal joint (CMC I joint) caused by airbag deployment during a car collision.
Purpose This study was conducted to compare the in vitro biomechanical properties of tensile strength and gap resistance of a double grasping loop (DGL) flexor tendon repair with the established four-strand cross-locked cruciate (CLC) flexor tendon repair, both with an interlocking horizontal mattress (IHM) epitendinous suture. The hypothesis is that the DGL-IHM method which utilizes two looped core...
Background The purpose of this study is to evaluate the outcome of closed reduction and percutaneous Kirschner wire pinning in acute dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint. Methods Eight men and one woman were treated with closed reduction and percutaneous Kirschner wire pinning by one orthopaedic surgeon. The ring finger was injured in six patients, the...
Background Although precise ulna-shortening osteotomy is popular, the procedure sometimes results in delayed union or nonunion. The periosteum including the inner cambium layer plays an important role in fracture healing. We tested the hypothesis that preservation of the corticoperiosteal attachment may accelerate healing at osteotomy sites after ulna-shortening osteotomy. Methods We performed...
Background The sural nerve is the most common nerve graft donor despite requiring a second operative limb and causing numbness of the lateral foot. The purposes of this study were to review our experience using nerve autografts in upper extremity nerve reconstruction and develop recommendations for donor selection. Methods A retrospective case series study was performed of all consecutive patients...
Extensor tendon injuries in the pediatric population require careful evaluation and treatment. This article focuses on the differences in injury type and treatment of pediatric versus adult extensor tendon injuries. A detailed history and physical examination is crucial in the management of extensor tendon injuries of the young patient. Treatment of pediatric extensor tendon injuries depends largely...
Background We prospectively studied patients clinically diagnosed with carpal tunnel syndrome (CTS) and treated with the injection of corticosteroid into their carpal tunnel in order to compare changes in the six-item CTS symptoms scale and portable nerve conduction study (NCS) parameters as outcome tools. Our pilot study was the first to assess the utility of the six-item CTS symptom scale (CTS-6)...
Background Thumb hypoplasia and thenar muscle anomalies are complex congenital conditions that are associated with other congenital anomalies or syndromes. Congenital absence of the opponens pollicis muscle is very rare and is associated with the absence of other muscles. Methods A 6-year-old male was referred to our clinic with a provisional diagnosis of carpal tunnel syndrome because...
Background This study aims to compare surgical outcomes of severe carpal tunnel syndrome (CTS) treated with mini-incision versus extensile release. Methods The method employed in this study was a retrospective review of patients with severe CTS, defined by electrophysiologic studies showing non-recordable distal sensory latency of the median nerve. Patients underwent either a mini-incision...
Background Generic upper extremity disability questionnaires utilize standardized items. The Patient-Specific Functional Scale (PSFS) allows the patient to identify specific self-reported items. This study evaluated the validity of the PSFS to assess outcome in patients with hand fractures or dislocations. Methods Adults with hand fractures or dislocations, who completed hand therapy between...
Introduction Traumatic tendon lacerations are a common problem encountered by hand surgeons worldwide. Although the use of barbed suture to repair tendon lacerations has gained theoretical popularity in recent years, there is little information available regarding the safety, efficacy, longevity, or complications encountered when used in tenorraphy. In this study, we review the available literature...
Background Enchondromas are benign cartilaginous tumours. The most common location is in the long bones of the hand. Treatment methods fall into a broad spectrum ranging from conservative, medical therapies, to a variety of surgical procedures, which may or may not employ the use of local adjuvant treatment or bone grafting. The purpose of this study was to report our experience and evaluate the...
Carcinoma of the oesophagus metastasizes to distant sites in approximately one third of cases and rarely involves the upper limb bones. We describe three such rare cases of isolated metastasis to upper limb bone from oesophageal cancer.
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