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Failure to provide a balanced evidence-based consideration of the role of activity in illness can stigmatize individuals and their activities. We assessed the prevalence of language that stigmatized repetitive hand use and those that use their hand repetitively in newspaper coverage of common hand illnesses. The LexisNexis Academic database was used to search five major US newspapers for articles...
We report the unusual case of a patient with systemic lupus erythematosus (SLE)-associated arthritis mutilans. Arthritis mutilans is a variant of erosive arthritis that is more commonly reported with psoriatic and rheumatoid arthritis and not with SLE. Joint fusion has been shown to be the most effective measure to preserve bone length and prevent further erosive joint changes in arthritis mutilans...
Dorsally angulated malunions of the distal radius have historically been corrected with an opening wedge osteotomy fixed with a dorsal plate. Volar locking plates may facilitate a less morbid approach to corrective osteotomies of the wrist. Eight consecutive patients with an average age of 40 years (range, 15–52 years) underwent correction of a distal radius deformity through a volar approach. Clinical...
Rock climbing has become increasingly more popular in the USA over the past two decades. Accordingly, with increased participation comes an increase in climbing-related injuries. Rooks et al noted that three-quarters of elite and recreational climbers will suffer upper extremity injuries, approximately 60% involving the hand or wrist and 40% divided evenly between the shoulder and elbow. Most of these...
This study attempted to determine the safety of percutaneous release of trigger fingers, with particular attention given to border digits and the thumb. We performed percutaneous release of the A1 pulley in six fresh frozen cadaveric hands utilizing established surface landmarks. After freezing all specimens, we performed cross-sections at the A1 pulley, avoiding dissection of soft tissues, which...
Chronic osteomyelitis is difficult to resolve and usually requires radical debridement, filling of dead space, and a well-vascularized tissue to cover the involved bone. In the tibia, this is frequently accomplished with free vascularized muscle transfer and success rates over 90% for cases of limited involvement but lower success for diffuse involvement. Elbow joints, with advanced arthritis but...
Composite tissue allotransplantation holds great promise for upper extremity reconstruction but is limited by donor part availability. Cryopreservation may increase the availability of donor parts and even reduce antigenicity. The purpose of the study was to evaluate the viability of cryopreserved composite tissues and to demonstrate the feasibility of microvascular isotransplantation of cryopreserved...
A 1-year-old boy presented to us with congenital inability to flex his elbow. He had bilaterally absent biceps brachii and brachialis muscles, a rare condition. We performed pedicle latissimus dorsi musculocutaneous flaps to the left and right volar upper arm at 21 and 24 months of age, respectively, to create elbow flexors. By 4 years of age, he had excellent elbow flexion bilaterally with strength...
Introduction Intra-articular distal radius fractures with volar and dorsal comminution present a special challenge to the hand surgeon. Methods Ten patients formed the study cohort. All plates were low profile and stainless steel. Radiographic parameters, range of motion, and strength compared to the uninjured side were recorded. Functional outcome was evaluated by Disabilities of the Arm, Shoulder...
Purpose Fixed-angle devices have been a major advancement in orthopedic fracture care and have become an attractive option for fixation of distal radius fractures. Several volar locking plates exist, but there is insufficient literature comparing the strengths of these plates. This study compares the biomechanical strength of two popular volar locking plate systems (Synthes LCP and Hand Innovations...
Twenty-one patients with rheumatoid arthritis who underwent Swanson metacarpophalangeal (MP) arthroplasty from 1994 to 1999 were assessed for active flexion of individual MP joints an average of 59 months (range 27–114 months) postoperative. Published articles of Swanson MP arthroplasty were reviewed. Experienced hand surgeons were surveyed regarding outcomes of metacarpophalangeal arthroplasty. The...
Subungual metastasis as a presenting feature of lung adenocarcinoma is rare and may be confused with a benign inflammatory disorder of the nail unit with subsequent diagnostic and management delay. We discuss the case of a 46-year-old man with a subungual metastasis as a presenting feature of lung adenocarcinoma.
Immobilization protocols for nondisplaced scaphoid fractures have included the elbow, wrist, and thumb. This study attempts to demonstrate whether or not immobilization of the thumb makes a difference in preventing motion at the scaphoid fracture site. Using six fresh frozen forearm specimens, a transverse waist scaphoid fracture was created through a dorsal approach. Metallic markers were imbedded...
A case of unusual displacement in a finger, with an avulsion fragment from the dorsal metacarpal head of the finger displaced in the palmar direction under the volar plate is described. An 18-year-old woman presented with complaint of difficulty flexing the metacarpophalangeal (MP) joint of the right little finger after a fall onto the outstretched hand. Three-dimensional computed tomography (CT)...
In this pilot study, hypertonic dextrose solution was used to induce fibrosis of the subsynovial connective tissue (SSCT) and create an animal model of potential use in the study of carpal tunnel syndrome (CTS). The SSCT of the carpal tunnel in 15 New Zealand white rabbits were injected with 0.05 ml of 10% dextrose solution in 1 paw and 0.05 ml of saline in the contralateral paw, to serve as a control...
A unique case of combined intrauterine vascular insufficiency and complete brachial plexus palsy is described in a newborn delivered by cesarean section. Intrauterine vascular insufficiency resulted in a right below elbow amputation at 3 weeks of age. Amputation length was preserved after a pedicled thoracoabdominal flap. Function of the C5, C6, and C7 nerve roots returned to normal by 3 months of...
Epidemiological studies conducted largely in northern Europe and Australia have shown that Dupuytren’s disease is less common in women, with reported overall male-to-female ratios ranging from 3:1 to 9.5:1. Epidemiological data from other countries cannot be extrapolated to the modern U.S. population due to genetic and environmental differences between populations. The aim of this study was to determine...
Introduction The purpose of this paper is to evaluate the Silver Bullet Wound Closure Device (SBWCD, Boehringer Laboratories, Norristown, PA), a new device for delayed primary closure of fasciotomy wounds. Materials and Methods A retrospective review was performed over a period of 36 months of all patients with an upper extremity fasciotomy that could not be closed primarily. Cases that underwent...
A change in the practice of a single surgeon provided an opportunity for retrospective comparison of comparable cohorts treated with percutaneous fixation (17 patients) or a volar plate and screws (23 patients) an average of 30 months after surgery. The final evaluation was performed according to the Gartland and Werley and Mayo rating systems and the DASH questionnaire. There were no significant...
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