251
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Reichert B, Zöphel O, Möller M, Mailänder P. [Treatment costs in initially underestimated infections of the hand]. HANDCHIR MIKROCHIR P 2001; 33:354-8. [PMID: 11600953 DOI: 10.1055/s-2001-17768] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Summary. Infections that develop as a complication of minor injuries to the hand, frequently are underestimated by the patient or by the physician initially consulted. Between 1990 and 2000, we have treated 172 in-patients as a result of this underestimation. In a retrospective study we have tried to evaluate the economic consequences. According to our results, treatment costs of 210,000 D-Mark could have been saved, if adequate treatment had been initiated on time.
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252
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Jeyaratnam TS, Ahmad TS, Kassim NM. The use of an aberrant flexor carpi ulnaris tendon with an ulnar artery island forearm flap for reconstruction of a dorsal defect of the hand. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 2001; 6:99-102. [PMID: 11677671 DOI: 10.1142/s0218810401000448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2000] [Accepted: 08/30/2000] [Indexed: 04/17/2023]
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253
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Barrie KA, Wolfe SW. The relationship of suture design to biomechanical strength of flexor tendon repairs. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 2001; 6:89-97. [PMID: 11677670 DOI: 10.1142/s0218810401000473] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2000] [Accepted: 12/11/2000] [Indexed: 11/18/2022]
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254
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Yang CH, Chung PC, Yang CH. Hand motion assessment and rehabilitation system. Biomed Mater Eng 2001; 10:131-9. [PMID: 11202143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Along with the rapid development of information technology, computers play an increasingly prominent and important role. One current trend is to use computers as instruments for physical rehabilitation. In this study, we introduce a new hand motion assessment and rehabilitation system. This system assesses a user's grip strength and records the sudden changes in air pressure through a circuit and A/D adapter. A PC interface transforms and saves the data in a data record file. The data is then compiled and combined with a patient's case history and keyed into a database as reference for clinical use. The system is highly efficient, cheap and convenient to use. Doctors can use it to monitor and analyze the progress of a rehabilitation program.
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255
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256
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Pélissier P, Riahi R, Casoli V, Martin D, Baudet J. [Terminal-lateral nerve anastomoses. Preliminary clinical report of two cases]. ANN CHIR PLAST ESTH 2001; 46:129-33. [PMID: 11340935 DOI: 10.1016/s0294-1260(01)00009-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Nerve regeneration is based on three phenomenons of critical importance: neurotropism, nerve guidance and neurotrophis. These principles allow understanding the mechanisms of nerve suture and grafting, but also the newly described end-to-side nerve anastomoses. In this procedure, the distal stump of a severed nerve is anastomosed on the lateral side of an intact nerve, with or without removal of the perineurium. Authors report their beginning experience with this procedure (ten cases) and discuss the early results. End-to-side anastomosis seems to be a useful and reliable technique for clinical nerve repair. Even if nerve grafting remains the gold standard to bridge nerve defects, one has nothing to loose if a few minutes, anastomosing the severed nerve on the lateral side of an intact nerve, rather than doing nothing.
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257
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Oberlin C, Teboul F. [Functional anatomy and evaluation of hand function]. Joint Bone Spine 2001; 68:294-303. [PMID: 11402459 DOI: 10.1016/s1169-8330(01)00031-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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258
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259
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Saraiya H. Is 20 years of immobilization, not sufficient to render metacarpophalangeal joints completely useless?--Correction of a 20-year old post-burn palmar contracture: a case report. Burns 2001; 27:192-5. [PMID: 11226662 DOI: 10.1016/s0305-4179(00)00092-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This report presents a case of post-burn palmar contracture with flexion contracture of thumb of 20-year duration. The contracture was released and the raw area was covered with split thickness skin graft. Only one 'K' wire in soft tissue was needed to keep all the fingers straight and immobilized, suggestive of intermetacarpal ligamentous contracture. A static night splint was given to maintain the correction. Complete range of movement was achieved in a month with the combination of dynamic splinting and physiotherapy. It was interesting to note that even 20 years of contracted position did not render the metacarpophalangeal joints completely stiff and useless. Probable reasons are discussed.
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260
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Zeitoun F, Dubert T, Frot B, Laredo JD. [Imaging of the wrist and of the hand: what is the best modality?]. JOURNAL DE RADIOLOGIE 2001; 82:335-52; quiz 353-4. [PMID: 11287864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The authors describe the indications for radiologic explorations in case of traumatic as well as non-traumatic conditions. In case of trauma of the wrist, the radiologic exploration looks for a fracture, a dislocation or a ligament injury. Initially, postero-antérior and lateral views must be completed with an antero-posterior view, a scaphoid incidence and an oblique view. This initial examination can be completed secondarily by specific views for the carpal bones, dynamic X-Rays, CT scan or arthro CT scan. In non-traumatic cases, radiologic explorations look for osteo-articular or soft tissue abnormalities specific of a inflammatory or degenerative disease. The initial incidence is a postero-anterior view of both hands. It can be completed secondarly by other explorations (other X-Rays, Ultra-sound, CT scan or MRI).
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261
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Patton C. Hand wounds. Assessment and treatment issues. ADVANCE FOR NURSE PRACTITIONERS 2001; 9:91-2, 102. [PMID: 12416062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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262
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Pham TN, Hanley C, Palmieri T, Greenhalgh DG. Results of early excision and full-thickness grafting of deep palm burns in children. THE JOURNAL OF BURN CARE & REHABILITATION 2001; 22:54-7. [PMID: 11227685 DOI: 10.1097/00004630-200101000-00011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The timing and method of treatment of deep palm and finger burns varies widely. Our protocol involves performing full-thickness skin grafts (FTSG) in nonhealing palm burns. We reviewed the functional and cosmetic results after FTSG to the palm. From August 1997 to April 1999, 11 patients (12 palms) underwent excision and FTSG within 2 weeks of injury. A panel of medical and nonmedical professionals evaluated follow-up pictures of the grafts at 1, 2 to 4, and beyond 4 months. Parameters used for evaluation were color match with the unburned skin (1 = no difference to 4 = large difference), graft thickness (1 = flat to 4 = markedly raised), overall appearance (1 = poor to 100 = excellent), and time to maturity. Hand function, as assessed by occupational therapy notes, was also recorded. All 12 grafted palms had a 100% take and healed with minimal scarring. Mean color match scores were 2.4 at 1 month, 1.8 at 2 to 4 months, and 1.6 beyond 4 months. On the graft thickness scale, grafts were given scores of 2.6, 2.2, and 1.9 during the same intervals. The overall appearance was 71 at 1 month, 81 at 2 to 4 months, and 85 beyond 4 months. All grafts except 1 were judged to be mature at 2 to 4 months follow-up. Full passive range of motion was attained in all grafted hands within the period of 2 to 4 months after operation. Early excision and FTSG of deep pediatric palm burns can be performed in the outpatient setting. The grafts have an acceptable color match, are minimally raised, and achieve excellent cosmetic result. The grafts mature within a few months after surgery to allow for rapid return to normal range of motion. FTSG should be considered as a first choice for deep palm burns.
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263
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Flowers KR, Stephens-Chisar J, LaStayo P, Galante BL. Intrarater reliability of a new method and instrumentation for measuring passive supination and pronation: a preliminary study. J Hand Ther 2001; 14:30-5. [PMID: 11243557 DOI: 10.1016/s0894-1130(01)80022-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Because of the clinical impression that traditional forearm goniometry has several potential sources of error and is therefore inherently unreliable, a new method using a newly designed goniometer was compared with traditional forearm passive range-of-motion goniometry. The new method utilized an offset face with a plumbline design and a patient-held tubular handle. Thirty orthopedic patients (31 wrists) were measured by three experienced hand therapists in a test-retest protocol to determine the reliability of both the traditional and new methods. Both the intraclass correlation coefficients and standard error of the measure showed improved scores with the new goniometric technique, compared with the traditional one. The differences between methods may not be clinically significant.
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264
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Le TB, Hentz VR. Hand and wrist injuries in young athletes. Hand Clin 2000; 16:597-607. [PMID: 11117050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Successful treatments of musculoskeletal injuries in the pediatric population demand a thorough understanding of the basic anatomy and its biomechanics, and the physiology of growth and development of the immature skeleton. In addition, good treatment outcomes rely on the treating physician being an effective teacher to the young athlete and the patient's parents, coaches, and trainers. At the same time, the physician must be a good student in learning the nature of the patient's sports and each patient's athletic ability and aspirations. Most pediatric hand and wrist injuries can be treated nonoperatively with proper immobilization techniques and activity modification, but cases requiring surgical intervention must be recognized promptly to avoid long-term complications.
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265
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Barnes NA, Howes AJ, Jeffers H, Carty H. Quiz case. Avascular necrosis of the metacarpal head III. Eur J Radiol 2000; 36:115-7. [PMID: 11221752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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266
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Peljovich AE, Simmons BP. Traumatic arthritis of the hand and wrist in children. Hand Clin 2000; 16:673-84. [PMID: 11117056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Principles, and not established rules, form the basis for treating children with painful, posttraumatic arthritis involving the hand and wrist. The authors' preference is to exhaust nonoperative measures unless the involved joints are unstable or grossly incongruent. The authors would also recommend a greater degree of cautious observation in young children because of reports of successful outcomes associated with remodeling. Once surgery is necessary, the authors prefer motion-preserving procedures, bearing in mind that arthrodesis is well tolerated in the thumb interphalangeal joint and the finger DIP joints. Some authors have presented novel treatments, including complex microvascular reconstructions, but these authors recommend these procedures only in special circumstances, and only by physicians who are experienced with the techniques.
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267
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Li XJ, Tong J, Wang Y. Combined free toe and free deep inferior epigastric perforator flap for reconstruction of the thumb and thumb web space. J Reconstr Microsurg 2000; 16:427-36. [PMID: 10993088 DOI: 10.1055/s-2006-947149] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To repair a complexly injured hand with composite loss of the thumb and the thumb web space in one stage, the combined transfer of a free second toe and a free deep inferior epigastric perforator flap was designed. It was used to simultaneously reconstruct the thumb and thumb web space of the injured hand in five cases. All flaps survived and there were no complications at any donor site after the reconstructions. In follow-up averaging 35.6 months, the final functional and cosmetic outcomes of the reconstructed thumbs and thumb web spaces were satisfactory. Results demonstrated that the combined transfer of a free second toe and a free deep inferior epigastric perforator flap is a valid method for simultaneous reconstruction of the thumb and the thumb web space of the injured hand.
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268
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269
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Mizani MR, Weber BE. High-pressure injection injury of the hand. The potential for disastrous results. Postgrad Med 2000; 108:183-5, 189-90. [PMID: 10914127 DOI: 10.3810/pgm.2000.07.1161] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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270
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Snelson C, Dieckman B. Recognizing and managing purple glove syndrome. Crit Care Nurse 2000; 20:54-61. [PMID: 11876214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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271
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Newberg A, Dalinka MK, Alazraki N, Berquist TH, Daffner RH, DeSmet AA, el-Khoury GY, Goergen TG, Keats TE, Manaster BJ, Pavlov H, Schweitzer ME, Haralson RH, McCabe JB. Acute hand and wrist trauma. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000; 215 Suppl:375-8. [PMID: 11037450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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272
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Krticka F. [Epistola chirurgica. VIII. Hand injuries]. ROZHLEDY V CHIRURGII : MESICNIK CESKOSLOVENSKE CHIRURGICKE SPOLECNOSTI 2000; 79:192-3. [PMID: 10916456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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273
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Stiris MG. [Magnetic resonance tomography in skeletal and soft tissue trauma]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2000; 120:1060-6. [PMID: 10833967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
MRI has revolutionized the diagnostic yield in musculo-skeletal trauma. Studies have documented that MRI can be an accurate, cost-effective means of assessing injuries in the knee, the foot and the ankle, and it may also be cost-effective in other anatomic locations. MRI may have a significant impact on decision-making in relation to these patients and on the follow-up. The patient does not need to be moved for evaluation in all the anatomical planes. Each study can also be post-processed if necessary. MRI may be used in patients with fractures for evaluation of complications. The fracture lines as well as accompanying soft tissue damage are well documented.
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274
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Saxton JM. A review of current literature on physiological tests and soft tissue biomarkers applicable to work-related upper limb disorders. Occup Med (Lond) 2000; 50:121-30. [PMID: 10829433 DOI: 10.1093/occmed/50.2.121] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Work-related upper limb disorders (WRULD) are among the most commonly reported occupational illnesses. Epidemiological evidence of work-relatedness has been reported for a number of conditions, including carpal tunnel syndrome, hand/wrist tendinitis, shoulder tendinitis and hand-arm vibration syndrome. A range of electrodiagnostic techniques and psychophysical tests has been used to assess neurological dysfunction associated with WRULD, whereas only very few studies have examined biochemical markers of soft tissue injury. This report reviews key literature on physiological tests and biochemical markers of musculoskeletal stress/injury, which are applicable to studies of WRULD. The paper concludes by proposing new ways that testing might be implemented during occupational health surveillance to enable early warning of impending problems and to provide more insight into the underlying nature of soft tissue disorders.
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275
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Brown A, Cramer LD, Eckhaus D, Schmidt J, Ware L, MacKenzie E. Validity and reliability of the dexter hand evaluation and therapy system in hand-injured patients. J Hand Ther 2000; 13:37-45. [PMID: 10718221 DOI: 10.1016/s0894-1130(00)80051-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This study compares measurements obtained using the Dexter Hand Evaluation and Therapy System with those obtained using manual goniometers and grip and pinch dynamometers. Intrarater and inter-rater reliabilities for each tool were also examined. Repeated digit range of motion and strength measurements were performed on 30 subjects who had prior upper extremity injuries. Three therapists performed all measurements on each subject three times, using both Dexter and manual instruments. Analyses of variance (ANOVAs) and intraclass correlation coefficients (ICCs) were used to assess concurrent validity and therapist reliability. The findings show that the computerized Dexter finger goniometer and grip and pinch dynamometers provide measurements that are statistically similar to those of their manual counterparts. The ANOVA results for concurrent validity showed no significant differences between mean measurement values across therapists for the Dexter tools compared with the manual tools (p> or =0.54). In addition, no significant differences were found among or between the therapists' measurements. The range of ICCs for intrarater and inter-rater reliability for all four tests was 0.86 to 0.99. However, a two-way ANOVA revealed a therapist effect during pinch strength measurements (p< or =0.05), suggesting the need for same-therapist and same-tool measurements until the Dexter pinch dynamometer has been further evaluated.
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