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Herisson O, Masquelet AC, Doursounian L, Sautet A, Cambon-Binder A. Finger reconstruction using induced membrane technique and ulnar pedicled forearm flap: a case report. Arch Orthop Trauma Surg 2017; 137:719-723. [PMID: 28289889 DOI: 10.1007/s00402-017-2666-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Injuries referred to as "rollover hands" are associated with multiple and complex lesions of the dorsal aspect of the hand. We present a case of a multitissular reconstruction following a severe injury of the dorsum of the fingers in a 45-year-old woman. MATERIALS AND METHODS The bone loss reconstruction was performed in two stages using the Masquelet induced membrane technique. In the first stage, a cement spacer was inserted into the phalanx bone defects. For the second stage, the membrane induced by the foreign-body reaction was opened, the spacer was removed, and an autologous cancellous bone graft was inserted into the defects. The skin coverage was obtained using a reverse ulnar artery forearm pedicled flap. The digits were covered jointly. Three surgical procedures over the course of a 2-month period were required to desyndactylize the fingers and to defat the flap. RESULTS At the 2-year follow-up examination, the patient exhibited good integration of their hand use in daily living. The esthetic result was deemed to be satisfactory. Definitive bone consolidation occurred 4 months after the second stage. CONCLUSIONS Rollover hands are typically a challenge for both the patient and the hand surgeon. The risk of septic complications, as well as the need for several stages of surgical reconstruction, makes the Masquelet technique particularly attractive for the treatment of phalanx bone defects consecutive to rollover injuries.
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Vester H, Deiler S. [Strategies for complex injuries of the hand]. Unfallchirurg 2017; 120:237-251. [PMID: 28243689 DOI: 10.1007/s00113-017-0327-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The quality of the reconstruction, follow-up treatment and care determine the treatment outcome of complex hand injuries. The initial estimation and therapy are decisive. Optimal results necessitate a structured approach with strategic planning, including thorough débridement, precise analysis of the resulting defect and loss of function and if possible unilateral reconstruction and well-founded planning of secondary interventions. Within the framework of the detailed patient clarification the perspectives, possibilities and alternatives must be realistically presented. Taking these fundamental strategic steps into consideration, the primary aims of reconstruction and preservation of function, rapid occupational and social reintegration and avoidance of delayed complications can best be realized. There is no standard approach for these extremely variable injuries. Decisive is that even in cases of apparently harmless injuries, the involvement of functional structures must be considered early in the initial stages.
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Banting J, Meriano T. Hand Injuries. JOURNAL OF SPECIAL OPERATIONS MEDICINE : A PEER REVIEWED JOURNAL FOR SOF MEDICAL PROFESSIONALS 2017; 17:93-96. [PMID: 29256203 DOI: 10.55460/g5mx-dcaw] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2017] [Indexed: 06/07/2023]
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Cohen BH, Gaspar MP, Daniels AH, Akelman E, Kane PM. Multifocal Neuropathy: Expanding the Scope of Double Crush Syndrome. J Hand Surg Am 2016; 41:1171-1175. [PMID: 27751780 DOI: 10.1016/j.jhsa.2016.09.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 09/16/2016] [Indexed: 02/02/2023]
Abstract
Double crush syndrome (DCS), as it is classically defined, is a clinical condition composed of neurological dysfunction due to compressive pathology at multiple sites along a single peripheral nerve. The traditional definition of DCS is narrow in scope because many systemic pathologic processes, such as diabetes mellitus, drug-induced neuropathy, vascular disease and autoimmune neuronal damage, can have deleterious effects on nerve function. Multifocal neuropathy is a more appropriate term describing the multiple etiologies (including compressive lesions) that may synergistically contribute to nerve dysfunction and clinical symptoms. This paper examines the history of DCS and multifocal neuropathy, including the epidemiology and pathophysiology in addition to principles of evaluation and management.
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Trevatt AE, Smith OJ, Needleman J, Banerjee A. An analysis of the most common types of hand injury mistakes and their cost in the acute setting. Med Leg J 2016; 84:206-211. [PMID: 27553446 DOI: 10.1177/0025817216664663] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study aimed to explore the most common hand injury errors occurring in Emergency Departments in England. A Freedom of Information request was made to the NHS Litigation Authority for claims data related to hand injuries in English Emergency Departments from 2004 to 2014. All successful hand injury claims against an individual DGH ED were also analysed. Two hundred and eighteen successful claims were made, costing a total of £6,273,688.22. Diagnosis error was the most common successful claim (97). Four successful claims were brought against the Emergency Department. Causes of error included the use of inappropriate views and failure to correlate imaging with clinical findings. Hand injury diagnostic error has been the most common cause of successful litigious claims against Emergency Departments over the past 10 years. This paper demonstrates that fracture recognition and clinical diagnosis of hand injuries are key areas to target to reduce error rates.
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Abstract
Human bite wounds to the hand are relatively common injuries and are associated with high infection rates. Given the unique anatomy of the hand, the bite mechanism and the organisms found in human saliva, even the smallest wound can result in an aggressive infection. Failure to recognise and treat human bite wounds appropriately, can therefore have negative outcomes for patients. This article outlines the diagnostic features of, and complications associated with, bite wounds and discusses the recommended treatment options.
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Springorum HR, Baier C, Götz J, Schwarz T, Benditz A, Grifka J, Heers G. [Examination of the wrist and hand]. DER ORTHOPADE 2016; 45:1083-1098. [PMID: 27826626 DOI: 10.1007/s00132-016-3350-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The wrist and hand form a highly complex organ that is of great importance in almost all daily activities. The hand serves as a tool and an organ of sense. Injuries of the hand and wrist as well as mechanical, neurological or systemic inflammatory changes are common. Taking a detailed history can already lead to a diagnosis. Almost all structures of the hand are easily accessible for clinical examination, i. e. inspection, palpation and clinical tests, including dynamic testing. Diagnostic imaging completes the examination procedure.
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Seldén A, Hermiz F, Östlund B. [Hypothenar hammer syndrome is rare - or simply an unusually overlooked condition]. LAKARTIDNINGEN 2016; 113:DYCP. [PMID: 27727416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Hypothenar hammer syndrome is a possibly underdiagnosed but treatable cause of Raynaud's phenomenon and hand ischemia elicited by thombosis or aneurysm secondary to acute or chronic blunt trauma to the ulnar artery at the level of Guyon's canal. This paper provides a summary of the condition with some emphasis on prophylactic and therapeutic aspects.
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Shah KN, Hodax JD, Katarincic JA. Evaluating a Flexor Tendon Laceration with the Tenodesis Effect. J Pediatr 2016; 176:214-214.e1. [PMID: 27297206 DOI: 10.1016/j.jpeds.2016.05.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 05/12/2016] [Indexed: 11/18/2022]
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Winsauer S, Gardetto A, Kompatscher P. Pedicled hypothenar perforator flap: Indications and clinical application. J Plast Reconstr Aesthet Surg 2016; 69:843-847. [PMID: 27068643 DOI: 10.1016/j.bjps.2016.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 03/01/2016] [Accepted: 03/06/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Soft-tissue defects of the palm and the palmar aspect of the fifth finger are a constant problem in reconstructive hand surgery. We present a possible approach to planning and harvesting pedicled hypothenar perforator flaps for the reconstruction of such defects. METHODS A hypothenar perforator flap was used to reconstruct a soft-tissue defect on the ulnar aspect of the palm and the palmar aspect of the fifth finger of 17 patients. The defects were located over the proximal phalanx of the fifth finger (n = 9), the palm (n = 5), and across both areas (n = 3). The size of the defects was up to 7.9 cm(2). RESULTS Eleven of the flaps healed primarily, out of which partial flap necrosis was observed in six. Four of these six flaps required operative revision, including debridement and delayed primary wound closure, while two healed secondarily. After an average of 26.6 days (range 21-45 days), all 17 patients achieved complete functional recovery. Despite the complications described, all the primary defects remained covered. CONCLUSION The pedicled hypothenar perforator flap is an option for reconstruction of ulnar-sided, soft-tissue defects of the palm and little finger. The flap is thin and the donor-site morbidity is low. Hand surgeons may wish to consider this flap when presented with soft-tissue defects in this area.
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Barker BJ, Kolovich GP, Klinefelter RD. Partial Flexor Tendon Laceration Assessment: Interobserver and Intraobserver Reliability. AMERICAN JOURNAL OF ORTHOPEDICS (BELLE MEAD, N.J.) 2016; 45:E127-E131. [PMID: 26991579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Accurate assessment of partial-thickness flexor tendon lacerations in the hand is difficult owing to the subjectivity of evaluation. In this study, we created 12 partial-thickness flexor tendon lacerations in a cadaveric hand, evaluated the accuracy of 6 orthopedic residents and 4 fellowship-trained hand surgeons in estimating the percentage thickness of each laceration, and assessed the groups' interobserver and intraobserver agreement. The 10 participants estimated each laceration independently and on 2 separate occasions and indicated whether they would repair it. The actual thickness of each laceration was calculated from measurements made with a pair of digital microcalipers. Overall estimates differed significantly from calibrated measurements. Estimates grouped by residents and fellowship-trained hand surgeons also differed significantly. Third-year residents were the most accurate residents, and fellowship-trained hand surgeons were more accurate than residents. Overall interobserver agreement was poor for both readings. There was moderate overall intraobserver agreement. Fellowship-trained hand surgeons and first-year residents had the highest intraobserver agreement. These results highlight the difficulty in accurately assessing flexor tendon lacerations. Accuracy appears not to improve with surgeon experience.
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Stade N, Kanz KG, Biberthaler P. [Emergency treatment of electrical injuries]. MMW Fortschr Med 2016; 157:56-7. [PMID: 26759889 DOI: 10.1007/s15006-015-3593-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hageman MGJS, Reddy R, Makarawung DJS, Briet JP, van Dijk CN, Ring D. Do Upper Extremity Trauma Patients Have Different Preferences for Shared Decision-making Than Patients With Nontraumatic Conditions? Clin Orthop Relat Res 2015; 473:3542-8. [PMID: 26040968 PMCID: PMC4586205 DOI: 10.1007/s11999-015-4375-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Shared decision-making is a combination of expertise, available scientific evidence, and the preferences of the patient and surgeon. Some surgeons contend that patients are less capable of participating in decisions about traumatic conditions than nontraumatic conditions. QUESTIONS/PURPOSES (1) Do patients with nontraumatic conditions have different preferences for shared decision-making when compared with those who sustained acute trauma? (2) Do disability, symptoms of depression, and self-efficacy correlate with preference for shared decision-making? METHODS In this prospective, comparative trial, we evaluated a total of 133 patients presenting to the outpatient practices of two university-based hand surgeons with traumatic or nontraumatic hand and upper extremity illnesses or conditions. Each patient completed questionnaires measuring their preferred role in healthcare decision-making (Control Preferences Scale [CPS]), symptoms of depression (Patients' Health Questionnaire), and pain self-efficacy (confidence that one can achieve one's goals despite pain; measured using the Pain Self-efficacy Questionnaire). Patients also completed a short version of the Disabilities of the Arm, Shoulder, and Hand questionnaire and an ordinal rating of pain intensity. RESULTS There was no difference in decision-making preferences between patients with traumatic (CPS: 3 ± 2) and nontraumatic conditions (CPS: 3 ± 1 mean difference = 0.2 [95% confidence interval, -0.4 to 0.7], p = 0.78) with most patients (95 versus 38) preferring shared decision-making. More educated patients preferred a more active role in decision-making (beta = -0.1, r = 0.08, p = 0.001); however, differences in levels of disability, pain and function, depression, and pain-related self-efficacy were not associated with differences in patients' preferences in terms of shared decision-making. CONCLUSIONS Patients who sustained trauma have on average the same preference for shared decision-making compared with patients who sustained no trauma. Now that we know the findings of this study, clinicians might be motivated to share their expertise about the treatment options, potential outcomes, benefits, and harms with the patient and to discuss their preference as well in a semiacute setting, resulting in a shared decision.
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Abstract
Flexor tendon injury is the most commonly seen hand injury. Tendons are the structures which enable the muscles to adhere to the bones and transmit the movement starting from the muscle to the bones. They have significant role in hand movement. As treatment method, surgical repair: (1) Primary repair, (2) Secondary repair; techniques are used. With the scientific studies conducted, flexor tendon morphology, kinematics, biomechanics, biological properties and tendon improvement became quite understandable, good suturing materials were developed and consequently successful studies regarding primary repair results were published. Flexor tendon surgery has reached its current level with the accumulation of knowledge obtained from the increased clinical and experimental studies. This study addresses flexor tendon injuries and surgical treatment methods. We achieved 76.12% full functioning fingers in the results; we obtained following the physical treatment application that started on the 10th day after primary repair that we performed in 67 patients who applied with acute flexor tendon Zone 1-2 and 3 incision. Flexion restriction and contracture developed in 16 patients (23.88%) at various levels. Scar softening and revision surgery for contracture excision was performed in 8 patients (11.94%) with Zone 2 injury due to contracture. Superficial skin infection developed in 21 patients (31.34%) and was treated. Revision surgery was performed in 6 patients with Zone 1 injury due to rupture occurred during rehabilitation.
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Langford MA, Cheung K, Li Z. Percutaneous Distraction Pinning for Metacarpophalangeal Joint Stabilization After Blast or Crush Injuries of the Hand. Clin Orthop Relat Res 2015; 473:2785-9. [PMID: 25754757 PMCID: PMC4523529 DOI: 10.1007/s11999-015-4233-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Unstable, severely comminuted fractures of the metacarpophalangeal (MCP) joint are difficult to treat. Closed treatment and casting of these fractures often fail to maintain proper alignment and impede wound care where concomitant open injuries such as gunshot wounds are present. Conventional pinning or plating techniques are not feasible if extensive bone loss and comminution are present. A distraction pinning technique represents a potential alternative, but results with this approach, to our knowledge, have not been reported. QUESTIONS/PURPOSES The purposes of this study were (1) to evaluate the effectiveness (defined as osseous union and joint stability) of distraction pinning for comminuted fractures involving MCP joints after gunshot or crush injuries; (2) to report the short-term results in terms of pain and function in a small group of patients who underwent MCP distraction pinning; and (3) to evaluate complications and return to work status of these patients in the short term. METHODS We reviewed 10 patients with comminuted pilon-type fractures of the base of the proximal phalanx or metacarpal head treated with wire distraction fixation from 2005 and 2014. During that period, we used this technique to treat all patients whose fractures were deemed too comminuted for plating or pinning, and during that period, no other techniques (such as simple external fixation) were used for patients meeting those indications. The minimum followup was 6 months; eight of the 10 patients were accounted at a median of 10 months (range, 6-89 months). The median age was 47 years (range, 28-57 years), and seven of the eight were male. Kirschner wire fixation frames were removed 3.5 to 6 weeks after the index surgery when fracture consolidation was confirmed on radiography by the treating surgeon. Stability and range of motion of the MCP joint were assessed using physical examination, radiographs, and goniometer by the treating surgeon. Patients completed the Quick Disabilities of the Arm, Shoulder and Hand score at latest followup or by telephone, and complications were assessed by chart review. RESULTS All fractures were healed with stable MCP joints. Eight patients reported having no pain or minimal pain of their injuries to the hand. The median finger and thumb MCP arc of motion were 80° (range, 70°-105°) and 30° (range, 0°-60°), respectively. The median Quick Disabilities of the Arm, Shoulder and Hand score was 3 (range, 0-41). One patient underwent a second surgical procedure for bone grafting and soft tissue coverage. Three patients developed pin site irritations and were treated with oral antibiotics. Six patients returned to their original job. CONCLUSIONS The distraction pinning technique provides reliable osseous union and joint stability of comminuted pilon-type fractures of the base of the proximal phalanx or metacarpal head, even with associated open wounds. Future studies will need to evaluate these patients at longer term followup and compare this approach with other available techniques, because arthrosis, stiffness, and progressive loss of function seem likely to occur given the severity of these injuries. LEVEL OF EVIDENCE Level IV, therapeutic study.
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MESH Headings
- Adolescent
- Adult
- Biomechanical Phenomena
- Blast Injuries/diagnosis
- Blast Injuries/physiopathology
- Blast Injuries/surgery
- Bone Nails
- Disability Evaluation
- Female
- Fracture Fixation, Internal/adverse effects
- Fracture Fixation, Internal/instrumentation
- Fracture Fixation, Internal/methods
- Fracture Healing
- Fractures, Comminuted/diagnosis
- Fractures, Comminuted/physiopathology
- Fractures, Comminuted/surgery
- Hand Injuries/diagnosis
- Hand Injuries/physiopathology
- Hand Injuries/surgery
- Humans
- Joint Instability/diagnosis
- Joint Instability/physiopathology
- Joint Instability/surgery
- Male
- Metacarpophalangeal Joint/diagnostic imaging
- Metacarpophalangeal Joint/injuries
- Metacarpophalangeal Joint/physiopathology
- Metacarpophalangeal Joint/surgery
- Middle Aged
- Postoperative Complications/etiology
- Postoperative Complications/surgery
- Radiography
- Range of Motion, Articular
- Recovery of Function
- Reoperation
- Retrospective Studies
- Return to Work
- Time Factors
- Treatment Outcome
- Wounds, Gunshot/diagnosis
- Wounds, Gunshot/physiopathology
- Wounds, Gunshot/surgery
- Young Adult
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Abstract
Boxer's fractures are common hand injuries, but their management varies greatly. Two years ago, a boxer's fracture care pathway was developed for use in the Royal London Hospital emergency department to standardise management. This article describes a clinical service evaluation carried out to test the validity of the pathway. The evaluation examined the functional outcomes of patients with boxer's fractures with 50° or less palmar angulation who were discharged with no follow up. Findings show that most returned to work immediately and had good functional outcomes, which suggests that the pathway is safe for uncomplicated fractures with 50° or less palmar angulation.
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Mrkonjic A, Lindau T, Geijer M, Tägil M. Arthroscopically diagnosed scapholunate ligament injuries associated with distal radial fractures: a 13- to 15-year follow-up. J Hand Surg Am 2015; 40:1077-82. [PMID: 25936737 DOI: 10.1016/j.jhsa.2015.03.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/17/2015] [Accepted: 03/18/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the natural history of untreated complete or partial scapholunate (SL) ligament tears associated with displaced distal radius fractures. METHODS Between 1995 and 1997, 51 consecutive patients aged < 60 years with displaced distal radius fractures were examined arthroscopically to assess for concomitant soft tissue injuries. Thirty-two of 51 patients had an SL ligament tear, 10 had a complete tear (Lindau grade 3), and 22 had a partial tear (Lindau grades 1 and 2). Thirty-two patients had AO type-C fractures, 3 had type-B fractures, and 16 had type-A fractures. In 2010, 47 of the 51 patients were still alive, and they were invited for an interview, clinical examination, and radiography. RESULTS Thirty-eight of the 51 original patients participated in the long-term follow-up. Mean grip strength was 83% relative to the contralateral hand in patients with a complete tear, as compared with 92% in patients with partial or no SL tears (nonsignificant). Median Disabilities of the Arm, Shoulder, and Hand questionnaire score was 2 (range, 0‒55) for complete SL tears, compared with 9 (range, 0‒70) for the others (nonsignificant). No differences were found regarding visual analog scale pain or wrist motion/forearm rotation. None of the patients developed a static SL dissociation or a SL advanced collapse wrist. CONCLUSIONS No major differences were found in the subjective, objective, or radiographic outcome after a complete (grade 3) or partial (grade 1 or 2) SL untreated tear associated with displaced distal radius fracture. It should be noted that none of the patients had a grade 4 SL tear, which may have a different outcome. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
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Howell RD, Sapienza A. The Management of Domestic Animal Bites to the Hand. BULLETIN OF THE HOSPITAL FOR JOINT DISEASE (2013) 2015; 73:156-160. [PMID: 26517170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hand bites from domestic animals are extremely common. Though many may initially appear benign, it is important for treating physicians to be aware of the factors that place patients sustaining animal bites at additional risk for infection. As clinicians, we must be able to efficiently diagnose and treat these patients properly to avoid the morbidity that animal bites can provoke. The current paper reviews the evaluation and management of domestic animal bites to the hand.
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Abstract
Treatment goals for the management of extensor tendon injuries include restoration of function, minimizing disability, and decreasing the risk of complications. These goals can be achieved with an accurate understanding of the zone-specific concerns for extensor tendon injuries, early referral to hand therapy, and active communication between hand surgeons and therapists. This article reviews extensor tendon injuries by zone, outlines optimal management strategies that help prevent complications, and describes the treatment of these complications.
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Ghannad LA, Watson AM, Brooks A, LaBella CR. Musculoskeletal Injuries Not to Miss in Teens. ADOLESCENT MEDICINE: STATE OF THE ART REVIEWS 2015; 26:53-78. [PMID: 26514032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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46
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Jepsen JR, Røder O. [Bilateral hypothenar hammer syndrome]. Ugeskr Laeger 2015; 177:58-59. [PMID: 25612968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Hypothenar hammer syndrome is caused by ulnar artery occlusion subsequent to repeated blunt trauma such as by using the hypothenar as a hammer during work. Allen's test permits the detection of this frequent and often overlooked cause of hand pain and ischaemia. The four bilateral hypothenar hammer syndromes described in this case report occurred after several years of occupational exposure to hard shocks/impacts to the hypothenar from workpieces, which were held with a firm grip.
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48
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Ilyas AM. Upper extremity. Orthop Clin North Am 2015; 46:xxiii. [PMID: 25435050 DOI: 10.1016/j.ocl.2014.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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49
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Buisman FE, de Meijer VE. [A woman with a blast injury]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 2015; 159:A8853. [PMID: 26043255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 39-year-old woman presented with extensive soft tissue injury involving her upper legs and her left hand caused by the explosion of her cell phone. She suffered second and third-degree burns. She underwent surgery. She underwent surgical removal of metal slivers, wound debridement and repair of the soft tissue injury.
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Bowen WT, Slaven EM. Evidence-Based Management Of Acute Hand Injuries In The Emergency Department. EMERGENCY MEDICINE PRACTICE 2014; 16:1-27. [PMID: 26371445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 09/10/2014] [Indexed: 06/05/2023]
Abstract
Although injuries of the hand are infrequently life-threatening, they are common in the emergency department and are associated with significant patient morbidity and medicolegal risk for physicians. Care of patients with acute hand injury begins with a focused history and physical examination. In most clinical scenarios, a diagnosis is achieved clinically or with plain radiographs. While most patients require straightforward treatment, the emergency clinician must rapidly identify limb-threatening injuries, obtain critical clinical information, navigate diagnostic uncertainty, and facilitate specialist consultation, when required. This review discusses the clinical evaluation and management of high-morbidity hand injuries in the context of the current evidence.
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