Journals Techniques in Hand & Upper Ext...

Techniques in Hand & Upper Extremity Surgery
Stuart W Jones, Fiona C Campbell, Douglas A Campbell
Nonanatomic surgical stabilization of the unstable extensor carpi ulnaris (ECU) tendon (where the subluxing tendon is re-routed away from the bony groove in the distal ulna) utilizes a flap of extensor retinaculum to create a new retaining sheath that will stabilize the tendon during forearm rotation movements. When this surgery fails, the extensor retinaculum tissue does not regenerate with sufficient structural strength to be used again. Previously, a different approach has then been needed for revision surgery, often using more complex surgical techniques with a substantially greater impact on recovery...
December 13, 2023: Techniques in Hand & Upper Extremity Surgery
Laura M Perez-Lopez, Miguel Perez-Abad, María Alejandra Suarez Merchan, David Alejandro Cabrera Ortiz
Subacute or late-presenting unstable osseous mallet finger might be hard to reduce and, therefore, remain subluxed when using the traditional Ishiguro technique. In such cases, we suggest it is best to prioritize correction of joint subluxation over step-by-step adherence to the traditional Ishiguro technique. Specifically, we contend that carrying out the procedure in reverse order typically results in an easier and more stable reduction of both joint and fracture.
December 12, 2023: Techniques in Hand & Upper Extremity Surgery
Robin N Kamal, Pedro Bronenberg, Lauren M Shapiro
Distal radius fractures are one of the most common injuries seen globally with increasing use of use of volar plating for surgical treatment. Although it is common to directly visualize the articular surface for most other periarticular fractures, during volar plating of the distal radius the joint is typically not visualized. This is due to concern for carpal instability from disruption of the volar carpal ligaments. When direct visualization of the articular surface is deemed necessary, either to reduce articular fragments or to confirm the quality of reduction, current options include a separate dorsal arthrotomy or arthroscopic assistance...
November 23, 2023: Techniques in Hand & Upper Extremity Surgery
Victor E Greco, Ethan Wiesler
A colorful array of fixation options exists for the management of operative long oblique or spiral proximal phalanx fractures. These include lag screws, intramedullary devices, Kirschner wires, dorsal or lateral plating, and cerclage wiring. The "Nice double-suture knot," described by Boileau and colleagues, is a sliding, self-stabilizing knot initially created for tuberosity fixation in the shoulder. Nice knot cerclage has been described in shoulder arthroplasty, as well as for comminuted patella fractures...
November 22, 2023: Techniques in Hand & Upper Extremity Surgery
Sailesh V Tummala, Eugenia Lin, Vikram Gill, Kevin J Renfree
Medial epicondylitis is a common elbow pathology secondary to flexor-pronator tendinosis associated with repetitive wrist flexion activities. Though often responsive to nonoperative management, recalcitrant symptomatology is not uncommon. Surgical intervention for chronic medial epicondylitis most commonly involves open debridement of degenerative tendon which can be difficulty to identify and with a notably risk of iatrogenic complication. We present a reproducible musculofascial z-lengthening of the flexor-pronator mass for management of chronic medial epicondylitis and report the mid-term results of this intervention...
November 16, 2023: Techniques in Hand & Upper Extremity Surgery
Vincent Lau, Rick Tosti, Michael Rivlin
Distal radius fractures are common injuries that often require surgical intervention. Commonly, these fractures are fixed using open reduction internal fixation with plating and screws. This often requires a more extensive soft tissue dissection and exposure. In contrast for certain cases, percutaneous headless compression screws may be appropriate. We present a technique for minimally invasive arthroscopic-assisted reduction and percutaneous screw fixation with an extremity traction device. A case is provided to demonstrate the technique as a viable option for the treatment of intra-articular distal radius fractures...
November 16, 2023: Techniques in Hand & Upper Extremity Surgery
Sanju P Eswaran, Michael J Schreck, Brian J Harley
Traumatic dislocations of the fourth and fifth metacarpals, in conjunction with dorsal hamate fractures, are a common entity that can lead to the instability of the fourth and fifth carpometacarpal (CMC) joints. The fracture of the hamate, usually in a coronal dorsal shear configuration, can lead to the dorsal subluxation of the hamatometacarpal joint. Open reduction and internal fixation of the hamate bone with a dorsally applied buttress plate can re-establish a stable and congruent joint surface and anatomically align the articular surfaces of the small and ring finger CMC joints...
November 2, 2023: Techniques in Hand & Upper Extremity Surgery
Brynn A Hathaway, Samantha J Burch, Chloe C Krasnoff, Matthew R Zeiderman, Joel S Solomon
Ulnar nerve injury initiates an imbalance between the intrinsic muscles and extrinsic extensors of the ring and small fingers, which leads to the characteristic hyperextension of the metacarpophalangeal (MP) joints and flexion of the proximal interphalangeal joints of these 2 digits-commonly referred to as the ulnar claw hand. In addition to these changes in the static posture of the hand, ulnar nerve palsy severely impairs grasp due to deficient active MP joint flexion. In most cases, motor balance can be restored by preventing MP joint hyperextension and augmenting MP joint flexion using the Zancolli lasso procedure (ZLP)...
October 26, 2023: Techniques in Hand & Upper Extremity Surgery
Alexander Y Shin
No abstract text is available yet for this article.
October 20, 2023: Techniques in Hand & Upper Extremity Surgery
Paula A Pino, Kitty Y Wu, Peter C Rhee
Triceps spasticity can occur in patients with upper motor neuron syndrome. It is often undetected when there is predominant elbow flexion spasticity and/or contracture. This condition can become apparent after surgery for elbow flexor spasticity, leading to impaired active elbow. Although triceps muscle-tendon lengthening procedures can be performed, these techniques do not directly address the issue of spasticity which is neurally mediated. This article presents a surgical technique for addressing triceps spasticity with a combined approach of hyperselective neurectomy of the medial head of the triceps and muscle-tendon lengthening of the long and lateral heads...
September 25, 2023: Techniques in Hand & Upper Extremity Surgery
Julia Chung, Salma Albino-Hakim, Kate Samuels, David Bodansky, Alejandro Badia
Thumb carpometacarpal (CMC) osteoarthritis is painful and debilitating. Here, we explore outcomes of a modular, press-fit thumb CMC hemiarthroplasty prosthesis (BioPro). This surgical option permits minimal bone resection, sparing the trapezium, hence allowing revision options if necessary. A retrospective review of all cases of the modular thumb CMC implants performed at one community US center between 2018 and 2021 were included and invited for email or telephone review. Electronic records were examined for demographics, patient outcomes, and morbidity...
September 22, 2023: Techniques in Hand & Upper Extremity Surgery
Ismail Bulent Ozcelik, Mohd Hanifah Jusoh, Ali Cavit
Ulnar impaction syndrome occurs when excessive load across the ulnocarpal joints results in pathologic changes, especially over the articular surface of the ulnar head and proximal ulnar corner of the lunate. The 2 main surgical options in ulnar impaction syndrome are ulnar shortening osteotomy and wafer procedure, whether open or arthroscopically, to decompress the ulnocarpal joint load. However, all of these techniques have their shortcomings and drawbacks. The current study demonstrates a novel technique to decompress the ulnocarpal joint load: the "reverse wafer procedure" for ulnar impaction syndrome...
September 13, 2023: Techniques in Hand & Upper Extremity Surgery
Kun-Han Lee, Hui-Kuang Huang, Jung-Pan Wang
Wrist arthroscopy could be a treatment option for dorsal ganglion cysts. To achieve a thorough dorsal capsulectomy for the removal of midcarpal ganglion cysts, it is commonly necessary to combine both the radiocarpal and midcarpal portals. We present a modified method using radiocarpal portals only for arthroscopically excising dorsal midcarpal ganglion cysts. No extra midcarpal portals are necessary, and the method potentially generates satisfactory results.
September 11, 2023: Techniques in Hand & Upper Extremity Surgery
Steven C Kronlage, Edward Alex Whitaker
Optimal surgical treatment of first carpometacarpal joint instability remains a subject of debate. Consensus on thumb carpometacarpal stability originating with the dorsoradial ligamentous complex has shifted reconstruction techniques towards stabilization dorsally. We describe a dorsal stabilization technique with internal brace augmentation of the dorsoradial ligamentous complex. A single fellowship-trained hand surgeon treated 10 women, average age 34 years (range, 21 to 52 y) and 1 man, age 34 years, between 2019 and 2022...
September 1, 2023: Techniques in Hand & Upper Extremity Surgery
Luis Carlos Díaz, Enrique Vergara-Amador, Felipe Camacho Castro
The Moberg flap has been used to achieve coverage of amputations of the thumb's fingertip. However, it has been associated with flexion contractures of the interphalangeal (IP) joint of the thumb. A modification of the surgical technique is presented, adding a distal V-Y flap to allow greater advancement, and avoiding IP joint contractures. The proposed surgical technique is presented, and a case series of patients treated with this modification is introduced. A total of 5 patients underwent this surgical technique...
September 1, 2023: Techniques in Hand & Upper Extremity Surgery
Joanne Y Zhou, Christopher S Frey, Kalpit N Shah, Peter J Ostergaard, Jeffrey Yao
The ulnar shortening osteotomy (USO) is a common procedure used to treat ulnar impaction syndrome secondary to static or dynamic ulnar-positive variance. There are many described techniques for the USO. The distal metaphyseal ulnar shortening osteotomy (DMUSO) with retrograde cannulated screw fixation was described to reduce complications seen with other techniques. Biomechanical analysis of fixation constructs demonstrates 2-screw constructs are significantly stiffer than 1 screw and antegrade constructs have similar or greater stiffness when compared with retrograde constructs...
September 1, 2023: Techniques in Hand & Upper Extremity Surgery
Farsad Biglari, Amir Sabaghzadeh, Mehrdad Sadighi, Adel Ebrahimpour, Maryam Davoodi Bojd, Meisam Jafari Kafiabadi
Various surgical techniques are available for the alleviation of symptoms in carpal tunnel syndrome and each of them has its pros and cons. This study was designed and performed to present a novel approach for cutting transverse carpal ligament by the thread looping technique without the use of ultrasonography. The novel modification of looped threaded carpal tunnel release was performed on 10 hands of 10 patients. The disabilities of arm, shoulder, and hand score, visual analog scale, and 2-point discrimination were used for assessing the outcomes...
September 1, 2023: Techniques in Hand & Upper Extremity Surgery
Joel O'Sullivan, Jack Jeffrey, Caroline Miller, Dominic Power
Peripheral motor nerve transfer surgery is a technique that may be used to restore motor function to paralyzed muscles. Motor nerve transfer involves harvesting an expendable motor nerve branch, and transfer to the motor branch of the denervated target muscle, using microsurgical coaptation. To date, a standardized rehabilitation protocol does not exist. The 6 stages of rehabilitation after motor nerve transfer surgery were outlined by colleagues in the Birmingham Peripheral Nerve Injury service in 2019. This article aims to provide a practical therapy perspective on the rehabilitation stages of motor nerve transfer surgery outlined in that paper, focusing on the radial to axillary nerve transfer...
August 25, 2023: Techniques in Hand & Upper Extremity Surgery
Hossein Saremi, Sepehr Shirouei, Babak Shojaie
Nonunion is a rare complication after surgical treatment of olecranon fracture, but indeed it is a devastating one because of the high potential for elbow stiffness, pain, soft tissue and skin problems, and device complaining. To our knowledge, there is no treatment of choice for olecranon nonunion in the literature. Here we describe a unique and new technique by sliding osteotomy of the olecranon in the form of prism and refixation with tension band wiring. Then, we report the clinical results for our 2 patients operated using this technique...
August 17, 2023: Techniques in Hand & Upper Extremity Surgery
Hsueh-Min Kuo, Hui-Kuang Huang, Cheng-Yu Yin, Yi-Chao Huang, Jung-Pan Wang
Various surgical techniques have been described for the fixation of displaced unicondylar fractures of the proximal phalanx, with K-wire and interfragmentary screws being the most commonly used. Although open reduction with joint exposure can provide direct visualization and allow for anatomic reduction, its potential drawbacks, such as joint stiffness and loss of range of motion, are of significant concern. We introduced a novel fixation technique for displaced unicondylar fractures of the proximal phalanx using antegrade intramedullary pinning and transfixation of the proximal interphalangeal joint, which is simple, effective, and does not require open reduction...
August 3, 2023: Techniques in Hand & Upper Extremity Surgery
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.