Journal of Hand and Microsurgery

The surgical soft tissue release of extension contracture at metacarpophalangeal (MP) joint is technically easy; however, the preventive hand therapy after surgery is really difficult in clinical practice. Congenital MP joint contracture, especially little finger, is also difficult to spread its limited range of motion (ROM). Here, we present a patient with a congenital MP joint contracture of the little finger managed with dynamic external fixator (DEF). A 21-year-old male irritated from limited ROM associated with pain of the right little finger of more than 1 year...

Introduction  Music is commonly played in operating rooms. Because microsurgery demands utmost concentration and precise motor control, we conducted the present study to investigate a potentially beneficial impact of music on performing a microsurgical anastomosis. Materials and Methods  We included a novice group (15 inexperienced medical students) and a professional group (15 experienced microsurgeons) in our study. Simple randomization was performed to allocate participants to the music-playing first or music-playing second cohort...

Background  Polycythemia vera (PV) is a myeloproliferative disease with overproduction of erythrocytes, leukocytes, and platelets causing an increased risk of both thrombosis and hemorrhage. There are limited reports and no established guidelines for managing such patients undergoing reconstructive surgery. Methods  We present four patients with PV and head and neck cancer who required reconstruction after resection and provide a review of the current literature. Results  Preoperatively, patients on cytoreductive therapy continued with their treatment throughout their hospital course and had hematologic parameters normalized with phlebotomy or transfusions if needed...

The frequency of prosthetic total wrist arthroplasty continues to increase. With this increase comes the expected subsequent increase in need for revision or salvage procedures. The technique presented here involves the use of a cortical allograft interposition graft to restore bone stock and length for failed total wrist arthroplasty.

Introduction  The aim of this study was to determine if the combined use of curcumin and platelet-rich plasma (PRP) improves the axonal regeneration process in acutely repaired nerve injuries. Materials and Methods  The right sciatic nerves of 32 Holtzman albino rats were transected and immediately repaired. Four treatments were randomly allocated: (1) nerve repair only; (2) nerve repair + local PRP; (3) nerve repair + intraperitoneal curcumin; and (4) nerve repair + local PRP + intraperitoneal curcumin...

The distal radioulnar joint (DRUJ), the articulation between the sigmoid notch of the radius and the distal ulna, plays a pivotal role in stability and load bearing and allows for pronation and supination of the forearm. Osteoarthritis (OA) of the DRUJ commonly occurs due to distal radius trauma but may also be the result of conditions such as joint instability, septic arthritis, or primary OA. It is initially managed with conservative therapy, but surgery is often considered when nonoperative methods fail...

Introduction  Trapeziectomy and suture-button suspensionplasty (SBS) are a novel option to treat end-stage trapeziometacarpal (TMC) osteoarthritis. Our purpose is to evaluate our outcomes with this technique and in this setting, with a minimum of 18 months of follow-up. Materials and Methods  Twenty-eight patients were included, operated between 2016 and 2018. We recorded demographic data, preoperative Eaton stage, follow-up and operative times. The patients completed the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire and tip pinch, key pinch, and grip strength were measured...

Introduction  The superficial branch of the radial nerve (SBRN) has a risk of nerve injury during cephalic vein (CV) cannulation. Due to the lack of imaging study regarding SBRN and CV relationship, we analyzed the anatomical relationship between the SBRN and the CV using ultrasound (US) imaging. Materials and Methods  In total, 82 upper limbs of 41 healthy volunteers were analyzed. The SBRN and CV were identified at the following three points in the elbow extension and pronation position: at the radial styloid process (point 1), 5 cm proximal to point 1 (point 2), and 10 cm proximal to point 1 (point 3)...

Introduction  Utilize a national pediatric database to assess whether hospital characteristics such as location, teaching status, ownership, or size impact the performance of pediatric digit replantation following traumatic digit amputation in the United States. Materials and Methods  The Kid's Inpatient Database (KID) was used to query pediatric traumatic digit amputations between 2000 and 2012. Ownership (private and public), teaching status (teaching and non-teaching), location (urban and rural), hospital type (general and children's), and size (large and small-medium) characteristics were evaluated...

Introduction  Wound dehiscence is the most common complication after spinal fusion procedures, resulting in an increase in mortality rate and hospital length of stay. Reconstruction of these wounds presents a challenge, as the spine is dependent on these implants for stability and must be maintained throughout the wound dehiscence treatment protocol. We describe a method for extending the thoracodorsal pedicle with an arteriovenous loop to permit an increased excursion of the latissimus dorsi muscle in patients with exposed implants and present the results of this procedure...

Introduction  Pursuit for a new technique, which could be placed on flat extensor tendons and strong enough to withstand the tension forces of early mobilization to prevent stiffness, started few decades ago. We evaluated the new technique of tendon repair using running interlocking horizontal mattress (RIHM) sutures followed by early controlled motion protocol in traumatic extensor tendon injuries and compared it to modified Kessler technique. Materials and Methods  We conducted a prospective randomized interventional study of 18 months' duration, with 30 patients...

No abstract text is available yet for this article.

Digit replantation is a complex surgery that nearly always needs to be done as an emergency. As such it is often difficult to teach. Several models have been developed to train surgeons in this procedure. We compare three rat models of replantation with the aim of ascertaining which most simulates the digit replantation. Inbred albino rats were selected and divided into three groups of 13 each, tail, penile, and hind replant groups. Three rats in each group were anesthetized, the specific amputation injury is created and is replanted for the anatomic component of the study...

Introduction  The objectives of this study were to assess long-term outcomes, complications, and reoperations after open reduction internal fixation (ORIF) of radial head fractures. Materials and Methods  35 adult patients, who underwent ORIF of an isolated, displaced radial head fracture without elbow instability (Mason classification type II or III) at two tertiary care referral centers from 2000 to 2017, were identified. Patient satisfaction, pain, and QuickDASH scores were assessed by telephone follow-up at median 12...

No abstract text is available yet for this article.

Background  There is notable evidence that unhelpful thoughts (symptoms of anxiety and depression) increase symptom intensity among patients with trapeziometacarpal osteoarthritis (TMC OA). Surgeons may or may not be mindful of this line of evidence when interacting with patients. In a survey-based experiment, we randomized surgeons to be prompted about the psychosocial aspects of TMC OA. We aimed to measure the influence of mindfulness of mental health on treatment recommendations and willingness to discuss mental health interventions...

No abstract text is available yet for this article.

Primary aneurysmal bone cyst of the capitate is a rare disorder and it occurs commonly in the metacarpal bones. There are only three documented cases in literature of its occurrence in carpal bones. We report one such case of a 21-year-old male serving soldier, its clinical presentation, imaging findings, and treatment by curettage and bone grafting.

Introduction  Scapholunate interosseous ligament injury (SLIL) is the most common cause of wrist instability and a cause of morbidity in a proportion of patients with wrist injuries. Aim  To evaluate the accuracy of plain magnetic resonance imaging (MRI) and MR arthrogram (MRA) in the diagnosis of SLIL injury against the existing gold standard-wrist arthroscopy. Materials and Methods  We retrospectively reviewed 108 cases by comparing MRI/MRA reports and their wrist arthroscopy operation notes...

Traumatic dislocation of the pisiform bone (PB) is a rare injury of the carpal bones, especially in pediatric patients. A few cases were reported, and there is no consensus about the treatment. Each author supports his own method, such as an open reduction internal fixation (ORIF) approach or a closed reduction. However, failures of both techniques with recurrent dislocation of the PB have been reported in the literature. In this article, a fracture dislocation of the PB was treated with ORIF in an 11-year-old boy with a greenstick radial fracture...