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Journal of Hand and Microsurgery

Vidhya Kasilingam, Ronak Patel, Kerementi Othieno-P'otonya, Karthik Karuppaiah
No abstract text is available yet for this article.
December 2018: Journal of Hand and Microsurgery
Robert Miller, Dariush Nikkhah
No abstract text is available yet for this article.
December 2018: Journal of Hand and Microsurgery
Shrikant J Chinchalkar, Juliana Larocerie-Salgado, Jeremy Cepek, Marie-Lyne Grenier
Therapeutic management of brachial plexus injuries remains complex. The impact of brachial plexus injuries on everyday human functioning should not be underestimated. Early active-assisted range of motion following such injuries may prevent myostatic contractures, minimize muscle atrophy, facilitate muscle fiber recruitment, and enable a faster return to baseline strength levels. The dynamic assist elbow flexion orthosis proposed is designed to provide patients with a graded system for muscle reeducation and function...
December 2018: Journal of Hand and Microsurgery
David Edelman, Asif M Ilyas
Triceps tendon ruptures are uncommon injuries, but they typically require surgical repair. Multiple primary repair techniques are available, including transosseous, suture anchor, and anatomic repairs. The technique described here, the "suture bridge" repair, provides an anatomic repair of the distal triceps tendon to its footprint. It has the potential advantages of increased load to failure, better footprint coverage, higher load resistance, and allows for early motion.
December 2018: Journal of Hand and Microsurgery
Johanna N Riesel, Aviram M Giladi, Matthew L Iorio
A right-hand-dominant 55-year-old male automotive mechanic presented 24 hours following a hydrofluoric acid burn to the volar left thumb. Despite the severity of soft tissue injury, the neurovascular bundles were intact. Although a free toe-pulp flap is often described to cover volar digit defects, the resultant 6- × 4-cm full-thickness injury of the thumb was too large to be adequately covered by a toe-pulp flap or other commonly used local flaps from the ipsilateral hand. The authors used a superficial circumflex iliac artery perforator (SCIP) flap to reconstruct the volar surface of the thumb from the tip to the metacarpophalangeal joint...
December 2018: Journal of Hand and Microsurgery
Ahmadreza Afshar, Ali Tabrizi, Ali Aidenlou, Ata Abbasi
This case report describes a 16-year-old female patient with a giant cell tumor in her right capitate bone. The tumor was removed by intralesional curettage. A high-speed burr was used to extend the margins of the curettage, and alcohol irrigation was used for adjuvant therapy. The cavity of the capitate was filled with allogenic bone graft. There was no recurrence after 2 years of follow-up, and the right wrist radiographs demonstrated healing of the lesion.
December 2018: Journal of Hand and Microsurgery
Tito Brambullo, Erica Dalla Venezia, Vincenzo Vindigni, Franco Bassetto
Thumb tip injuries are very common in hand trauma, and several flaps are available to restore the defect. One of them is the Hueston flap. It is very simple and quick to harvest, but it could lead to donor site problems. The variant "radial extended" of this flap, proposed in this article, allows a primary closure of donor site avoiding making scar on contact areas subject to frequent use. We performed this technique in a clinical case that presented a distal thumb amputation with good aesthetic result and satisfactory function...
December 2018: Journal of Hand and Microsurgery
Bushu Harna, Dhananjaya Sabat
Background Divergent trapezium-trapezoid fracture dislocation is a rare and complex injury. The authors present an unusual case of dislocation of the trapezium-trapezoid complex with scaphoid fracture. Case Description A 25-year-old man suffered a road traffic accident leading to complex carpal injury due to axial and rotation forces (steer wheel injury) on the left wrist. X-rays and computed tomographic (CT) scan were done showing trapezium-trapezoid dissociation with fracture of distal pole of scaphoid and ulna styloid...
December 2018: Journal of Hand and Microsurgery
Òscar Izquierdo, Pilar Aparicio, Enric Domínguez, Juan Castellanos
There is a general consensus that the pathogenesis for Kienböck's disease remains uncertain, though it is probably related to nonphysiologic stress transmission across the lunate, acting in concert with one of several possible vascular abnormalities. Most surgical treatments focus on mechanical aspects rather than real physiopathology, but in the recent years several articles have shown the utility of vascularized grafts in the treatment of Kienböck's disease, especially in its early stages. The authors present a case of a successfully reconstruction of a IIIA stage Kienböck's disease with an osteochondral vascularized graft from medial femoral condyle...
December 2018: Journal of Hand and Microsurgery
Ting-Chien Tsai, Sheng-Pin Lo, Fang-Chieh Lien
Epidermal inclusion cyst is a benign lesion that commonly occurs due to inclusion of epidermal cells into the dermal or deeper layers in a trauma event. Percutaneous release is a minimally invasive technique, and good surgical outcomes can be achieved. However, the percutaneous procedure is a puncture injury, and the epidermal inclusion cyst is reasonable to become a possible complication. In this article, we presented a case of trigger finger in left middle finger. The patient underwent percutaneous release as the treatment and a second percutaneous release 5 months later due to recurrence of the symptoms...
December 2018: Journal of Hand and Microsurgery
Prashant Nashiket Chaware, John Ashutosh Santoshi, Manmohan Patel, Mohtashim Ahmad, Bertha A D Rathinam
The innervation pattern of triceps is complex and not fully comprehended. Anomalous innervations of triceps have been described by various authors. We have attempted to delineate the nerve supply of the triceps and documented the anomalous innervations of its different heads. The brachial plexus and its major branches (in the region of the axilla and arm) and triceps were dissected in 36 embalmed cadaver upper limbs. Long head received one branch from radial nerve in 31 (86%) specimens. Four (11%) specimens received two branches including one that had dual innervation from the radial and axillary nerves, and one (3%) specimen had exclusive innervation from a branch of the axillary nerve...
December 2018: Journal of Hand and Microsurgery
Sezai Özkan, Ritsaart F Westenberg, Lydia A Helliwell, Chaitanya S Mudgal
Objective Closed reduction and percutaneous pinning (CRPP) is losing popularity as a treatment modality for distal radius fractures. However, in select cases, CRPP may have advantages relative to open reduction and internal reduction. We aimed to retrospectively assess the outcomes after CRPP for the treatment of distal radius fractures. Study Design This is a retrospective cohort study. Methods We used billing records to identify all skeletally mature patients with a distal radius fracture who were treated with CRPP by a single surgeon at a level I trauma center in an urban city in the United States...
December 2018: Journal of Hand and Microsurgery
Tessa Drijkoningen, Paul Willem Louis Ten Berg, Thierry G Guitton, David Ring, Chaitanya S Mudgal
Computed tomography (CT) is increasingly used not just to diagnose union but also to estimate the percentage of the fracture gap that is bridged by healing bone. This study tested the primary null hypothesis that there is no agreement between observers on the extent of union of a scaphoid waist fracture on CT. CT scans of 13 nondisplaced scaphoid waist fractures treated nonoperatively were rated by 145 observers. CT scans were done 10 to 12 weeks after injury. Observers were asked to "eyeball" measure percentage of union...
December 2018: Journal of Hand and Microsurgery
Toshiki Miura, Maki Ando, Shinya Tanaka, Kosuke Uehara
Background Although dorsal subluxation is a typical finding for osteoarthritis of the thumb carpometacarpal (CMC) joint, it is difficult to evaluate the subluxation after trapeziectomy and the significance of its surgical correction combined with trapeziectomy is still controversial. The purpose of this study was to develop a method to evaluate dorsal subluxation without using landmarks on the trapezium. Methods Thirty patients with thumb CMC arthritis and 13 normal patients were included in this study. Dorsal subluxation of the CMC joint was evaluated by measuring the distance between the volar tip of the thumb metacarpal base and dorsoradial border of the index metacarpal base (M1M2 overlap) on the X-ray true lateral view of the thumb as well as previously reported methods...
December 2018: Journal of Hand and Microsurgery
Rishi Mugesh Kanna
No abstract text is available yet for this article.
December 2018: Journal of Hand and Microsurgery
Tetsushi Aizawa, Chiaki Inada, Satoshi Kubo, Shimpo Aoki, Ryuichi Azuma, Tomoharu Kiyosawa
No abstract text is available yet for this article.
August 2018: Journal of Hand and Microsurgery
Feiran Wu, Asim Rajpura, Dilraj Sandher
Introduction de Quervain's tenosynovitis is a common pathologic condition of the hand. Finkelstein's test has long been considered to be a pathognomonic sign of this diagnosis, yet most clinicians and instruction manuals erroneously describe what is in fact the Eichhoff's test, which is thought to produce similar pain by tendon stretching in a normal wrist. The purpose of this study was to compare Finkelstein's test with Eichhoff's test in asymptomatic individuals. Materials and Methods Thirty-six asymptomatic participants (72 wrists) were examined using both Finkelstein's and Eichhoff's tests with a minimum interval of 24 hours between the tests...
August 2018: Journal of Hand and Microsurgery
Farid Najd Mazhar, Tina Shoushtarizadeh, Alireza Mirzaei
Glomus tumors are glomus body neoplasms that most commonly occur in the subungual areas of the hand, typically characterized by small nodules associated with localized tenderness, cold sensitivity, and excruciating paroxysmal pain. Extradigital glomus tumors can present a diagnostic challenge because they are rare and usually accompanied by nonspecific symptoms. Intravenous origin of the glomus tumor, especially in the wrist, is much rarer. The authors here report an intravenous glomus tumor of the wrist presented with atypical features such as insensitivity to cold and a history of long-term pain, which led to the misdiagnosis of the lesion as extensor tendonitis...
August 2018: Journal of Hand and Microsurgery
Jason S Hoellwarth, Robert J Goitz
Background Lipofibromatous hamartoma (LFH) is a benign tumor of peripheral nerves, most commonly reported in the median nerve, and often associated with carpal tunnel symptoms. There have been nearly 200 reported cases of LFH in the median nerve, but to the authors' knowledge, this 10-year-old girl represents the first case report involving the palmar cutaneous branch. Methods An excisional biopsy of the mass was performed via a standard midline palmar incision. The tumor was found encapsulating the palmar cutaneous branch, and thus it was sacrificed...
August 2018: Journal of Hand and Microsurgery
Ryosuke Sato, Naohito Hibino, Masahiro Yamano, Shinji Yoshioka, Tomoya Terai, Kenichiro Kita, Shingo Hama, Yoshitaka Hamada, Ichiro Tonogai, Koichi Sairyo
Reconstruction is challenging in a patient with loss of a segment of Achilles tendon and infection in the overlying soft tissue. Here the authors describe one-stage tendon reconstruction, using an anterolateral thigh free flap incorporating a vascularized muscle flap and a strip of iliotibial tract in a patient with re-rupture of an Achilles tendon and soft tissue infection. Postoperative immobilization of the affected ankle using an external fixator enabled us to observe the flap directly and reduce pressure on the flap...
August 2018: Journal of Hand and Microsurgery
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