Journal of Hand Surgery Asian-Pacific Volume

Background: Arthritis of the distal interphalangeal joint (DIPJ) can result in significant functional limitations and pain. While arthrodesis is the most common surgical intervention, this can decrease grip strength and have other limitations. DIPJ arthroplasty may be an appealing alternative in select patient with this study aiming to review the outcomes of this procedure. Methods: A search was conducted according to PRISMA guidelines using PubMed, Embase and Ovid Medline from date of inception to April 2022...

Background: We used antibiotic-impregnated polymethylmethacrylate (PMMA) bone cement to make a patient-specific radial head prosthesis (RHP) by applying the 3-dimensional (3D) designing technique in patients with Mason types 3 and 4 radial head fractures. The aim of this study is to report the short- to mid-term outcomes of this procedure. Methods: This is a prospective study of all patients who underwent a patient-specific PMMA bone cement RHP at our institute over a 1-year period from May 2017 to June 2018...

Background: Division of one or more slips of the flexor digitorum superficialis (FDS) tendon has been posited as an effective surgical modality for advanced or recurrent trigger finger. This may be an effective approach among patients with diabetes or rheumatoid arthritis, or in those with fixed flexion deformities who have poor outcomes from A1 pulley release alone. However, there is limited evidence regarding the effectiveness of this procedure. The role of this study was to systematically review the evidence on functional outcomes and safety of partial or complete FDS resection in the management of trigger finger...

Background: In patients with perilunate injuries (PLI) with multiple ligamentous and bony injuries involving the proximal carpal row, open reduction and internal fixation (ORIF) can be difficult and lead to poor functional outcomes. Proximal row carpectomy (PRC) is an alternative procedure that has been used for severely comminuted fractures. The aim of our study is to evaluate the long-term functional outcome (minimum 5 years) of patients that underwent an emergency PRC for PLI. Methods: We conducted a retrospective study of patients who underwent PRC at our centre between 2001 and 2016...

Background: The human hand is a specialised organ for fine motion and sensation and has a relatively large representation in the homunculus. The pathway of sensation starts from information sent by mechanoreceptors in the hand. This study reports the topography of the Pacinian corpuscle in the fingertips of a human cadaver. Methods: All 10 digits from both hands of a fresh-frozen cadaver were examined. Glabrous skin distal to the distal interphalangeal joint was harvested superficial to the periosteum including fat and subcutaneous tissue...

The authors describe a novel opponensplasty for severe carpal tunnel syndrome that uses the palmaris longus (PL) tendon transferred to the rerouted extensor pollicis brevis (EPB) tendon with pulley reconstruction using a portion of the PL tendon simultaneously with the carpal tunnel release. Like the Camitz opponensplasty, this technique utilises the PL as the motor source, does not require special postoperative treatment and enables fast functional recovery even in older patients. Compared with the Camitz procedure, this technique can easily acquire thumb rotation without tendon bowstringing...

No abstract text is available yet for this article.

Background: The objective of this study was to assess whether resident involvement in distal radius fracture open reduction internal fixation (ORIF) affect 30-day postoperative complication, hospital readmission, reoperation and operative time. Methods: A retrospective study was performed using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database by querying the Current Procedural Terminology (CPT) codes for distal radius fracture ORIF from 1 January 2011 to 31 December 2014...

Background: Hand surgeons sometimes place more weight on clinical findings and may not always consider the results of electrodiagnostic studies (EDX) in the diagnosis of carpal tunnel syndrome (CTS). The aim of this study is to determine factors associated with a change in diagnosis of CTS after EDX. Methods: This is a retrospective study of all patients with an initial clinical diagnosis of CTS who underwent EDX at our hospital. We identified patients whose diagnosis changed from CTS to non-CTS after EDX and used univariate and multivariate analysis to determine if age, sex, hand dominance, unilateral symptoms, history of diabetes mellitus, rheumatoid arthritis, haemodialysis, cerebral lesion, cervical lesion, mental disorder, initial diagnosis by a non-hand surgeon, the number of examined items in CTS-6 and a CTS-negative EDX result were associated with a change in diagnosis after EDX...

Background: Little is known regarding the effect timing of repair has on extensor tendon repair results. The purpose of this study is to determine if a relationship exists between the time of extensor tendon injury to extensor tendon repair and patient outcomes. Methods: A retrospective chart review was conducted on all patients that underwent extensor tendon repair at our institution. The minimum time to final follow-up was 8 weeks. Patients were then divided into two cohorts for analysis; those that underwent repair less than 14 days after injury and those that underwent extensor tendon repair at or greater than 14 days after injury...

Background: To compare the observed healthcare and societal costs of intramedullary screw (IMS) and plate fixation of extra-articular metacarpal and phalangeal fractures in a contemporary Australian context. Methods: A retrospective analysis, based on previously published data, was performed utilising information from Australian public and private hospitals, the Medicare Benefits Schedule (MBS) and the Australian Bureau of Statistics. Results: Plate fixation demonstrated longer surgical lengths (32 minutes, compared to 25 minutes), greater hardware costs (AUD 1,088 vs...

Background: Reliable methods for measuring range of motion is important for hand therapists. Currently, there is no gold standard for the measurement of thumb metacarpophalangeal joint (MCPJ) hyperextension. We hypothesised that visual and goniometric measurements of thumb MCPJ hyperextension vary greater than 10° from radiographic measurements, and between observers. Methods: Twenty-six fresh-frozen hands were measured by a senior orthopaedic resident and fellowship trained hand surgeon. Passive thumb MCPJ hyperextension was measured by visual estimation, goniometry and axis measurement on a lateral thumb radiograph...

Background: Primary repair for traumatic injuries to the ulnar nerve alone does not always restore satisfactory hand function, particularly in injuries above the elbow where the long distances for regeneration limit motor reinnervation. Reductions in key pinch and grip strength are some of the main complaints. Tendon transfers have traditionally been used to improve key pinch and grip strength as a late salvage where primary nerve regeneration has run its course. Nerve transfers have been proposed as an alternative procedure and may be offered early to augment recovery, lengthen the window for reinnervation or provide motor reinnervation where the results of nerve repair are expected to be poor...

No abstract text is available yet for this article.

Background: Electrocautery is an option for skin incision for the neck, abdominal or inguinal surgery, but is not generally used for hand surgery. The aim of this study was to clarify whether electrocautery skin incision would be beneficial in open carpal tunnel release (OCTR). Methods: A total of 16 patients with carpal tunnel syndrome underwent skin incision for OCTR using either a scalpel ( n = 9) or a microdissection diathermy needle ( n = 7). Postoperative pain was assessed using a visual analogue scale (VAS 0-100 mm) daily from postoperative days 1 till 7...

Background: Congenital constriction ring syndrome (CCRS) is a rare condition diagnosed at birth characterised by deformation due to a constriction ring. The usual treatment for CCRS involves excision of the constriction ring and suture of the skin incorporating a Z-plasty to prevent scar contracture. A Z-plasty often results in an unsightly scar. In order to avoid this, we performed linear circumferential skin closure (LCSC). The aim of this paper is to report the outcomes of LCSC for CCRS. Methods: We retrospectively investigated all patients with CCRS who underwent LCSC between 2002 and 2020...

Surgical principles in sarcoma are a wide resection, including surrounding tissues and maximisation of the function of the affected limb. Rotator cuff muscles are biomechanically important structures acting as a force couple in movement of the shoulder joint. Thus, conjoined tendons are essential for motion capability in absence of the supraspinatus muscle. This article reports a case of a large undifferentiated pleomorphic sarcoma (UPS) at the suprascapular fossa in a 78-year-old man. After diagnosis of sarcoma, he underwent wide, en-bloc excision preserving conjoined tendons of rotator cuff muscles and low-dose radiation therapy for surveillance of local recurrence...

Background: With lack of regulation and incentivisation on YouTube for high-quality healthcare information, it is important to objectively evaluate the quality of information on trigger finger - a common condition for hand surgeon referral. Methods: YouTube was queried (11/21/2021) for videos on trigger finger release surgery. Videos were excluded if they were about unrelated topics or not in English. The most viewed 59 videos were categorised by source as physician or non-physician. Two independent reviewers quantified the reliability, quality and content of each video, with inter-rater reliability assessed using Kohen's Kappa test...

Cryptococcal infection is well-documented in immunocompromised individuals. Cutaneous manifestations are not as common and are often difficult to diagnose due to variable presentations. Furthermore, there have been reports of coexisting cutaneous Cryptococcus and malignancy. We describe a patient that presented with a fast-growing mass (suspected sarcoma) in the hand that was ultimately treated for a Cryptococcus skin infection. We believe familiarity with the possibility of coexistence of these two conditions in an immunocompromised host could have brought about earlier diagnosis and possibly more effective treatment...

Publications on lunotriquetral interosseous ligament (LTIL) injuries among adolescent professional golfers are scarce. Inconclusive clinical and radiographic imaging in rendering a definitive treatment may inform the lack of documentation in literature. In this case study, we present three case series of highly competitive adolescent golfers who presented with persistent and intractable ulnar-sided wrist pain. While the physical examination was clinically suspicious for lunotriquetral (LT) ligament injury, plain radiographs and MRI imaging did not elucidate the cause...