MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Hand Clinics' source. Thu, 09 Feb 2012 00:02:28 +0100 http://www.medworm.com/index.php?rid=5450747&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211001211%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450747 Mon, 28 Nov 2011 17:08:23 +0100 5450747 http://www.medworm.com/index.php?rid=5450746&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000825%2Fabstract%3Frss%3Dyes Intrinsic muscle dysfunction can be devastating. Patients often have difficulty using the affected hand for most daily activities. Physicians, occupational therapists, and patients have to work together to enable the patient to regain functional use of the hand to perform activities that are a part of their life roles. Occupational therapists play an important role in the rehabilitation process to regain motion, strength, and dexterity so that patients can use the hand more functionally. Patient education and active participation in their therapy is also essential in the functional recovery of the hand. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450746 Mon, 28 Nov 2011 17:08:23 +0100 5450746 http://www.medworm.com/index.php?rid=5450745&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211001053%2Fabstract%3Frss%3Dyes This article reviews diagnosis, etiology, and treatment algorithms in the management of intrinsic contractures of the fingers. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450745 Mon, 28 Nov 2011 17:08:23 +0100 5450745 http://www.medworm.com/index.php?rid=5450744&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000898%2Fabstract%3Frss%3Dyes A wide range of conditions can lead to intrinsic contractures of the thumb. A thorough understanding of the normal and pathologic anatomy as well as the disease processes and their effect on thumb function is essential in understanding and treating these contractures. Because intrinsic contractures of the thumb rarely present in isolation, a patient-specific approach based on functional needs is required. Prevention of iatrogenic contractures and progression of predictable contractures regardless of etiology is the health care provider’s primary responsibility. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450744 Mon, 28 Nov 2011 17:08:23 +0100 5450744 http://www.medworm.com/index.php?rid=5450743&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000904%2Fabstract%3Frss%3Dyes This article describes the clinical evaluation and surgical treatment options for claw hand. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450743 Mon, 28 Nov 2011 17:08:23 +0100 5450743 http://www.medworm.com/index.php?rid=5450742&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211001089%2Fabstract%3Frss%3Dyes The primary intrinsic muscles responsible for key and tip pinch are the adductor pollicis, first dorsal interosseous and flexor pollicis brevis muscles. Numerous conditions can lead to their dysfunction. Non-operative treatment consists of exercises of the compensating extensor pollicis longus and flexor pollicis longus muscles and use of adaptive devices, such as larger grips. Operative treatments include tendon transfers and joint fusions. The most common tendon transfer procedures include transfering of the extensor carpi radialis brevis to the adductor pollicis muscle or transfering of the abductor pollicis longus to the first dorsal interosseous muscle. Both require use of extension tendon grafts. In cases of joint instability or arthrosis, arthrodesis of the thumb and index finger MP... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450742 Mon, 28 Nov 2011 17:08:23 +0100 5450742 http://www.medworm.com/index.php?rid=5450741&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000850%2Fabstract%3Frss%3Dyes Opposition is not grasp but a preposition for grasp that involves 3 components of thumb movements: abduction, flexion, and pronation. Thumb opposition is usually lost with paralysis of the thenar muscles innervated by the median nerve. Many opposition transfers have been described that differ in the donor tendon, route of transfer, and method of attachment to the thumb. No one transfer is applicable for every clinical condition, and each transfer has its advantages and disadvantages. Many factors must be evaluated to decide if surgery is likely to be beneficial and then decide on the optimum treatment. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450741 Mon, 28 Nov 2011 17:08:23 +0100 5450741 http://www.medworm.com/index.php?rid=5450740&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000849%2Fabstract%3Frss%3Dyes This article discusses the muscular anatomy and function, vascular anatomy, and nerve anatomy and innervation of the hypothenar muscles. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450740 Mon, 28 Nov 2011 17:08:23 +0100 5450740 http://www.medworm.com/index.php?rid=5450738&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000862%2Fabstract%3Frss%3Dyes This article gives an overview of the functional anatomy and pathologic dysfunction of the interosseous muscles within the context of this Hand Clinics issue on the intrinsic muscular function of the hand. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450738 Mon, 28 Nov 2011 17:08:23 +0100 5450738 http://www.medworm.com/index.php?rid=5450737&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000874%2Fabstract%3Frss%3Dyes The four thenar muscles make up the intrinsic muscles of the thumb. They include the abductor pollicis, adductor pollicis, opponens pollicis, and flexor pollicis brevis. Thumb motion is facilitated through the coordination of these intrinsic muscles. The thumb musculature dynamically allows for precision pinching ad power gripping. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450737 Mon, 28 Nov 2011 17:08:23 +0100 5450737 http://www.medworm.com/index.php?rid=5450736&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000886%2Fabstract%3Frss%3Dyes “There is a general tendency to curtail progressively the time allotted to the teaching of anatomy in the medical schools, but the need for anatomy is greater than ever. It is essential in surgery, where an adequate knowledge of structure could have eliminated inadequate operations performed in the past and those still being performed.” (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450736 Mon, 28 Nov 2011 17:08:23 +0100 5450736 http://www.medworm.com/index.php?rid=5450735&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121100120X%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450735 Mon, 28 Nov 2011 17:08:23 +0100 5450735 http://www.medworm.com/index.php?rid=5450734&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211001193%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450734 Mon, 28 Nov 2011 17:08:23 +0100 5450734 http://www.medworm.com/index.php?rid=5450733&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211001181%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450733 Mon, 28 Nov 2011 17:08:23 +0100 5450733 http://www.medworm.com/index.php?rid=5366696&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000989%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366696 Tue, 01 Nov 2011 04:00:00 +0100 5366696 http://www.medworm.com/index.php?rid=5366695&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121100062X%2Fabstract%3Frss%3Dyes This article discusses the preliminary results of treatment of chronic scapholunate lesions by arthroscopic dorsal capsuloligamentous repair, which does not require open exposure of the wrist capsule. Thirty six patients underwent arthroscopically assisted dorsal capsuloplasties. Sixteen had percutaneous pinning. Mean follow-up was at 11.4 months. The average arc of motion was 105°preoperatively and 120°postoperatively. The average grip strength attained 92% of the contralateral side. Most of the results were excellent-to-good. Seven professional athletes returned to preinjury level. Arthroscopic dorsal capsuloligamentous repair is a promising option, but a longer follow-up is necessary to confirm these results. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366695 Tue, 01 Nov 2011 04:00:00 +0100 5366695 http://www.medworm.com/index.php?rid=5366693&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000795%2Fabstract%3Frss%3Dyes This article discusses the unique elements of such protocols, including training and education, the consent process, the necessary recipient and donor data, donor management, and operating room procedures. Candidate listing, allocation, and oversight of hand donation in the future are also discussed. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366693 Tue, 01 Nov 2011 04:00:00 +0100 5366693 http://www.medworm.com/index.php?rid=5366689&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000801%2Fabstract%3Frss%3Dyes Upper extremity transplantation is an innovative reconstructive strategy with potential of immediate clinical application and the most near-term pay-off for select amputees, allowing reintegration into employment and society. Routine applicability and widespread impact of such strategies for the upper extremity amputees with devastating limb loss could be enabled by implementation of cellular therapies that integrate and unify the concepts of transplant tolerance induction with those of reconstructive transplantation. Such therapies offer the promise of minimizing the risks, maximizing the benefits and optimizing outcomes of these innovative procedures. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366689 Tue, 01 Nov 2011 04:00:00 +0100 5366689 http://www.medworm.com/index.php?rid=5366688&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000618%2Fabstract%3Frss%3Dyes This article highlights interventions to enhance nerve regeneration through acceleration of axonal regeneration or augmentation of Schwann cell support and discuss their relevance to composite tissue allotransplantation. Surgical techniques that may be performed at the time of transplantation to optimize intrinsic muscle recovery—including appropriate alignment of ulnar nerve motor and sensory components, transfer of the distal anterior interosseous nerve to the recurrent motor branch of the median nerve, and prophylactic release of potential nerve entrapment points—are also presented. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366688 Tue, 01 Nov 2011 04:00:00 +0100 5366688 http://www.medworm.com/index.php?rid=5366687&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000783%2Fabstract%3Frss%3Dyes To date, 78 upper extremity transplants have been performed in 55 recipients around the world. The purpose of this article is to provide an overview of acute and chronic rejection (CR) and to summarize collective insights in upper extremity transplantation. To date, almost all patients experienced AR that is pathophysiologically similar to that in solid organs. The spectre of chronic rejection is just emerging. Upper extremity transplantation has significant potential as a reconstructive option only if efforts are invested in strategies to reduce risks of prolonged immunosuppression and in approaches to better diagnose, monitor and treat AR and CR. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366687 Tue, 01 Nov 2011 04:00:00 +0100 5366687 http://www.medworm.com/index.php?rid=5366686&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000606%2Fabstract%3Frss%3Dyes There are many immunological challenges related to hand transplantation. Curbing the immune system's ability to effectively mount an immune response against the graft is the goal. As the various components of the immune response are defined and their mechanisms of action delineated, more specific immunosuppressive agents and protocols have been developed. Complications related to immunosuppression in hand transplant recipients are similar to incidences among solid organ recipients. With longer follow-up, the increased cardiovascular risk factors or the development of a neoplasm will likely cause mortality. Standardizing immunosuppression in hand transplantation with the long-term goal of minimization is critically needed. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366686 Tue, 01 Nov 2011 04:00:00 +0100 5366686 http://www.medworm.com/index.php?rid=5366685&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000746%2Fabstract%3Frss%3Dyes The first successful hand transplant in the modern era of reconstructive transplantation was performed in 1998. Since then, more than 65 hand and upper limb transplantations have been performed around the globe, with encouraging results. The main goal of all upper limb transplantations is to enhance the patient's quality of life. The transplant must be successfully integrated into the patient's body and self-image and the recipient should be satisfied with the recovery of sensitivity and muscle function of the new limb. To achieve these goals, a proper and thorough design of the rehabilitation regimen is of critical importance. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366685 Tue, 01 Nov 2011 04:00:00 +0100 5366685 http://www.medworm.com/index.php?rid=5366683&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000722%2Fabstract%3Frss%3Dyes This article summarizes the experience of this center with HTx over the past 5 years. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366683 Tue, 01 Nov 2011 04:00:00 +0100 5366683 http://www.medworm.com/index.php?rid=5366681&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000734%2Fabstract%3Frss%3Dyes This report summarizes the successes and challenges of the Louisville CTA experience in composite tissue allotransplantation. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366681 Tue, 01 Nov 2011 04:00:00 +0100 5366681 http://www.medworm.com/index.php?rid=5366680&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000667%2Fabstract%3Frss%3Dyes The first hand transplantation was realized in Lyon and the results achieved in this case showed the feasibility of the surgical technique, the efficacy of the immunosuppressive protocol, the limited adverse effects and the importance of a patient's compliance and rehabilitation to ensure graft viability and functional recovery. Based on these findings and the positive results achieved in other single hand transplants realized around the world the authors performed also the first double hand transplantation, then followed by other four cases. The recipients received the same immunosuppressive treatment including tacrolimus, prednisone, mycophenolate mofetil and antithymocyte globulins for induction, nevertheless they showed some episodes of acute rejection episodes which reversed after a p... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366680 Tue, 01 Nov 2011 04:00:00 +0100 5366680 http://www.medworm.com/index.php?rid=5366677&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000977%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366677 Tue, 01 Nov 2011 04:00:00 +0100 5366677 http://www.medworm.com/index.php?rid=5366676&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000965%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366676 Tue, 01 Nov 2011 04:00:00 +0100 5366676 http://www.medworm.com/index.php?rid=5366675&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000953%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366675 Tue, 01 Nov 2011 04:00:00 +0100 5366675 http://www.medworm.com/index.php?rid=5450739&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000837%2Fabstract%3Frss%3Dyes The lumbrical muscles are unique in having their origin and insertion on tendons. The lumbricals assist in metacarpophalangeal joint flexion; they contribute to interphalangeal joint extension by acting as deflexors of the proximal interphalangeal joint. Anatomically, they are highly specialized in terms of their architectural properties, with a small physiologic cross-sectional area but long fiber length. Their unique properties indicate that they are probably important in fast, alternating movements and fine-tuning digit motion. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5450739 Mon, 31 Oct 2011 04:00:00 +0100 5450739 http://www.medworm.com/index.php?rid=5366692&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000680%2Fabstract%3Frss%3Dyes This article discusses the various criteria that are important in the selection of patients for CTA. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366692 Mon, 10 Oct 2011 04:00:00 +0100 5366692 http://www.medworm.com/index.php?rid=5366691&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000679%2Fabstract%3Frss%3Dyes Starting a hand transplant program poses tremendous challenges. Solid organ transplantation and hand replantation are time-tested procedures and are now standard of care. Hand transplantation is the amalgamation of the scientific principles of reconstructive surgery and the concepts of organ transplantation. Thus, for any hand transplant program to be successful, there must be collaboration within a multidisciplinary team comprising a core group of hand and transplant surgeons. Such a joint effort can overcome the challenges that are inherent in a complex therapeutic option that integrates different disciplines and organizations during the planning, procedural, and posttransplant phases. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366691 Mon, 10 Oct 2011 04:00:00 +0100 5366691 http://www.medworm.com/index.php?rid=5366684&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000709%2Fabstract%3Frss%3Dyes This article summarizes the findings from 3 recipients of hand allografts, including a description of the preparatory surgery and the transplant and secondary procedures to enhance the function of the hand, forearm, and arm allografts. The study focuses on the complications and disability reported by each patient, with a minimum follow-up of 2 years. The few complications were controlled successfully with medical treatment. Hand transplantation is a major reconstructive procedure that requires careful medical follow-up. The authors provide the first report of a significant improvement in disabilities of the upper limb as a result of hand allotransplantation. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366684 Mon, 10 Oct 2011 04:00:00 +0100 5366684 http://www.medworm.com/index.php?rid=5366678&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000813%2Fabstract%3Frss%3Dyes Reconstructive transplantation has become a clinical reality over the past decade with more than 70 upper limb transplants performed with highly encouraging graft survival and good to excellent functional outcomes. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366678 Mon, 10 Oct 2011 04:00:00 +0100 5366678 http://www.medworm.com/index.php?rid=5366682&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000631%2Fabstract%3Frss%3Dyes This article review the clinical courses of 3 bilateral hand transplant recipients and highlights psychological aspects on reconstructive hand transplantation with special regard to unilateral/bilateral transplantation. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366682 Tue, 04 Oct 2011 04:00:00 +0100 5366682 http://www.medworm.com/index.php?rid=5366694&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000655%2Fabstract%3Frss%3Dyes Currently, more than 65 hand transplants have been performed with studies demonstrating favorable cosmetic and functional outcomes and cortical reintegration of the transplanted hand. Due to such favorable outcomes, many view hand transplant as a potential gold standard for treatment of a double amputee. However, ethical debate continues regarding risks and benefits of this nonlifesaving procedure. Clinicians, patients, and society must agree on whether hand transplantation is ethical and affordable. If a decision is made to transplant a hand, this must be performed in a dedicated center that facilitates integration of multiple specialists, ethicists, pharmacists, and rehabilitationists. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366694 Thu, 22 Sep 2011 04:00:00 +0100 5366694 http://www.medworm.com/index.php?rid=5366690&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000692%2Fabstract%3Frss%3Dyes This article describes the steps in hand allotransplantation, and the importance of patient selection as well as preoperative and postoperative care. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366690 Thu, 22 Sep 2011 04:00:00 +0100 5366690 http://www.medworm.com/index.php?rid=5366679&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000643%2Fabstract%3Frss%3Dyes This article traces the events of the modern era of hand transplantation. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5366679 Thu, 22 Sep 2011 04:00:00 +0100 5366679 http://www.medworm.com/index.php?rid=5164888&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000564%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164888 Sun, 31 Jul 2011 23:00:00 +0100 5164888 http://www.medworm.com/index.php?rid=5164886&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000461%2Fabstract%3Frss%3Dyes This article covers new and emerging techniques in small joint arthroscopy in the hand. Recent improvement in the quality of small joint scopes and advancement in techniques have allowed for many new small joint arthroscopic procedures in the hand. The arthroscopic classification for thumb carpometacarpal (CMC) arthritis as well as treatment of each stage are described. Arthroscopic treatment of pantrapezial arthrosis is reviewed. Metacarpophalangeal arthroscopy for the treatment of synovitis, arthritis, fractures, and gamekeeper injuries are discussed, as is arthroscopy of the proximal interphalangeal, pisotriquetral, fourth and fifth CMC, and distal interphalangeal joints. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164886 Sun, 31 Jul 2011 23:00:00 +0100 5164886 http://www.medworm.com/index.php?rid=5164885&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000357%2Fabstract%3Frss%3Dyes This article describes our experience with MCPJ arthroscopy and seeks to establish its role in clinical practice. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164885 Sun, 31 Jul 2011 23:00:00 +0100 5164885 http://www.medworm.com/index.php?rid=5164884&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000382%2Fabstract%3Frss%3Dyes This article describes arthroscopic techniques for reduction and percutaneous fixation of fifth CMC fracture dislocations. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164884 Sun, 31 Jul 2011 23:00:00 +0100 5164884 http://www.medworm.com/index.php?rid=5164882&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000370%2Fabstract%3Frss%3Dyes Trapeziometacarpal osteoarthritis is a common problem, due to the anatomy of the first ray and the forces applied to the trapeziometacarpal joint throughout activities of daily living. Numerous treatment options exist, and continue to be developed, for this problem. The current goal is to eliminate pain and restore function and strength in a timely manner. New advances allow for earlier return to function with minimally invasive techniques. Arthroscopic hemitrapeziectomy combined with interposition arthroplasty and/or suspensionplasty is a treatment option for Stage II and III trapeziometacarpal arthritis that uses a minimally invasive technique and allows for earlier return of function. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164882 Sun, 31 Jul 2011 23:00:00 +0100 5164882 http://www.medworm.com/index.php?rid=5164879&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000345%2Fabstract%3Frss%3Dyes This article discusses an approach to assessment that respects the articular cartilage and places at the front of the decision-making process the pathoanatomic components of the articular cartilage. It primarily respects the articular cartilage in the patient with avascular necrosis. This approach was developed for avascular necrosis of the lunate, but in principle applies to other joints with avascular necrosis as well. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164879 Sun, 31 Jul 2011 23:00:00 +0100 5164879 http://www.medworm.com/index.php?rid=5164878&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000291%2Fabstract%3Frss%3Dyes Scaphotrapeziotrapezoid (STT) joint osteoarthritis accounts for 13% of all wrist arthritis cases. The arthroscopic treatment combines radial midcarpal portal and STT portal called 1–2 midcarpal portal. We performed 13 isolated resections from the scaphoid distal pole. Patients were only women (average age, 58 years). Pain, mobility, and muscular strength improved significantly. At the same time, we fitted an interposition pyrocarbon implant after resection in 13 patients (average age, 67 years). We had 2 implant dislocations due to technical errors. Outcome quality optimized by the initial mini-invasive approach and arthroscopy should make selection of some treatment indications possible. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164878 Sun, 31 Jul 2011 23:00:00 +0100 5164878 http://www.medworm.com/index.php?rid=5164877&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000473%2Fabstract%3Frss%3Dyes This article reviews the background and results of thermal treatment of predynamic instability of the SLIL. Case examples are discussed as well as a series of patients treated with our protocol for this injury. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164877 Sun, 31 Jul 2011 23:00:00 +0100 5164877 http://www.medworm.com/index.php?rid=5164876&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121100045X%2Fabstract%3Frss%3Dyes The peculiar shape of scaphoid hinders a precise evaluation of its fracture configuration, displacement and accuracy of screw placement. Its tenuous vascular supply risks the complications of delayed union, nonunion and avascular necrosis. Scaphoid is the focus of ligamentous attachment governing carpal kinematics. Preservation of its anatomy and vascularity is critical for normal wrist function. A new fracture classification clearly denoting every fracture type and guiding the management is introduced. The minimal invasive management of different scaphoid fracture conditions, including acute non-displaced and displaced fracture, delayed presentation, and nonunion are discussed. Role of arthroscopy is emphasized. Detailed surgical techniques are shared here. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164876 Sun, 31 Jul 2011 23:00:00 +0100 5164876 http://www.medworm.com/index.php?rid=5164873&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000424%2Fabstract%3Frss%3Dyes This article presents an algorithm of the treatment of traumatic peripheral TFCC tear based on clinical, radiological, and arthroscopic findings. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164873 Sun, 31 Jul 2011 23:00:00 +0100 5164873 http://www.medworm.com/index.php?rid=5164872&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121100031X%2Fabstract%3Frss%3Dyes Anatomical and biomechanical studies have highlighted the importance of the deep attachment of the TFCC for maintaining stability of the distal radioulnar joint (DRUJ). The standard arthroscopic assessment of the TFCC does not allow one to definitively determine whether the deep fibers are indeed intact, and establishing the diagnosis of a foveal detachment remains an exacting challenge. DRUJ arthroscopy is useful to assess the foveal fibers in any patient with DRUJ instability and can aid in the surgical decision making. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164872 Sun, 31 Jul 2011 23:00:00 +0100 5164872 http://www.medworm.com/index.php?rid=5164871&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000412%2Fabstract%3Frss%3Dyes The triangular fibrocartilage complex (TFCC) is the key structure at the wrist that facilitates the rotation of the radius and the carpus on the distal ulnar. The radial or type 1D tears of the TFCC are uncommon, but they pose a major disruption of the articular contact between the carpus and the distal ulna. The tears can heal by arthroscopically repairing the TFCC back to the radius using sutures through bone tunnels. This procedure allows patients to return to their work and sports activities with significant recovery of strength and range of motion. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164871 Sun, 31 Jul 2011 23:00:00 +0100 5164871 http://www.medworm.com/index.php?rid=5164870&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000321%2Fabstract%3Frss%3Dyes This article describes and reviews an all-arthroscopic technique of repair of Palmer type IB TFCC injuries with FasT-Fix suture technology (Smith and Nephew, Andover, MA, USA), which is advantageous both biomechanically and in terms of decreasing risk of morbidity. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164870 Sun, 31 Jul 2011 23:00:00 +0100 5164870 http://www.medworm.com/index.php?rid=5164868&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000552%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164868 Sun, 31 Jul 2011 23:00:00 +0100 5164868 http://www.medworm.com/index.php?rid=5164867&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000540%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164867 Sun, 31 Jul 2011 23:00:00 +0100 5164867 http://www.medworm.com/index.php?rid=5164866&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000539%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164866 Sun, 31 Jul 2011 23:00:00 +0100 5164866 http://www.medworm.com/index.php?rid=5164887&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000436%2Fabstract%3Frss%3Dyes Arthroscopic synovectomy is safe and reliable, with mild postoperative morbidity. The rationale of a surgical synovectomy is to excise inflamed synovium and thereby, remove as much effusion and inflammatory substrate as possible. In most cases, arthroscopic synovectomy is performed as an outpatient procedure. The technique has also been used for other diagnoses causing wrist arthritis, but very few results have been reported and the indications remain to be defined. In rheumatoid arthritis (RA), juvenile chronic arthritis (JCA), systemic lupus erythematosus (SLE), and postinfectious monoarthritis, a long period of increased comfort and improved function can be anticipated. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164887 Sun, 10 Jul 2011 23:00:00 +0100 5164887 http://www.medworm.com/index.php?rid=5164880&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000400%2Fabstract%3Frss%3Dyes This article describes the surgical technique for arthroscopic I and D of the wrist and discusses the indications and benefits of arthroscopic versus open I and D for septic arthritis of the wrist. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164880 Sun, 10 Jul 2011 23:00:00 +0100 5164880 http://www.medworm.com/index.php?rid=5164875&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000308%2Fabstract%3Frss%3Dyes This article describes both an arthroscopic and open repair technique to reattach the TFCC to the fovea. Both techniques reanchor the detached TFCC to the fovea. Both techniques are reliable and promising techniques in the repair of a foveal detachment of the TFCC. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164875 Sun, 10 Jul 2011 23:00:00 +0100 5164875 http://www.medworm.com/index.php?rid=5164874&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000369%2Fabstract%3Frss%3Dyes This article describes an all-arthroscopic knotless technique for TFCC repair. This technique has the advantage of being all arthroscopic using 3 portals, has the ability to repair both the superficial and deep layers of the articular disk, repairs the articular disk directly back to bone, and does not require any suture knots that may irritate the surrounding soft tissues. The surgical technique is described in detail. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164874 Sun, 10 Jul 2011 23:00:00 +0100 5164874 http://www.medworm.com/index.php?rid=5164883&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000333%2Fabstract%3Frss%3Dyes While trapeziectomy with or without interposition arthroplasty and ligament reconstruction or suspensionplasty have been demonstrated to have a high rate of satisfactory outcomes, recent interest has focused on arthroscopy because of its perceived limited invasive nature as well as its versatility. In addition, using the arthroscope, other options are available that preserve all or part of the trapezium to limit subsidence of the thumb axis, preserve grip and pinch strength, and retain later options for joint reconstruction, should that become necessary. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164883 Sun, 03 Jul 2011 23:00:00 +0100 5164883 http://www.medworm.com/index.php?rid=5164881&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000394%2Fabstract%3Frss%3Dyes Wrist arthroscopy can be performed without infusing fluid, as simple traction suffices to maintain the working space. The lack of tissue infiltration by fluid keeps soft tissues in pristine condition if open surgery is needed after the arthroscopic exploration. The dry technique makes fluid distension irrelevant, thus opening new possibilities by combining arthroscopy with moderate-sized incisions. Although any modification of a technique with which one is familiar can be regarded with major reticence, the advantages of the dry technique merit its use. Accomplished wrist arthroscopists will have minimal problems swapping from the wet to the dry and vice versa. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164881 Sun, 03 Jul 2011 23:00:00 +0100 5164881 http://www.medworm.com/index.php?rid=5164869&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000485%2Fabstract%3Frss%3Dyes Arthroscopy of the wrist and hand has evolved from being a mostly diagnostic modality to a valuable and effective therapeutic tool. There are so many new innovations that it was a struggle to limit the size of this issue to less than 20 articles, so the articles that are included consist of a choice pick of some of the best contributions from North America and overseas. Arthroscopy has revolutionized the diagnosis and treatment of wrist instability as well as the treatment of triangular fibrocartilage tears, which continues to evolve. Four separate articles on the diagnosis and treatment of foveal tears highlight the importance of this previously undertreated entity. Small joint arthroscopy of the CMC and MP joints has similarly undergone huge leaps in the diagnosis and treatment of small... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=5164869 Sun, 03 Jul 2011 23:00:00 +0100 5164869 http://www.medworm.com/index.php?rid=4727963&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000205%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727963 Wed, 20 Apr 2011 05:26:57 +0100 4727963 http://www.medworm.com/index.php?rid=4727962&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000072%2Fabstract%3Frss%3Dyes This article reviews the literature on hemiarthroplasty of the ulnohumeral and radiocapitellar joints. It discusses the indications and outcomes of the technique and summarizes the author's experiences and results. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727962 Wed, 20 Apr 2011 05:26:56 +0100 4727962 http://www.medworm.com/index.php?rid=4727961&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000047%2Fabstract%3Frss%3Dyes This article focuses on unlinked and convertible prostheses. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727961 Wed, 20 Apr 2011 05:26:56 +0100 4727961 http://www.medworm.com/index.php?rid=4727960&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000059%2Fabstract%3Frss%3Dyes This article provides an overview of the current state of linked total elbow arthroplasty. Discussed are the general indications for using a linked implant and currently available implants. Disease-specific indications, contraindications, surgical technique, and rehabilitation are discussed. The overall results and disease-specific results, as well as complications after a linked elbow arthroplasty, are reviewed. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727960 Wed, 20 Apr 2011 05:26:56 +0100 4727960 http://www.medworm.com/index.php?rid=4727959&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000035%2Fabstract%3Frss%3Dyes End-stage elbow arthritis in young, active patients presents a challenging problem to the upper extremity surgeon. Total elbow arthroplasty is not a viable option in this population because of functional restrictions, limited implant survivorship, and the lack of an adequate salvage option. With the appropriate surgical indication, interposition arthroplasty can relieve severe pain, affording a functional elbow without severely proscribing permitted activities. In addition, bone stock is preserved, as are other reconstructive options for the future. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727959 Wed, 20 Apr 2011 05:26:56 +0100 4727959 http://www.medworm.com/index.php?rid=4727958&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000102%2Fabstract%3Frss%3Dyes Elbow arthrodesis (EA) is a procedure reserved for the salvage of failed elbow reconstruction or elbow injuries that defy reconstruction of a useful joint. Although arthrodesis of some joints is often straightforward and predictable, EA is technically difficult and associated with a high rate of complications. Furthermore, a successful EA does not translate to a gratifying clinical success. The functional limitations to activities of daily living and personal care are significant. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727958 Wed, 20 Apr 2011 05:26:56 +0100 4727958 http://www.medworm.com/index.php?rid=4727957&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000060%2Fabstract%3Frss%3Dyes Elbow arthroscopy has been used to treat patients with arthritis since the initial report of its efficacy by Savoie and colleagues in 1992. It has proved extremely useful as an adjunct treatment to decrease symptoms and increase function. A thorough knowledge of anatomy is essential for this modality to be used successfully. In young or active patients, it is the treatment of choice for arthritis of the elbow. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727957 Wed, 20 Apr 2011 05:26:56 +0100 4727957 http://www.medworm.com/index.php?rid=4727956&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000126%2Fabstract%3Frss%3Dyes Open capsular debridement is an excellent option for the treatment of elbow arthritis. This technique is particularly indicated in a patient population physiologically younger than 60 years. Given the young age and high functional demand of patients with primary osteoarthritis of the elbow, prosthetic replacement is generally not recommended. Open capsular debridement preserves the native joint and thus does not inherently require permanent activity modification as does replacement arthroplasty. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727956 Wed, 20 Apr 2011 05:26:56 +0100 4727956 http://www.medworm.com/index.php?rid=4727955&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000084%2Fabstract%3Frss%3Dyes This article highlights issues surrounding hemophilic arthropathy of the elbow and focuses on preventive measures, management strategies of the hemophilic elbow, and treatment options for established arthropathy. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727955 Wed, 20 Apr 2011 05:26:56 +0100 4727955 http://www.medworm.com/index.php?rid=4727954&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000023%2Fabstract%3Frss%3Dyes Rheumatoid arthritis (RA) is the most common form of inflammatory arthropathy. RA is considered a disease of synovial joints, although it can cause various extra-articular manifestations. The synovium appears to be the primary target; however, investigations are ongoing to determine the exact etiology and pathoanatomy. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727954 Wed, 20 Apr 2011 05:26:56 +0100 4727954 http://www.medworm.com/index.php?rid=4727953&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000096%2Fabstract%3Frss%3Dyes This article focuses primarily on the unique pathogenesis and general treatment rationale for primary osteoarthritis and posttraumatic arthritis of the elbow. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727953 Wed, 20 Apr 2011 05:26:56 +0100 4727953 http://www.medworm.com/index.php?rid=4727952&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000114%2Fabstract%3Frss%3Dyes The elbow is essential as a stable platform to position the hand in space. Large stresses and forces transmitted through this joint make reconstruction and joint replacement challenging, while the unique anatomy of the joint adds to the complexity of surgical management. Arthritis of the elbow presents a problem in clinical practice and requires an understanding of the pathology present and the options available. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727952 Wed, 20 Apr 2011 05:26:56 +0100 4727952 http://www.medworm.com/index.php?rid=4727951&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000199%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727951 Wed, 20 Apr 2011 05:26:56 +0100 4727951 http://www.medworm.com/index.php?rid=4727950&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000187%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727950 Wed, 20 Apr 2011 05:26:56 +0100 4727950 http://www.medworm.com/index.php?rid=4727949&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071211000175%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4727949 Wed, 20 Apr 2011 05:26:56 +0100 4727949 http://www.medworm.com/index.php?rid=4290370&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210001071%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290370 Tue, 28 Dec 2010 22:18:19 +0100 4290370 http://www.medworm.com/index.php?rid=4290369&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000934%2Fabstract%3Frss%3Dyes Although rheumatoid arthritis causes significant disability for more than 1 million individuals in the United States, prior research regarding surgical treatment options has been limited by study sample size, study design, and methods of comparison. Furthermore, there is wide variation in the referral pattern for hand surgery consideration and type of surgical treatment of rheumatoid hand disease, yet the reasons for these differences are unclear. This review describes the role of outcomes research in rheumatoid hand disease by summarizing variations in surgical treatment, detailing current outcome assessment strategies, and offering potential strategies for designing future studies for rheumatoid hand disease. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290369 Tue, 28 Dec 2010 22:18:19 +0100 4290369 http://www.medworm.com/index.php?rid=4290368&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000922%2Fabstract%3Frss%3Dyes Tendon involvement in rheumatoid arthritis is frequent and might even be the first sign of the disease. In long-standing untreated conditions, especially in combination with bony erosions, tenosynovitis may lead to tendon fraying and finally tendon rupture. Tendon reconstruction includes tendon grafting and tendon transfer. Direct repair is almost never possible in patients with rheumatoid arthritis, because the inflammatory process produces extensive tendon damage over a long distance. In patients with significant impaired joint function, additional joint treatment should be planned at the same time as tendon reconstruction. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290368 Tue, 28 Dec 2010 22:18:19 +0100 4290368 http://www.medworm.com/index.php?rid=4290367&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000946%2Fabstract%3Frss%3Dyes Digital deformities result from rheumatoid synovitis. These deformities are easier to treat in the early stage, when the deformity is passively correctable. Treatment options become limited as the disease progresses and the deformity becomes fixed. Surgical treatment of digital deformities is last in the priority of surgical procedures for the rheumatoid hand and wrist. It is therefore important to understand the patient's needs and expectations for improvement and attempt to match them with the surgical options that can predictably improve the patient's function. A close collaboration with the patient's rheumatologist is helpful in the overall management of patients. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290367 Tue, 28 Dec 2010 22:18:19 +0100 4290367 http://www.medworm.com/index.php?rid=4290366&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000703%2Fabstract%3Frss%3Dyes This article discusses the commonly used reconstructive techniques and their benefits. Case selection through a combined clinic with rheumatologists and hand therapists is recommended. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290366 Tue, 28 Dec 2010 22:18:19 +0100 4290366 http://www.medworm.com/index.php?rid=4290365&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000880%2Fabstract%3Frss%3Dyes This article provides an overview of the types of deformities associated with, and surgical management of, RA of the thumb. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290365 Tue, 28 Dec 2010 22:18:19 +0100 4290365 http://www.medworm.com/index.php?rid=4290364&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000697%2Fabstract%3Frss%3Dyes Wrist involvement in rheumatoid arthritis (RA) is common. Within 2 years of diagnosis, more than half of patients will have wrist pain, and more than 90% will have wrist disease by 10 years. Although wrist involvement is generally thought to be less disabling than RA of the fingers and hand, it can be a significant cause of pain and disability. Severe disease with bony destruction and synovitis in the wrist can also result in soft-tissue problems including tendon ruptures. In addition to musculoskeletal involvement, systemic manifestations of RA can occur. Felty syndrome can result in a low white blood count and splenomegaly in association with RA. New generation, disease-modifying pharmacologic agents offer promise in controlling the disease progression. Surgical treatments for the diseas... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290364 Tue, 28 Dec 2010 22:18:19 +0100 4290364 http://www.medworm.com/index.php?rid=4290363&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000909%2Fabstract%3Frss%3Dyes Rheumatoid arthritis (RA) may progressively affect all articulations of the wrist. Involvement of the distal radioulnar joint (DRUJ) is common and may be the first clinical signs of symptoms of RA. When the DRUJ is affected by RA, upper extremity function can be affected. Effective surgical management includes the Darrach procedure, the Suave-Kapandji procedure, the hemiresection interposition arthroplasty procedure and extensor tenosynovectomy. The long-term effectiveness of DRUJ arthroplasty is currently unknown. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290363 Tue, 28 Dec 2010 22:18:19 +0100 4290363 http://www.medworm.com/index.php?rid=4290362&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000910%2Fabstract%3Frss%3Dyes The elbow is often involved in the progression of rheumatoid arthritis. Because of the elbow's unique role in maneuvering and positioning the hand in space, loss of normal elbow motion, loss of stability, or increased pain with the use of the elbow are all significant sources of impairment in patients with rheumatoid arthritis. The improvements in disease-modifying medications have greatly diminished the prevalence of severe elbow degeneration among patients with rheumatoid arthritis. However, it hasn't been eliminated. In this article the authors discuss strategies for managing it. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290362 Tue, 28 Dec 2010 22:18:19 +0100 4290362 http://www.medworm.com/index.php?rid=4290360&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121000065X%2Fabstract%3Frss%3Dyes This article explores the reasons for the controversy, presents the history of rheumatoid hand surgery, and offers some possible solutions to the problem. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290360 Tue, 28 Dec 2010 22:18:19 +0100 4290360 http://www.medworm.com/index.php?rid=4290359&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000958%2Fabstract%3Frss%3Dyes The clinical picture of rheumatoid arthritis (RA) is best viewed as a combination of systemic symptoms associated with the inflammatory process and articular symptoms related both to potentially reversible synovitis and structural damage brought on by inflammation. In simple terms, the treatment of inflammation is medical, and structural lesions often require surgical solutions. The prime indications for surgery in patients with RA are essentially determined by the patient and consist of a desire to obtain pain relief and/or functional improvement. Pain is difficult to quantify. Essential concepts regarding surgical intervention are that surgery is elective in all but a few rare situations and always requires local therapy. Any evaluation of surgical intervention must be based on its total... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290359 Tue, 28 Dec 2010 22:18:19 +0100 4290359 http://www.medworm.com/index.php?rid=4290358&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000673%2Fabstract%3Frss%3Dyes Over the past 2 decades, the treatment of rheumatoid arthritis (RA) has been revolutionized by advances in the understanding of its pathologic mechanisms and the development of drugs that target them. These newer medications have shown great promise at improving disease outcomes, but they come with notable side effects that can pose long-term treatment challenges and difficulties in the perioperative arena. In this article, the major manifestations of RA and the current medical options for management are discussed. Complications from treatment are then reviewed, and special consideration is given to perioperative medication recommendations. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290358 Tue, 28 Dec 2010 22:18:19 +0100 4290358 http://www.medworm.com/index.php?rid=4290357&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000867%2Fabstract%3Frss%3Dyes Contributions of historical analyses to the development of a cogent etiologic theory of rheumatoid arthritis (RA) have been limited to date. In this article, the authors analyze this literature with respect to the types and conclusions of the research that has been conducted, present the major points of evidence and conclusions that have been drawn, and trace the evolution of 3 historical theories of RA. The authors combine a comprehensive overview of paintings and paleopathological investigations with consideration of contemporary immunologic and genetic studies. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290357 Tue, 28 Dec 2010 22:18:19 +0100 4290357 http://www.medworm.com/index.php?rid=4290356&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121000096X%2Fabstract%3Frss%3Dyes The care for the rheumatoid hand has been a fascinating journey for hand surgeons as well as rheumatologists. From a hand surgeon’s standpoint, the complexity of the anatomic structures ravaged by rheumatoid arthritis creates an intriguing sequence of deformities that taxes the surgical creativity of hand surgeons to restore function and to ameliorate the continued functional deterioration of the hand and wrist. From a rheumatologist’s standpoint, hand conditions are the first sign of the progression of rheumatoid arthritis and effective treatments are available now to slow down—but not to cure—the continual destruction of the hand. For many years, hand surgeons and rheumatologists worked separately to take care of this unique group of patients. Our prior studies have shown that th... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290356 Tue, 28 Dec 2010 22:18:19 +0100 4290356 http://www.medworm.com/index.php?rid=4290355&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210001034%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290355 Tue, 28 Dec 2010 22:18:19 +0100 4290355 http://www.medworm.com/index.php?rid=4290354&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210001022%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290354 Tue, 28 Dec 2010 22:18:19 +0100 4290354 http://www.medworm.com/index.php?rid=4290353&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210001010%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290353 Tue, 28 Dec 2010 22:18:19 +0100 4290353 http://www.medworm.com/index.php?rid=4290361&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000685%2Fabstract%3Frss%3Dyes Rheumatoid arthritis (RA) is a progressively destructive disease. Gradual loss of hand function in RA patients affects their ability for self-care and interferes with their productivity in society. The continuing improvement in the medical management of RA has markedly decreased the incidence of RA hand surgery. In contrast to RA, osteoarthritis (OA) has less inflammatory reaction in the joints and is characterized by degradation of cartilage, resulting in joint destruction and osteophyte formation. The initial treatment of OA is medication and therapy. Steroid injection into affected joints can provide short-term relief, though repeat injections carry a cumulative risk of weakening the soft tissue. In this article the authors share their extensive experience in RA and OA hand surgery to p... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4290361 Mon, 22 Nov 2010 00:00:00 +0100 4290361 http://www.medworm.com/index.php?rid=4079703&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000788%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079703 Tue, 19 Oct 2010 15:57:30 +0100 4079703 http://www.medworm.com/index.php?rid=4079702&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000478%2Fabstract%3Frss%3Dyes This article reviews the etiology, clinical presentation, and treatment strategies for the management of the unique problems that can affect the pediatric and adolescent DRUJ. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079702 Tue, 19 Oct 2010 15:57:30 +0100 4079702 http://www.medworm.com/index.php?rid=4079701&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000648%2Fabstract%3Frss%3Dyes This article prospectively analyzes a series of ulnar head implants with special reference to bone resorption at the prosthesis collar and erosion of the sigmoid notch of the distal radius at an average follow-up of 32 months (minimum 24 months). (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079701 Tue, 19 Oct 2010 15:57:30 +0100 4079701 http://www.medworm.com/index.php?rid=4079700&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000612%2Fabstract%3Frss%3Dyes Arthrodesis is the most reliable and durable surgical procedure for the treatment of a joint disorder, with the main disadvantage of loss of motion of the fused joint. The distal radioulnar joint can be arthrodesed, while forearm pronation and supination are maintained or even improved by creating a pseudoarthrosis of the ulna just proximal to the arthrodesis. This is known as the Sauvé-Kapandji procedure. This procedure is not void of possible complications, such as nonunion or delayed union of the arthrodesis, fibrous or osseous union at the pseudoarthrosis, and painful instability at the proximal ulna stump. All of these can be prevented if a careful surgical technique is used. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079700 Tue, 19 Oct 2010 15:57:30 +0100 4079700 http://www.medworm.com/index.php?rid=4079699&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000454%2Fabstract%3Frss%3Dyes This article discusses the etiology of ulnar impaction syndrome, and its diagnosis and treatment. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079699 Tue, 19 Oct 2010 15:57:30 +0100 4079699 http://www.medworm.com/index.php?rid=4079698&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000351%2Fabstract%3Frss%3Dyes This article outlines various treatment strategies, which include considerations at the wrist, forearm, and elbow. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079698 Tue, 19 Oct 2010 15:57:30 +0100 4079698 http://www.medworm.com/index.php?rid=4079697&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000363%2Fabstract%3Frss%3Dyes In the patient in whom primary distal radioulnar joint surgery has failed, consideration must be given to the anatomy and biomechanics of the native joint; how this has been disrupted by injury, disease, and previous trauma; and what is required to reconstruct the joint. The forearm relies on a congruent condylar cam of the distal ulna, with intact soft tissue restraints for normal biomechanics. Surgical reconstruction using tendon graft, autologous bone graft, allograft interposition, and prosthetic reconstruction are discussed in this article. If these procedures fail, then salvage procedures including wide excision of the ulna or one-bone forearm can be performed. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079697 Tue, 19 Oct 2010 15:57:30 +0100 4079697 http://www.medworm.com/index.php?rid=4079696&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000442%2Fabstract%3Frss%3Dyes The stabilizing constraints of the distal radioulnar joint (DRUJ) include its bony geometry and the surrounding soft tissue support. Given the shallow nature of the sigmoid notch, reconstruction of the palmar and dorsal ligamentous sleeve provides the best solution for restoring stability in cases of chronic DRUJ instability. The pertinent anatomy, indications, contraindications, soft tissue stabilizing procedures, and rehabilitation for the management of chronic DRUJ instability are highlighted in this review. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079696 Tue, 19 Oct 2010 15:57:29 +0100 4079696 http://www.medworm.com/index.php?rid=4079695&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000430%2Fabstract%3Frss%3Dyes This article reviews acute dislocations of the distal radioulnar joint (DRUJ) and distal ulna fractures. Acute dislocations can occur in isolation or in association with a fracture to the distal radius, radial metadiaphysis (Galeazzi fracture), or radial head (Essex-Lopresti injury). Distal ulna fractures may occur in isolation or in combination with a distal radius fracture. Both injury patterns are associated with high energy. Outcomes are predicated on anatomic reduction and restoration of the stability of the DRUJ. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079695 Tue, 19 Oct 2010 15:57:29 +0100 4079695 http://www.medworm.com/index.php?rid=4079694&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000636%2Fabstract%3Frss%3Dyes Unlike tears of the peripheral triangular fibrocartilage or avulsions of the distal radioulnar ligaments, longitudinal split tears of the ulnotriquetral (UT) ligament do not cause any instability to the distal radioulnar joint or the ulnocarpal articulation. It is mainly a pain syndrome that can be incapacitating. However, because the UT ligament arises from the palmar radioulnar ligament of the triangular fibrocartilage complex (TFCC), it is by definition, an injury of the TFCC. The purpose of this article is to describe the cause of chronic ulnar wrist pain arising from a longitudinal split tear of the UT ligament. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079694 Tue, 19 Oct 2010 15:57:29 +0100 4079694 http://www.medworm.com/index.php?rid=4079693&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000624%2Fabstract%3Frss%3Dyes Injury to the triangular fibrocartilage complex is the most common cause of ulnar-sided wrist pain. This functionally related complex of anatomic structures can be a source of pain secondary to acute injury or chronic degeneration. Strategies for the treatment of these injuries involve determining the anatomic location of the tear, the presence of associated distal radioulnar joint instability, and the presence of associated degenerative changes. Surgical management with open and arthroscopic techniques have been described, both with successful results. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079693 Tue, 19 Oct 2010 15:57:29 +0100 4079693 http://www.medworm.com/index.php?rid=4079691&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000600%2Fabstract%3Frss%3Dyes Imaging the DRUJ requires knowledge of the complex bony, muscular, and ligamentous anatomy that contribute to this unique joint. Standard well-positioned radiography is always the appropriate first step in any imaging evaluation of the wrist. High-resolution MRI of the wrist, preferably performed at 3T, helps to delineate the important ligamentous structures relevant to the DRUJ and ulnar wrist, whether the joint is unstable or not. The presence of instability on physical examination is an indication for dynamic CT evaluation. Close attention to technique, no matter what the modality of choice, offers the best chance for success in providing added value with imaging. Finally, communication between the radiologist and hand surgeon allows the advanced imaging examinations to be tailored to t... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079691 Tue, 19 Oct 2010 15:57:29 +0100 4079691 http://www.medworm.com/index.php?rid=4079690&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121000034X%2Fabstract%3Frss%3Dyes The authors describe the anatomy of the distal radioulnar joint (DRUJ) and delineate the importance of viewing this joint as part of the whole forearm. The osseous congruity and ligamentous integrity is of essence for the stability of the DRUJ, according to the principles of tensegrity. The neuromuscular control and possible proprioceptive function of the DRUJ are also outlined. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079690 Tue, 19 Oct 2010 15:57:29 +0100 4079690 http://www.medworm.com/index.php?rid=4079689&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000661%2Fabstract%3Frss%3Dyes In 1998 Dr Thomas Graham edited an issue of the Hand Clinics entitled “Problems About the Distal End of the Ulna”; that issue of the Hand Clinics remained on my desk for the better part of three years as I kept returning to it for clarification on the anatomy, biomechanics, and the pathophysiology of the distal radial ulnar joint (DRUJ). Since that time, the DRUJ has remained an area of discovery and controversy within the field of hand surgery. The complexity of diagnoses within this area and the lack of established treatment algorithms have led my coeditor, Dr Richard Berger, to occasionally refer to the management of these problems as “DRUJury.” Fortunately, recent advancements in imaging and arthroscopy have allowed hand surgeons to identify injuries in this area earlier, while... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079689 Tue, 19 Oct 2010 15:57:29 +0100 4079689 http://www.medworm.com/index.php?rid=4079688&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000776%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079688 Tue, 19 Oct 2010 15:57:29 +0100 4079688 http://www.medworm.com/index.php?rid=4079687&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000764%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079687 Tue, 19 Oct 2010 15:57:29 +0100 4079687 http://www.medworm.com/index.php?rid=4079686&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000752%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079686 Tue, 19 Oct 2010 15:57:29 +0100 4079686 http://www.medworm.com/index.php?rid=3796997&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000557%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796997 Thu, 29 Jul 2010 06:41:42 +0100 3796997 http://www.medworm.com/index.php?rid=3796995&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000326%2Fabstract%3Frss%3Dyes Nerve repair after transection has variable and unpredictable outcomes. In addition to advancements in microvascular surgical techniques, nerve allografts and conduits are available options in peripheral nerve reconstruction. When tensionless nerve repair is not feasible, or in chronic injuries, autografts have been traditionally used. As substitute to autografts, decellularized allografts and conduits have become available. These conduits can reduce donor site morbidity, functional loss at the donor area in cases where autografts are used, and immune reaction from transplants or unprocessed allografts. The development of new biomaterials for use in conduits, as well as use of cytokines, growth factors, and other luminal fillers, may help in the treatment of acute and chronic nerve injurie... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796995 Thu, 29 Jul 2010 06:41:42 +0100 3796995 http://www.medworm.com/index.php?rid=3796993&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000429%2Fabstract%3Frss%3Dyes This article describes two surgical techniques that can be used to tackle these difficult fractures: Parallel plating and orthogonal plating. Both techniques have yielded excellent outcomes after open reduction and internal fixation; yet each has its own set of unique considerations. However, the key to successful treatment of these difficult fractures regardless of technique remains obtaining anatomic reduction with stable fixation and the implementation of early motion. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796993 Thu, 29 Jul 2010 06:41:42 +0100 3796993 http://www.medworm.com/index.php?rid=3796992&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000193%2Fabstract%3Frss%3Dyes This article discusses the surgical considerations related to radial head arthroplasty, including anatomy, indications, and surgical technique. Radial head arthroplasty outcomes literature and a review of current implant options are also discussed. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796992 Thu, 29 Jul 2010 06:41:42 +0100 3796992 http://www.medworm.com/index.php?rid=3796986&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000399%2Fabstract%3Frss%3Dyes Carpometacarpal (CMC) arthritis of the thumb affects half of postmenopausal women and up to 25% of elderly men. This disease can cause significant disability in affected patients often necessitating surgical intervention. Various surgical options have been used to treat refractory CMC arthritis. Any successful surgical intervention must address three goals: removal of diseased joint surfaces, reconstruction of ligamentous stabilizers, and preservation of the joint space. In this article we will discuss various interposition arthroplasty options for CMC arthritis of the thumb. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796986 Thu, 29 Jul 2010 06:41:42 +0100 3796986 http://www.medworm.com/index.php?rid=3796985&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000405%2Fabstract%3Frss%3Dyes Resection arthroplasty with or without ligament reconstruction for thumb trapeziometacarpal arthritis can be complicated by thumb shortening and pinch-strength weakness. Implant arthroplasties have been developed to limit loss of thumb length, improve strength, and limit postoperative convalescence. The ideal thumb carpometacarpal implant should be strong and stable, provide full range of motion, and prevent loosening. Unfortunately, no current prosthesis accomplishes all of these goals. Until the ideal implant is developed, clinical acumen must be used to determine appropriate patients and implants. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796985 Thu, 29 Jul 2010 06:41:41 +0100 3796985 http://www.medworm.com/index.php?rid=3796984&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000375%2Fabstract%3Frss%3Dyes Metacarpal fractures are common, especially in men, and account for about 10% of all fractures in patients. The fracture pattern and location, and the degree of angulation are important in determining the optimal treatment approach. Although metacarpal fractures can be treated nonsurgically, certain indications such as irreducible fractures, malrotations, and open fractures may necessitate surgery. Intramedullary nail fixation has been successful in treating metacarpal fractures. Complications can be minimized by taking appropriate precautions and care in performing the surgery. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796984 Thu, 29 Jul 2010 06:41:41 +0100 3796984 http://www.medworm.com/index.php?rid=3796982&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000466%2Fabstract%3Frss%3Dyes We are living in a period of rapid technological advances in the field of medicine. Nowhere are these advances more obvious that in the subspecialties of orthopaedic surgery, particularly in hand and upper extremity surgery. These new tools and techniques have resulted in a spectrum of changes to the way we manage our practice and approach upper extremity pathologies. Examples of these advances include locking plates for fractures of the hand and wrist, new-generation headless compression screws, new intramedullary nailing techniques, new metal and soft tissue arthroplasty options for the basal joint of the thumb, varied elbow fracture treatment approaches, and increased nerve repair options. In some cases these advances have augmented our traditional treatment modalities and in other case... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796982 Thu, 29 Jul 2010 06:41:41 +0100 3796982 http://www.medworm.com/index.php?rid=3796981&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000545%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796981 Thu, 29 Jul 2010 06:41:41 +0100 3796981 http://www.medworm.com/index.php?rid=3796980&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000533%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796980 Thu, 29 Jul 2010 06:41:41 +0100 3796980 http://www.medworm.com/index.php?rid=3796979&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000521%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796979 Thu, 29 Jul 2010 06:41:41 +0100 3796979 http://www.medworm.com/index.php?rid=4079692&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000338%2Fabstract%3Frss%3Dyes For the distal radioulnar joint (DRUJ) to be stable, not only do the articulating surfaces need to be congruent and well aligned but also the capsule and ligaments need to be mechanically and sensorially competent. According to recent investigations, ligaments should not be regarded as simple static structures maintaining articular alignment but as complex arrangements of collagen fibers containing mechanoreceptors, which are able to generate neural reflexes aiming at a more efficient and a more definitive muscular stabilization. By careful planning and meticulous execution of surgical incisions to approach the DRUJ, the nerve endings innervating the capsule and DRUJ ligaments may be safeguarded, thus preserving the proprioceptive function of the joint. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=4079692 Wed, 21 Jul 2010 23:00:00 +0100 4079692 http://www.medworm.com/index.php?rid=3796989&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000144%2Fabstract%3Frss%3Dyes This article reviews this new technology and presents the authors' experience with the Aptus (Medartis, Kennett Square, Pennsylvania) variable-angle volar locking plates. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796989 Sun, 20 Jun 2010 23:00:00 +0100 3796989 http://www.medworm.com/index.php?rid=3796987&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000168%2Fabstract%3Frss%3Dyes Scaphoid fractures carry significant long-term morbidity and short-term socioeconomic difficulty in the young and active patient population in which they most commonly occur. While cast immobilization results in high rates of radiographic union in nondisplaced scaphoid fractures, internal fixation with headless compression screws has been recommended in cases of displaced fractures. Internal fixation has led to high rates of union in both nondisplaced and displaced fractures with the added benefits of earlier mobilization and return to work and sports. Multiple manufacturers are now offering “second generation” headless compression screws for the internal fixation of scaphoid fractures. The few biomechanical studies that exist demonstrate improved compression forces and load to failure... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796987 Sun, 20 Jun 2010 23:00:00 +0100 3796987 http://www.medworm.com/index.php?rid=3796996&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000181%2Fabstract%3Frss%3Dyes Technologic advances in imaging of the upper extremity have taken an immense leap in the last decade. So has the amount of research that has been published on this subject. Three-dimensional (3D) reconstructions, in particular, have improved identification of fracture characteristics, such as fragments, fracture edges, and articular surfaces. Three-dimensional physical models can even increase the advantages of the 3D reconstructions. Together, 3D reconstructions and physical modeling may outweigh the disadvantages of increased cost, resource usage, and additional time, as research has shown that it can benefit both the surgeon and the patient significantly. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796996 Sun, 13 Jun 2010 23:00:00 +0100 3796996 http://www.medworm.com/index.php?rid=3796991&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000132%2Fabstract%3Frss%3Dyes Plate fixation remains the primary surgical treatment option for most adult forearm fractures. However, intramedullary nailing can be successful and might be preferable in cases of massive soft-tissue injury and burns, certain segmental fractures, pathologic fractures, and skeletally immature adolescent patients. Furthermore, the risk for refracture after plate removal is decreased with fixation by intramedullary nailing. The history, indications, surgical technique, and results of intramedullary fixation of forearm fractures are described in this article. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796991 Sun, 13 Jun 2010 23:00:00 +0100 3796991 http://www.medworm.com/index.php?rid=3796988&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121000020X%2Fabstract%3Frss%3Dyes Intramedullary fixation is the latest in a variety of techniques that have been developed to manage distal radius fractures. Intramedullary nailing of these fractures combines the soft-tissue advantages of a less invasive surgical approach with the biomechanical advantages of locking screw technology. These features may enable an accelerated postoperative rehabilitation and quicker return to function. Disadvantages associated with the intramedullary technique include the necessity of a closed or percutaneous reduction and the inability of the implant to adequately stabilize intraarticular or highly comminuted fractures. Consequently, intramedullary implants are primarily indicated for fixation of extra-articular or simple intraarticular split patterns and should not be employed for managem... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796988 Thu, 10 Jun 2010 23:00:00 +0100 3796988 http://www.medworm.com/index.php?rid=3796983&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000120%2Fabstract%3Frss%3Dyes Locked fixed-angle plating in the hand and wrist helps to optimize outcomes following surgical fixation of select acute fractures and complex reconstructions. Select indications include unstable distal ulna head/neck fractures, periarticular metacarpal and phalangeal fractures, comminuted/multifragmentary diaphyseal fractures with bone loss (ie, combined injuries of the hand), osteopenic/pathologic fractures, nonunions and corrective osteotomy fixation, and small joint arthrodesis. Locked plating techniques in the hand should not be seen as a panacea for wrist and digital acute trauma and delayed reconstructions. An understanding of the biomechanics of fixed-angle plating and proper technical application of locking constructs will optimize outcomes and minimize complications. As clinical e... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796983 Thu, 10 Jun 2010 23:00:00 +0100 3796983 http://www.medworm.com/index.php?rid=3796994&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000156%2Fabstract%3Frss%3Dyes Hinged external fixation of the elbow provides the advantages of static fixation with the benefits of continued motion through the joint. Indications for the use of this method of fixation include traumatic instability, distraction interposition arthroplasty, instability after contracture release, and instability after excision of heterotopic ossification. Orthopedic surgeons should be familiar with hinged fixators and their application when faced with an unstable ulnohumeral joint. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796994 Wed, 09 Jun 2010 23:00:00 +0100 3796994 http://www.medworm.com/index.php?rid=3796990&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121000017X%2Fabstract%3Frss%3Dyes Surgical management of distal radius fractures continues to evolve because of their high incidence in an increasingly active elderly population. Traditional radiocarpal external fixation relies on ligamentotaxis for fracture reduction but has several drawbacks. Nonbridging external fixation has evolved to provide early wrist mobility in the setting of anatomic fracture reduction. Several studies of the nonbridging technique have demonstrated satisfactory results in isolated nonbridging external fixation series and in comparison with traditional spanning external fixation. Nonbridging external fixation for surgical treatment of distal radius fractures can be technically demanding and requires at least 1 cm of intact volar cortex in the distal fracture fragment for successful implementation.... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3796990 Wed, 09 Jun 2010 23:00:00 +0100 3796990 http://www.medworm.com/index.php?rid=3597626&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000284%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597626 Fri, 30 Apr 2010 23:00:00 +0100 3597626 http://www.medworm.com/index.php?rid=3597625&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000089%2Fabstract%3Frss%3Dyes Although many advances have been made in microsurgery, it is not without complications. As microsurgeons continue to make advances in technology, technique, and applications that expand the utility of this field to more and more patients, they must be prepared to deal with the complications related to donor and recipient sites and the medical comorbidity that accompanies these large endeavors in the pre-, post-, and intraoperative periods. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597625 Fri, 30 Apr 2010 23:00:00 +0100 3597625 http://www.medworm.com/index.php?rid=3597624&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071209001267%2Fabstract%3Frss%3Dyes This article discusses the diagnosis, physiology, and management of postsurgical CRPS that occurs after hand surgery. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597624 Fri, 30 Apr 2010 23:00:00 +0100 3597624 http://www.medworm.com/index.php?rid=3597623&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907121000003X%2Fabstract%3Frss%3Dyes This article outlines the principles that can help guide treatment. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597623 Fri, 30 Apr 2010 23:00:00 +0100 3597623 http://www.medworm.com/index.php?rid=3597622&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000053%2Fabstract%3Frss%3Dyes This article emphasizes that attention to restoration of anatomy of the DRUJ should be considered at least as important as that given to the radio-carpal relationship. This article also points out how stiffness of forearm rotation can result from a well-treated distal radius fracture and how this complication can be treated to restore healthy upper limb function. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597622 Fri, 30 Apr 2010 23:00:00 +0100 3597622 http://www.medworm.com/index.php?rid=3597621&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000028%2Fabstract%3Frss%3Dyes This article discusses the major and minor complications of distal plating in the light of a cohort study carried out by the authors, who reviewed all patients undergoing bridge distraction plate fixation of distal radius fractures by three surgeons in a single level I trauma center. The article discusses the effectiveness and the complication rates associated with the technique. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597621 Fri, 30 Apr 2010 23:00:00 +0100 3597621 http://www.medworm.com/index.php?rid=3597620&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071209001279%2Fabstract%3Frss%3Dyes Distal radius fractures account for approximately 15% of all fractures in adults. Care of these fractures is associated with a myriad of complications. This review focuses on the soft tissue complications encountered during the management of distal radius fractures, including tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, complex regional pain syndrome, and ligament dysfunction. There are many vital soft tissue structures in close proximity to the osseous anatomy around the wrist, and the complications associated with the soft tissues may be more problematic than the bone injury itself. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597620 Fri, 30 Apr 2010 23:00:00 +0100 3597620 http://www.medworm.com/index.php?rid=3597619&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071209001280%2Fabstract%3Frss%3Dyes Partial and total wrist arthrodeses have become common procedures for treating degenerative diseases arising from numerous conditions, including posttraumatic arthrosis, intercalated segment instability, inflammatory arthropathy, and carpal osteonecrosis. The goals of these two procedures are to provide pain relief and improved function by fusing arthritic or unstable joints. A thorough understanding of the complications and the best practices to avoid them is critical for the surgeon in the preoperative, intraoperative, and postoperative management of candidates for total or limited wrist arthrodesis. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597619 Fri, 30 Apr 2010 23:00:00 +0100 3597619 http://www.medworm.com/index.php?rid=3597618&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000077%2Fabstract%3Frss%3Dyes This article discusses these risks and complications and provides strategies to minimize risks and manage complications. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597618 Fri, 30 Apr 2010 23:00:00 +0100 3597618 http://www.medworm.com/index.php?rid=3597617&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000041%2Fabstract%3Frss%3Dyes Arthritis in the small joints of the hand can be treated with arthrodesis or arthroplasty. Arthrodesis has known risks of infection, pain, and nonunion. Distal interphalangeal (DIP) arthroplasty has been successful in preserving motion and alleviating pain for distal DIP, proximal interphalangeal, and metacarpophalangeal joints. Unfortunately, complications arise that limit the success of surgery. Silicone implants have been reliable for many years but still present with the risks of infection, implant breakage, stiffness, and pain. Newer implant designs may limit some of these complications, but present with unique problems such as dislocations and loosening. It is not yet clear as to which type of implant provides the most reliable results, although implant arthroplasty appears to give ... Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597617 Fri, 30 Apr 2010 23:00:00 +0100 3597617 http://www.medworm.com/index.php?rid=3597616&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000090%2Fabstract%3Frss%3Dyes The stiff finger is a frequently encountered entity in hand surgical practice. It stems from a myriad of causes, may have multiple components, and requires a variety of solutions. A true understanding of the ideal treatments for the stiff finger requires a basic understanding of the local milieu that arises from injury and the anatomic features that are at risk for pathologic changes. Hand surgeons must be able to help patients understand the various factors at play and the time course of wound healing and injury-induced inflammation, because an educated and motivated patient is the best ally in the battle against the stiff finger. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597616 Fri, 30 Apr 2010 23:00:00 +0100 3597616 http://www.medworm.com/index.php?rid=3597615&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071209001292%2Fabstract%3Frss%3Dyes Management of flexor tendon injuries is one of the most demanding tasks in hand surgery. Despite substantial improvements in surgical technique and postoperative rehabilitation protocols, functional outcomes may still be somewhat unreliable. In the present article, the authors present complications encountered after flexor tendon repair and provide their preferred methods of prevention and treatment. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597615 Fri, 30 Apr 2010 23:00:00 +0100 3597615 http://www.medworm.com/index.php?rid=3597614&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000065%2Fabstract%3Frss%3Dyes Fractures of the metacarpals and phalanges represent 40% of all upper extremity fractures. Complications associated with these fractures are also prevalent, and can arise with both conservative and surgical treatment of hand fractures, making treatment of complications an essential part of caring for these injuries. In this article the treatment of complications associated with open fractures and infection are reviewed, in addition to current treatment options for malunion and stiffness. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597614 Fri, 30 Apr 2010 23:00:00 +0100 3597614 http://www.medworm.com/index.php?rid=3597613&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000119%2Fabstract%3Frss%3Dyes Complications are the bane of any surgeon's existence. They are no doubt under-reported because permanent injury is rare; some surgeons view them as unusual events; surgeons are viewed as infallible; and there is a fear of malpractice litigation. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597613 Fri, 30 Apr 2010 23:00:00 +0100 3597613 http://www.medworm.com/index.php?rid=3597612&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000107%2Fabstract%3Frss%3Dyes Alone in my woodshop, threateningly close to razor-sharp carbide and steel moving faster than 100 miles per hour, I am constantly aware of a potential “complication.” An error in technique, rushing to get done, or skipping a step in my mental safety checklist could ruin a valuable piece of wood, or, more seriously, a piece of my extremity, which could possibly threaten my career. The wood is easily replaced. I can start all over. Hopefully, by following strict safety protocols, bodily damage will not occur. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597612 Fri, 30 Apr 2010 23:00:00 +0100 3597612 http://www.medworm.com/index.php?rid=3597611&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000272%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597611 Fri, 30 Apr 2010 23:00:00 +0100 3597611 http://www.medworm.com/index.php?rid=3597610&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000260%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597610 Fri, 30 Apr 2010 23:00:00 +0100 3597610 http://www.medworm.com/index.php?rid=3597609&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071210000259%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3597609 Fri, 30 Apr 2010 23:00:00 +0100 3597609 http://www.medworm.com/index.php?rid=3087352&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS074907120900122X%2Fabstract%3Frss%3Dyes (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3087352 Tue, 15 Dec 2009 14:55:35 +0100 3087352 http://www.medworm.com/index.php?rid=3087351&cid=s_33227_31_f&fid=33227&url=http%3A%2F%2Fwww.hand.theclinics.com%2Farticle%2FPIIS0749071209001073%2Fabstract%3Frss%3Dyes Traumatic injuries of the distal radioulnar joint (DRUJ) may give rise to complex wrist pathologies. Substantial ongoing disability can arise should these injuries go unrecognized resulting in sub-optimal treatment and lack of appropriate rehabilitation. Injuries of the DRUJ may occur in isolation but more commonly are found with a fracture of the radius. These challenging DRUJ injuries may be simple or complex (irreducible or severe instability), acute or chronic. An adequate knowledge of the stabilizers of the DRUJ is essential in understanding treatment options. Traumatic instability of the DRUJ is reviewed and the anatomy and stabilizing factors are discussed. An algorithm to guide selection of treatment options in complex cases is presented. (Source: Hand Clinics) Hand Clinics journals http://www.medworm.com/rss/comments.php?id=3087351 Tue, 15 Dec 2009 14:55:35 +0100 3087351