Hand Clinics
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Index
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(Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Source Type: journals
Outcome Assessment After Hand Burns
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Overall outcome following hand burns is closely related to the depth of injury. Although even full-thickness burns tend to result in favorable outcomes, injuries to the deeper structures may result in some degree of impairment. Reviewing the existing literature on hand burns clearly demonstrates the need for validated measurement tools for the evaluation of hand burn outcomes. (Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Karen Kowalske Source Type: journals
Microsurgical Reconstruction of the Burned Hand
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Although most thermal injuries to the hand can be successfully managed with excision and grafting, deeper injuries may require microsurgical techniques to provide stable, durable coverage and the optimal functional result. In delayed reconstruction, thin pliable flaps can be used to resurface the hand or allow for contracture releases. Proper patient and procedure selection are critical to the success of microsurgical reconstruction. (Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Yvonne L. Karanas, Rudolf F. Buntic Source Type: journals
Reconstruction of the Pediatric Burned Hand
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Though the hand constitutes only 3% of the total body surface area, a burned hand is a major injury. Reconstruction of the burned hand is key to the overall rehabilitation of the burned patient. Whether an isolated injury, or part of burns to a large overall body surface area, loss of the hand represents a major functional impairment. The American Burn Association recognizes the importance of the burned hand by designating it a major injury. In addition, loss of the hand constitutes a 57% loss of function for the whole person. Thus, successful management of the burned hand is important. (Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Robert L. McCauley Source Type: journals
Rehabilitation of the Burned Hand
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Successful outcomes following hand burn injury require an understanding of the rehabilitation needs of the patient. Rehabilitation of hand burns begins on admission, and each patient requires a specific plan for range of motion and/or immobilization, functional activities, and modalities. The rehabilitation care plan typically evolves during the acute care period and during the months following injury. (Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Merilyn L. Moore, William S. Dewey, Reginald L. Richard Source Type: journals
Scar and Contracture: Biological Principles
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Dysregulated wound healing and pathologic fibrosis cause abnormal scarring, leading to poor functional and aesthetic results in hand burns. Understanding the underlying biologic mechanisms involved allows the hand surgeon to better address these issues, and suggests new avenues of research to improve patient outcomes. In this article, the authors review the biology of scar and contracture by focusing on potential causes of abnormal wound healing, including depth of injury, cytokines, cells, the immune system, and extracellular matrix, and explore therapeutic measures designed to target the various biologic causes of poor s...
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Peter Kwan, Keijiro Hori, Jie Ding, Edward E. Tredget Source Type: journals
The Use of Skin Substitutes in Hand Burns
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Several skin substitutes are available that can be used in the management of hand burns; some are intended as temporary covers to expedite healing of shallow burns and others are intended to be used in the surgical management of deep burns. An understanding of skin biology and the relative benefits of each product are needed to determine the optimal role of these products in hand burn management. (Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Richard Benjamin Lou, William L. Hickerson Source Type: journals
Cold Injury
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The pathophysiology of true frostbite reveals that the direct injury produced during the initial freeze process has a minor contribution to the global tissue damage. However, rapid rewarming to reverse the tissue crystallization has essentially been the lone frostbite intervention for almost half a century. The major pathologic process is the progressive microvascular thrombosis following reperfusion of the ischemic limb, with the cold-damaged endothelial cells playing a central role in the outcome of these frozen tissues. Newer interventions offer the opportunity to combat this process, and this article offers a scientifi...
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Wm J. Mohr, Kamrun Jenabzadeh, David H. Ahrenholz Source Type: journals
The Diagnosis and Management of Electrical Injuries
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Electrical injuries to the extremity can result in significant local tissue damage and systemic problems. An understanding of the pathophysiology of electrical injuries is critical to the medical and surgical management of patients who sustain these injuries. (Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Brett D. Arnoldo, Gary F. Purdue Source Type: journals
Initial Management of Acute Pediatric Hand Burns
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Hand burns, in particular, are one of the leading causes of hand injury in children and can result in significant impairment of hand function. Appropriate initial management of hand burns in children is imperative to optimize function and minimize long-term scarring, and it is for this reason that the American Burn Association advocates referral of pediatric hand burns to a verified burn center. (Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Tina L. Palmieri Source Type: journals
Acute Management of Hand Burns
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Hand burns occur commonly either as part of more extensive burn injuries or in isolation. Optimal management requires careful examination, appropriate wound care, timely surgical excision if warranted, and aggressive range-of-motion therapy. (Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Jose Sterling, Nicole S. Gibran, Matthew B. Klein Source Type: journals
Preface
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Advances in critical care and resuscitation have significantly improved survival following thermal injury. In 2009 survival following extensive burn injury has become the rule rather than the exception. Given this increase in survival, there has been an evolution in the emphasis in clinical care of the burn patient toward optimizing the function and appearance of those that survive their injuries. The hand plays a critical role in an individual's interactions with his or her environment. Hand function is critical to completing activities of daily living and the conduct of vocational and leisure activities. (Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Authors: Matthew B. Klein Source Type: journals
Forthcoming Issues
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(Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Source Type: journals
Contents
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(Source: Hand Clinics)
Source: Hand Clinics - October 5, 2009 Category: Orthopaedics Source Type: journals
Index
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(Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Source Type: journals
Bracing and Rehabilitation for Wrist and Hand Injuries in Collegiate Athletes
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Athletic injuries of the hand and wrist are common. The key to management of these injuries is prevention. Certain sports require athletes to participate in positions that pose a higher risk of injury to the fingers and wrists. Once healing of the injured digit and wrist has occurred, rehabilitation of the injury is important. This requires close communication between the therapist and the strength and conditioning coach to allow strengthening exercises but limit traction to the involved injury in order to limit the risk of reinjury. Finally, once the injury has been rehabilitated, protective playing casts and splints are ...
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Shannon Singletary, William B. Geissler Source Type: journals
Acute Ulnar Collateral Ligament Injury in the Athlete
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The functional thumb is a necessity for successful athletic participation. It not only allows the athlete to manipulate athletic equipment but also allows the precise manipulation of objects in the athlete's hand. Injury to the thumb often negates power grip and finesse of the athletic hand. Injuries can range from fractures, to dislocations, to ligamentous injuries. The relatively unconstrained thumb metacarpophalangeal joint is particularly vulnerable to injury from an abduction moment to its distal segment. Such injuries occur from direct contact and with falls on equipment such as racquet handles and ski poles. The sta...
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Jeff W. Johnson, Randall W. Culp Source Type: journals
Management of Proximal Interphalangeal Joint Dislocations in Athletes
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This article reviews the relevant anatomy, injury characteristics, and treatment options for proximal interphalangeal joint dislocations and fracture dislocations. Treatment methods discussed include closed reduction, percutaneous fixation, and open reduction. (Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Randy R. Bindra, Brian J. Foster Source Type: journals
Operative Fixation of Metacarpal and Phalangeal Fractures in Athletes
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This article discusses percutaneous and open reduction techniques of hand fractures as these injuries pertain to athletes. The goal is stable fixation to allow early return to competition and rehabilitation. (Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: William B. Geissler Source Type: journals
Management of Carpal Instability in Athletes
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Hand and wrist injuries are common in most athletic events and sports. Carpal fractures and ligamentous injuries are common in athletes and require physicians, trainers, and therapists who treat and diagnosis these injuries to have an understanding of the carpal bone anatomy and vascularity along with the potential for progression to instability. Research is still needed to further investigate the optimal treatments of all carpal injuries in athletes along with designing new means to prevent these injuries. (Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Joseph F. Slade, Matthew D. Milewski Source Type: journals
Repair of Arthroscopic Triangular Fibrocartilage Complex Tears in Athletes
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Triangular fibrocartilage complex (TFCC) injuries are a common source of wrist pain in athletes. These injuries constitute a unique orthopedic challenge because of the particular physical demands on these patients. A specialized management approach is often necessary, due to the short recovery time available and the need for high demand performances afterward. Arthroscopic repair of TFCC is becoming the treatment of choice in this group of patients. (Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Periklis A. Papapetropoulos, David S. Ruch Source Type: journals
Carpal Fractures in Athletes Excluding the Scaphoid
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A wide range of hand and wrist injuries occur in today's recreational and elite athletes and account for 3% to 9% of all sports injuries. The onus is on the physician to discriminate between injuries that can be managed with an early return to sport, and those injuries that place the athlete at risk of further injury if they are not managed aggressively from the outset. The physician and the athlete must understand the balance between safe, early return to sport, and prompt surgical treatment that prevents late disability. (Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Jeffrey Marchessault, Matt Conti, Mark E. Baratz Source Type: journals
Arthroscopic Management of Scaphoid Fractures in Athletes
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Fractures of the scaphoid are a common athletic injury. In this article the indications and treatment strategy for arthroscopic management of scaphoid fractures and nonunions in athletes are reviewed. Various arthroscopic assisted and percutaneous techniques for the fixation of fractures of the scaphoid are discussed, including the volar and dorsal percutaneous approaches, and arthroscopic reduction by the Geissler technique. In general, these techniques include a small amount of wrist arthroscopy and a significant amount of fluoroscopy. (Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: William B. Geissler Source Type: journals
Biceps Tendon Injuries in Athletes
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Although rare, athletes involved in competitive strength training and contact sports may sustain distal tendon biceps injuries. Treatment of complete distal biceps tendon ruptures in athletes is primarily surgical. Early repair, through either one-incision or two-incision techniques with anatomic reinsertion of the ruptured tendon to the bicipital tuberosity, is highly recommended. In this article the etiology and pathophysiology of distal biceps tendon ruptures, current diagnostic modalities, and surgical indications are discussed. Also, treatment options, surgical techniques, outcomes, and potential complications are rev...
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Zinon T. Kokkalis, Dean G. Sotereanos Source Type: journals
Medial Collateral Ligament Reconstruction in the Baseball Pitcher's Elbow
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Pitchers are prone to elbow injuries because of high and repetitive valgus stresses on the elbow. The anterior bundle of the medial ulnar collateral ligament (MCL) of the elbow is the primary restraint and is often attenuated with time, leading to functional incompetence and ultimate failure. Pitchers with a history of medial elbow pain, reduced velocity, and loss of command may have an MCL injury in evolution. Physical examination and imaging can confirm the diagnosis. Treatment begins with rest and activity modification. All medial elbow pain is not MCL injury. Surgery is considered only for talented athletes who wish to...
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Holger C. Erne, Ioannis C. Zouzias, Melvin P. Rosenwasser Source Type: journals
Open and Arthroscopic Management of Lateral Epicondylitis in the Athlete
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This article reviews the relevant anatomy of the common extensor tendon origin at the elbow and provides guidelines for surgical management of recalcitrant epicondylitis. Special emphasis is placed on arthroscopic techniques, which, when required, may allow for a more rapid return of the athlete to sport. (Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Mark S. Cohen, Anthony A. Romeo Source Type: journals
Arthroscopic and Open Radial Ulnohumeral Ligament Reconstruction for Posterolateral Rotatory Instability of the Elbow
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Arthroscopic repair and/or plication of the radial ulnohumeral ligament (RUHL) complex can be as successful as open repair. The diagnosis of posterolateral rotatory instability (PLRI), made by a combination of positive clinical findings and radiologic evidence, can be confirmed by arthroscopic examination. The authors describe four clinical tests for PLRI. Magnetic resonance arthrography is recommended to assist in the preoperative evaluation. In surgical cases, the means to arthroscopically confirm instability are explained. Finally, the authors describe a repair and a ligament plication technique that can be performed by...
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Felix H. Savoie, Larry D. Field, Daniel J. Gurley Source Type: journals
The Emerging Role of Elbow Arthroscopy in Chronic Use Injuries and Fracture Care
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This article reviews the basic principles and techniques of elbow arthroscopy and their application to common sports-related conditions, such as valgus overload syndrome, medial collateral ligament insufficiency, and the various causes of lateral elbow pain. Newer applications of elbow arthroscopy in fracture care are addressed as well. (Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: Jennifer W. Hsu, Jason L. Gould, Habimana Fonseca-Sabune, Michael H. Hausman Source Type: journals
Preface
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The incidence of athletic injuries continues to increase for a number of reasons. First, high school and collegiate athletes continue to grow in size, power, and speed as compared with the past. This results in higher velocity and energy injuries. In addition, “weekend warrior” athletic injuries continue to increase as our population continues to participate in athletic activities throughout the life span. (Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Authors: William B. Geissler Source Type: journals
Forthcoming Issues
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(Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Source Type: journals
Contents
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(Source: Hand Clinics)
Source: Hand Clinics - July 31, 2009 Category: Orthopaedics Source Type: journals
Index
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(Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Source Type: journals
Congenital Hand Surgery: What's New and What's Coming
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This article reviews the literature with a survey of 70 articles from seven leading journals published in the last 12 years. The author concludes that the next decade should be even more exciting with the incorporation of an improved understanding of tissue engineering and molecular genetics into classification and treatment algorithms. Understanding the genetic pathways of normal, and therefore abnormal, development should allow improved classification schemes and intervention to prevent, modify, or remedy these birth abnormalities. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Charles A. Goldfarb Source Type: journals
Congenital Differences About the Elbow
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This article discusses diagnosis and treatment of synostosis, arthrogryposis, pterygium, multiple hereditary exostosis, and the unsalvageable forearm. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Scott H. Kozin Source Type: journals
Generalized Skeletal Abnormalities
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This article presents congenital trigger finger, congenital clasped thumb, Madelung's deformity, and other skeletal hand deformities that are characteristic of generalized bone and connective tissue disorders, including achondroplasia and Marfan syndrome. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Andrew J. Watt, Kevin C. Chung Source Type: journals
Constriction Band Syndrome
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Constriction band syndrome is an uncommon congenital abnormality with multiple disfiguring and disabling manifestations. Early amnion rupture with subsequent entanglement of fetal parts by amniotic strands is currently the primary theory for the development of this syndrome. Management of constriction band syndrome is focused on improving function and development while providing a more acceptable esthetic appearance. The treatment should be tailored to the individual. Timing of repair and surgical planning are important to provide the best functional results for affected hands. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Kenji Kawamura, Kevin C. Chung Source Type: journals
Undergrowth: Brachydactyly
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This article discusses the results of conventional reconstruction using nonvascularized toe phalangeal bone grafting and distraction lengthening and the newer technique of microsurgical toe-to-hand transfers. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Michael L. Nguyen, Neil F. Jones Source Type: journals
Overgrowth Conditions: A Diagnostic and Therapeutic Conundrum
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Over the past five decades, one of the major problems in the treatment of overgrowth syndromes of the hand has been classification. Currently, a number of specific conditions with known natural histories have been delineated and reviewed. Treatment is highly individualized. Amputation is still recommended for grotesque deformities of the upper limb. Early aggressive surgery, when indicated, will improve contour, function, and appearance. Specific therapeutic techniques include radical debulking, microvascular neurolysis, vascular reconstruction, epiphysiodesis, and, in some cases, thumb or digit replacement. Long-term outc...
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Matthew J. Carty, Amir Taghinia, Joseph Upton Source Type: journals
Duplication
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This article provides an inclusive review of the embryologic and molecular mechanisms underlying these deformities and focuses on their clinical treatment. The anatomic variation, classification, surgical treatment, and outcomes of surgical intervention are reviewed for each of the disorders of duplication. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Andrew J. Watt, Kevin C. Chung Source Type: journals
Failure of Differentiation: Part II (Arthrogryposis, Camptodactyly, Clinodactyly, Madelung Deformity, Trigger Finger, and Trigger Thumb)
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The term “failure of differentiation” describes the phenotypes of a large number of otherwise unrelated conditions. The six conditions described here (arthrogryposis, camptodactyly, clinodactyly, Madelung deformity, trigger finger, and trigger thumb) are believed to occur because various structures failed to differentiate normally; however, they have neither common features nor a common cause. We have included information about the history and diagnosis of these conditions, the cause (if known), and the current concepts of treatment and expected outcomes. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Jennifer M. Ty, Michelle A. James Source Type: journals
Failure of Differentiation Part I: Syndactyly
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This article discusses the various types of syndactyly, the current state of known genetic mechanisms, and the author's preferred surgical techniques for correction. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Michael A. Tonkin Source Type: journals
Congenital Failure of Formation of the Upper Limb
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This article provides an overview of the various classification systems for radial longitudinal, central longitudinal, and ulnar longitudinal deficiencies. It looks specifically at radius deficiency, hypoplastic thumb, index finger pollicization, narrowed thumb web, forearm-elbow deformities, and hand abnormalities. Various surgical approaches to these conditions and their results are explored. The authors conclude that longitudinal failure of formation deformities comprises a substantial portion of the anomalies of the upper limb. Although much of the past and current congenital hand literature has been devoted to these c...
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Paul R. Manske, Charles A. Goldfarb Source Type: journals
Congenital Hand Differences: Embryology and Classification
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Congenital hand differences affect approximately 1 in 500 persons and present unique diagnostic and classification challenges. The embryology of the hand and upper extremity is discussed, including the molecular basis for patterning of the upper limb. The Swanson/International Federation of Societies for Surgery of the Hand classification system is described, along with a discussion of the difficulties in classifying congenital hand differences based on morphology or etiology. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Douglas M. Sammer, Kevin C. Chung Source Type: journals
Preface
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The most enticing and challenging component of a hand surgery practice is the treatment of children who have congenital hand differences. Children are incredibly adaptable, and they can compensate remarkably well, despite missing a major portion of a limb. The difficulty in treating children's hands is not only what to do and how to do it, but when to do it and when not to do it. For example, children who have syndactyly of border digits need to have earlier operations, perhaps before the age of 6 months, to avoid permanent contractures of the joints that can inevitably result in irrevocable deformities. Similarly, newbor...
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Authors: Kevin C. Chung Source Type: journals
Forthcoming Issues
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(Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Source Type: journals
Contents
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(Source: Hand Clinics)
Source: Hand Clinics - April 21, 2009 Category: Orthopaedics Source Type: journals
Surgical management of windblown hand: results and literature review.
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CONCLUSION: Definitive conclusions on this condition cannot be drawn due to limited experience in the surgical management of this rare condition. We believe that early surgical management is probably the best option available for the patient based on the results obtained. Early surgery and good post-operative compliance from patients can facilitate successful management of this rare condition with predictable results.
PMID: 19308621 [PubMed - in process] (Source: Hand Clinics)
Source: Hand Clinics - March 26, 2009 Category: Orthopaedics Authors: Gavaskar KG, Chowdary N Tags: J Child Orthop Source Type: journals
Effect of sample storage on stability of salivary glutathione, lipid peroxidation levels, and tissue factor activity.
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Saliva samples are often required to be stored for longer periods of time either because of the project protocol or because of lack of funding for analysis. The effects of 6 months storage (fresh, 30, 60, 90 120, 150, and 180 d) on the stability of salivary reduced glutathione (GSH), lipid peroxidation (LPO) and 90 days of storage (fresh, 15, 30, 60, and 90 d) on the stability of salivary tissue factor (TF) activity and the stability of saliva imprint samples at -20 degrees C were evaluated in this study. Salivary GSH, malondialdehyde (MDA) levels as an index of LPO, and TF activities were determined using the methods ...
Source: Hand Clinics - March 13, 2009 Category: Orthopaedics Authors: Emekli-Alturfan E, Kasikci E, Alturfan AA, Pisiriciler R, Yarat A Tags: J Clin Lab Anal Source Type: journals
The palmaris longus muscle and its relations with the antebrachial fascia and the palmar aponeurosis.
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The palmaris longus (PL) is a muscle of the forearm with a long distal tendon that is continuous with the palmar aponeurosis (PA). It is generally assumed that the muscle lies deep to the antebrachial fascia from origin to termination, but a detailed description is lacking. The relationship of the PL tendon with the antebrachial fascia was studied in 30 dissections. The PL was completely absent in six specimens (20%), whereas the PA was identified in all. Average length of the forearm was 25.5 cm (SD: 2.1 cm, range 22-29 cm), overall length of the PL muscle 26.9 cm (SD: 2.6 cm, range 22.5-31.5 cm), muscular belly 13.8 ...
Source: Hand Clinics - February 10, 2009 Category: Orthopaedics Authors: Stecco C, Lancerotto L, Porzionato A, Macchi V, Tiengo C, Parenti A, Sanudo JR, De Caro R Tags: Clin Anat Source Type: journals
Clinical significance of C4d deposition in stable renal allografts in the early post-transplantation period.
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In conclusion, C4d-positive allografts with stable graft function in the early post-transplantation period take an indolent course.
PMID: 19191803 [PubMed - as supplied by publisher] (Source: Hand Clinics)
Source: Hand Clinics - December 19, 2008 Category: Orthopaedics Authors: Yoon HE, Kim SH, Kim JY, Oh EJ, Park SC, Choi BS, Choi YJ, Moon IS, Kim YS, Yang CW Tags: Clin Transplant Source Type: journals
