Techniques in Hand and Upper Extremity Surgery最新文献

Shoulder Arthrodesis With Reamer Irrigation Aspiration Bone Grafting in Patients With Brachial Plexus Injury. 臂丛神经损伤肩关节融合术联合扩眼器灌吸植骨。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-22 DOI: 10.1097/BTH.0000000000000536

Lauren E Tagliero, Alexandra M Cancio-Bello, Brandon J Yuan, Alexander Y Shin

引用次数: 0

A Two-Point Flexion Orthosis for Proximal Interphalangeal Joint Stiffness: Simplified Traction Without Volar Obstruction. 两点屈曲矫形治疗近端指间关节僵硬：无掌侧梗阻的简化牵引。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-18 DOI: 10.1097/BTH.0000000000000535

Paolo Boccolari, Pasquale Arcuri, Roberto Tedeschi, Danilo Donati

{"title":"A Two-Point Flexion Orthosis for Proximal Interphalangeal Joint Stiffness: Simplified Traction Without Volar Obstruction.","authors":"Paolo Boccolari, Pasquale Arcuri, Roberto Tedeschi, Danilo Donati","doi":"10.1097/BTH.0000000000000535","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000535","url":null,"abstract":"Stiffness of the proximal interphalangeal (PIP) joint remains one of the most challenging conditions encountered in hand rehabilitation. When untreated or treated with delay, trauma to the PIP joint often results in progressive capsular contracture, loss of tendon gliding, and functional compromise. Although traditional orthotic management using 3-point pressure systems remains widely adopted, these devices frequently present mechanical limitations as flexion improves, particularly due to volar component impingement. This report describes a novel 2-point static progressive orthosis developed to restore PIP joint flexion without volar obstruction. The orthosis consists of a dorsal thermoplastic base anchored at the metacarpophalangeal (MCP) joint, combined with a semi-rigid dorsal ring placed on the middle phalanx (P2). A dorsal thread passing through the ring applies adjustable flexion traction through an internal-external path, avoiding the palmar side of the joint. The system eliminates the need for volar support and minimises shear forces, allowing greater flexion with increased comfort. The orthosis is fabricated in <20 minutes using low-cost materials and is indicated in patients with post-traumatic or postsurgical flexion deficits where passive range of motion exceeds 60 degrees. It is not suitable for extension contractures or night use. Clinical use suggests that this approach improves the range of motion and patient tolerance while simplifying orthotic design and monitoring. This technique may offer a practical and accessible alternative for therapists and hand surgeons managing flexion contractures of the PIP joint, particularly in cases where conventional orthoses fail due to volar interference.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Radial Neck Osteotomy for Malunion Correction in the Pediatric and Adolescent Population. 儿童和青少年桡骨颈截骨术治疗畸形愈合。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-16 DOI: 10.1097/BTH.0000000000000534

Daniel Y Hong, Charles A Goldfarb

{"title":"Radial Neck Osteotomy for Malunion Correction in the Pediatric and Adolescent Population.","authors":"Daniel Y Hong, Charles A Goldfarb","doi":"10.1097/BTH.0000000000000534","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000534","url":null,"abstract":"Radial head and neck fractures can be difficult to diagnose acutely in the pediatric and adolescent population, especially when radiographic findings are subtle. Visualization of fracture displacement and incongruency of the radiocapitellar joint is highly dependent on ossification of the radial head and arm positioning, leading to missed or inaccurate diagnoses. If these fractures heal with joint subluxation/dislocation or in a position that leads to pain, loss of motion, or functional limitations, corrective osteotomy of the radial neck may be indicated. The goal of radial neck osteotomy is a stable and congruent radiocapitellar joint that provides full elbow and forearm motion. Radial neck osteotomy is challenging given concerns for healing without mechanical impingement, the proximity of critical neurovascular structures, avascular necrosis, and physeal arrest. In addition to restoring alignment, reconstructive surgery should address deficient ligamentous anatomy if necessary to address subluxation of the radiocapitellar joint. We present our surgical technique and case examples of radial neck osteotomy and lateral ulnar collateral ligament advancement for chronic injuries in the pediatric population.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Weber Clamp Dorsal Compression Technique for Distal Radius Fracture Open Reduction and Internal Fixation With Case Series. Weber钳背侧加压技术在桡骨远端骨折切开复位内固定中的应用。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-01 DOI: 10.1097/BTH.0000000000000520

Braden Mattison, Tantien Nguyen, Joshua U Hancock, Humberto Cardona, Kinsey Rice, James J Creighton

{"title":"Weber Clamp Dorsal Compression Technique for Distal Radius Fracture Open Reduction and Internal Fixation With Case Series.","authors":"Braden Mattison, Tantien Nguyen, Joshua U Hancock, Humberto Cardona, Kinsey Rice, James J Creighton","doi":"10.1097/BTH.0000000000000520","DOIUrl":"10.1097/BTH.0000000000000520","url":null,"abstract":"Open reduction and internal fixation (ORIF) of distal radius fractures (DRF) is a common procedure performed by hand surgeons. Complications include, but are not limited to, failure/loss of reduction, improper positioning of hardware, and nerve or tendon injury. Although uncommon, these risks should be considered when choosing a surgical technique. In this article, we present a novel dorsal compression reduction technique (DCRT) using a Weber clamp and surgical towel for ORIF of DRFs. The DCRT maintains efficacy and efficiency and improves safety by minimizing the risks of penetrating skin or fracturing bone during reduction due to its broad distribution of compression forces. A single surgeon retrospective case series was performed and demonstrated appropriate reduction of acute fractures. Subsequent fracture healing was demonstrated without complications. The DCRT provides a promising DRF reduction technique that is safe, easily reproducible, and effective. This technique should be added to all hand surgeons' repertoires as a surgical option for properly indicated patients.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anatomic Autograft Reconstruction of the Collateral Ligaments of the Thumb Metacarpophalangeal Joint. 自体解剖移植重建拇指掌指关节副韧带。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-01 DOI: 10.1097/BTH.0000000000000525

Stacia M Ruse, Nichole Shaw, Robert Kaufmann

引用次数: 0

Extensor Tendon Centralization of the Metacarpophalangeal Joint Using a Synthetic Suture Tape. 人工缝合带用于掌指关节伸肌腱集中。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-01 DOI: 10.1097/BTH.0000000000000524

Dang-Huy Do, Ryan Constantine, Daniel Koehler

引用次数: 0

Trapeziometacarpal Arthrodesis Technique and Outcomes using a Nitinol Compression Staple. 使用镍钛诺加压钉钉的斜跖关节融合术和疗效。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-01 DOI: 10.1097/BTH.0000000000000519

Alec J Talsania, Nathan F Miller, Jay S Talsania

{"title":"Trapeziometacarpal Arthrodesis Technique and Outcomes using a Nitinol Compression Staple.","authors":"Alec J Talsania, Nathan F Miller, Jay S Talsania","doi":"10.1097/BTH.0000000000000519","DOIUrl":"10.1097/BTH.0000000000000519","url":null,"abstract":"Trapeziometacarpal (TMC) arthrodesis is a reliable procedure to treat individuals with trapeziometacarpal osteoarthritis (TMC OA) who have failed conservative treatment. Arthrodesis has classically been deemed as a suitable treatment for young, active males, particularly in the post-traumatic setting, who desire maximum strength. There are numerous arthrodesis techniques described in the literature, however, reported high nonunion rates may deter surgeons from treating TMC OA with arthrodesis. A technique for TMC arthrodesis using the Speed™ Continuous Compression Nitinol Fixation System (BioMedical Enterprises, Inc., San Antonio, TX) and autogenous bone graft is presented here, along with outcomes of 60 consecutive patients (72 thumbs) who underwent the procedure. Subjective, clinical, and radiographic outcomes were collected and analyzed. Average patient age was 54.2 years (range, 30 to 69), and 51.7% were male. Fusion rate was 95.8% (69/72). Two of the three nonunions required revision fusion surgery. Key pinch strength increased from an average of 6.7 to 9.3 kg ( P <0.05) and grip strength increased from an average of 33.7 to 41.1 kg ( P <0.05) at an average follow-up of 23.4 months (median, 16.5). Patient satisfaction was 94%. Ninety percent of patients would repeat the procedure. Average postoperative Quick Disability of the Arm, Shoulder, and Hand ( Quick DASH) score was 11.7 (median, 4.5) at an average follow-up of 54.2 months. Trapeziometacarpal arthrodesis using Nitinol Compression staples is a reliable treatment option for TMC OA, with a low nonunion rate. This technique leads to excellent patient satisfaction and improved key pinch and grip strength.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Arthroscopic Treatment for Intra-articular Distal Radius Malunion: The "4-Step" Procedure. 关节镜治疗桡骨远端关节内畸形愈合：“四步”手术。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-01 DOI: 10.1097/BTH.0000000000000527

Gustavo L Goméz Rodríguez, Ricardo Kaempf, Paula Fischer, Pedro J Delgado

{"title":"Arthroscopic Treatment for Intra-articular Distal Radius Malunion: The \"4-Step\" Procedure.","authors":"Gustavo L Goméz Rodríguez, Ricardo Kaempf, Paula Fischer, Pedro J Delgado","doi":"10.1097/BTH.0000000000000527","DOIUrl":"10.1097/BTH.0000000000000527","url":null,"abstract":"Distal radius fractures have a high incidence of unsatisfactory functional outcomes when not treated appropriately, with malunion being the most common complication. This occurs in 5% to 70% of cases of fractures treated nonoperatively and can impair functionality, strength, and mobility, as well as lead to early articular degeneration if displacement exceeds 2 mm. Surgical treatment through osteotomies aims to correct deformities and restore joint function. The surgical technique presented in this study involves 4 main steps: preoperative arthroscopy to evaluate the joint and rule out other lesions, extra- and intra-articular osteotomies to realign bone fragments following the original fracture line, and definitive fixation with anatomic volar plates that allow early mobilization. Arthroscopy improves visualization and reduces soft tissue damage compared with open procedures, making it a key factor for the procedure's success. Early treatment (within 8 wk) is critical to facilitate correction. Indications for intra-articular osteotomy include active patients with articular step-offs greater than 2 mm, while contraindications include advanced joint degeneration or irreducible midcarpal instability. Potential complications include nerve or tendon injuries, joint stiffness, and issues with fixation materials. Due to its complexity, this surgery requires advanced expertise in arthroscopic techniques and osteotomies.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Arthroscopy in Intra-articular Fractures of the Base of the Proximal Phalanx of the Hand. 关节镜治疗手部近端指骨基部关节内骨折。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-01 DOI: 10.1097/BTH.0000000000000511

Carlos E Torres Fuentes, Paula Alejandra López González, Maria Paula Castiblanco Díaz

{"title":"Arthroscopy in Intra-articular Fractures of the Base of the Proximal Phalanx of the Hand.","authors":"Carlos E Torres Fuentes, Paula Alejandra López González, Maria Paula Castiblanco Díaz","doi":"10.1097/BTH.0000000000000511","DOIUrl":"10.1097/BTH.0000000000000511","url":null,"abstract":"Intra-articular fractures of the base of the proximal phalanx tend to have a significant functional impact in the metacarpophalangeal joint since the articular congruency and gliding motion of the tendons are compromised, with some degree of postoperative stiffness, limited range of motion and pain. We describe a case series of 12 patients who attended our institution, diagnosed with an intra-articular fracture of the base of the proximal phalanx. They underwent surgery for reduction and internal fixation with screws, miniplates and/or Kirschner wires, with an arthroscopic evaluation of the articular surface. In the postoperative follow-up, we evaluated functional outcomes, mobility range, stiffness and recovery time needed to return to daily activities. The functional and clinical outcomes in patients with arthroscopic assistance were satisfactory and allowed them to return promptly to their daily activities without any limitations, with no evidence of articular damage and minimum postoperative pain. The evaluation of the articular surface with a small arthroscopic lens allows the surgeon to visualize possible step-offs and gaps that were not evident in the fluoroscopic examination, with proper placement of osteosynthesis material, using either Kirschner wires or screws through conventional minimally invasive approaches. Even though arthroscopic skills usually tend to go through a learning curve, this method is an alternative and complementary procedure for providing a healing environment for early postoperative mobilization. Alignment and stability preserve the gliding motion of the tendons, which allows an early active range of motion.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Technique of Nonvascularized Second Metacarpal Transfer in the Treatment of Symbrachydactyly. 无血管第二掌骨移植治疗近指畸形。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-09-01 DOI: 10.1097/BTH.0000000000000521

Casey L Wright, Theodore T Guild, Peter M Waters, Andrea S Bauer

引用次数: 0