Techniques in Hand and Upper Extremity Surgery最新文献

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Femoral Trochlea Osteochondral Autograft Transplant for Scaphoid Proximal Pole Nonunions.
Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-03-06 DOI: 10.1097/BTH.0000000000000510
Ellen Y Lee, Allen T Bishop, Alexander Y Shin
{"title":"Femoral Trochlea Osteochondral Autograft Transplant for Scaphoid Proximal Pole Nonunions.","authors":"Ellen Y Lee, Allen T Bishop, Alexander Y Shin","doi":"10.1097/BTH.0000000000000510","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000510","url":null,"abstract":"<p><p>Small proximal pole scaphoid nonunions are challenging to treat. We describe a technique for replacing the proximal pole fragment with an osteochondral autograft transplant harvested from the ipsilateral femoral trochlea. This is indicated in nonunions where the proximal pole fragment is smaller than the scaphoid isthmus; the scapholunate ligament complex is intact on the distal fragment, and in nonunions without dorsal intercalated segment instability and radiocarpal arthritis. The osteochondral autograft transplant is press-fitted into the distal scaphoid and does not require implants for osteointegration. This provides an advantage during revision surgery of previously fixed proximal scaphoid fractures that are not united with an implant in situ.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568244","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
Elbow Interposition Arthroplasty With Meniscal Allograft.
Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-03-04 DOI: 10.1097/BTH.0000000000000509
Ryan C Xiao, Christine S Williams, Amanda L Walsh, Jaehon M Kim, Michael R Hausman
{"title":"Elbow Interposition Arthroplasty With Meniscal Allograft.","authors":"Ryan C Xiao, Christine S Williams, Amanda L Walsh, Jaehon M Kim, Michael R Hausman","doi":"10.1097/BTH.0000000000000509","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000509","url":null,"abstract":"<p><p>Painful, end-stage elbow arthritis in young, active patients remains a challenging and unsolved problem. Lifetime weight-bearing restrictions make total elbow arthroplasty (TEA) an unrealistic and unsustainable option for most of these patients, and the alternatives for treating a failed TEA are limited and mostly unsatisfactory. Elbow interposition arthroplasty can provide good pain relief and reasonable restoration of motion while avoiding weight-bearing restrictions. However, resurfacing materials such as fascia, Achilles tendon, and skin are not durable and are likely torn or displaced. We propose using meniscus allograft as the interposition material, as it is strong, robust, and designed to resist high compressive and shearing loads. It can heal the native tissue, and the topological properties of an amphitheater-shaped meniscus wrapped in a semicircle anatomically simulates the native shape of the trochlea, conferring additional stability that abets concentric motion. We present a series of 5 patients who underwent meniscal allograft arthroplasty from 2021 to 2023 at a single institution. All patients had resurfacing with meniscus allographs with supplemental stabilization using a double internal joint stabilizer. All patients demonstrated improvement in pain and ulnohumeral range of motion. Our technique of meniscus allograft interposition arthroplasty demonstrates good short-term pain relief and functional improvement. Further follow-up is warranted to assess the longevity of the meniscus interposition. Level of Evidence: Level IV-treatment study.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543724","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
The Free Distal Clavicle Osteochondral Flap: Cadaveric Dissection and Case Report to Introduce a Novel Technique.
Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-02-25 DOI: 10.1097/BTH.0000000000000506
Emily Van Kouwenberg, Brittany L Sacks, Matthew J Gluck, Zachary L Bernstein, Yiyang Zhang, Ogechukwu Onuh, Michael R Hausman
{"title":"The Free Distal Clavicle Osteochondral Flap: Cadaveric Dissection and Case Report to Introduce a Novel Technique.","authors":"Emily Van Kouwenberg, Brittany L Sacks, Matthew J Gluck, Zachary L Bernstein, Yiyang Zhang, Ogechukwu Onuh, Michael R Hausman","doi":"10.1097/BTH.0000000000000506","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000506","url":null,"abstract":"<p><p>Vascularized osteochondral flap reconstruction is an innovation with several potential benefits, but there are limited described autologous donor site options. This study explores the distal clavicle as a viable donor site for vascularized free osteochondral tissue transfer. Cadaveric dissection was performed in which a 39-year-old male with a comminuted fracture of the right distal humerus underwent open reduction and internal fixation. The patient later presented with avascular necrosis of the lateral column of the distal humerus and right trochlea and underwent reconstruction of the distal humerus with iliac crest bone graft and vascularized free osteochondral transfer of the distal clavicle. The distal clavicle was harvested with its periosteum and a small muscle cuff based on the acromial branch of the thoracoacromial system. The authors report a novel technique for distal clavicle osteochondral flap harvest and present a case in which the technique was used successfully in complex elbow reconstruction.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494103","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
Vascularized Proximal Radius Bone Graft for a Massive Elbow Bone Defect: An Anatomic Study and Case Report.
Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-02-10 DOI: 10.1097/BTH.0000000000000508
Sergi Barrera-Ochoa, Julio A Martínez-Garza, Maximiliano Ibañez, José A Prieto-Mere, Melissa Bonilla-Chaperon, Francisco Soldado
{"title":"Vascularized Proximal Radius Bone Graft for a Massive Elbow Bone Defect: An Anatomic Study and Case Report.","authors":"Sergi Barrera-Ochoa, Julio A Martínez-Garza, Maximiliano Ibañez, José A Prieto-Mere, Melissa Bonilla-Chaperon, Francisco Soldado","doi":"10.1097/BTH.0000000000000508","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000508","url":null,"abstract":"<p><p>From an anatomic perspective, this paper delineates the proximal radial bone branches of the radial artery (RA). We also report the successful clinical use of a vascularized proximal radius bone graft (VPRBG), supplied by the RA, in a complex case involving a massive osseous elbow defect. In 10 latex-colored upper limbs from fresh human cadavers, RA branches were dissected under ×2.5 loupe magnification, noting all periosteal and osseous branches for the proximal radius. VPRBG length was measured. In the proximal forearm, the RA provides 10 (range: 7 to 14) periosteal and osseous branches to supply the area from the radial head to the proximal diaphysis. A 15 cm (11 to 17) vascularized bone graft can be harvested from the proximal radius, and RA dissection generates a 12 cm (9 to 15) pedicle with a wide arc of rotation, readily capable of reaching the distal part of the humerus. We used a 14 cm long VPRBG for elbow arthrodesis to fill a 12 cm defect, caused by a previous recalcitrant elbow infection in a 68-year-old man. The patient experienced no postoperative complications and successful consolidation was achieved 6 months postoperatively, with flap survival confirmed. After 2 years of follow-up, the contoured dorsal plate was removed, with no signs of infection. Final Disabilities of the Arm, Shoulder, and Hand and Mayo Wrist scores were 23 and 88, respectively. A VPRBG might be a safe and effective surgical option for massive osseous elbow defects, whenever elbow arthrodesis is planned, where it should be combined with a one-bone forearm technique.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383284","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
Orthokids Precise De-rotation Jig for Rotational Osteotomies of Humerus. 肱骨旋转截骨术矫形儿童精确去旋转夹具。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-01-17 DOI: 10.1097/BTH.0000000000000507
Maulin Shah, Joyance James, Tashfin Rubaiath, Preksha Vijay
{"title":"Orthokids Precise De-rotation Jig for Rotational Osteotomies of Humerus.","authors":"Maulin Shah, Joyance James, Tashfin Rubaiath, Preksha Vijay","doi":"10.1097/BTH.0000000000000507","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000507","url":null,"abstract":"<p><p>Humerus de-rotational osteotomies are one of the commonly done salvage procedures in children with residual brachial plexus birth injuries. Conventionally, the degree of angular correction was measured clinically intraoperatively by the ability to reach the occiput and the belly or it can be measured by putting reference k-wires at the appropriate angles. However, accurate angular correction is essential to success, as under-correction may lead to parental dissatisfaction and over-correction may lead to loss of mid-line function. The 'Orthokids Precise De-rotation Jig' (Nebula Surgical, Rajkot, INDIA) allows the exact measurement of the rotational correction required, which will lead to improved clinical outcomes. This accurate measurement mitigates the risk of errors due to parallax or eyeballing. The jig is handy, radio-opaque, autoclavable, and can be used without extensive dissection than what is required for the plate fixation.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013584","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
Flexor Carpi Ulnaris Surgical Approach to the Volar Ulnar Corner of the Distal Radius. 尺侧腕屈肌手术入路桡骨远端掌尺角。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2025-01-13 DOI: 10.1097/BTH.0000000000000505
Arya Minaie, Christopher Warburton, Nikhil Patel, Nicolette Schurhoff, Christopher Oguayo, Seth D Dodds
{"title":"Flexor Carpi Ulnaris Surgical Approach to the Volar Ulnar Corner of the Distal Radius.","authors":"Arya Minaie, Christopher Warburton, Nikhil Patel, Nicolette Schurhoff, Christopher Oguayo, Seth D Dodds","doi":"10.1097/BTH.0000000000000505","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000505","url":null,"abstract":"<p><p>There are many approaches to the wrist both volar and dorsal, depending on the injury at hand. The design of the volar locking plate has created a rise in distal radius fractures being treated using a volar FCR approach and its modifications. It does, however, have limitations in visualization of the volar ulnar corner of the radius. In this paper, we will revisit the flexor carpi ulnaris approach and pose some considerations for its historical context, safety, efficacy, and surgical technique.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972550","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
De Quervain's Tenosynovitis Release With Excision of the First Dorsal Compartment: Novel Surgical Technique and a Case Series. 通过切除第一背侧腱鞘室解除 De Quervain's Tenosynovitis:新颖的手术技术和病例系列。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2024-12-01 DOI: 10.1097/BTH.0000000000000488
Adam Margalit, Jared Bookman, Michael Aversano, Michael Guss, Omri Ayalon, Nader Paksima
{"title":"De Quervain's Tenosynovitis Release With Excision of the First Dorsal Compartment: Novel Surgical Technique and a Case Series.","authors":"Adam Margalit, Jared Bookman, Michael Aversano, Michael Guss, Omri Ayalon, Nader Paksima","doi":"10.1097/BTH.0000000000000488","DOIUrl":"10.1097/BTH.0000000000000488","url":null,"abstract":"<p><p>Incision of the dorsal side of the tendon sheath in release of De Quervain's tenosynovitis has traditionally been advocated to prevent the risk of volar tendon subluxation. We describe a novel technique of complete excision, rather than simple incision, of the first dorsal compartment tendon sheath. Over a 10-year period, 147 patients (154 wrists) underwent first dorsal compartment release using this technique of complete excision of the sheath. No postoperative immobilization is used. Patients were followed for a mean of 7.0 months. Records were assessed for any complications including reoperation, tendon subluxation, recurrence, wound complications, scar tenderness, and superficial radial sensory nerve paresthesias. There were no cases of recurrence, reoperation, or tendon subluxation after release with this technique. Postoperatively, 7 (4.5%) patients had scar tenderness and 5 (3.2%) of these patients also had superficial radial sensory nerve parasthesias, which all resolved at the time of final follow-up. Mean range of motion was 73±11 degrees of flexion and 69±10 degrees of extension. In contrast to simple incision, we propose that this technique provides a more complete release of the compartment without risk of symptomatic subluxation or bowstringing and provides a complete release of a separate extensor pollicis brevis subsheath or any concomitant retinacular cysts associated with the tendonitis. There is an immediate removal of the symptomatic swelling and visible, painful bump associated with the thickened retinaculum with this technique. Furthermore, no immobilization is required after surgery.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":"197-200"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440941","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
Snapping Triceps Syndrome: Surgical Technique. 肱三头肌折断综合征:手术技术。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2024-09-01 DOI: 10.1097/BTH.0000000000000475
Fa Yu Chan, Caroline Lam, Roger Butorac, Laurent Willemot
{"title":"Snapping Triceps Syndrome: Surgical Technique.","authors":"Fa Yu Chan, Caroline Lam, Roger Butorac, Laurent Willemot","doi":"10.1097/BTH.0000000000000475","DOIUrl":"10.1097/BTH.0000000000000475","url":null,"abstract":"<p><p>Snapping triceps syndrome is a rare cause of medial elbow pain and ulnar neuritis caused by subluxation and triggering of the medial tricipital muscle belly over the medial distal humeral ridge and condyle. The diagnosis and surgical management of snapping triceps syndrome can be challenging due to the subtlety of the symptoms and the infrequent presentation. Despite the diagnosis relying largely on clinical examination, noninvasive dynamic ultrasonography may facilitate detection. Correct recognition of this condition is crucial in the avoidance of surgical misadventure and revision surgery. This paper illustrates our surgical technique for the management of snapping triceps and reviews the available literature on this relatively obscure condition.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":"129-131"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029225","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
Tenoscopy for the Treatment of Hand Intratendinous Ganglion: Technique Description and Case Report. 腱鞘镜治疗手部腱鞘内神经节:技术描述和病例报告。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2024-09-01 DOI: 10.1097/BTH.0000000000000481
Ricardo Kaempf de Oliveira, João Pedro Farina Brunelli, Fernando Corella Montoya, Pedro J Delgado
{"title":"Tenoscopy for the Treatment of Hand Intratendinous Ganglion: Technique Description and Case Report.","authors":"Ricardo Kaempf de Oliveira, João Pedro Farina Brunelli, Fernando Corella Montoya, Pedro J Delgado","doi":"10.1097/BTH.0000000000000481","DOIUrl":"10.1097/BTH.0000000000000481","url":null,"abstract":"<p><p>Synovial or ganglion cysts are the most common soft tissue tumors of the wrist and hand and can arise from joints or tendons. Intratendinous synovial cysts, in contrast, are rare and their pathogenesis is still a matter of debate. The treatment of synovial cysts of articular origin using arthroscopy is commonly used with good results. For cysts of tendon origin, that is, extra-articular, when located at the ankle, shoulder, knee, and wrist, endoscopic treatment has also been described in a procedure called tenoscopy. We describe the technique and the good results using tenoscopy for a patient treated for an intratendinous synovial cyst located at the extensor communis tendon of the third digit. It is a reproducible, safe technique with low morbidity, and the patient has had no complications or recurrence.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":"166-170"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874865","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
Evaluation of the Dysfunctional Scapula. 肩胛骨功能障碍评估。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2024-09-01 DOI: 10.1097/BTH.0000000000000484
Joaquin Sanchez-Sotelo
{"title":"Evaluation of the Dysfunctional Scapula.","authors":"Joaquin Sanchez-Sotelo","doi":"10.1097/BTH.0000000000000484","DOIUrl":"10.1097/BTH.0000000000000484","url":null,"abstract":"<p><p>Periscapular pain and dysfunction are relatively common complaints in the practice of upper extremity surgeons. However, evaluation of the dysfunctional scapula is intimidating for most. Physical examination of the periscapular muscles is very rich, and a systematic approach provides the opportunity to establish a diagnosis for most patients. Conditions underlying scapular dysfunction include trapezius palsy, serratus palsy, brachial plexus injuries, muscular dystrophy, snapping scapula, pectoralis minor syndrome, congenital undescended scapula, and functional scapular dyskinesis, among others. Patients should be examined with their torso uncovered and assessed from the front and back. Inspection, evaluation of motion, and strength testing may be followed by certain examination maneuvers specific for each condition. The scapular assistance test may help predict the outcome of treatment for certain conditions. Plain radiographs oftentimes need to be complemented with magnetic resonance of the chest to capture periscapular muscles as well as an electromyogram with nerve conduction studies. Computed tomography is particularly helpful for skeletal abnormalities. Ultrasound is used to assess certain peripheral nerve injuries and to guide diagnostic and therapeutic injections. A focused evaluation of the scapula followed by a more specific and directed approach for each condition suspected will allow upper extremity surgeons to approach the evaluation of the dysfunctional scapula with much more confidence.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"28 3","pages":"182-191"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000983","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
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