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Techniques in Hand and Upper Extremity Surgery最新文献

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Mindset. 心态
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-09-01 DOI: 10.1097/BTH.0000000000000442
Nicholas Pulos, Alexander Y Shin
{"title":"Mindset.","authors":"Nicholas Pulos, Alexander Y Shin","doi":"10.1097/BTH.0000000000000442","DOIUrl":"10.1097/BTH.0000000000000442","url":null,"abstract":"","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 3","pages":"131"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10032424","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
V-Y Flap Over Moberg's Flap to Cover the Thumb's Fingertip Injury: Technique and Cases. V-Y皮瓣复盖Moberg皮瓣覆盖拇指指尖损伤的技术与案例。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-09-01 DOI: 10.1097/BTH.0000000000000428
Luis Carlos Díaz, Enrique Vergara-Amador, Felipe Camacho Castro
{"title":"V-Y Flap Over Moberg's Flap to Cover the Thumb's Fingertip Injury: Technique and Cases.","authors":"Luis Carlos Díaz, Enrique Vergara-Amador, Felipe Camacho Castro","doi":"10.1097/BTH.0000000000000428","DOIUrl":"10.1097/BTH.0000000000000428","url":null,"abstract":"<p><p>The Moberg flap has been used to achieve coverage of amputations of the thumb's fingertip. However, it has been associated with flexion contractures of the interphalangeal (IP) joint of the thumb. A modification of the surgical technique is presented, adding a distal V-Y flap to allow greater advancement, and avoiding IP joint contractures. The proposed surgical technique is presented, and a case series of patients treated with this modification is introduced. A total of 5 patients underwent this surgical technique. All the flaps healed without complications. No patient presented stiffness or flexion contracture of the thumb´s IP joint. There were no cases of neuropathic pain and the 2-point discrimination over the flap was 6.8 mm on average. In conclusion, the proposed variation to the Moberg's flap allows adequate coverage of injuries to the thumb's fingertip with a low rate of complications, adequate sensitivity of the reconstructed digit and avoiding flexion contractures of the IP joint.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 3","pages":"151-156"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031405","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
Stabilization of Recurrent Elbow Instability in the Presence of Hyperlaxity in Children Using a Nonanatomic Soft Tissue Reconstruction. 应用非解剖性软组织重建稳定儿童高松弛状态下复发性肘关节不稳。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-06-01 DOI: 10.1097/BTH.0000000000000420
Neil John Jones, Anouska Ayub, Kalpesh R Vaghela, Livio DiMascio, Gregory B Firth, Daniel Williams
{"title":"Stabilization of Recurrent Elbow Instability in the Presence of Hyperlaxity in Children Using a Nonanatomic Soft Tissue Reconstruction.","authors":"Neil John Jones,&nbsp;Anouska Ayub,&nbsp;Kalpesh R Vaghela,&nbsp;Livio DiMascio,&nbsp;Gregory B Firth,&nbsp;Daniel Williams","doi":"10.1097/BTH.0000000000000420","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000420","url":null,"abstract":"<p><p>Despite growing concordance of opinion in the adult setting, pediatric elbow instability and its management are poorly represented in the literature due to its low prevalence and often unique circumstances. The authors present a case of posttraumatic recurrent posterior pediatric elbow instability in a patient with joint hypermobility. Our patient, a 9-year-old girl, sustained a right-sided supracondylar fracture of the humerus in April 2019. Having been managed operatively, the elbow remained unstable and dislocated posteriorly in extension. Definitive surgical management was designed to provide a stable functional elbow. The principle of the surgery was to create a checkrein of tissue, not changing in length in extension and flexion, and to prevent further posterior elbow instability. A 3 mm slip of the central triceps tendon was dissected, leaving its attachment to the olecranon tip. Gracilis allograft was sutured to the strip of the triceps tendon to increase the tensile properties of the native tendon graft using a braided nonabsorbable suture. The tendon construct was then passed through a window made in the olecranon fossa and a transosseous tunnel in the ulna from the coronoid tip to the dorsal cortex. The tendon was tensioned and secured to the radial-dorsal aspect of the ulna with a nonabsorbable suture anchor in 90 degrees of flexion. At one year follow-up, the patient has a stable and pain-free elbow joint with no functional limitations.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 2","pages":"115-119"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9498234","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 Surgeon's Arena. 外科医生竞技场。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-06-01 DOI: 10.1097/BTH.0000000000000432
Alexander Y Shin
{"title":"The Surgeon's Arena.","authors":"Alexander Y Shin","doi":"10.1097/BTH.0000000000000432","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000432","url":null,"abstract":"","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 2","pages":"69"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125120","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
Continuous Passive Elongation Through an External Fixator: A Versatile and Beneficial Adjunct Technique to Treat Severe and Recurrent Cases of Dupuytren Contracture. 通过外固定架进行持续被动延伸:一种治疗严重和复发性双膝挛缩的通用和有益的辅助技术。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-06-01 DOI: 10.1097/BTH.0000000000000422
Peter Yw Chan, Alexander Marcus, Virak Tan
{"title":"Continuous Passive Elongation Through an External Fixator: A Versatile and Beneficial Adjunct Technique to Treat Severe and Recurrent Cases of Dupuytren Contracture.","authors":"Peter Yw Chan,&nbsp;Alexander Marcus,&nbsp;Virak Tan","doi":"10.1097/BTH.0000000000000422","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000422","url":null,"abstract":"<p><p>Dupuytren disease and its associated digit contracture often negatively impact the quality of life for patients. Severe cases of Dupuytren contracture and symptom recurrence are both difficult for hand surgeons to treat. Improved treatment options are therefore needed. One method is continuous passive elongation (CPE). In CPE, a device is affixed to the digit, which applies a continuous extending force to pull the affected finger out of flexion. Multiple external fixators used to induce CPE have been reported. However, a low-profile, hand-specific external fixator, the DigiFix, provides benefits over previously reported devices. We present the technique of CPE using DigiFix as a beneficial and versatile adjunct treatment for severe and recurrent cases of Dupuytren contracture.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 2","pages":"125-130"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10478965","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
Novel Diagnostic and Treatment Techniques for Neurogenic Thoracic Outlet Syndrome. 神经源性胸廓出口综合征的新诊断和治疗技术。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-06-01 DOI: 10.1097/BTH.0000000000000419
Eric R Wagner, Michael B Gottschalk, Adil Shahzad Ahmed, Alexander R Graf, Anthony L Karzon
{"title":"Novel Diagnostic and Treatment Techniques for Neurogenic Thoracic Outlet Syndrome.","authors":"Eric R Wagner,&nbsp;Michael B Gottschalk,&nbsp;Adil Shahzad Ahmed,&nbsp;Alexander R Graf,&nbsp;Anthony L Karzon","doi":"10.1097/BTH.0000000000000419","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000419","url":null,"abstract":"<p><p>Neurogenic thoracic outlet syndrome is a challenging condition to diagnose and treat, often precipitated by the triad of repetitive overhead activity, pectoralis minor contracture, and scapular dyskinesia. The resultant protracted scapular posture creates gradual repetitive traction injury of the suprascapular nerve via tethering at the suprascapular notch and decreases the volume of the brachial plexus cords and axillary vessels in the retropectoralis minor space. A stepwise and exhaustive diagnostic protocol is essential to exclude alternate pathologies and confirm the diagnosis of this dynamic pathologic process. Ultrasound-guided injections of local anesthetic or botulinum toxin are a key factor in confirming the diagnosis and prognosticating potential response from surgical release. In patients who fail over 6 months of supervised physical therapy aimed at correcting scapular posture and stretching of the pectoralis minor, arthroscopic surgical release is indicated. We present our diagnostic algorithm and technique for arthroscopic suprascapular neurolysis, pectoralis minor release, brachial plexus neurolysis, and infraclavicular thoracic outlet decompression.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 2","pages":"100-114"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10497217","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
Plating of Proximal Ulna Fractures Using Posterolateral Distal Humerus Plates: Surgical Technique and Case Series. 肱骨远端后外侧钢板钢板治疗尺骨近端骨折:手术技术和病例系列。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-06-01 DOI: 10.1097/BTH.0000000000000415
Allicia O Imada, Samuel McArthur, Nathan T Morrell
{"title":"Plating of Proximal Ulna Fractures Using Posterolateral Distal Humerus Plates: Surgical Technique and Case Series.","authors":"Allicia O Imada,&nbsp;Samuel McArthur,&nbsp;Nathan T Morrell","doi":"10.1097/BTH.0000000000000415","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000415","url":null,"abstract":"<p><p>Precontoured olecranon plates are frequently used in the management of proximal ulna fractures. Occasionally, in comminuted proximal ulna fractures or segmental ulna fractures, available precontoured olecranon plates are too short for the management of these fractures. The authors have utilized posterolateral distal humerus plates in these instances. The coronal bend in some posterolateral distal humerus plates anecdotally fits well to the proximal ulna, despite being designed for the distal humerus. We sought to measure the coronal angulation of precontoured posterolateral distal humerus plates from various companies and compare these to established proximal ulna angles. Case examples are also provided.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 2","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10124544","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
Bilateral Lesser Tuberosity Fractures: Technique and a Case Report with Literature Review. 双侧小结节骨折:技术及1例报告并文献复习。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-06-01 DOI: 10.1097/BTH.0000000000000417
Daniel M Zuchelli, Gregory S Penny, William R Aibinder
{"title":"Bilateral Lesser Tuberosity Fractures: Technique and a Case Report with Literature Review.","authors":"Daniel M Zuchelli,&nbsp;Gregory S Penny,&nbsp;William R Aibinder","doi":"10.1097/BTH.0000000000000417","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000417","url":null,"abstract":"<p><p>Isolated lesser tuberosity fractures are a rare subset of proximal humerus fractures and are often associated with seizures. Displaced fractures can lead to chronic pain, reduced shoulder function, and posterior instability. Operative treatment is frequently recommended with the displacement of more than 5 mm or angulation of more than 45 degrees. We report on a 31-year-old man with bilateral lesser tuberosity fractures who underwent operative fixation for 1 fracture and nonoperative fixation for the other.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 2","pages":"90-94"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10126685","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
Assessment of Intraoperative Rotational Alignment of Closed Locked Intramedullary Nailing for Humerus Fractures. 闭锁髓内钉治疗肱骨骨折术中旋转对准的评价。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-06-01 DOI: 10.1097/BTH.0000000000000411
Benjamin Boothby, Lucas Haase, Robert Wetzel
{"title":"Assessment of Intraoperative Rotational Alignment of Closed Locked Intramedullary Nailing for Humerus Fractures.","authors":"Benjamin Boothby,&nbsp;Lucas Haase,&nbsp;Robert Wetzel","doi":"10.1097/BTH.0000000000000411","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000411","url":null,"abstract":"<p><p>Intramedullary nailing of humerus fractures has evolved over the past half century and has grown in popularity especially for the polytraumatized patient. The importance of restoring appropriate rotational alignment is equivalent to that of restoring sagittal and coronal alignment to decrease the risk of shoulder degenerative changes and limit range of motion discrepancy from the contralateral limb. This technique is designed to introduce an intraoperative fluoroscopic method to obtain adequate rotational alignment of humeral shaft fractures treated with closed antegrade humeral locked nailing.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 2","pages":"70-72"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10126639","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 Capsulodesis for the Treatment of Dynamic Scapholunate Dissociations. 关节镜下囊腔固定术治疗动态舟月骨分离。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-06-01 DOI: 10.1097/BTH.0000000000000418
Max Haerle, Nicole Schmelzer-Schmied, Florian M Lampert
{"title":"Arthroscopic Capsulodesis for the Treatment of Dynamic Scapholunate Dissociations.","authors":"Max Haerle,&nbsp;Nicole Schmelzer-Schmied,&nbsp;Florian M Lampert","doi":"10.1097/BTH.0000000000000418","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000418","url":null,"abstract":"<p><p>Management of scapholunate dissociations remains a significant challenge. Open approaches suffer from a disadvantageous further impairment of the stabilizing local structures. The minimally invasive arthroscopic technique described provides reliable stability of the scapholunate interosseous ligament complex in dynamic lesions. The anatomic key structure is the dorsal capsuloligamentous scapholunate septum, which provides a mechanical connection between the scaphoid, lunate, and dorsal capsule of the wrist. Arthroscopic capsuloplasty aims to tighten and stabilize this complex structure in long term. This approach preserves the adjacent structures, namely the secondary wrist stabilizers and their neuromuscular feedback loops. With a certain degree of experience in wrist arthroscopy, the technique is reliably adaptable and reproducible.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 2","pages":"95-99"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10497208","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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