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Techniques in Hand and Upper Extremity Surgery最新文献

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Rehabilitation Following Nerve Transfer Surgery. 神经转移手术后的康复。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-06-01 DOI: 10.1097/BTH.0000000000000359
Juliana Larocerie-Salgado, Shrikant Chinchalkar, Douglas C Ross, Joshua Gillis, Christopher D Doherty, Thomas A Miller
{"title":"Rehabilitation Following Nerve Transfer Surgery.","authors":"Juliana Larocerie-Salgado,&nbsp;Shrikant Chinchalkar,&nbsp;Douglas C Ross,&nbsp;Joshua Gillis,&nbsp;Christopher D Doherty,&nbsp;Thomas A Miller","doi":"10.1097/BTH.0000000000000359","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000359","url":null,"abstract":"<p><p>Nerve transfer surgery is an important new addition to the treatment paradigm following nerve trauma. The following rehabilitation plan has been developed over the past 15 years, in an interdisciplinary, tertiary peripheral nerve program at the \"Roth|McFarlane Hand and Upper Limb Centre.\" This center evaluates more than 400 patients with complex nerve injuries annually and has been routinely using nerve transfers since 2005. The described rehabilitation program includes input from patients, therapists, physiatrists, and surgeons and has evolved based on experience and updated science. The plan is comprised of phases which are practical, reproducible and will serve as a framework to allow other peripheral nerve programs to adapt and improve the \"Roth|McFarlane Hand and Upper Limb Centre\" paradigm to enhance patient outcomes.</p>","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"26 2","pages":"71-77"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123978","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: 4
Single-stage Congenital Polysyndactyly Release: Outcomes and Long-term Followup 单期先天性多指畸形松解术的疗效及远期随访
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-05-17 DOI: 10.1097/BTH.0000000000000399
S. Nazerani, Tina Nazerani, M. Keramati
{"title":"Single-stage Congenital Polysyndactyly Release: Outcomes and Long-term Followup","authors":"S. Nazerani, Tina Nazerani, M. Keramati","doi":"10.1097/BTH.0000000000000399","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000399","url":null,"abstract":"The current surgical strategy for syndactyly is multistage operations in which every other web is released, leaving adjacent webs unoperated for the next stage to avoid a presumed possible digital vascular compromise. In this series, we present our experience with single-stage multiple syndactylies release. A total of 7 patients, including 2 patients with bilateral hand involvement, were included. Dorsal and volar triangular flaps were created for commissure reconstruction, and zigzag manner volar and dorsal incisions were made to release the webbed fingers. Sterile thermoplastic splints were molded directly over the skin grafts without any dressing or tie-over. Following the surgical operation, minimal flexion contracture was seen in three patients that needed future correction procedures. Cosmesis and functional outcome were acceptable. This study shows that the release of all webs in 1 setting can be accomplished by no vascular compromise, and there is no need for a preoperative vascular imaging study.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"26 1","pages":"276 - 281"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48908338","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
Loop Anchor Tension Band Fixation for Olecranon Fractures and Chevron Olecranon Osteotomy. 环锚张力带内固定治疗鹰嘴骨折和Chevron鹰嘴截骨术。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-05-05 DOI: 10.1097/BTH.0000000000000394
W. Ho, Shu-Hsin Yao, Chun-Ho Chen
{"title":"Loop Anchor Tension Band Fixation for Olecranon Fractures and Chevron Olecranon Osteotomy.","authors":"W. Ho, Shu-Hsin Yao, Chun-Ho Chen","doi":"10.1097/BTH.0000000000000394","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000394","url":null,"abstract":"Although tension band wiring is effective for treating olecranon fractures, it is associated with a high reoperation rate because of hardware-related problems. The loop anchor tension band technique is a novel modification of the Arbeitsgemeinschaft für Osteosynthesefragen (AO)-modified tension band wiring technique. This technique is suitable for treating olecranon fractures without severe comminution and olecranon osteotomy. In the current case series, 2 intramedullary 1.25-mm Kirschner wires (K wires) were inserted as temporary fixation into the ulnar shaft from the olecranon after anatomical reduction. The proximal end of each K-wire was bent into a loop shape and advanced deep into the triceps tendon. A transverse hole was drilled distal to the fracture site, and a 1.0-mm metal wire was passed through the bone tunnel and the loops. The wire was tightened to form a figure-of-eight tension band construct. In total, 10 patients with a mean age of 49 (range: 19 to 85) years were included in this pilot series. The mean and minimum follow-up periods were 13.9 and 12 months, respectively. All fractures achieved favorable union, both radiographically and clinically. The mean QuickDASH score was 15.4 (range: 13.6 to 18.2) and the mean Mayo elbow performance score was 94 (range: 85 to 100). None of the patients experienced K-wire migration. The loop anchor tension band technique is a simple, cost effective modification of conventional tension band wiring and exhibited no implant migration in a pilot series.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49462334","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
A Combined Revision Surgical Technique for Failed Operative Lateral Epicondylitis With Concomitant Radial Tunnel Syndrome 外侧上髁炎合并桡骨隧道综合征手术失败的联合翻修手术技术
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-05-05 DOI: 10.1097/BTH.0000000000000398
William P Stults, Zachary C. Hanson, G. Lourie
{"title":"A Combined Revision Surgical Technique for Failed Operative Lateral Epicondylitis With Concomitant Radial Tunnel Syndrome","authors":"William P Stults, Zachary C. Hanson, G. Lourie","doi":"10.1097/BTH.0000000000000398","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000398","url":null,"abstract":"Lateral epicondylitis afflicts a large percentage of the population with most recovering through conservative treatment. The 5% to 10% of patients who undergo operative intervention are met with mixed results. Those that fail to improve often demonstrate a complex presentation of inadequate debridement of the “angiofibroblastic tissue,” missed concomitant radial tunnel syndrome, and iatrogenic residual devascularized tissue resulting from the index procedure. To address all 3 of these causes of failure, the authors have developed a revision procedure that includes repeat debridement of residual tendinosis, decompression of the posterior interosseous nerve, and a vascularized anconeus muscle flap to help cushion soft tissue defects and promote a healthier environment for healing. Performed initially in part in 20 patients, this combined procedure has developed into our recommended treatment for these challenging patients.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"26 1","pages":"271 - 275"},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48045240","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: 1
Treatment of Thumb Metacarpophalangeal Joint Hyperextension by Volar Plate Advancement and Capsulodesis With Suture Tape Augmentation. 掌侧钢板推进及缝合带增强包膜固定术治疗拇指掌指关节过伸症。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-05-04 DOI: 10.1097/BTH.0000000000000396
Tonya W. An, Michael Sun, S. Shin
{"title":"Treatment of Thumb Metacarpophalangeal Joint Hyperextension by Volar Plate Advancement and Capsulodesis With Suture Tape Augmentation.","authors":"Tonya W. An, Michael Sun, S. Shin","doi":"10.1097/BTH.0000000000000396","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000396","url":null,"abstract":"Basal joint arthritis is commonly associated with attenuation of the volar structures at the thumb metacarpophalangeal (MCP) joint, leading to an initially dynamic, and eventually passive hyperextension deformity. In surgical treatment of basilar thumb disease, intervention at the MCP joint should also be considered to correct deformity and prevent persistent dysfunction. We present a novel technique using suture tape augmentation of the thumb MCP joint volar plate advancement and capsulodesis, with the goal of preventing recurrent instability as a result of tissue attenuation and enabling early functional recovery. We also report a representative case of a 66-year-old woman with symptomatic thumb carpometacarpal osteoarthritis and 50 degrees of MCP passive hyperextension. She underwent trapeziectomy and MCP joint volar plate advancement and capsulodesis with suture tape augmentation. Postoperatively, the patient underwent early mobilization of the affected thumb and at final follow-up of 2 years postsurgery had a painless thumb with full opposition and without hyperextension at the MCP joint during pinch maneuvers.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43958963","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
Dry Arthroscopy of the Wrist With a Single-use, 1.9 mm Chip-on-tip System in Wide-awake Local Anesthesia No Tourniquet. 无止血带的全清醒局部麻醉中使用一次性1.9毫米尖端芯片的腕部干性关节镜。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-05-04 DOI: 10.1097/BTH.0000000000000393
Daniel Reiser, Mattias Hedspång, M. Sagerfors
{"title":"Dry Arthroscopy of the Wrist With a Single-use, 1.9 mm Chip-on-tip System in Wide-awake Local Anesthesia No Tourniquet.","authors":"Daniel Reiser, Mattias Hedspång, M. Sagerfors","doi":"10.1097/BTH.0000000000000393","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000393","url":null,"abstract":"We retrospectively reviewed our 34 first wrist dry arthroscopy cases using a single-use, 1.9 mm chip-on-tip system in wide-awake local anesthesia no tourniquet (WALANT). Thirteen patients were acute injuries; all acute patients underwent a magnetic resonance imaging (MRI) before arthroscopy. In total, 20 of 34 patients had a preoperative MRI. We use this method as a diagnostic tool in patients with wrist pain with suspected ligament tears and for the planning of treatment. We see 2 main advantages in the use of the needle chip-on-tip system: the simplicity of the procedure, and the minimal invasive character of the procedure due to the needle size that makes it possible to perform the procedure in WALANT. We find that the needle chip-on-tip arthroscopy system is a safe and cost-efficient alternative to wrist MRI with superior diagnostic ability. The procedure is minimally invasive and well suited for WALANT.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42884211","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: 1
Arthroscopic Trapeziectomy. 关节镜下斜方切除术。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-05-03 DOI: 10.1097/BTH.0000000000000397
R. Tosti
{"title":"Arthroscopic Trapeziectomy.","authors":"R. Tosti","doi":"10.1097/BTH.0000000000000397","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000397","url":null,"abstract":"Several methods of resection arthroplasty for the thumb basal joint exist, yet one commonality of these procedures is the removal of the trapezium. My preference is to achieve total trapeziectomy through a less invasive approach and encourage immediate mobilization in order to expedite return to function. Herein I present a step by step method of arthroscopic total trapeziectomy without suspensionplasty.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42780339","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 Management for Carpometacarpal Boss of Third Joint and Synovectomy: Technique and Case Report 关节镜下治疗第三关节腕节肌凸和滑膜切除术：技术和病例报告
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-04-25 DOI: 10.1097/BTH.0000000000000391
Luis Guilherme Rosifini Alves Rezende, F. J. Shimaoka, L. G. Mandarano-Filho, N. Mazzer
{"title":"Arthroscopic Management for Carpometacarpal Boss of Third Joint and Synovectomy: Technique and Case Report","authors":"Luis Guilherme Rosifini Alves Rezende, F. J. Shimaoka, L. G. Mandarano-Filho, N. Mazzer","doi":"10.1097/BTH.0000000000000391","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000391","url":null,"abstract":"The carpometacarpal boss (CMCB) is painful bony prominence in the dorsum of the hand that can lead to functional and aesthetic impairment. Nonoperative methods are the management of choice, achieving good outcomes. However, operative management could be an alternative in the absence of improvement. Nevertheless, open procedures are more likely to be done, but there are complications, and it is more aggressive to the soft tissue. The use of arthroscopic techniques has increased in the last decade, being a safe alternative for CMCB management. It has the advantage of being a minimally invasive technique, allowing the early range of motion. This minimally invasive method allows synovectomy and preserves tendon attachments, achieving good functional outcomes. This case report presents an arthroscopic technique for managing the middle finger CMCB.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"26 1","pages":"240 - 245"},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42629778","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
Headless Compression Screw for Metacarpal Nonunion: Description of a New Technique and Report of 4 Cases 无头加压螺钉治疗腕骨不连：一项新技术的描述及4例报告
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-04-13 DOI: 10.1097/BTH.0000000000000390
Rene Jorquera Aguilera, Francisco Melibosky, J. Brunelli, P. Delgado, Ricardo Kaempf de Oliveira
{"title":"Headless Compression Screw for Metacarpal Nonunion: Description of a New Technique and Report of 4 Cases","authors":"Rene Jorquera Aguilera, Francisco Melibosky, J. Brunelli, P. Delgado, Ricardo Kaempf de Oliveira","doi":"10.1097/BTH.0000000000000390","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000390","url":null,"abstract":"Nonunion is a rare complication of metacarpal fractures and is usually associated with compound, open fractures with tissue loss and infection, or after failed surgical treatment. Repair by rigid osteosynthesis with plate and screws combined with autologous bone grafting has always been the treatment of choice for most patients. Such method allows early motion, although it has been proven that the presence of hardware may cause local soft tissue irritation. Often, hardware removal and tendon releases are necessary. We describe an original technique with a fixation method for the treatment of metacarpal nonunions, considering the excellent results attained with an intramedullary, headless screw for metacarpal fracture fixation. We report a series of three cases that evolved to bone healing with excellent clinical, functional, and radiographic outcomes.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"26 1","pages":"232 - 239"},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44160188","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: 2
Denervation With Periosteal Resection of the First Carpometacarpal Joint. 第一腕骨-腕骨关节骨膜切除去神经支配。
Techniques in Hand and Upper Extremity Surgery Pub Date : 2022-04-08 DOI: 10.1097/BTH.0000000000000389
Joan Arenas-Prat
{"title":"Denervation With Periosteal Resection of the First Carpometacarpal Joint.","authors":"Joan Arenas-Prat","doi":"10.1097/BTH.0000000000000389","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000389","url":null,"abstract":"Osteoarthritis of the first carpometacarpal joint is a frequent condition that hand surgeons have to deal with. When conservative measures such as physiotherapy, steroid injections, or splinting fail to alleviate symptoms, trapeziectomy is considered the gold standard for surgical treatment. In the present article, a novel technique is presented to denervate the joint capsule together with the periosteum and the endosteum to address sensory receptors located in these 2 extracapsular structures in the proximity of the first carpometacarpal joint area. Denervation with periosteal resection, apart from being a relatively easy and less aggressive technique compared with trapeziectomy, offers satisfactory pain relief with a faster recovery time.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48122852","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: 3
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