Techniques in Hand and Upper Extremity Surgery最新文献_第4页

Antegrade Flexible Nailing for Pediatric Metaphyseal-diaphyseal Junction Distal Radius Fracture, is it Safe? 顺行柔性内钉治疗小儿骨干骺端-骨干端桡骨远端骨折安全吗?

Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-09-01 DOI: 10.1097/BTH.0000000000000430

Aaron Lam, Adam M Gordon, Ahmed M Thabet, Amr A Abdelgawad

{"title":"Antegrade Flexible Nailing for Pediatric Metaphyseal-diaphyseal Junction Distal Radius Fracture, is it Safe?","authors":"Aaron Lam, Adam M Gordon, Ahmed M Thabet, Amr A Abdelgawad","doi":"10.1097/BTH.0000000000000430","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000430","url":null,"abstract":"Fractures involving the distal radius metaphyseal-diaphyseal junction (MDJ) present a unique challenge for pediatric orthopedic surgeons. These fractures are too proximal for percutaneous K -wire fixation and too distal for retrograde flexible nailing. The purpose of this study was to: (1) determine the safety of a described antegrade approach from the posterior interosseous nerve (PIN); (2) assess the efficacy of antegrade nailing in cases of distal MDJ fractures; and (3) describe a standardized lateral approach to the proximal radius. A cadaveric study was performed using 10 adult forearms. Anterograde flexinail was introduced at the proximal radius based on the described \"safe zone\". Distal MDJ fractures were created using osteotomes. We evaluated the distance between the entry point to the PIN in addition to the quality of the reduction for the fracture. The average distance between the entry point and piercing instrument to the PIN was 5.4 cm (range: 4.7 to 6.0 cm). When grouped based on sex, the average distance was significantly further for males (5.8 cm, range: 5.2 to 6.0 cm) versus females (4.9 cm, range: 4.7 to 5.2 cm), P =0.004. Fracture reduction was not maintained after the introduction of the antegrade flexible nail across the fracture site. For all specimens, >25% displacement was seen on the anterior-posterior imaging. Our modified lateral approach to the starting point in the proximal radius is safe as long as the entry point for antegrade flexible nailing stays proximal to the radial tuberosity during the lateral approach to the proximal radius while the elbow is flexed and the forearm pronated.","PeriodicalId":39303,"journal":{"name":"Techniques in Hand and Upper Extremity Surgery","volume":"27 3","pages":"161-164"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10085973","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

Form and Function: Technique for Free Functional Gracilis Harvest With Greater Saphenous Vein for Large Skin Paddle. 形态与功能:大隐静脉游离功能性股薄肌摘取术。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-09-01 DOI: 10.1097/BTH.0000000000000437

Alexander Graf, Akinade Ojemakinde, Sachin Gupta, Nicole Zelenski, L Scott Levin

引用次数: 0

Forequarter Amputation: Reconstruction With Targeted Muscle Reinnervation to the Filet of Forearm Free Flap. 前肢截肢:前臂游离皮瓣腓骨肌神经重建。

Techniques in Hand and Upper Extremity Surgery Pub Date : 2023-09-01 DOI: 10.1097/BTH.0000000000000424

Adrian Markewych, Mark Hansdorfer, Alan Blank, George Kokosis, David E Kurlander

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

引用次数: 0

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

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, Anouska Ayub, Kalpesh R Vaghela, Livio DiMascio, Gregory B Firth, Daniel Williams","doi":"10.1097/BTH.0000000000000420","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000420","url":null,"abstract":"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.","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

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

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, Michael B Gottschalk, Adil Shahzad Ahmed, Alexander R Graf, Anthony L Karzon","doi":"10.1097/BTH.0000000000000419","DOIUrl":"https://doi.org/10.1097/BTH.0000000000000419","url":null,"abstract":"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.","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

引用次数: 0