The Contemporary View of Distal Radius Fracture Management
For more than 2 centuries, distal radius fracture has been a fascination for surgeons because of the complexity of this anatomic region and the controversies surrounding its treatment. With the application of patient-rated outcomes instruments, we have a greater understanding of the impact of the treatment decisions we make to optimize patient function, while considering the fracture patterns, patients ’ socioeconomic status, and most importantly, their wishes and autonomy. Although spirited discussions when reviewing radiographs lead to intricate treatments options, the data from the WRIST trial highlight the importance...
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Kevin C. Chung Tags: Preface Source Type: research
Applying Evidence-Based Concepts in the Treatment of Distal Radius Fractures in the 21st Century
HAND CLINICS (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Kevin C. Chung Source Type: research
Copyright
ELSEVIER (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Source Type: research
Contributors
KEVIN C. CHUNG, MD, MS (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Source Type: research
Contents
Kevin C. Chung (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Source Type: research
Forthcoming Issues
Applying Evidence-based Concepts in the Treatment of Distal Radius Fractures in the 21st Century (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Source Type: research
Primary Management of Nail Bed and Fingertip Injuries in the Emergency Department
Appropriate management of the acute fingertip and nail bed injury is critical for optimizing patient outcomes. Mismanaged injuries can lead to chronic pain and deformity. Subungual hematomas may be treated with simple trephination for pain relief. Nail bed lacerations may be repaired using dissolvable suture or octyl-2-cyanoacrylate, and in most cases with no need to replace the nail plate or stent the fold. Amputations, partial or complete, can be treated with a wide variety of techniques, but many distal injuries can be left to heal by secondary intention with excellent results. (Source: Hand Clinics)
Source: Hand Clinics - November 14, 2020 Category: Orthopaedics Authors: Jessica B. Hawken, Aviram M. Giladi Source Type: research
Microsurgical Free Tissue Options for Fingertip Reconstruction
This article discusses various free flap options for different fingertip defects. (Source: Hand Clinics)
Source: Hand Clinics - November 14, 2020 Category: Orthopaedics Authors: Min Ki Hong, Jin Ha Park, Sung Hoon Koh, Dong Chul Lee, Si Young Roh, Kyung Jin Lee, Jin Soo Kim Source Type: research
Grafting and Other Reconstructive Options for Nail Deformities
This article reviews the nomenclature, anatomic components, and physiologic growth involving the perionychium. Fingertip and nailbed injuries are commonly encountered problems in hand surgery. This article focuses primarily on dealing with chronic nailbed deformities following traumatic injury such as nonadherence, split nails, avulsion loss, and hook nails. Nail deformities secondary to pincer nail, mass effect, and pigmented lesions are reviewed as well. The underlying pathology and treatment options are examined for each deformity. The senior author highlights technical pearls and surgical planning for his preferred met...
Source: Hand Clinics - November 14, 2020 Category: Orthopaedics Authors: Michael W. Neumeister, James N. Winters Source Type: research
Locoregional Options for Acute Volar Pulp Fingertip Defects
The volar fingertip is a unique anatomic structure, delicate yet durable, that allows us to navigate the world, acquire information from our surroundings, and express ourselves. Injuries to the volar finger can cause permanent dysfunction and should be taken seriously. In treating injuries of the volar fingertip, the surgeon has an opportunity to choose from a host of reconstructive options and provide the patient with an outcome suitable to their needs. In doing so, the hand surgeon is well-positioned to aim for the reconstructive ideal of restoring both structure and function. (Source: Hand Clinics)
Source: Hand Clinics - November 14, 2020 Category: Orthopaedics Authors: Brian L. Chang, Ryan D. Katz Source Type: research
Management of Tendon and Bony Injuries of the Distal Phalanx
Acute tendon and bony injuries of the distal phalanx are challenging injuries because they may result in chronic pain, hypersensitivity, stiffness, and deformity if they are not adequately treated. Flexor tendon avulsions require early surgical repair. Conversely, most extensor tendon injuries and fractures heal well with nonoperative treatment. However, surgery is indicated in selected patients, and meticulous technique is required to achieve good postoperative outcomes. In this article, we outline the pertinent clinical anatomy of the distal phalanx, review the current literature regarding treatment options, and highligh...
Source: Hand Clinics - November 14, 2020 Category: Orthopaedics Authors: Janice C.Y. Liao, Soumen Das De Source Type: research
Fingertip Replantation
Fingertip replantation is technically challenging, but in a motivated patient excellent aesthetic and functional outcomes can be achieved. Fingertip microanatomy by zone is described to facilitate the classification and treatment of these injuries. In this article, we outline our preferred techniques for fingertip replantation and review the current body of evidence surrounding indications, techniques, and outcomes while highlighting opportunities for future study. (Source: Hand Clinics)
Source: Hand Clinics - November 14, 2020 Category: Orthopaedics Authors: Amelia C. Van Handel, Mitchell A. Pet Source Type: research
Non-microsurgical Composite Grafting for Acute Management of Fingertip Amputation
Following a fingertip amputation, if vessels are present and of adequate condition, microsurgical replantation is the preferred technique for management. Composite grafting has a limited role in the management of fingertip amputations due to its unreliable nature but can be an option when an amputated fingertip is not replantable and the patient desires restoration of fingertip length and aesthetics. When composite grafting is selected as the treatment of choice for a particular patient, there are methods of optimizing the chances of graft revascularization and survival, including early grafting, graft cooling, and a moist...
Source: Hand Clinics - November 14, 2020 Category: Orthopaedics Authors: Kate Elzinga, Kevin C. Chung Source Type: research
Secondary Management of Nonnail Perionychial Deformities
Delayed finger and thumb tip reconstruction should try to optimally reconstruct perioncyhial aesthetic and functional units by replacing tissue as closely resembling the original loss as possible. Avoid thinking in terms of a “reconstructive ladder” but rather going directly to the reconstructive choice that seems most suited to the task. Some reconstructive choices may seem more attractive because of their simplicity, but may not necessarily give the best functional and aesthetic result. Free flaps and the newer adv ancements with vascular island flaps give many more and versatile reconstructive options. (Source: Hand Clinics)
Source: Hand Clinics - November 14, 2020 Category: Orthopaedics Authors: Nikola Lekic, Luis Scheker, David Netscher Source Type: research
Pediatric Fingertip Injuries
This article reviews the evidence and approach for treating pediatric fingertip injuries and amputations. (Source: Hand Clinics)
Source: Hand Clinics - November 14, 2020 Category: Orthopaedics Authors: Scott N. Loewenstein, Joshua M. Adkinson Source Type: research
