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Single-stage Congenital Polysyndactyly Release: Outcomes and Long-term Followup
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. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

A Combined Revision Surgical Technique for Failed Operative Lateral Epicondylitis With Concomitant Radial Tunnel Syndrome
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, decompressio...
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Arthroscopic Trapeziectomy
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. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Treatment of Thumb Metacarpophalangeal Joint Hyperextension by Volar Plate Advancement and Capsulodesis With Suture Tape Augmentation
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...
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Surgical Management of Acute on Chronic Distal Radius Fractures: Correcting Malunion Deformities Through the Secondary Fracture Plane
We present our technique to correct both primary and secondary distal radius deformities through the new or secondary fracture plane. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Loop Anchor Tension Band Fixation for Olecranon Fractures and Chevron Olecranon Osteotomy
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 en...
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Dry Arthroscopy of the Wrist With a Single-use, 1.9 mm Chip-on-tip System in Wide-awake Local Anesthesia No Tourniquet
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 proce...
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Arthroscopic Management for Carpometacarpal Boss of Third Joint and Synovectomy: Technique and Case Report
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 r...
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Headless Compression Screw for Metacarpal Nonunion: Description of a New Technique and Report of 4 Cases
We report a series of three cases that evolved to bone healing with excellent clinical, functional, and radiographic outcomes. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Denervation With Periosteal Resection of the First Carpometacarpal Joint
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...
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Intramedullary Headless Screw Fixation for Phalanx Fractures: Technique and Review of Current Literature
Fractures of the phalanges can often be managed nonoperatively, but displaced phalangeal fracture patterns, including malrotation, are more amenable to operative treatment. There are several described methods for surgical management of phalanx fractures, but there remains no consensus on a clearly superior method of fixation. Percutaneous Kirschner wires, interfragmentary screws, plate and screw constructs, intramedullary nails, and cannulated intramedullary headless screws are all utilized in the treatment of these fractures. Intramedullary headless screws for phalanx fractures may provide suitable fixation allowing early...
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

Double Barrel Screw Fixation for Proximal Phalanx Fracture
A variety of fixation options exist for treatment of unstable proximal phalanx fractures. Variables which require consideration include the strength of fixation, the invasiveness of the technique and the postoperative rehabilitation protocol. Here we present a minimally invasive technique for dual headless compression screw fixation of proximal phalanx fractures which reduces extensor tendon violation and allows early motion in the immediate postoperative period. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Techniques Source Type: research

A Task Completed
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 24, 2022 Category: Surgery Tags: Editorial Source Type: research

Coracoclavicular Ligament Reconstruction Using TightRope for Delayed Grade III Acromioclavicular Joint Injury After Ipsilateral Diaphyseal Clavicle Fracture Fixation: Surgical Technique and Review of Current Literature
Athletes commonly sustain high-energy direct impact injuries to the shoulder, with acromioclavicular joint (ACJ) injuries accounting for over half. Ipsilateral ACJ injury and diaphyseal clavicle fracture occur nearly 7% of the time. There is limited literature offering treatment suggestions for this unique injury pattern and limited evidence providing guidance to suggest which injury patterns should be treated operatively or nonoperatively. Here, we present successful treatment of a high-level athlete utilizing a Knotless TightRope XP placed through a superior clavicle plate with successful return to full activity at 6 mon...
Source: Techniques in Hand and Upper Extremity Surgery - August 25, 2022 Category: Surgery Tags: Techniques Source Type: research

Modified Graft Loop Technique Augmented With Nonabsorbable Suture Tape for Chronic Elbow Dislocation
We describe a technique of reconstructing both bands of the medial ligament, and the lateral ulnar collateral ligament of the elbow, by using a looped tendon graft and reinforcing the lateral side with nonabsorbable tape and anchors. The graft is passed as a loop once through the humerus and ulna, recreating the anterior portion of the medial collateral ligament and the lateral ulnar collateral ligament. Then the lateral side is augmented with the tape and anchors and the loop is fixed. Lastly, the medial tail of the graft is used in order to recreate the posterior part of the medial ligament. This technique uses a single ...
Source: Techniques in Hand and Upper Extremity Surgery - August 25, 2022 Category: Surgery Tags: Techniques Source Type: research