Arthroscopic Pisiform Excision in Pisotriquetral Osteoarthritis Technique Using a Direct Pisotriquetral Portal
Pisotriquetral (PT) joint arthritis is a common cause of ulnar-sided wrist pain. Open pisiform excision is a well-established procedure and is indicated when the conservative treatment fails. Although arthroscopic visualization of the PT joint is part of the routine examination in a patient with ulnar-sided wrist pain, therapeutic arthroscopy of the PT joint is limited to one case in the literature through the standard dorsal portals. Arthroscopic pisiform excision is a novel technique described by the authors. The first aim of this procedure is pain relief maintaining wrist stability and strength. With this minimally inva...
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Management of Highly Comminuted Intra-articular Fracture Subluxations at the Proximal Interphalangeal Joint by Subchondral Buttress Fixation and Early Mobilization
This article describes our technique of managing highly comminuted intra-articular fracture subluxations at the proximal interphalangeal joint by subchondral buttress fixation followed by early mobilization. This technique has proven to be reliable and all patients have been able to return to their preinjury level of activity. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Vascularized Ulnar Transposition and Ulno-scapholunate Fusion for Reconstructing Campanacci Grade 3 Giant Cell Tumor of Distal Radius: Technique and a Series of 5 Cases
In conclusion vascularized ulnar transposition with partial wrist fusion for a Camapanacci grade 3 giant cell tumor is an alternate procedure in the management of these difficult tumors. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Novel Use of Pennig External Fixation for the Treatment of Pediatric Syndactyly
Syndactyly is one of the most common congenital limb malformations, second only to polydactyly. Syndactyly is treated with surgical intervention. During separation, free skin grafting or skin flap transplantation is required to allow for adequate skin closure. We introduce a novel application method of the Pennig external fixation device for the management of pediatric syndactyly without skin grafting. The Pennig minifixator was used in syndactyly to expand the web space soft tissue in order to allow a Z-plasty to be performed in a second operation. All patients had developed sufficient skin tissue from the external fixati...
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Functional and Cosmetic Reconstruction of Floating Thumb: A Thumb-preserving Technique
For the severely hypoplastic thumb, including floating thumb, it is difficult to acquire function while preserving the thumb. Pollicization using the index finger after removing the hypoplastic thumb is usually indicated for such cases. However, most parents of children undergoing surgery for deformed hands desire retaining the digit number, 1 thumb and 4 fingers. A floating thumb has a neurovascular band in its pedicle, and we can identify and divide the band with precision for preservation, although it seems impossible to retain it. For acquiring function while retaining the thumb, we developed carpometacarpal arthroplas...
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Widening of Pulley by Interdigitating Cuts
We describe a technique of expanding the pulley by interdigitating cuts. This technique greatly increases the diameter of the pulley which could be demonstrated in cadaver model and noted in clinical setting. This technique is easy to perform and maintains the integrity of the pulley without complete division. It would allow easy tendon retrieval, provide space for the repair and gliding, and improve exposure during tenolysis. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Vascularized Toe Joint Transfer for Hypoplastic Thumb Type IV
This article describes details of the surgical procedures. The outcomes of this reconstruction are shown in a 7-year-old girl who presented with hypoplastic thumb type IV. Initially, her thumb was unstable, nonmobile, and had no function. The skin pedicle of this thumb had a diameter of about 3 mm. Preoperative radiography showed floating thumb without first metacarpal bone. The vascularized metatarsophalangeal joint from the opposite second toe was used for her hypoplastic thumb reconstruction. During the procedure, the flail thumb was preserved. The intraoperative bone gap that was needed for reconstruction was 3....
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Failed Trapeziectomy Treated by Thumb Metacarpal Base Arthrodesis: A Case Series
Trapeziometacarpal joint arthritis is a prevalent condition with a preponderance to women. Most cases are asymptomatic, but typical symptoms are pain, reduced dexterity, and functional decline. Trapeziectomy is the most common surgical treatment in the United Kingdom for patients who remain significantly symptomatic despite nonoperative measures, and this generally produces acceptable outcomes; however, a proportion of patients remain significantly symptomatic. The authors present a case series of 4 patients who underwent successful thumb metacarpal base to index metacarpal base arthrodesis with either distal radial or ili...
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Resurfacing Capitate Pyrocarbon Implant Without Capitate Pole Resection to Improve Clinical Results in the Treatment of Chronic Wrist Arthritis
Proximal row carpectomy (PRC) is a long-time, well-accepted, easy-to-reproduce procedure for the treatment of several painful degenerative conditions of the wrist, when capitate pole and radius lunate fossa are preserved. It has been reported to relieve pain and preserve a substantial wrist range of motion, although a partial loss of strength has to be expected because of the decreased length of the carpus. Since 2010, a new technique has been described in the literature using the resurfacing capitate pyrocarbon implant, combined with PRC. This implant has been designed to perform PRC even in the presence of degenerate joi...
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Revisiting Gillies’ “Cocked Hat” Reconstruction for Thumb Reconstruction
We present our use of the technique, which was performed at a forward operating base for a coalition service member. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Techniques Source Type: research

Mentorship: Perspectives Through the Eyes of the Mentee and Mentor
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2021 Category: Surgery Tags: Editorial Source Type: research

Modified Oblique Triangular Neurovascular Island Flap Technique to Prevent the Development of Hooked Nail Deformity
Hooked fingernail deformity can develop after any type of fingertip amputation. A more proximal amputation is associated with a higher probability of developing hooked fingernails. Proximal fingertip amputations with very short remaining nail beds are recommended for revision amputation with nail bed ablation. This procedure eliminates the possibility that the patient may have a functional nail. When the nail matrix is still retained, an oblique triangular neurovascular island flap may preserve the nail and digit length. At our institution, the modified oblique triangular neurovascular island flap is routinely used for pat...
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Fascial Epicondylar Augmentation in Cases of Cubital Tunnel Syndrome With Ulnar Nerve Instability
Cubital tunnel syndrome (CubTS) is one of the most common compression-traction neuropathy in the upper extremity. The gold standard is simple in situ decompression with revision of potential compression sites through skin incision as small as rationally possible. Properly conducted conservative treatment is more effective in CubTS as opposed to carpal tunnel syndrome. At the same time, optimal management of CubTS remains controversial. Nevertheless, there is a subclass of patients with symptoms of CubTS that have ulnar nerve instability (UNI) with subluxation of the nerve over the medial epicondyle where conservative treat...
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Pedicled Split Hypogastric Flap (Superficial Inferior Epigastric Artery flap): A New Technique for Coverage of Nonadjacent Defects in the Hand
Flap coverage of soft tissue defects on both surfaces of the hand or of nonadjacent defects in the hand is a challenge. Two flaps are needed or if a single flap is used, the intervening normal area or part of the flap must be deepithelialized or the flap tunneled under the normal bridge segment. We are presenting a new technique whereby the hypogastric flap based on the superficial inferior epigastric artery is split into 2 components for the coverage of such defects. The hypogastric flap is separated into a cutaneous component and an adipofascial component at the level of Scarpa fascia. The flaps are separated almost to t...
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Simultaneous 4 Compartment Pressure Monitoring in Diagnosis of Chronic Exertional Compartment Syndrome of the Forearm
The authors describe a technique for bilateral simultaneous measuring of forearm compartments pressure for assessment of suspected chronic exertional compartment syndrome of the forearm. Under ultrasound guidance, 18-G cannulae were inserted bilaterally into the superficial flexor and dorsal extensor forearm compartments. The imaging was used to confirm safe subfascial placement, and ensured no kinking or catching on the muscle bellies during dynamic movements. An arterial pressure transducer with 4 portals allowed simultaneous measurements from 4 compartments. Intracompartmental pressure (ICP) was measured in 2 ways, (1) ...
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

The Dorsal Periosteal Curtain for Distal Radius Osteotomy Via the Volar Approach
We present a technique whereby the dorsal periosteum is incised more proximally creating a dorsal vascularized periosteal “curtain.” Our technique has several advantages including systematic release of restraining soft tissues to allow better distraction and reduction of the malunion; a dorsal periosteal curtain of vascular tissue with which to contain bone graft, protect extensor tendons and expedite healing; and better access to locally available bone graft. The previously described rotation-advancement of pronator quadratus is also used for plate coverage. We have found this technique straightforward to exec...
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Percutaneous Fixation of Pediatric Fractures of the Proximal Phalanx Neck: A Novel Technique
Conclusions: We find this axial pinning technique to be simpler and faster than divergent pin fixation, with no significant differences in time to radiographic healing, time to full activity, final proximal interphalangeal active flexion or extension, loss of reduction, or radiographic parameters. Level of Evidence: Level III—Therapeutic. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

First Carpometacarpal Joint Instability: Dorsal Ligament Reconstruction
The first carpometacarpal (CMC-I) joint has an elaborate ligamentous support. Recent evidence has demonstrated that the dorsal ligament group is imperative for joint stability and that CMC-I joint instability may occur as a consequence of trauma and ligamentous laxity, and other conditions, with possible CMC-I subluxation and the development of osteoarthritis. Although various surgical techniques have been introduced for the treatment of ligamentous CMC-I instability, the Eaton-Littler reconstruction has been regarded as the gold standard. It is widely accepted that impaired hand function may still be present following the...
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Using Extensor Retinaculum to Reconstruct the Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament
We describe a technique for reconstruction that utilizes a slip of the extensor retinaculum for reconstruction. The advantages of extensor retinaculum as a graft choice are that it matches the native ligament with a synovial and nonsynovial surface, has elasticity similar to the ligament and minimal donor site morbidity. Reconstruction of the ulnar collateral ligament with this graft successfully restores pinch. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Management of Metadiaphyseal Proximal Radius Fractures
We describe 6 patients who achieved satisfactory functional outcomes, even in cases of severe bone loss secondary to ballistic trauma. An extensile dorsal approach with exposure of the posterior interosseous nerve is recommended when normal soft tissue intervals have not already been extensively disrupted. Robust fixation can be achieved by contouring and repurposing a variety of plates such as a variety of mini fragment plates (2.4 mm T or Y-plates), flexible nails, or even distal radius plates. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Anatomic Reconstruction of the Anterior Oblique and the Dorsoradial Ligaments for Painful Subluxating Carpometacarpal Joint of the Thumb
We report a case series of 26 patients (32 operations) with Eaton stage I and II CMC OA who underwent a novel surgical technique that anatomically restores the CMC joint with autologous double ligament reconstruction. All cases were retrospectively reviewed as a prospective study and performed at a single regional health system from 2012 to 2016. Preoperative and postoperative radiographs, grip and pinch strength measurements, and DASH scores were collected to evaluate the outcomes. The mean CMC subluxation ratio decreased from 0.59±0.14 to 0.35±0.21 (P (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Complete Decompression of a Forearm Neonatal Compartment Syndrome Using a Volar Approach: A Surgical Technique
Fasciotomy of the forearm is a well-described technique for the treatment of compartment syndrome in adults; however, it has not been discussed with sufficient details in the setting of neonatal compartment syndrome. When performing a fasciotomy, it is imperative to decompress all compartments within the forearm to limit the ischemic damage and prevent the progression of the disease. Although it is common to utilize both volar and dorsal incisions to release these compartments, we describe a method that potentially allows for total decompression through a single volar incision with minimal to no morbidity. This novel techn...
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Pollicization of the Index Finger in the Treatment of Thumb Hypoplasia
Pollicization of the index finger allows to reconstruct the hand’s ability to pinch and grasp. It has been broadly used to address traumatic loss of the thumb. Today it is the procedure of choice for severe congenital thumb hypoplasia. It allows children prehension of small and large objects and gives the hand a more normal appearance. This is a demanding technique with well-defined and perfected steps that, if carefully performed, can minimize complications. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Corrective Osteotomy of Distal Radius Malunion Using a Rectangular-shaped Iliac Bone Graft and Volar Plating
Distal radius fractures are one of the most common injuries seen by orthopedists at the emergency room and clinics. Severity and configuration may vary, and therapeutic options are broad, but regardless of the course of treatment, all cases can potentially lead to malunion. When malunion requires surgical correction, the surgery can be technically demanding. Here, we demonstrate an alternative technique to perform corrective osteotomies for extra-articular or minimally displaced articular distal radius malunion. We provide simplification of the procedure by eliminating one of the planes taken into consideration when perfor...
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Techniques Source Type: research

Graduation
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - September 1, 2021 Category: Surgery Tags: Editorial Source Type: research

Chronic Exertional Compartment Syndrome of the Forearm: Mini-invasive Technique Using an Endoscopic Soft Tissue Release System
We describe a mini-invasive endoscopic technique for the treatment of forearm chronic exertional compartment syndrome using the SmartRelease endoscopic tissue release system (MicroAire). (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Video Technique Source Type: research

Shortening Dome Osteotomy for Correction of Complex Multiplanar Elbow Deformities: A New Surgical Technique
Despite surgical advances in fracture management, it is not uncommon to find pediatric or adolescent patients with elbow deformities. Correction of severe deformities, often leaves the ingenuity of the treating surgeon asking for more. Various osteotomy techniques have been described in the literature for the correction of elbow deformities. Although, the concept of dome osteotomy did address certain inadequacies of the existing osteotomy techniques for distal humerus, but correction of complex deformities associated with deformation of trochlea and olecranon fossa still remain a surgical challenge which has not been adequ...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Pulley Release and Reconstruction With Acellular Dermal Matrix After Zone 2 Flexor Tendon Injury
Zone 2 flexor tendon repair has been historically associated with poor outcomes, mainly due to stiffness. In an effort to minimize adhesions, accommodate flexor digitorum profundus and flexor digitorum superficialis bulk, and prevent bowstringing, we have developed a novel approach to flexor tendon repair that relies on aggressive flexor tendon pulley release and pulley reconstruction with acellular dermal matrix. This technique leverages the antiadhesive properties and high tensile strength of acellular dermal matrix to maximize gliding and prevent bowstringing. Here we describe the details of our technique and illustrate...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Lateral Pinning of the Pediatric Phalangeal Neck Fracture
We describe our technique of closed reduction and percutaneous pinning, which avoids the physis and increases the wire insertion accuracy, minimizing the number of attempts and wire passes made at percutaneous pinning. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Transolecranon Exposure of Monteggia Variant Fracture-dislocations of the Elbow
Posterior Monteggia fracture-dislocations are uncommon injuries that can result from a fall onto an outstretched hand. Often, these injuries are associated with coronoid and/or radial head fractures. When this is the case, direct fixation can require 3 separate fascial incisions: posterior to address the proximal ulnar fracture, lateral to address the radial head fracture, and medial to address the coronoid fracture. We illustrate a transolecranon surgical approach for fixation of a type IIA posterior Monteggia fracture-dislocation with associated radial head and coronoid fractures. In this approach, the 3 associated fract...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Volar Approach to the First Extensor Compartment for Surgical Treatment of DeQuervain Tenosynovitis
We describe a novel volar approach to the first extensor compartment, which allows direct visualization of the retinaculum and a midline retinacular release. In addition, the volar approach has an associated decreased risk of iatrogenic nerve injury by passing volar and deep to the more superficial sensory nerves that overly the retinaculum. On the basis of our experience, patients do not experience an increased risk of volar tendon subluxation with this approach. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Thumb Carpometacarpal Suspension Arthroplasty With Flexor Carpi Radialis Ligament Reconstruction and Tendon Interposition Using An Absorbable Interference Screw: A Volar Approach Technique
The goal of operative intervention for pantrapezial arthritis is to relieve pain, maintain or improve motion, stability, and strength, and restore function. The purpose of this article is to present a volar approach to thumb carpometacarpal suspension arthroplasty using an absorbable interference screw for flexor carpi radialis ligament reconstruction and tendon interposition in the treatment of pantrapezial arthritis. This technique allows for visualization of the volar beak and avoidance of the radial artery and the branches of the superficial radial nerve while allowing optimal surgical manipulation for suspensionplasty...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Allograft-Composite Reverse Shoulder Arthroplasty for Malignant Tumor of the Proximal Humerus
Composite-allograft reverse shoulder arthroplasties are a surgical alternative in malignant tumor reconstructions following segmental bone resection of the proximal humerus. They allow reinsertion of the rotator cuff tendons and reliable restoration of humeral height, increasing prosthetic stability and mobility. Preoperative local tumor extension assessment must be thorough and a strict surgical technique must be followed to obtain satisfactory functional results. The indications for this procedure include a strictly intraosseous tumor of the proximal humerus corresponding to an S3-S4 A resection following criteria provid...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Percutaneous Radiofrequency Ablation of the Posterior and Anterior Interosseous Nerves for Chronic Wrist Pain: A Novel Technique
The treatment of chronic wrist pain, due to posttraumatic, degenerative, or inflammatory arthritis, is challenging to adequately manage. The ideal surgical procedure should preserve wrist mobility and provide long-lasting pain relief. In this regard, denervation aims to decrease wrist pain by interrupting sensory innervation, without impairing motor function, and avoids the need for postoperative immobilization to decrease the risk of stiffness. For these reasons, denervation is particularly attractive as a possible treatment for chronic wrist pain. Our aim was to describe our novel technique for partial percutaneous wrist...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Modified Lateral Approach of the Elbow for Surgical Release and Synovectomy
We report the technical details of the modified lateral approach between extensor carpi radialis brevis and longus muscles, as well as the clinical results of 43 elbow release and/or synovectomy procedures, illustrating its feasibility. The modified lateral approach, providing visual control of the radial nerve and good anterior exposure of the elbow joint, is detailed. From 1994 to 2016, this approach was used in 43 release and/or synovectomy procedures of the elbow in 41 patients, 30 men and 11 women, with a mean age of 40.56 years (range, 17 to 84 y). Using this procedure, 38 elbows (93%) recovered full extension...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

F. Brunelli Ligamentoplasty as Treatment in Thumb Basal Joint Arthritis: Up to 9 Years Follow-up
Thumb basal joint arthritis treatment with biological arthroplasty is a widely used procedure in hand surgery centers. The several described techniques are based on the use of different tendons of the wrist, implying frequently a tenoplasty around flexor carpi radialis or transosseous tunnels to stabilize the articulation. The authors have been using, for many years, the technique conceived by F. Brunelli that relies on the anchorage of the volar band of the abductor pollicis longus tendon to the first intermetacarpal ligament, to obtain a suspension arthroplasty. Technical details are discussed. Sixty-seven patients in Ea...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Anatomic Repair and Reconstruction of Radial Sagittal Band Ruptures
Two cases of traumatic sagittal band rupture causing extensor tendon subluxation are reported. A case of subacute rupture is repaired and a new surgical technique for reconstruction of a chronic rupture is described. Extensor tendon subluxation at the metacarpophalangeal joint is a rare occurrence in patients not affected by rheumatoid arthritis. The majority of cases involve the disruption of the radial sagittal band with consequent ulnar subluxation of the extensor tendon. The technique of sagittal band reconstruction described involves harvesting a distally based ulnar-sided strip of the extensor digitorum communis tend...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

Volar Neurovascular Advancement Flap With an All Neural Branch–preserving Technique
We describe a concept of an all neural branch–preserving technique to harvest a volar flap. We demonstrate this technique on an anatomic specimen and 1 case with delicate surgical tips. We performed this technique in 16 patients, and the mean follow-up period was 28.4 months. The mean range of motion of the distal interphalangeal joint was 70.3 degrees, and that of the proximal interphalangeal joint was 101.9 degrees. The mean static 2-point discrimination of the volar pulp was 4.8 mm. This technique could be applied on the volar advancement flap with a better sensation recovery. (Source: Techniques in Hand an...
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Techniques Source Type: research

The Surgical Lifeline: Intraoperative Consultation
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - May 27, 2021 Category: Surgery Tags: Editorial Source Type: research

Letter to the Editor Regarding Errors in 2006 Review Titled “A Meta-Analysis of Success Rates for Digit Replantation”
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Letter to the Editor Source Type: research

Percutaneous Tenodermodesis for Mallet Fingers: An Office-based Procedure
We present a percutaneous tenodermodesis using only a digital block and a 4.0 nylon suture. This office-based procedure provides joint reduction and prevents joint movement during the immobilization period. The suture can be removed after 8 weeks, allowing active mobilization of the DIP joint. We present the results of 8 patients with a mean follow-up of 3 months and mean initial extension lag of 32 degrees, resulting in a mean final extension lag of 2 degrees and excellent outcomes using the Crawford criteria. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research

Masquelet Technique for Phalangeal Reconstruction and Osteomyelitis
Osteomyelitis of the finger presents a challenging problem. Although there are multiple treatments described in the literature, the infection often results in eventual amputation. The authors present a case of an open fracture of the index finger complicated by nonunion, infection, and osteomyelitis. This was successfully treated by the placement of an antibiotic cement spacer and subsequent reconstruction with iliac crest bone graft, after the 2-stage Masquelet technique, using intravenous and oral antibiotics. They show that this technique, although infrequently described in the hand and fingers, can be a successful opti...
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research

Intramedullary Headless Screw Fixation for Metacarpal Fractures
We describe a technique of retrograde IM headless screw fixation for extra-articular metacarpal fractures. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research

Surgical Technique for Harvesting ECRL and ECRB Concurrently as Upper Extremity Tendon Autograft
In this report, we describe an easily reproducible, quick, and low-morbidity technique using both the wrist extensors—extensor carpi radialis longus and extensor carpi radialis brevis, from near their distal attachments to their musculotendinous junctions proximally—as a source of tendon autograft for a variety of applications. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research

The Use of Nitinol Compression Staple Fixation and Bone Graft for Scaphoid Waist Fractures and Nonunion: A Surgical Technique
We describe the technique for utilizing Nitinol compression staples and bone grafting in the treatment of scaphoid nonunion. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research

Management of Paronychia in Patients With Apert Syndrome
This study aims to propose an effective and safe technique to manage paronychia when it occurs in patients with Apert complex syndactyly and to mitigate the length of delay to definitive polysyndactyly reconstruction. In the context of these patients’ need for multiple surgical interventions within the first few years of life, this strategy for preventing or mitigating paronychia can play an important role in streamlining their complex surgical management while avoiding multiple cancellations. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research

Surgical Approach and Internal Fixation Techniques for Intra-Articular Distal Humerus Fracture With Coronal Shear Capitellar Fracture
We describe a surgical exposure that releases the lateral ulnar collateral ligament in addition to an olecranon osteotomy to allow complete visualization of the entire articular surface. In contrast to an isolated capitellar fracture, the column stability and the posterior cortex are frequently disrupted with distal humerus fractures. Depending on the comminution of the posterior cortex, a supplemental posterolateral plate or headless compression screws can provide fixation to the coronal fracture plane. The lateral ulnar collateral ligament is repaired at the conclusion of fracture stabilization through a bone tunnel or t...
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research

Arthroscopic Tenovaginotomy and Ganglion Excision of the Flexor Carpi Radialis Fibro-Osseous Tendon Sheath
This report describes a technique of arthroscopic tenovaginotomy for stenosing tenosynovitis of the FCR tendon at the trapezial fibro-osseous sheath with or without excision of any associated ganglion through a not previously described new volar radial trapezial arthroscopic portal. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research

An Incision-less Ultrasound-guided Carpal Tunnel Release Technique
This article will provide a step-by-step overview of the technique and includes a review of clinical outcomes published so far. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research

Transulnar Styloid Foveal TFC Reconstruction: With a Palmaris Longus Tendon Graft
We describe an evolution of the senior author’s technique in the repair or reconstruction of foveal triangular fibrocartilage complex tears. This technique uses a transulnar styloid approach, which gives superior access to the fovea, without disruption of secondary stabilizers. A free palmaris longus graft is used to stabilize and augment the triangular fibrocartilage complex with an interosseous anchor through an ulnar tunnel. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 25, 2021 Category: Surgery Tags: Techniques Source Type: research