Techniques in Hand and Upper Extremity Surgery 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.Dorsal Intercarpal Ligament Preserving Arthrotomy and Capsulodesis for Scapholunate Dissociation
We report a novel technique of modified dorsal intercarpal ligament (DICL) capsulodesis for the treatment of SL dissociation. The surgical indication for this procedure is complete SL ligament tear with a reducible carpal malalignment and no secondary osteoarthritis. This procedure is indicated when the remnant of torn ligament in the dorsal SL interosseous space is available for repair. First, carpal malalignment is corrected and the scaphoid and the lunate are temporarily fixed with a transosseous screw or Kirschner wires. Using a dorsal approach, the DICL is then exposed, which originates from the triquetrum and attache...
Source: Techniques in Hand and Upper Extremity Surgery - February 22, 2020 Category: Surgery Tags: Technique Source Type: research
Radial Head Resection and Corium Interposition Arthroplasty in Skeletally Immature Patients With Isolated Posttraumatic Radial Head Arthrosis
Radiocapitellar arthrosis represents a serious sequela of pediatric elbow injuries. Although persistent pain and disability are not uncommon in such cases, treatment remains controversial. The present study aimed to review the clinical outcomes after a new surgical treatment with partial radial head resection and corium interposition arthroplasty. To date, 3 adolescent cases underwent the surgical procedure and postoperative care. Thorough clinical and radiographic follow-up was performed. The mean age at the time of surgery was 14.4 years (range, 13 to 16 y) and mean duration of follow-up was 19 months (range, 12 to 29...
Source: Techniques in Hand and Upper Extremity Surgery - February 22, 2020 Category: Surgery Tags: Technique Source Type: research
A Mini-Open, Dorsal Approach for Scaphoid Fracture Fixation With a Ligament Sparing Arthrotomy
There are several surgical approaches that are currently used to address nondisplaced scaphoid waist fractures, including percutaneous fixation, limited exposure fixation, and traditional open techniques through a volar or dorsal approach. Although percutaneous fixation has some theoretical advantages, it is much more difficult to achieve an accurate starting point for a headless compression screw. The purpose of this paper is to describe a simple, dorsal, mini-open approach to the scaphoid that minimizes incision size, extensor tendon dissection, capsular trauma, and vascular disruption, while still allowing for direct vi...
Source: Techniques in Hand and Upper Extremity Surgery - February 22, 2020 Category: Surgery Tags: Technique Source Type: research
The Inverted Free Functioning Gracilis Muscle Transfer For Restoration of Elbow Flexion Following Delayed Presentation or Failed Primary Nerve Reconstruction of Upper Trunk Injuries
Free functional gracilis transfer is a well-established technique for restoring active elbow flexion in brachial plexus injuries following delayed presentation or failed nerve reconstruction procedures. In cases of delayed presentation or failed nerve reconstruction following upper trunk injuries, the lower trunk intraplexal median and ulnar nerves are spared, thereby making them available to reinnervate the transferred gracilis. Therefore, we have inverted the conventional free functional gracilis orientation so as to orient the flap’s recipient nerve in closer proximity to donor median or ulnar nerve fascicles to enabl...
Source: Techniques in Hand and Upper Extremity Surgery - February 22, 2020 Category: Surgery Tags: Technique Source Type: research
A Reconstructive Extensor Tendon Centralization Technique for Sagittal Band Disruption
We present a surgical technique that diminishes tension of the repair with MCPJ flexion. Twenty-two EDC tendon stabilization procedures were performed between 2006 and 2017 using a tendon flap method. The selection criteria for this group of patients included completely dislocating extensor tendons with persistent complaints of pain and decrease in finger extension despite at least a 6-week conservative treatment attempt. All subjects underwent surgical treatment for tendon centralization using a distally based tendinous flap from the EDC sutured to the adjacent finger volar plate. A mathematical model was developed to ana...
Source: Techniques in Hand and Upper Extremity Surgery - February 22, 2020 Category: Surgery Tags: Technique Source Type: research
The Second Toe-to-Hand Transfer for Full-length Thumb Reconstruction in Congenital Thumb’s Grade IIIb to V Hypoplasia: MTPJ Arthrodesis Instead of Tendon Rebalansing
Congenital thumb hypoplasia is a rare deformity of the upper extremity. The classification of thumb hypoplasia was created by Blauth in 1967 (types I to V). The base of the first metacarpal bone is absent for hypoplasia types IIIb to V, therefore, toe-to-hand transplantation is not recommended. A stable first carpometacarpal joint has been considered a mandatory factor for a successful toe-to-hand transplantation. The aim of this study is to describe a new technique for thumb reconstruction with the second toe transfer and metatarsophalangeal joint (MTPJ) arthrodesis, which can provide a five-digit hand and restore thumb f...
Source: Techniques in Hand and Upper Extremity Surgery - February 22, 2020 Category: Surgery Tags: Technique Source Type: research
Failed Proximal Humerus Osteosynthesis Using Intramedullary Fibular Strut Allograft Conversion to Reverse Shoulder Arthroplasty
Comminuted proximal humerus fractures are more frequently being treated utilizing an intramedullary fibular strut allograft to assist with open reduction internal fixation. Although this technique has led to improved outcomes, avascular necrosis, rotator cuff failure, and/or prominent hardware may still occur necessitating conversion to reverse shoulder arthroplasty. The presence of an intramedullary strut allograft makes this conversion technically demanding and creates certain potential complications unique to this group. This manuscript details the conversion of a proximal humerus open reduction internal fixation with a...
Source: Techniques in Hand and Upper Extremity Surgery - February 22, 2020 Category: Surgery Tags: Technique Source Type: research
Long-Term Outcomes After Extensor Carpi Ulnaris Subsheath Reconstruction With Extensor Retinaculum
This study assessed the long-term outcomes and complications of patients that underwent operative treatment for extensor carpi ulnaris subluxation. Fifteen patients underwent extensor carpi ulnaris subsheath reconstruction at a median of 5.9 weeks nonoperative treatment interval (interquartile range: 2.4 to 13). Reconstruction consisted of using the extensor retinaculum as a sling reconstruction. We found that about 1 in 3 patients had a complication or reoperation. At a median of 8 years follow-up, many patients had some residual symptoms, but in general, most patients were satisfied. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 22, 2020 Category: Surgery Tags: Technique Source Type: research
An Old Dog Learns a New Trick
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 22, 2020 Category: Surgery Tags: Editorial Source Type: research
Three-step Bending Procedure For an Easy Endomedullary K-Wire Osteosynthesis of Metacarpal Neck Fractures
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Letter to the Editor Source Type: research
Using Tongue Depressors as a Technique to Aid Cord Localization During Collagenase Injection For Dupuytren Disease
We describe a technique to improve visualization and isolation of Dupuytren cords using a tongue depressor. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Techniques Source Type: research
Anatomic Considerations and Reconstruction of the Thumb Flexor Pulley System
Disruption to the flexor pulley system of the thumb is an infrequent but devastating injury that can lead to significant compromise in both strength and function. Acute rupture leads to pain, weakness, reduced range of motion (ROM), and potential bowstringing of the flexor tendons. Conservative treatment with a pulley ring should be considered in all patients. However, failure of conservative treatment and bowstringing of the thumb are indications for operative intervention. Reconstruction of the oblique pulley system can be performed either in situ or using a free palmaris longus graft. Care should be taken to identify th...
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Techniques Source Type: research
Extra-articular Corrective Osteotomy With Bone Grafting to Achieve Lengthening and Regain Alignment for Distal Radius Fracture Malunion
Surgical correction of the distal radius fracture malunion is challenging because of the 3-dimensional deformity. We propose a method by using the Kapandji intrafocal pinning in corrective osteotomy for treatment of the distal radius fracture malunion to facilitate the alignment correction while using the bone graft to restore the radial length. The surgery was started with the osteotomy from a volar approach, and the osteotomy gap was expanded gradually. Then, allobone grafting was performed to maintain the corrected radial length. We used the Kapandji intrafocal pinning dorsally to provide dorsal supporting force and rad...
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Techniques Source Type: research
Triquetrum Excision in Radioscapholunate Arthrodesis for Posttraumatic Radiocarpal Osteoarthritis With Ulnar Impaction Syndrome
Dependent on fracture type, concomitant carpal injuries, and operative treatment, distal radius fractures can lead to symptomatic radiocarpal osteoarthritis. In addition, radial shortening can cause ulnar impaction syndrome. Radiocarpal arthrodesis and ulnar shortening osteotomy are known and frequently applied surgical procedures for each of those pathologies. There are limited data concerning treatment options for a combined disorder. The presented technique in this article demonstrates that radioscapholunate arthrodesis with distal pole scaphoidectomy and total triquetrum excision successfully treats both symptomatic ra...
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Techniques Source Type: research
A Novel External Fixation Technique for Injuries of the Proximal Interphalangeal Joint
Digital external fixation is often used for the management of complex injuries involving the proximal interphalangeal joint, including pilon fractures of the middle phalanx base and unstable fracture-dislocations. Several dynamic “homemade” constructs have been described which utilize only K-wires and rubber bands and allow early range of motion within the construct. Although these constructs are inexpensive and their application is fairly straightforward, their designs pose a few potential problems when the construct is stressed during rehabilitation efforts. These designs utilize a blocking K-wire which relies on pin...
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Techniques Source Type: research
