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.Anteromedial Release for Posttraumatic Flexion-pronation Contracture of the Wrist: Surgical Technique
We describe a safe, effective, and reproducible technique to treat these patients. (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
Steindler Flexorplasty: A Description of Current Technique and Case Series
This year marks the 100th anniversary of Dr Steindler’s original report of a proximal transfer of the flexor pronator mass to restore elbow flexion. The authors present their updated surgical technique to perform the Steindler flexorplasty. In this procedure, the flexor-pronator mass origin on the medial epicondyle is transferred proximally to the anterior humerus to restore elbow flexion. They also report a retrospective case series of patients from 2007 to 2017 who underwent a Steindler flexorplasty at their institution to restore elbow flexion. In the series, 8 of 9 patients achieved at least 90 degrees of active anti...
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Techniques Source Type: research
Fixation of a Type 3 Flexor Digitorum Avulsion Injury
This article describes a novel technique for flexor digitorum profundus (FDP) avulsion injuries, useful for Leddy Packer type 3, 4, and 5 injuries. Multidirectional stability is achieved with combination pull-out suture, which neutralizes the deforming force of FDP, and cerclage wire, which holds the bone fragment in an anatomic position and provides interfragmentary compression. Traditional techniques such as interosseous wires, Kirschner wires, or plating risk fragment comminution and loss of reduction due to proximal pull of FDP as demonstrated in this case report of failed Kirschner-wire fixation. The technique present...
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Techniques Source Type: research
Combined Pedicled Vascularized and Wedge Nonvascularized Bone Graft for Treating Scaphoid Waist Nonunion With Humpback Deformity
We describe a method by using combined wedge non-VBG to correct the nonunion deformity when treating scaphoid nonunion with pedicled VBG. The wedge bone graft was harvested just proximal to the 2,3 intercompartmental supraretinacular artery VBG and was used as an inlay at the volar site to correct the humpback deformity, whereas the VBG was set at the dorsal site for bone bridging and blood supply. We also present our results of 10 patients with scaphoid fracture nonunion and humpback deformity treated with this method. Bone healing was achieved and the lateral intrascaphoid angles could be improved in all the 10 patients....
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Techniques Source Type: research
Arterialized Posterior Interosseous Nerve Graft for Digital Neuroma
Painful neuromas are not uncommon following nerve injury, and are especially bothersome in the hand, with severe cases resulting in significant disability. Outcomes of neuroma surgery are unpredictable regardless of technique. It is recognized that optimal soft tissue environment influences nerve healing more than the specific nerve graft technique, and it is in this context, we present a novel technique of transferring a posterior interosseous nerve graft along with vascularized synovial and fat tissue based on a branch of the posterior interosseous artery to provide healthy soft tissue for nerve healing of neuroma in con...
Source: Techniques in Hand and Upper Extremity Surgery - November 19, 2019 Category: Surgery Tags: Techniques Source Type: research
On the Shoulders of a Giant
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: Editorial Source Type: research
Semicircumferential Detachment of the Extensor Enthesis For Surgical Treatment of Chronic Lateral Epicondylitis: A Prospective Study
About 10% of patients with lateral epicondylitis are nonresponsive to conservative treatment; as controversy persists on etiology and pathogenesis of this pathology, there is no surgical technique universally approved. The purpose of this study is to describe and evaluate the clinical outcomes of our technique consisting in a semicircumferential and partial detachment of the entire extensor apparatus enthesis. The technique was performed on 14 consecutive patients affected by painful chronic epicondylitis between January 2010 and April 2016. Two patients were lost during follow-up. At 6 months, 1 year, and 2 years after su...
Source: Techniques in Hand and Upper Extremity Surgery - August 27, 2019 Category: Surgery Tags: Techniques Source Type: research
The Anterolateral Thigh-Medial Femoral Condyle Chimeric Flow-through Flap for Posttraumatic Wrist Arthrodesis
Wrist arthrodesis in the setting of segmental bone loss can have high failure rates. Therefore, vascularized bone grafting has been advocated for select patients. Patients suffering concomitant large soft tissue loss present even greater challenge. To that end, we describe for the first time successful anterolateral thigh-medial femoral condyle chimeric flow-through flap for posttraumatic wrist arthrodesis and soft tissue coverage. This is a case report of a 19-year-old male laborer who suffered a large blast injury resulting in significant bone and soft tissue injury to the dominant right hand and wrist. After multiple de...
Source: Techniques in Hand and Upper Extremity Surgery - August 27, 2019 Category: Surgery Tags: Techniques Source Type: research
Intra-Articular Osteotomy for Symptomatic Bennett Fracture Malunion
We present a new technique to correct the intra-articular gap and restore joint congruency in the event of a symptomatic Bennett malunion with a gap of at least 2 mm. The joint is exposed through an anterolateral approach, and the malunion is marked with K-wires under fluoroscopic control. A closing wedge osteotomy with excision of the malunion site is then performed to restore joint congruency. The osteotomy is fixed with 3 interfragmentary screws, and the joint is immobilized for 2 weeks before passive mobilization is initiated. Hardware can be removed between 3 and 6 months postoperatively after consolidation of the o...
Source: Techniques in Hand and Upper Extremity Surgery - August 27, 2019 Category: Surgery Tags: Techniques Source Type: research
Techniques for Continuous Irrigation of Septic Joints of the Hand
We describe a method of continuous irrigation of septic joints of the hand postoperatively in the ward setting using an intravenous cannula placed within the joint and connected to an intravenous giving set with delivery of physiological fluid using a pump driver. Modifications of the technique are described for distal interphalangeal, proximal interphalangeal, and metacarpophalangeal joints and illustrated in each joint by 3 case studies. In addition to the irrigation, intravenous antibiotics were administered. All patients healed well with a full return of joint motion, no radiologic change, and a mean QuickDASH score of...
Source: Techniques in Hand and Upper Extremity Surgery - August 27, 2019 Category: Surgery Tags: Techniques Source Type: research
Glenohumeral Arthrodesis With Reamer-Irrigator-Aspirator (RIA) Bone Grafting After Traumatic Proximal Humerus Bone Loss and Flail Shoulder
Glenohumeral arthrodesis is a salvage procedure in the shoulder with few indications. However, in young patients with flail shoulder, shoulder arthrodesis is a durable, functional option. Allograft or autograft can be used to reconstruct the defect during glenohumeral arthrodesis. Autografts be vascularized or nonvascularized. The use of vascularized autograft can increase operative time and is associated with substantial donor-site morbidity. The reamer-irrigator-aspirator, a system that irrigates and aspirates reamed bone and medullary contents, including mesenchymal stem cells, isolating bone graft with little donor-sit...
Source: Techniques in Hand and Upper Extremity Surgery - August 27, 2019 Category: Surgery Tags: Techniques Source Type: research
Interosseous Membrane Reconstruction Utilizing Flexor Digitorum Superficialis Autograft
We describe a 2-bundle method of IOM reconstruction, utilizing flexor digitorum superficialis autograft. This technique has the benefits of utilizing a locally available and robust autograft with minimal donor-site morbidity, obviating the concerns associated with synthetic grafts or bone-patella tendon-bone constructs. It also replicates the nonisometric nature of the native IOM. We also present long-term results of a patient who underwent IOM reconstruction utilizing this method, following a cadaveric feasibility study. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - August 27, 2019 Category: Surgery Tags: Techniques Source Type: research
Open Surgery for Trigger Finger Required Combined a1-a2 Pulley Release. A Retrospective Study on 1305 Case
Conclusions:
Is possible to reduce the percentage of relapse triggering or PPIJF after trigger finger surgery, by performing that combined A1-A2 pulley release.
Level of Evidence:
Level III. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - August 27, 2019 Category: Surgery Tags: Techniques Source Type: research
Sliding the Medial Pin: A Safer Approach to Cross-pinning Humerus Supracondylar Fractures?
Conclusions:
The sliding method is a novel technique of protecting the ulnar nerve during closed reduction percutaneous pinning of SCHF.
Level of Evidence:
Level IV. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - August 27, 2019 Category: Surgery Tags: Techniques Source Type: research
The “FraMo” System: A New Mini-Invasive Technique in the Treatment of Proximal Humerus Fractures
Fractures of the proximal humerus are relatively common injuries in adults accounting for 5% of fractures. Nowadays the most common technique used is open reduction internal fixation with LCP plates. The risks associated with open reduction internal fixation had led us to develop and apply a “hybrid” system, which is based on external fixation and closed surgery principles. This system is capable of stabilize up to 4 fragment fractures on different planes while conferring a strong enough fixation to maintain fracture reduction while allowing the patient to perform passive and active movement since the first day followi...
Source: Techniques in Hand and Upper Extremity Surgery - August 27, 2019 Category: Surgery Tags: Techniques Source Type: research
