Techniques in Hand and Upper Extremity Surgery 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.

Technique Tip: Platysma-flap Approach to the Clavicle
The surgical treatment of a displaced fracture of the clavicular shaft generally consists in an open reduction and plate fixation. The most common complications of the classic direct “transplatysma” approach are hardware related. These consist of simple hardware irritations requiring secondary plate removal but also feared wound healing problems ranging from dehiscence to superficial and deep wound infections. In the present article, we describe the so-called “platysma-flap” approach in which the platysma muscle is entirely preserved and distally raised as a flap. This modified exposure allows to cover the osteosyn...
Source: Techniques in Hand and Upper Extremity Surgery - February 21, 2019 Category: Surgery Tags: Techniques Source Type: research

Arthroscopic Treatment of Lateral Elbow Pain Mimicking Lateral Epicondylitis: Long-term Follow-up of a Unique Surgical Protocol
Conclusions: We report promising long-term clinical and functional results of a novel arthroscopic resection of the capsulosynovial complex in lateral epicondylitis. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 21, 2019 Category: Surgery Tags: Techniques Source Type: research

Palmar Capsuloligamentous Plication in Dorsal Capitolunate Instability: Technique and Preliminary Results
We describe a novel technique which aims to address palmar ligamentous hyperlaxity by plication of the radioscaphocapitate, radiolunotriquetral, and arcuate ligaments, thus closing the so-called space of Poirier. This palmar technique has been used in several cases in isolated form or in conjunction with other concomitant procedures. After the floor of the carpal tunnel and thus the palmar ligaments are exposed and the weak spot meticulously verified, 2 or rarely 3 deep FibreWire pulley sutures are used for capsuloligamentous plication. Among 11 patients, 4 cases (5 operated wrists) with isolated capitolunate capsuloligame...
Source: Techniques in Hand and Upper Extremity Surgery - February 21, 2019 Category: Surgery Tags: Techniques Source Type: research

Volar Vascularized Strut Graft for Avascular Scaphoid Nonunion Using the 1,2 Intercompartmental Supraretinacular Artery
In this retrospective study, we report the preliminary results of a novel technique for volar vascularized strut grafting to treat avascular scaphoid nonunion by using the 1,2 intercompartmental supraretinacular artery through a single incision. Forty-three of 45 patients with avascular scaphoid nonunion healed at a mean of 13 weeks (range, 3 to 10 mo). Complications consisted of 1 pin tract infection that resolved with oral antibiotics and 4 cases of transient dysesthesia of the radial sensory nerve. In 4 patients with equivocal radiographs, computed tomography scans confirmed bony union. The 2 patients who remained unh...
Source: Techniques in Hand and Upper Extremity Surgery - February 21, 2019 Category: Surgery Tags: Techniques Source Type: research

FCR Interposition Arthroplasty for Concomitant STT and CMC Arthritis
We describe a novel technique of flexor carpi radialis (FCR) tendon interposition to tackle this condition. Our common treatment for CMC arthritis is trapezium resection with ligament reconstruction and tendon interposition with half of the FCR. With this procedure, through the same exposure, the proximal part of the trapezoid is resected. An anchor is placed into the trapezoid and the sutures are passed through a remnant of the FCR. Thus the FCR is pulled in between the scaphoid and the trapezoid and secured in place. We performed this procedure in 13 hands with average follow-up of 36 months. All patients were satisfied ...
Source: Techniques in Hand and Upper Extremity Surgery - February 21, 2019 Category: Surgery Tags: Techniques Source Type: research

Volar Approach to Percutaneous Fixation of Acute Nondisplaced Fractures of the Scaphoid
Scaphoid fractures typically occur in young, healthy males at the peak of their employment and productivity, and left untreated or inadequately treated will ultimately progress to nonunion and a “predictable” pattern of wrist arthritis and carpal collapse. Nonoperative treatment of these fractures requires prolonged cast immobilization, which can lead to wrist stiffness, loss of grip strength, muscle atrophy, and protracted loss of economic productivity. To prevent these devastating sequelae, percutaneous techniques for scaphoid fixation have been described and popularized; however, these techniques are technically dem...
Source: Techniques in Hand and Upper Extremity Surgery - February 21, 2019 Category: Surgery Tags: Techniques Source Type: research

Brachioradialis Flap for Soft Tissue Coverage of Posterior Elbow Wounds: Case Report and Surgical Technique
We present a review of the literature, case report, and surgical technique using the brachioradialis muscle for coverage of a large posterior elbow wound after failure of an anconeus flap. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 21, 2019 Category: Surgery Tags: Techniques Source Type: research

Is There More to Life Than an Evidence-based Study
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 21, 2019 Category: Surgery Tags: Editorial Source Type: research

An Eco-conscious Alternative Material for Splinting in Hand Surgery
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 20, 2018 Category: Surgery Tags: Letter to the Editor Source Type: research

Reconstruction of Traumatic Central Slip Injuries: Technique Using a Slip of Flexor Digitorum Superficialis
We describe a surgical technique for central slip reconstruction using a slip of the flexor digitorum superficialis tendon through a bone tunnel. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - November 20, 2018 Category: Surgery Tags: Techniques Source Type: research

Tether Creation Between the Second and Third Extensor Digitorum Communis for Third Extensor Tendon Subluxation at the Metacarpophalangeal Joint
We developed a substitution technique for a sagittal band reconstruction for subluxation of the third extensor tendon at the metacarpophalangeal joint. Through this procedure, we attempted to supply a tether between the second and third extensor digitorum communis (EDC) tendons. A half-slip of the second EDC was interlaced to the third EDC tendon at the level of the third metacarpal head with the metacarpophalangeal joint in full flexion position; this ensured that the interlace of the graft serves as a direct stabilizer against ulnar subluxation. A key advantage of our procedure is the strong and reliable interlace of the...
Source: Techniques in Hand and Upper Extremity Surgery - November 20, 2018 Category: Surgery Tags: Techniques Source Type: research

Tenodesis of the Ulnotriquetrum Ligament to the Fovea for a Triangular Fibrocartilage Complex Tear
We developed a novel procedure to treat a triangular fibrocartilage complex (TFCC) foveal tear, namely tenodesis of the ulnotriquetrum ligament (UTL) to the fovea. We attempted to reestablish the tension of the palmar radioulnar ligament by the procedure specifically in cases with palmar radius instability relative to the ulna. We used a palmar surgical approach to expose the palmar aspect of TFCC in which the ulnocarpal ligament merges with the palmar radioulnar ligament. UTL was distally excised at a 4 mm width from the triquetrum without disrupting its ligamentous connection to the palmar radioulnar ligament proximall...
Source: Techniques in Hand and Upper Extremity Surgery - November 20, 2018 Category: Surgery Tags: Techniques Source Type: research

Preparation is the Only Shortcut You Need in Surgery: A Guide to Surgical Rehearsals for Hand and Upper Extremity Transplantation
As upper extremity transplantation is becoming more accepted worldwide, the demand for a fresh tissue cadaveric training model for this procedure is increasing and necessary to assure surgical success. Surgical rehearsals can decrease operative time, improve technique, and reduce errors made on the actual day of surgery. The purpose of this article is to describe a method for surgical rehearsal of upper extremity transplantation using cadaveric specimens based on the clinical experience of an academic institution with an active transplantation program. The logistics of rehearsal setup, equipment, and modified version of pr...
Source: Techniques in Hand and Upper Extremity Surgery - November 20, 2018 Category: Surgery Tags: Techniques Source Type: research

Therapeutic Management of the Posttraumatic Stiff Elbow After Open Osteocapsular Release
Arthrofibrosis is an inevitable consequence of elbow trauma that oftentimes requires surgical release to restore range of motion and function. Although the surgical procedure for elbow osteocapsular release can result in marked improvement in elbow motion, postrelease rehabilitation is paramount to maintaining and even improving the gains achieved in surgery. There are a variety of rehabilitation protocols and modalities that can be implemented that can be divided into an early versus late stage of rehabilitation after surgery. Irrespectively, patient ownership in the rehabilitative process and effective communication betw...
Source: Techniques in Hand and Upper Extremity Surgery - November 20, 2018 Category: Surgery Tags: Beyond the Technique Source Type: research

Surgical Management of the Posttraumatic Stiff Elbow: A Step-Wise Algorithm for Open Osteocapsular Release
Posttraumatic elbow stiffness is common with the primary indication for contracture release being limited motion that affects functional activities which has not adequately improved after intensive therapy and rehabilitation. Preoperative evaluation focuses on the history of previous nonoperative and/or operative treatment, physical exam with particular attention paid to the status of the ulnar nerve, and imaging consisting of radiographs and computed tomography. There are multiple intrinsic and extrinsic causes of posttraumatic contracture. In general, limitation of motion in one direction can be attributed to a mechanica...
Source: Techniques in Hand and Upper Extremity Surgery - November 20, 2018 Category: Surgery Tags: Technique Source Type: research