Techniques in Hand and Upper Extremity Surgery Techniques in Hand and Upper Extremity Surgery RSS feedThis 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.

“Hills, Plains, and Valleys”: A Topographical Concept in the Treatment of Dupuytren’s Contracture With Needle Aponeurotomy
This article describes a unique topographical concept in the treatment of Dupuytren’s contracture with needle aponeurotomy. This concept guides portal placement in a planned manner to achieve better correction and avoid potential complications. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - May 24, 2017 Category: Surgery Tags: Techniques Source Type: research

Triplanar Humeral Osteotomy for Restoration of Midline Function in Patients With Brachial Plexus Birth Palsy
Brachial plexus birth palsy resolves spontaneously in a majority of patients, however, others may have serious permanent dysfunction. Although nerve transfers or grafts are early options for treatment, many children have residual deficits or present too late for such procedures. In these patients, rotational osteotomy of the humerus may restore improved function and motion. Unfortunately, traditional humeral osteotomies only provide correction in a single plane, therefore appropriate correction of the typical residual deformity is incomplete. Here, we describe a novel technique for obtaining a calculated correction in 3 pl...
Source: Techniques in Hand and Upper Extremity Surgery - May 24, 2017 Category: Surgery Tags: Techniques Source Type: research

An Articulating Antibiotic Cement Spacer for First-stage Reconstruction for Infected Total Elbow Arthroplasty
Management of an infected total elbow replacement is a significant clinical challenge. Although preservation of the prosthesis is ideal, a 2-stage revision is often necessary. Unlike lower limb arthroplasty, antibiotic spacers are not commercially available. Monoblock cement spacers do not allow elbow movements and are therefore associated with severe stiffness and scarring, leading to poor clinical outcomes. In our paper we present a simple and novel technique for constructing an articulating antibiotic-impregnated spacer for use as an implant for a 1-stage revision of an infected elbow arthroplasty. (Source: Techniques i...
Source: Techniques in Hand and Upper Extremity Surgery - May 24, 2017 Category: Surgery Tags: Techniques Source Type: research

Chronic Boutonniere Deformities, Supple, or Stiff: A New Surgical Technique With Early Mobilization in 11 Cases
We report a series of 11 patients treated by lengthening-dorsalizing the lateral bands and tightening the central slip with early mobilization. The average age of the patients was 42 years (14;52). The extension defect of the proximal interphalangeal (PIP) joint was 64 degrees (80;55) and the hyperextension of the distal interphalangeal joint was 10 degrees (15;5). The surgery was performed with peripheral nerve block (sensitive), allowing dynamic adjustment of the tendinous sutures. With a dorsal incision, a tenolysis of the extensor was performed. The central slip was tightened and the lateral bands dorsalized by cross-s...
Source: Techniques in Hand and Upper Extremity Surgery - May 24, 2017 Category: Surgery Tags: Techniques Source Type: research

Open Glenohumeral Joint Reduction and Latissimus Dorsi and Teres Major Tendon Transfers for Infants and Children Following Brachial Plexus Birth Palsy
Glenohumeral dysplasia can occur in brachial plexus birth palsy due to an imbalance of muscle forces. Most commonly this occurs in C5-C6 injuries where the shoulder external rotators are weak compared with the shoulder internal rotators. Treatment of the dysplasia with open reduction of the glenohumeral joint in combination with rebalancing the muscles can improve the development of the joint. Furthermore, the tendon transfer can improve shoulder function by decreasing the internal rotation forces about the shoulder while increasing the external rotation forces. This paper describes the indications, contraindications, and ...
Source: Techniques in Hand and Upper Extremity Surgery - May 24, 2017 Category: Surgery Tags: Techniques Source Type: research

What Is Surgical Grit?
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - May 24, 2017 Category: Surgery Tags: Editorial Source Type: research

Volar, Dorsal, and Lateral Locking Plate Fixation for Pilon Fractures
The more common dorsal fracture subluxations at the base of the middle phalanx have an intact dorsal buttress of articular surface in continuity with the shaft. Capitalizing on this foundation, various fixation methods have met with relatively equivalent success including Kirschner wires, screws only, nonlocking plate and screws, and external fixation. Pilon fractures are complete articular fractures, where the comminuted articular fragments lack any structural connection to the more distal shaft of the middle phalanx, and have largely relied upon external fixation traction systems. The theoretical concept is that axial di...
Source: Techniques in Hand and Upper Extremity Surgery - February 17, 2017 Category: Surgery Tags: Techniques Source Type: research

Internal Bone Grafting for the Treatment of Scaphoid Nonunions
We describe a technique of internal bone grafting, where curettage of the nonunion site was performed through a drill hole in the scaphoid and bone graft was packed through this same hole before fixation with a headless compression screw. We have been able to achieve a union rate of 86% using this technique. The advantage of the technique is that it does not disturb the external fibrocartilaginous shell that would have formed around the nonunion site, thus leaving the articular surface undisturbed. (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 17, 2017 Category: Surgery Tags: Techniques Source Type: research

Dorsal Distraction Plating and Lunate Decortication for Stage III Kienböck Disease: A Novel Technique
We report a novel technique of lunate decompression and bone grafting, combined with wrist distraction with or without radial shortening osteotomy via dorsal wrist bridge plating for the treatment of stage II-IIIa/b KD. This technique provides the advantages of distraction of the carpus unloading the lunate after bone grafting and during revascularization without the issues inherent to external fixation. In addition, this technique allows compression through a radial osteotomy site when performed. Our approach to the treatment of KD has incorporated this technique for patients with stage II or IIIa/b disease. (Source: Tech...
Source: Techniques in Hand and Upper Extremity Surgery - February 17, 2017 Category: Surgery Tags: Techniques Source Type: research

Free Functional Muscle Transfer Tendon Insertion Secondary Advancement Procedure to Improve Elbow Flexion
One method of restoring elbow flexion in patients with brachial plexus injuries is through the use of free functional muscle transfer. Most of our patients achieve good outcome, resulting in improved usefulness of the affected limb. However, a minority of our patients have successful reinnervation of the transferred muscle but with a suboptimal strength and range of motion (ROM) of elbow flexion. In this subset of patients, we perform a secondary procedure to improve the moment arm of the muscle on the elbow joint. This involves advancing the transferred muscle distally along the radius. The technique of the advancement pr...
Source: Techniques in Hand and Upper Extremity Surgery - February 17, 2017 Category: Surgery Tags: Techniques Source Type: research

Surgical Treatment of Chronic Essex-Lopresti Lesion: Interosseous Membrane Reconstruction and Radial Head Prosthesis
The Essex-Lopresti lesion, or radioulnar longitudinal dissociation, results from an axial load to the forearm with lesion to the radial head, interosseous membrane and distal radioulnar joint. The lesion is rarely diagnosed early, therefore treatment is often subacute or chronic. In these cases, procedures such as radial head replacement, ulnar shortening and/or wafer procedures should be combined with reconstruction of the interosseous membrane central band to restore longitudinal stability of the forearm. In the technique described, we use a folded fascia lata allograft fixed with specific device throughout transulnar an...
Source: Techniques in Hand and Upper Extremity Surgery - February 17, 2017 Category: Surgery Tags: Techniques Source Type: research

Back to Basics
No abstract available (Source: Techniques in Hand and Upper Extremity Surgery)
Source: Techniques in Hand and Upper Extremity Surgery - February 17, 2017 Category: Surgery Tags: Editorial Source Type: research

Arthroscopic-assisted Acromioclavicular and Coracoclavicular Ligaments Reconstruction for Chronic Acromioclavicular Dislocations: Surgical Technique
Chronic acromioclavicular (AC) instability is a rare posttraumatic shoulder condition that can lead to undesirable symptoms like persistent pain, muscle fatigue, loss of strength, or even scapular dyskinesis. It is well known that in these cases the superior functional results depend on the restoration of the anatomy and stability of the AC joint in both vertical and horizontal planes. Considering the ligaments degeneration and atrophy in chronic AC joint dislocations, we present an arthroscopic-assisted reconstruction of both the coracoclavicular and AC ligaments using autograft augmentation. In details the coracoclavicul...
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2016 Category: Surgery Tags: Techniques Source Type: research

Targeted Muscle Reinnervation for Transradial Amputation: Description of Operative Technique
Targeted muscle reinnervation (TMR) is a revolutionary surgical technique that, together with advances in upper extremity prostheses and advanced neuromuscular pattern recognition, allows intuitive and coordinated control in multiple planes of motion for shoulder disarticulation and transhumeral amputees. TMR also may provide improvement in neuroma-related pain and may represent an opportunity for sensory reinnervation as advances in prostheses and haptic feedback progress. Although most commonly utilized following shoulder disarticulation and transhumeral amputations, TMR techniques also represent an exciting opportunity ...
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2016 Category: Surgery Tags: Techniques Source Type: research

The Use of a Simple Dynamic External Fixator for the Treatment of Volar Fracture Subluxation of Proximal Interphalangeal Joints of the Fingers
Volar fracture dislocation is very uncommon, with few series reported in the literature. Patients with such injuries were treated by modified dynamic external fixators. The mean follow-up was 18 months (range, 6 to 92 mo). The mean range of interphalangeal (proximal interphalangeal) joints and distal interphalangeal joints were 90 and 74 degrees, respectively. The total active range of motion (TAM) was excellent (256 degrees). The mean quick disabilities of the arm, shoulder and hand score was 1.2. The advantages of our external fixators are that they are simple, cheap, adjustable, and allow immediate range of motion. (Sou...
Source: Techniques in Hand and Upper Extremity Surgery - November 17, 2016 Category: Surgery Tags: Techniques Source Type: research