The journal of hand surgery Asian-Pacific volume
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J Hand Surg Asian Pac Vol · Dec 2020
A Novel Technique for Dynamic External Fixation of Proximal Interphalangeal Joint Fracture-Dislocations.
Background: The pins and rubbers traction system is widely used to treat unstable proximal interphalangeal (PIP) joint fracture-dislocations. However, dealing with rubber bands can be difficult due to its elasticity and weakness. The purpose of this study was to report the results of an alternative dynamic external fixator technique for unstable PIP joint injuries. ⋯ Conclusions: The results were comparable to other dynamic external fixation techniques used for unstable PIP joint fracture-dislocations. The main advantages of this technique were strength of the system, procedure simplicity, the compact design, and relatively low cost. In addition, this technique can also be used in pilon fractures and comminuted shaft fractures of a middle phalanx with or without PIP joint extension.
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J Hand Surg Asian Pac Vol · Sep 2020
ReviewManagement of Birth Brachial Plexus Injury Including Use of Distal Nerve Transfers.
Birth Brachial plexus injury continues to remain a problem despite significant care from obstetricians to prevent it. Many children show spontaneous recovery but a significant proportion do not have adequate recovery. ⋯ Surgical strategy consists of primary intraplexal repair as the standard of care but of late the distal nerve transfers used in adult plexus injuries are increasingly being used in infants too. We discuss the history, current usage and pros and cons of distal nerve transfers, the usage of Botulinum Toxin and finally given an overall algorithm for the management.
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J Hand Surg Asian Pac Vol · Sep 2020
Elbow Flexion Reconstruction in Brachial Plexus Avulsion Injuries - Results with Intercostal Nerve and Distal Nerve Transfers.
Background: The neural surgical options for reconstruction of elbow flexion in brachial plexus injuries depend on the availability of nerve donors. In upper-type avulsion injuries, the ulnar or median nerves, when intact, are reliable intra-plexal donor nerves for transfers to the biceps muscle. In complete avulsion injuries, donors are limited to extra-plexal sources, such as intercostal nerves (ICNs). ⋯ In the subgroup of patients with upper-type brachial plexus injuries, there were no significant differences in motor outcomes between the ICN versus distal nerve transfers group. Conclusions: In our entire cohort, patients with distal nerve transfers had faster motor recovery and better elbow flexion power than patients with ICN transfers. In patients with partial brachial plexus injuries, outcomes of ICN transfers were not inferior to distal nerve transfers.
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J Hand Surg Asian Pac Vol · Jun 2020
Comparative StudyA Comparison of Splint Versus Pinning the Distal Interphalangeal Joint for Acute Closed Tendinous Mallet Injuries.
Background: The vast majority of acute closed tendinous mallet injuries are treated with a splint. Very few studies have directly compared splinting versus pinning the distal interphalangeal joint for this injury. The aim of this cohort study is to determine the outcomes of both methods. ⋯ Results: The mean extension lag of the DIP joint in the surgical treatment group was significantly better than it was with conservative treatment (2.1° vs 13.8°). Three patients who were noncompliant with the splint showed poor results, while no patients in the surgical treatment group had a poor result. Conclusions: Surgical treatment with K-wire fixation leads to satisfactory results for acute tendinous mallet injury.
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J Hand Surg Asian Pac Vol · Jun 2020
Outcomes Following Open Reduction and Internal Fixation in Proximal Phalangeal Fracture with Rotational Malalignment.
Background: The rotational malalignment in proximal phalanx fracture is unacceptable. Authors attempted to describe clinical and radiographic outcomes as well as complications after open reduction and internal fixation with screw only or plate for phalangeal fractures accompanied by rotational malalignment. Methods: Authors conducted a retrospective review of 46 patients who had been treated between Jan. 2010 and Dec. 2016. ⋯ Depending on rotation direction, preoperative 21.7° to postoperative 12.1° in 27 patients of convergent group and preoperative -5.0° to postoperative 8.3° in 19 patients of divergent group were achieved. Conclusions: The rotation from proximal phalanx fractures could be corrected with anatomic reduction by open reduction. Our results showed that open reduction and rigid internal fixation after physical examination for acute proximal phalanx fractures accompanied by rotational malalignment could achieve good clinical results.