The journal of hand surgery Asian-Pacific volume
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J Hand Surg Asian Pac Vol · Jun 2019
Surgical Treatment of Distal Radius Fractures under the Ultrasound-Guided Brachial Plexus Block Performed by Surgeons.
Background: The upper limb surgery under the ultrasound-guided brachial plexus block is becoming popular due to its safety, effectiveness, and convenience. However, the uneven distribution of anesthesiologists become a social problem. Ultrasound-guided brachial plexus block by surgeons has been widespread especially in hand surgeons. ⋯ However, 6 cases (5.9%) shifted to general anesthesia. Although it needs training, we consider that hand surgery including distal radius fractures treatment under the ultrasound-guided brachial plexus block is possible. On the other hand, cooperation or a cooperative system with anesthesiologists is necessary for surgeons to administer this anesthesia.
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J Hand Surg Asian Pac Vol · Jun 2019
Seasonal Variation in Hand and Upper Limb Soft Tissue Infections.
Background: Hand and upper limb soft tissue infections result in significant disability and loss of productivity. Many infections have been shown to follow a seasonal variation, however little is known about this is the context of upper limb soft tissue infections. We aimed to evaluate seasonal variation in acute bacterial, hand and upper limb skin and soft-tissue infections, and correlate findings with key environmental variables. ⋯ Conclusions: This study demonstrates a seasonal variation in hand and upper limb infections, with a significant correlation between infection rates and ambient temperature. Appreciating seasonal variability of these infections could prove beneficial for surgical planning, public health recommendations and antibiotic guidelines. However, further international data is needed to understand potential mechanisms involved.
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J Hand Surg Asian Pac Vol · Jun 2019
Benefits of Additional Procedures for Metacarpophalangeal Hyperextension on Simple Trapeziectomy in Thumb Basal Osteoarthritis: A Biomechanical Cadaver Study.
Background: Patients with advanced osteoarthritis of the first carpometacarpal joint (CMC-1) may develop hyperextension of the first metacarpophalangeal joint (MCP-1). No clear clinical benefice has been reported consecutively to the surgical treatment of the MCP-hyperextension combined to a trapeziectomy. The reason of the missing benefit may be due to changes in the thumb position impairing the thumb stability secondary to the surgical procedures. ⋯ The lowest shift was achieved when performing the arthrodesis in 20° supination or by overloading of the adductor pollicis. Conclusions: Combining the trapeziectomy with surgeries addressing the MCP-1-joint hyperextension induced a shift of the thumb in pronation-abduction that could impair the key-pinch stability. When considering additional procedures for MCP-1-joint hyperextension deformities, it should be recommended to fix the EPB-tendon on the radial aspect of the metacarpal head if a tendon transfer is considered, otherwise the MCP joint arthrodesis should be performed in supinated position, in order to achieve lateral key-pinch stability.