The journal of hand surgery Asian-Pacific volume
-
J Hand Surg Asian Pac Vol · Dec 2019
The Role of Early Post-Operative Radiographs Following Distal Radius Fracture Fixation with a Volar Locking Plate: Time for Change?
Background: The role of early radiographic imaging in the management of distal radius fractures (DRFs) is unclear. The aim of this study was to assess whether early post-operative radiographs for DRFs influences the ongoing management of this patient group. We hypothesize that routine early radiographs do not influence the management of DRFs. ⋯ Of patients who underwent imaging, 7 (4.0%) had their post-operative fracture management altered (7 intra-articular, 0 extra-articular) with 1 (0.58%) requiring immediate surgical revision as indicated by imaging. Conclusions: Our study questions the value of routine early post-operative radiographs in the management of distal radius fracture fixations, in particular if the fracture is extra-articular. This is of importance in the setting of constrained resources and represents a poor use of limited healthcare facilities, as well as unnecessary radiation exposure.
-
One of the serious complications of Seymour fractures is infection. A 24-year-old male presented with the open infected distal phalanx fracture of the middle finger. Wound debridement, irrigation, use of antibiotics and external fixation with the aid of mini-Ilizarov provided a resolution to the infectious process and enabled us to achieve a stable osseous union in correct position.
-
J Hand Surg Asian Pac Vol · Sep 2019
Minimum Ten-Year Outcomes of Partial Ulnar Nerve Transfer for Restoration of Elbow Flexion in Patients with Upper Brachial Plexus Injury.
Background: Partial ulnar nerve transfer to the biceps motor branch of the musculocutaneous nerve (Oberlin's transfer) is a successful approach to restore elbow flexion in patients with upper brachial plexus injury (BPI). However, there is no report on more than 10 years subjective and objective outcomes. The purpose of this study was to clarify the long-term outcomes of Oberlin's transfer based on the objective evaluation of elbow flexion strength and subjective functional evaluation of patients. ⋯ Patients were divided into two groups; three patients had lower scores and the other three patients had higher scores of QuickDASH. Conclusions: Oberlin's transfer is effective in the restoration of elbow flexion and can maintain the strength for more than 10 years. Patients with upper BPI with restored elbow flexion strength and no complicated nerve disorders have over ten-year subjective satisfaction.
-
J Hand Surg Asian Pac Vol · Sep 2019
Evolution of the Ring Concept for the Forearm and Its Implication on Treatment: From Galeazzi, Monteggia, Essex-Lopresti, and Darrach to the Current Era.
Geometrically, rings distribute their stress along their arc instead of concentrating at any one point. The forearm ring is composed of the radius, ulna, proximal radioulnar joint, and distal radioulnar joint. The annular ligament, interosseous membrane, and triangular fibrocartilage complex link and stabilize the ring. ⋯ Injuries to the forearm ring are unstable. Management of forearm injuries is centered on the restoration of the anatomy and stability of the forearm ring. Forearm ring injuries and their treatment are discussed in this article.
-
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.