The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Oct 2008
Comparative StudyClosed reduction and percutaneous K-wires versus open reduction and interosseous loop wires for displaced unstable transverse fractures of the shaft of the proximal phalanx of the fingers in industrial workers.
Seventy-eight male industrial workers with displaced unstable transverse fractures of the shaft of the proximal phalanx of the fingers were divided into two groups: Group 1 (n = 40 men, mean age = 34 years, range = 22-46 years) was treated with closed reduction and percutaneous K-wires, and Group 2 (n = 38 men, mean age = 33 years, range = 20-48 years) was treated with open reduction and interosseous loop wire fixation. At final follow-up, the total active motion (TAM) score of the injured finger was graded as excellent, good, fair or poor if it was greater than 240 degrees , 220 degrees , 180 degrees or less than 180 degrees , respectively. ⋯ The complication rate was higher in Group 1 than Group 2 (28% versus 11%) but the difference did not reach statistical significance (P = 0.084). The results were compared with those reported by other authors and other techniques of fixation of these fractures.
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Sea urchin spine injuries are common. They usually cause local pain and swelling that subsides. ⋯ We report two cases of sea urchin granulomata involving finger metacarpophalangeal joints. Both resolved following surgery.
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This study examined the features of 16 complications from 51 distraction lengthenings in the hands of 43 patients. From 1996 to 2006, 24 metacarpals and 27 phalanges were lengthened at a rate of 0.5 and 0.25 mm/day, respectively, using a callus distraction technique. The indications were congenital (33 cases in 27 patients) and traumatic (18 cases in 16 patients) deformities. ⋯ Most patients with complications except for two children with dislodgment were as satisfied with the final results as those without complications. Although callus distraction in the hand requires a long treatment period and has a relatively high rate of complication, it appears to be effective in achieving adequate bone length. A high level of patient compliance and prompt management of complications by an experienced surgeon are essential for achieving good results.