The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Aug 2008
Randomized Controlled TrialDigital blocks with and without adrenalin: a randomised-controlled study of capillary blood parameters.
This study compared fingertip capillary blood gas parameters before and after digital anaesthesia using lidocaine with and without Adrenalin. Twenty patients who underwent surgery on their fingers under digital ring block anaesthesia were randomly anaesthetised with 2% lidocaine or 2% lidocaine with 1:80,000 Adrenalin. Capillary blood parameters were measured prior to the digital blocks and 15 minutes after the injections. ⋯ However, this decrease was not statistically significant. Patients in the plain lidocaine group had return of sensation to the finger tip 4.8 (+/-0.6) hours after the operation. This period was 8.1 (+/-0.8) hours for the lidocaine with Adrenalin group.
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J Hand Surg Eur Vol · Aug 2008
Case ReportsRing avulsion injury with rupture of both digital arteries despite a completely intact skin envelope.
A rare case of ring avulsion injury with avulsion of both digital arteries yet without external soft tissue, tendon or skeletal injury in a 29 year-old man is reported.
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J Hand Surg Eur Vol · Aug 2008
Comparative StudyComparison of zones 1 to 4 flexor tendon repairs using absorbable and unabsorbable four-strand core sutures.
Absorbable sutures behave favourably in vitro and in an animal model. We report the outcome of flexor tendon injuries in a series of 272 consecutive patients treated over 45 months with a mean follow-up of 4 (range 3-12) months. Five hundred and seventy-six tendons were repaired in 416 digits. ⋯ There were six ruptures (2%) in Group 1 and two (2%) in Group 2. Using the original Strickland criteria, there were 72% excellent/good and 28% fair/poor results in the absorbable core suture group, and 73% and 27%, respectively, in the non-absorbable core suture group. This study suggests that appropriate absorbable core sutures can be used safely for flexor tendon repair.
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Combined fractures of the distal radius and scaphoid are uncommon, are usually the result of a high-energy trauma and there is no consensus regarding their optimal management. We present a retrospective study of ten patients, out of whom nine underwent internal fixation of their fractures. Open reduction and internal fixation were performed in six of the eight intraarticular fractures of the distal radius. ⋯ Emphasis on treatment of this combined fracture should be placed on the management of the distal radius fracture. Internal fixation of both fractures, followed by early rehabilitation, optimises outcomes. Cast treatment is indicated only in patients with completely undisplaced fractures of both the radius and the scaphoid.