The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Feb 2009
Randomized Controlled Trial Comparative StudySingle injection digital block: is a transthecal injection necessary?
Three different methods of injection to obtain digital block anaesthesia were performed on 15 healthy volunteers to evaluate the success and extent of anaesthesia. We found that the traditional transthecal injection technique was inaccurate and the injected agent mainly flowed into the subcutaneous space, and did not remain within the sheath. ⋯ However, the anaesthetic area after the deep transthecal injection was significantly smaller than that of the other two techniques (P<0.01). A transthecal digital block offers no advantage over a simple subcutaneous digital block.
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J Hand Surg Eur Vol · Feb 2009
The relative incidence of fractures at the base of the proximal phalanx of the thumb in children.
There is disagreement in the literature about the most common fracture type at the base of the proximal phalanx of the thumb in children below the age of adolescence. In this prospective study, 58 consecutive children aged 10 years or less with isolated fractures of the base of the proximal phalanx of the thumb were included and their radiographs were reviewed. The study included 38 boys and 20 girls with a mean age of 8 (range 1-10) years. After excluding one patient, in whom the type of fracture could not be determined, the most common fracture in the remaining 57 cases was the Salter-Harris type II fracture (72%), followed by the juxta-epiphyseal type II fracture (18%).
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J Hand Surg Eur Vol · Feb 2009
Idiopathic carpal tunnel syndrome and trigger finger: is there an association?
Carpal tunnel syndrome (CTS) and trigger finger are known to occur together in association with conditions such as diabetes mellitus, rheumatoid arthritis and hypothyroidism. Although most cases that present to a hand clinic have no obvious predisposing cause, the two conditions often appear together in the same patient. We performed a prospective study of the prevalence of CTS in hospital outpatients presenting with trigger finger. ⋯ Of 211 patients with trigger finger, 91 (43%) also had CTS. This prevalence is substantially higher than the population prevalence of CTS of approximately 4%. Our data support an association between idiopathic CTS and idiopathic trigger finger and lend support to common pathophysiological factors.
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J Hand Surg Eur Vol · Feb 2009
Endoscopic anatomical nerve observation and minimally invasive management of cubital tunnel syndrome.
Experience with the use of the Universal Subcutaneous Endoscope (USE) system in surgical treatment of cubital tunnel syndrome in 35 patients is reported. Patients included in the study had pre- and postoperative clinical and electrophysiological data, and had undergone a minimum follow-up period of 13 months. Mean patient age was 59.5 years and the mean follow-up period was 25.9 months. ⋯ There were no complications in this series. The endoscopic approach facilitates inspection of the ulnar nerve so that selective release of the tissue that compresses the nerve can readily be performed. The technique has proven effective in the treatment of cubital tunnel syndrome.