The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Mar 2019
Glenohumeral fusion in adults with sequelae of obstetrical brachial plexus injury: a report of eight cases.
The purpose of this study was to assess the outcomes of glenohumeral fusion performed in adulthood in patients with poor recovery after obstetric brachial plexus injury. We reviewed eight patients with obstetrical brachial plexus injury who had undergone shoulder arthrodesis. The mean age was 28 years (range 16 to 55). ⋯ Fusion was obtained between 3 and 6 months, and none of the patients experienced residual pain. Shoulder fusion improved the active shoulder abduction and external rotation in adults with residual obstetrical brachial plexus paralysis. Level of evidence: IV.
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J Hand Surg Eur Vol · Feb 2019
Comparative StudyOutcomes of cementless joint prosthesis versus tendon interposition for trapeziometacarpal osteoarthritis: a prospective study.
We compared 84 patients with the Ivory trapeziometacarpal prosthesis versus 62 with ligament reconstruction and tendon interposition arthroplasty performed for osteoarthritis. There were 134 women and 12 men with a mean age of 60 years. Prospective clinical assessment was made using the Quick Disability of the Arm, Shoulder and Hand (DASH) questionnaire, visual analogue scale for pain, range of motion, and grip and pinch strength. ⋯ Revision surgery was required for two patients in the prosthesis group, two for dislocation and one cup loosening, while in the ligament reconstruction group there were no revisions. We conclude that trapeziometacarpal prosthesis provides better mid-term results in terms of function compared with ligament reconstruction and tendon interposition for patients with Stages 2 and 3 osteoarthritis of the trapeziometacarpal joint. Level of evidence: II.
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J Hand Surg Eur Vol · Dec 2018
ReviewRepair of soft tissue defects in finger, thumb and forearm: less invasive methods with similar outcomes.
We review recent developments in using occlusive dressings, dermal templates, and venous flaps for less invasive approaches to treat soft tissue defects of the forearm and fingers. Occlusive dressings can be used for thumb tip or fingertip trauma with soft tissue defects of small or moderate sizes. They permit skin regeneration without use of skin graft or a flap transfer. ⋯ Extensive soft tissue defects in the thumb, fingers, hand and forearm require flap transfers traditionally, but in recent years, surgeons use dermal templates to cover the defect site to allow regeneration of subcutaneous tissues, over which a skin graft is used in lieu of a flap. Transfer of a venous flap is currently a reliable procedure and is less invasive compared with conventional flaps, which usually damage a named artery in the donor. We advocate that less invasive methods should be considered for soft tissue defects in the hand and forearm.
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J Hand Surg Eur Vol · Oct 2018
Randomized Controlled TrialMicrobial counts in hands with and without nail varnish after surgical skin preparation: a randomized control trial.
Nail varnish is commonly removed from fingernails prior to surgical procedures. We report the results of a randomized controlled trial comparing the microbial counts in hands with and without nail varnish applied, following surgical skin preparation. ⋯ There was no significant difference in terms of positive microbial growth between the nail plates or hyponichia with or without nail varnish applied. Our results demonstrate that the presence of nail varnish does not have an effect on the microbial counts of hands following surgical skin preparation.