The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Dec 2008
The use of a combination of cerclage and unicortical interosseous loop dental wires for long oblique/spiral metacarpal shaft fractures.
A literature review of metacarpal fracture fixation techniques revealed that the use of a combination of interosseous and cerclage dental loop wires has not been previously described. In this report, we review the results of 24 patients with long oblique/spiral metacarpal shaft fractures of the fingers treated by this combined technique of internal fixation, followed by immediate postoperative finger mobilisation in a wrist splint. ⋯ Complications included one case of CRPS Type 1 resulting in mild stiffness and all four women complained of the hyperpigmentation of the dorsal hand scars. The advantages of dental wire fixation were discussed and compared to those of lag screws.
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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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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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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.
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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.