The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Feb 2018
Meta AnalysisFunctional outcomes of distal radius fractures with and without ulnar styloid fractures: a meta-analysis.
The aim of this meta-analysis was to compare the functional outcomes of patients with a distal radius fracture with and without a concomitant fracture of the ulnar styloid process. A systematic literature search was performed to identify all studies comparing patients with a distal radius fracture with and without an ulnar styloid process fracture. The initial search revealed 511 articles, of which 12 articles with a total of 2243 patients were included; 1196 patients with and 1047 patients without an ulnar styloid process fracture. ⋯ This difference is less than 10 and therefore not clinically important. No significant difference was found in Patient-Rated Wrist Evaluation scores, range of motion, grip strength, visual analogue scale pain scores, ulnar-sided wrist pain and distal radio-ulnar joint instability between patients with and without an ulnar styloid process fracture after 1 year of follow-up. Moreover, no significant differences were found between ulnar styloid base and nonbase fractures.
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The purpose was to determine if smartphone photography is a reliable tool in measuring wrist movement. Smartphones were used to take digital photos of both wrists in 32 normal participants (64 wrists) at extremes of wrist motion. The smartphone measurements were compared with clinical goniometry measurements. ⋯ The Bland-Altman plots demonstrated 29-31 of 32 smartphone measurements were within the 95% confidence interval of the clinical measurements for all positions of the wrists. There was high reliability between the photography taken by the volunteer and researcher, as well as high inter-observer reliability. Smartphone digital photography is a reliable and accurate tool for measuring wrist range of motion.
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J Hand Surg Eur Vol · Nov 2017
Techniques and survival incidence for revascularization of degloved fingers.
We report techniques and survival incidence of three subtotally and nine completely degloved fingers in seven patients. We performed end-to-end arterial repairs in seven fingers, vein graft repairs for arteries in two fingers, arteriovenous anastomoses in three fingers. ⋯ Soft tissues in the eight degloved fingers survived completely, two failed completely, and two were partially necrotic. We conclude from our results that following revascularization, the skin from a completely degloved finger skin will survive in approximately two cases out of three.
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J Hand Surg Eur Vol · Oct 2017
Early active motion after rigid internal fixation of unstable extra-articular fractures of the proximal phalanx.
The purpose of this study is to describe active early rehabilitation in proximal phalanx fractures treated with rigid internal fixation. A total of 22 consecutive patients presenting with spiral, oblique or comminuted extra-articular fractures of the proximal phalanx were included in the study. All fractures were rigidly stabilized with plate and screws or screws alone and subsequently entered an active early rehabilitation programme. ⋯ According to the digital functional assessment, 86.3% of the patients had excellent results. Extension lags of the proximal interphalangeal joint were observed in seven fingers (mean lag, 3.4° (SD 5.5)). The results of this study demonstrated high patient satisfaction and good outcomes after the surgical technique and postoperative rehabilitation protocol described in open reduction and rigid internal fixation of proximal phalangeal fractures.
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J Hand Surg Eur Vol · Sep 2017
Comparative StudyReliability of functioning free muscle transfer and vascularized ulnar nerve grafting for elbow flexion in complete brachial plexus palsy.
We compared outcomes of primary vascularized ulnar nerve grafts from the C5 root neurotizing biceps and brachialis muscles, and gracilis functioning free muscle transfer neurotized by the distal spinal accessory nerve, as a primary or salvage procedure after complete brachial plexus injury. At 45 months, three of eight primary vascularized ulnar nerve graft patients regained grade 4 elbow flexion, while one regained grade 3. ⋯ Although vascularized ulnar nerve graft-based primary reconstructions can provide useful elbow flexion, this was achieved in less than half the cases. We consider primary gracilis functioning free muscle transfer neurotized by the distal spinal accessory nerve as the most reliable reconstruction for the restoration of elbow flexion in complete brachial plexus injury.