The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Oct 2005
Case ReportsNon-infective subcutaneous emphysema of the hand secondary to a minor webspace injury.
Subcutaneous emphysema in the hand is commonly associated with infection or high-pressure injection injuries, with other non-infectious causes being reported as rarities in the literature. We describe an unusual case of minor injury to the first webspace resulting in significant subcutaneous emphysema.
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J Hand Surg Eur Vol · Oct 2005
Randomized Controlled TrialSimple decompression or subcutaneous anterior transposition of the ulnar nerve for cubital tunnel syndrome.
The purpose of this prospective randomised study was to evaluate which operative technique for treatment of cubital tunnel syndrome is preferable: subcutaneous anterior transposition or nerve decompression without transposition. This study included 66 patients suffering from pain and/or neurological deficits with clinically and electromyographically proven cubital tunnel syndrome. ⋯ There were no significant differences between the outcomes of the two groups at either postoperative follow-up examination. We recommend simple decompression of the nerve in cases without deformity of the elbow, as this is the less invasive operative procedure.
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J Hand Surg Eur Vol · Oct 2005
Internal fixation of unstable fracture dislocations of the proximal interphalangeal joint.
We report a group of 14 patients with fracture dislocations of the proximal interphalangeal joint with fracture fragments of adequate size to allow reduction of the proximal interphalangeal joint and internal mini screw fixation of the bone fragment attached to the palmar plate to the base of the middle phalanx. Three years after surgery, (range 25-52 months) the average total active range of motion of the proximal interphalangeal joint was 100 degrees (range 65-115 degrees) for the acute group (operation within 14 days of injury, n=7) and 86 degrees (range 60-110 degrees) for the chronic group (operation on average 46 days after injury, range 21-120 days, n=7). Longer delay from injury was associated with a decreased total range of motion (P=0.028). ⋯ The key to successful treatment of this injury is the re-establishment of joint congruity and early mobilization. With appropriate patient selection, pain free, satisfactory range of motion can be achieved. There is a risk of persistent subluxation or dislocation, particularly if treatment is delayed.
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J Hand Surg Eur Vol · Aug 2005
Case ReportsThe management of hand injuries caused by sea urchin spines.
Injuries to the hand by sea urchin spines are not commonly seen in the United Kingdom. There are many varieties of sea urchins (Echinoidea) throughout the world. ⋯ Injury may also be caused by the urchin spines or pedicellaria (delicate seizing organs equipped with jaws). A small number of hand injuries associated with sea urchin spines have been reported in the literature.
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J Hand Surg Eur Vol · Aug 2005
Elbow flexion reconstruction by Steindler flexorplasty in obstetric brachial plexus palsy.
The results of Steindler flexorplasty in nine patients with obstetric brachial plexus palsy are reported. There were 5 girls and 4 boys with a mean age of 6 (range 2-13) years. Selection criteria for the procedure included strong (at least M4) grip strength and wrist and elbow extension, as well as the presence of the "Steindler effect". ⋯ At a mean follow-up of 5 years, the results in eight patients were good with mean active elbow flexion against resistance of 110 degrees and a mean elbow flexion contracture of 35 degrees. The result in the remaining patient was poor (unsuccessful transfer). It is concluded that the results of the Steindler flexorplasty in obstetric brachial plexus palsy patients are good and reliable, provided patient selection is careful.