The Journal of hand surgery, European volume
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During a four month period 851 patients presented to the Edinburgh Orthopaedic Trauma Unit with an acute sporting injury. Eighteen (2%) patients had either a soft tissue or bony mallet deformity. Six different sports were identified with rugby accounting for eight of the 18 mallet deformities. ⋯ Fourteen patients returned questionnaires regarding subjective digit function following treatment and nine patients claimed excellent function. The average splinting time for this group was 6 weeks and sports were avoided for an average of 5 weeks. Mallet deformity accounts for a minority of sporting injuries, but excellent functional outcome can be achieved with splintage and avoidance of the causative sport while splinted.
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J Hand Surg Eur Vol · Dec 2000
Open reduction and internal fixation of intra articular and unstable fractures of the distal radius using the AO distal radius plate.
This study reports the results of open reduction and internal fixation of 25 dorsally displaced distal radial fractures using a specifically designed plate for the distal radius, the AO pi plate (Synthes Ltd, Paoli, USA). Twenty-one of these fractures were complex and intra-articular (AO Type 'C'). ⋯ The final outcome, as assessed by the Gartland and Werley scale, was excellent in four cases, good in 11, and fair in ten cases. Complications were seen in five patients.
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J Hand Surg Eur Vol · Dec 2000
A modification of the technique for intravenous regional blockade for hand surgery.
A prospective study was conducted to assess a modification to Bier's intravenous regional anaesthesia which introduced a third temporary distal forearm tourniquet. This confines the injected lignocaine to the hand, resulting in a higher local lignocaine concentration. Subsequent exsanguination of the limb then channels the remaining intravascular lignocaine under the distal cuff of a double tourniquet. ⋯ No other anaesthetic complications were encountered. In a subjective assessment of the bloodlessness of the operating field, two were ranked satisfactory, ten good and six excellent. None of the patients required re-exsanguination when using this technique.
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J Hand Surg Eur Vol · Oct 2000
The diagnostic value of intraoperative measurement of choline acetyltransferase activity during brachial plexus surgery.
We used the measurement of choline acetyltransferase (CAT) activity to distinguish between preganglionic and postganglionic injuries of the spinal roots during brachial plexus surgery. This study includes ten spinal roots in six patients with traumatic brachial plexus injuries. ⋯ Whereas CAT activity in fascicles in preganglionic injured roots was below 500 cpm, it was above 2000 cpm in postganglionic injured roots. This study shows that intraoperative measurement of CAT activity can provide useful information on the site and severity of brachial plexus injuries and the assessment of the motor function status of the injured spinal root, both directly and quantitatively.
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J Hand Surg Eur Vol · Oct 2000
Case ReportsUltrasonography in the diagnosis of ulnar tunnel syndrome caused by an occult ganglion.
We report a case of ulnar tunnel syndrome caused by an occult ganglion which was diagnosed preoperatively by ultrasonography.