The Journal of hand surgery, European volume
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The rare condition of scapulothoracic dissociation (STD) is characterized by a lateral displacement of the scapula from the thoracic cage following severe trauma to the scapular girdle. This study presents an analysis of five STDs. ⋯ Nerve damage dominates the prognosis and nerve recovery only rarely occurs. Nerve surgery should attempt to reestablish elbow flexion.
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We investigated the diagnostic value of two different ultrasound scanning methods for the early diagnosis of acute scaphoid fractures. Fifty-seven patients with ten scaphoid fractures were assessed within a week of injury. ⋯ However, its sensitivity was only 50%. We conclude that ultrasound examination is unreliable for the diagnosis of acute scaphoid fractures.
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J Hand Surg Eur Vol · Dec 1999
Randomized Controlled Trial Clinical TrialThe role of Mepitel silicone net dressings in the management of fingertip injuries in children.
Forty-five children with isolated fingertip injuries were randomized for treatment with either Mepitel silicone net dressings or paraffin gauze dressings. Over a 4 week period, the objective adherence of the dressing, and the perceived level of stress caused to the child by the dressing change were scored by linear analogue scales. The wounds were also assessed for the progress of healing and presence of infection. ⋯ There was no difference in duration of healing or complication rates between the two groups. Statistically lower scores were seen for the Mepitel group for the first 3 weeks in both adherence and stress scores. These results suggest that silicone net dressings may be a less adherent and less painful method of dressing fingertip injuries in children.
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J Hand Surg Eur Vol · Dec 1999
Simultaneous fracture-dislocations of the distal and proximal interphalangeal joints.
Sixteen cases of simultaneous fracture-dislocations of both the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints in the same finger that were treated during the past 10 years were classified into three types: the swan-neck injury (dorsal fragment of the base of the distal phalanx at the DIP joint and palmar fragment of the base of the middle phalanx at the PIP joint); the double-hyperextension injury (palmar fragments at the DIP and PIP joints); and the straight-finger injury (with dorsal and palmar bone fragments at the DIP joint). The results of treatment were more satisfactory in PIP joints than in DIP joints.