The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Apr 1998
A regional audit of hand and wrist injuries. A study of 4873 injuries.
This study reports the characteristics, causes and disposal of isolated injuries to the hand and wrist presenting to six accident and emergency departments over a period of 4 months. The rate of isolated injury to the hand or wrist was 6.6%. ⋯ The right and left hand were injured almost equally. The dominant hand was more commonly injured although this was influenced by the cause of injury: 16.3% were caused by a fall; 15% by sport; and 7% were work/machinery related. 13.3% were referred to specialities for further treatment.
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J Hand Surg Eur Vol · Apr 1998
Case ReportsStabilization of an acute perilunate dislocation using the "TAG" suture anchor.
A case of acute perilunate dislocation associated with acute scapholunate dissociation and acute carpal tunnel syndrome is described in which the treatment was facilitated by the use of the TAG suture anchor.
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J Hand Surg Eur Vol · Apr 1998
Case ReportsUlnar styloid malunion with dislocation of the distal radioulnar joint.
Four patients with dorsal dislocation of the distal radioulnar joint and ulnar styloid malunion had corrective osteotomy of the ulnar styloid. Dislocation of the distal radioulnar joint was reduced in three of four patients. ⋯ These results support the contention that a displaced ulnar styloid fracture with distal radioulnar joint dislocation should be reduced and internally fixed. Corrective osteotomy is recommended for malunion of the ulnar styloid associated with dislocation of the distal radioulnar joint.
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J Hand Surg Eur Vol · Apr 1998
Case ReportsProximal and palmar dislocation of the lunate and proximal scaphoid as a unit in a case of scaphocapitate syndrome. A 32-month follow-up.
Various patterns of transscaphoid, transcapitate fracture-dislocations have been described in the literature. There is little information on the method of management and the long-term results of such severe and rare injuries. The case described here involved a transscaphoid, transcapitate, palmar perilunate fracture-dislocation with ejection of the proximal pole of the scaphoid and lunate into the palmar aspect of the forearm. The functional result 32 months after delayed open reduction and internal fixation is reported.
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In the early part of the century, when adrenaline first became widely available, it was used in an uncontrolled manner and cases of ischaemic necrosis led to it falling into disfavour for hand surgery. Local anaesthesia with adrenaline is currently widely used for palmar and dorsal hand surgery but there remains a very deeply ingrained resistance to its use for digital anaesthesia. ⋯ Our findings show that adrenaline only temporarily reduced digital blood flow. Perfusion of the digits persisted in every case.