The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Dec 1997
Alternative method of repairing collateral ligament injuries at the metacarpophalangeal joints of the thumb and fingers. Use of the Mitek anchor.
Injuries to the joints of the thumb and fingers frequently cause complete or partial tears of the collateral ligaments, resulting in marked instability of the involved joint. Twelve patients with 12 unstable metacarpophalangeal joints were treated surgically with a Mitek metal suture anchor. At the last postoperative follow-up (range 6 weeks-6 months) 11 of 12 patients had good to excellent results subjectively and had regained 75% of the strength of the uninjured side.
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J Hand Surg Eur Vol · Dec 1997
Occult fractures of the scaphoid. The diagnostic usefulness and indirect economic repercussions of radiography versus magnetic resonance scanning.
Scaphoid fractures that are not visible on initial radiographs are notoriously difficult to diagnose. This prospective study compared four-view plain radiography at an average of 14 days after injury, with high-definition macroradiography and magnetic resonance imaging at presentation. Initial magnetic resonance imaging was superior to repeat scaphoid radiography for the confirmation or exclusion of fractures as well as for the detection of associated wrist injuries. Macroradiography was unsuitable for screening for occult scaphoid fractures.
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J Hand Surg Eur Vol · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison between single injection transthecal and subcutaneous digital blocks.
A randomized double blinded study was performed on 142 patients to evaluate two different techniques of single injection digital anaesthesia. In group A, 86 digits in 71 patients were anaesthetized by a single injection transthecal technique using 3 cc of lignocaine and bupivacaine mixture. ⋯ Total anaesthesia of the digit was achieved in 75 (94%) digits. These two techniques were found to have no differences in effectiveness, distribution, onset and duration of anaesthesia.
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J Hand Surg Eur Vol · Oct 1997
X-ray characteristics of wrists in calcium pyrophosphate crystal deposition disease. Is pseudogout a major cause of scapholunate advanced collapse?
Deposition of calcium pyrophosphate dihydrate (CPPD) crystals has been considered to be a cause of scapholunate advanced collapse (SLAC) wrist. The aim of this study was to look at X-ray changes in wrist joints affected by CPPD crystal deposition disease and to determine whether crystal deposition is a cause of SLAC wrist. ⋯ In our population of Japanese patients with CPPD crystal deposition disease, the incidence of SLAC wrist was very low, and no case of Stage III SLAC wrist was found. We therefore conclude that SLAC wrist is not a radiographic characteristic of CPPD crystal deposition disease and that pyrophosphate crystal deposition cannot be a major cause of SLAC wrist.
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J Hand Surg Eur Vol · Jun 1997
Very distal finger amputations: replantation or "reposition-flap" repair?
Management of very distal finger amputations is still controversial. Successful replantation results in an almost normal finger but is not without problems, such as technical difficulty, risk of failure and cost. "Reposition-flap" repair is a simpler procedure: it consists of distal bone and nail bed "graft-reposition" and pulp reconstruction by a flap. ⋯ Replantation has several advantages over reposition-flap repair in terms of less finger shortening, longitudinal nail curvature, absence of PIP flexion contracture and shorter time off work. The results of reposition-flap repair are less satisfactory, but it is nevertheless a useful alternative when replantation is impossible or has failed.