The Journal of hand surgery, European volume
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Bilateral transscapholunate dislocations were treated with immediate open reduction and internal fixation. Eighteen months after injury the patient was asymptomatic.
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J Hand Surg Eur Vol · Dec 1996
Explosion injuries of the hand. Spatial relationship and injury pattern.
Twenty-six hands in 25 male patients were treated for peace-time explosion injuries of the palmar aspect. All patients were examined after a mean interval of 7 (1-17) years. ⋯ Comparing this regional score with the spatial relation between hand and exploding object resulted in six typical patterns depending on the grip during explosion. With knowledge of the three-dimensional relation between the hand and exploding object, the hand surgeon is prepared for potential problems during operation.
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J Hand Surg Eur Vol · Jun 1996
Comparative StudyClinical assessment of scaphoid injuries and the detection of fractures.
Difficulty in interpreting X-rays following carpal injury emphasizes the importance of clinical assessment in diagnosing scaphoid fractures. The classical sign of tenderness in the anatomical snuffbox is not specific and leads to many unnecessary out-patient reviews. A prospective comparison was made between anatomical snuffbox, scaphoid tubercle and scaphoid compression tenderness as indicators of scaphoid fracture in 221 patients with suspected scaphoid injury. ⋯ Swelling of the wrist joint was significantly greater when there was a fracture, compared to soft tissue injury alone, even when the initial X-ray was normal. This was independent of any physiological variation in circumference between dominant and non-dominant sides. Scaphoid compression tenderness is therefore suggested as the most accurate indicator of scaphoid fracture and marked swelling should raise suspicion even if the X-ray is normal.
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With the increasing popularity of day case surgery it is important to ensure that safe and appropriate techniques are being used. We retrospectively reviewed a large series of 732 patients who underwent planned day case hand surgery under intravenous regional anaesthesia (modified Bier's block) over a 5-year period. We found a modified Bier's block to be ideally suited to day case surgery with no deaths, minimal morbidity and a success rate in excess of 98%.
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J Hand Surg Eur Vol · Oct 1995
Case ReportsIsolated dislocation of all five carpometacarpal joints.
Fracture-dislocation of all five carpometacarpal joints is extremely rare, only ten cases having been reported since 1873. A case of isolated dislocation of all five carpometacarpal joints is presented. A good result was obtained 1 year after open reduction and internal fixation. This case is the only isolated dislocation of all five carpometacarpal joints in the English literature.