The Journal of hand surgery, European volume
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In order to determine the mechanical properties of the fibro-osseous pulleys in the hand, the diaphyseal annular pulleys, the volar plate annular pulleys and the cruciate or condensable portions were tested. A custom-made loading device provided proper fit of the soft tissues for a uniform distribution of the pulley load during testing. The A2 pulley was found to be the strongest of the pulleys; the A1 and A4 were the next strongest. ⋯ The A4 was the least compliant of the pulleys. We concluded that the fibro-osseous A2 and A4 were mechanically stronger and stiffer pulleys than the A1, A3, A5 (volar plate) pulleys. In testing one type of pulley reconstruction, we found that the "belt loop" technique of Karev nearly matched the annular pulleys in strength and energy absorption.
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J Hand Surg Eur Vol · Aug 1990
Why all finger fractures should be referred to a hand surgery service: a prospective study of primary management.
The quality of the treatment of finger fractures by Accident and Emergency Department staff has been prospectively assessed during a six-month period. 678 finger fractures were seen in the A. & E. Department. ⋯ Most management errors were elementary; they included failure to prescribe antibiotics for compound fractures, failure to reduce displaced fractures accurately and unsatisfactory splintage. It is recommended that all finger fractures should be assessed and treated by surgeons with training in the management of hand injuries.
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J Hand Surg Eur Vol · Feb 1990
Sequential forearm intravenous regional and infiltration anaesthesia: value for haemostasis.
Intravenous regional anaesthesia using 0.5% lignocaine with a forearm tourniquet is a satisfactory technique for operations on the distal forearm, wrist and hand. Since recovery of pain sensation is rapid, haemostasis after release of tourniquet becomes difficult and sometimes impossible. ⋯ Subsequent haemostasis and wound closure could be carried out without pain in 51 patients (92.7%); three patients (5.5%) noticed mild discomfort but the operations could be finished without any additional anaesthetic agent. No complications were encountered with this modified technique.
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J Hand Surg Eur Vol · Feb 1990
Case ReportsForeign body in the median nerve: a complication of acupuncture.
Fracture of an acupuncture needle resulted in a foreign body within the carpal tunnel of a patient who then developed median neuropathy. The needle fragment was recovered from within the median nerve during carpal tunnel release, with rapid post-operative relief of symptoms. Development of peripheral neuropathy is a potential complication of acupuncture.