The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Jun 1986
Comparative Study Clinical Trial Controlled Clinical TrialA comparative controlled trial of a new perforated splint and a traditional splint in the treatment of mallet finger.
A perforated mallet finger splint is described and the results of a controlled trial comparing its use with a conventional splint are presented. The perforated splint gives superior results by virtue of the fact that it does not require to be removed for purposes of hygiene and can thus produce a satisfactory result even in those patients who fail to grasp the technique of removal and replacement of the splint.
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J Hand Surg Eur Vol · Feb 1986
Case ReportsVolar dislocation of the metacarpophalangeal joint of the thumb--a case report.
A patient with a volar dislocation of the metacarpophalangeal joint of the thumb is reported in which closed reduction proved impossible because of the interposition of the dorsal capsule, extensor pollicis longus tendon and extensor pollicis brevis tendon in the metacarpophalangeal joint. The collateral ligament was also ruptured. Therefore open reduction is recommended for similar cases.
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J Hand Surg Eur Vol · Oct 1985
Randomized Controlled Trial Clinical TrialA prospective trial of prophylactic povidone iodine in lacerations of the hand.
A series of 418 patients with lacerations of the hands were allocated randomly to a control group or to a group where the injury was treated with povidone iodine before suture. The incidence of infected and imperfectly healed wounds was determined seven days later. As well as the effect of povidone iodine on infection, thirteen other factors were also analysed. ⋯ It is therefore recommended that hand lacerations should be treated with povidone iodine prior to suture. Other factors found to be significantly important in wound infection or imperfect healing were the condition of the dressing, the part of the hand injured and pain. Patients should be strongly advised to keep their dressing clean and dry.
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J Hand Surg Eur Vol · Jun 1985
Tourniquet pressure: the effect of limb circumference and systolic blood pressure.
Complications attributable to direct pressure may result from the use of pneumatic tourniquets during surgical procedures. Traditional estimates have determined the pressures employed rather than the minimal pressure necessary to produce a bloodless field. ⋯ From these results two equations were derived, one for each of the upper and lower limbs, which give the minimum tourniquet pressures to produce bloodless fields. In an average sized, normotensive patient, 200mm Hg was found to be adequate for the upper limb and 250mm Hg for the lower limb.
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J Hand Surg Eur Vol · Jun 1985
Effects of regional intravenous guanethidine block in posttraumatic cold intolerance in hand amputees.
In twenty-four patients with intolerance to cold after partial or complete finger amputations, lower skin temperature together with cold and vibration allodynia (allodynia = pain due to a non-noxious stimulus to neural skin) were found in the cold intolerant area compared with the corresponding area in the uninjured hand. When treated with regional intravenous guanethidine block nine patients became free from symptoms for up to twelve weeks, which is longer than would be expected from the duration of the known pharmacological effects of guanethidine. The patients had several features in common with reflex sympathetic dystrophies, and we suggest that neurogenic rather than vascular disturbances are mainly involved in the post-traumatic cold intolerance syndrome.