The Journal of hand surgery
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Case Reports
Symptomatic palmar tendon subluxation after surgical release for de Quervain's disease: a case report.
Palmar subluxation of the abductor pollicis longus and extensor pollicis brevis tendons developed in a 50-year-old woman after total excision of the first dorsal compartment sheath for de Quervain's disease. Conservative therapy did not improve her symptoms and surgical reconstruction of the first dorsal compartment from a slip of extensor retinaculum was performed. The patient was asymptomatic 1 year after surgery, with no evidence of subluxation or recurrence of de Quervain's disease. This complication can be avoided by leaving a palmarly based flap of extensor retinaculum to prevent palmar subluxation of the tendons with wrist flexion.
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The functional results in 25 of 30 patients after successful upper limb revascularization or replantation were evaluated by subjective-patient surveying and objective measurements. Young patients with complete, sharply amputated extremities at the wrist level or those with incomplete injuries and uninjured peripheral nerves had the best functional results. Multiple-level, diffuse crush, or avulsion injuries, even if the injuries were incomplete, and patients with high-level nerve injury had less return of function.