The Journal of hand surgery
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Although radial nerve palsy associated with a closed humeral shaft fracture may be managed by observation, it is our experience that an open humeral shaft fracture with radial nerve palsy requires exploration of the nerve. In a series of 14 patients with radial nerve palsy caused by an open humeral shaft fracture, 9 (64%) of the 14 patients had a radial nerve that was either lacerated or interposed between the fracture fragments. ⋯ Epineural radial nerve repair, done primarily or secondarily, provided a satisfactory return of radial nerve function. Rigid fixation of the associated fracture is the recommended treatment.
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The treatment of fracture dislocations of the proximal interphalangeal joint often results in pain and stiffness. A small dynamic external finger fixator was designed to maintain the reduced position of the dislocated middle phalanx and allow early active range-of-motion exercise. ⋯ The average range of the proximal interphalangeal joint motion with this device was 88 degrees. The average follow-up period was 21 months.
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Thirty wrists of 27 patients with ulnar impaction syndrome who underwent ulnar shortening osteotomy were retrospectively reviewed. The average follow-up was 51 months. The wrists were graded preoperatively and postoperatively according to a wrist-grading system modified from Gartland and Werley. ⋯ Twenty-four wrists were graded excellent, 4 good, 1 fair, and 1 poor after the surgery in comparison with 28 poor and 2 fair before the operative treatment. Complications were rare, with no ulnar nonunions. This long-term follow-up study revealed that distal ulnar shortening osteotomy is an excellent procedure for the treatment of ulnar impaction syndrome.
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Both true and false aneurysms are rare in the upper extremity and even more so in pediatric patients. When the condition is congenital, except for those aneurysms found in the circle of Willis, existence in the upper extremity is almost unknown. The following case report describes a congenital pseudoaneurysm involving the superficial palmar arch in a child.