The Journal of hand surgery
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Biography Historical Article
The embryogenesis of the specialty of Hand Surgery: a story of three great Americans--a politician, a general, and a duck hunter: The 2002 Richard J. Smith memorial lecture.
Although the origins of surgery of the hand come from many different countries over several decades, the specialty of Hand Surgery is uniquely American and came out of the experience of the US Army Medical Corps Hand Centers during and immediately after World War II. The circumstances and opportunities that allowed for the development of the specialty, however, were set in motion years before the war. It is a story of friendship, opportunity, ingenuity, and commitment. ⋯ Kirk, and Dr. Asa Sterling Bunnell. These men led fascinating lives and each had personal motivations that made it possible for the specialty to flourish.
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Three patients with nontraumatic anterior interosseous nerve palsy are presented. All patients also had paralysis of the pronator teres, flexor carpi radialis, and/or palmaris longus. One patient also had sensory disturbance and palsy of the thenar muscles. ⋯ All constrictions exhibited approximately 30 degrees of fascicular torsion. Because this nerve section is anatomically proximal to the branching point for the earlier mentioned motor branches and the anterior interosseous nerve, the nerve fascicles may have been structurally twisted before the onset of palsy. Structural abnormalities causing inflammation and edema of nerve fascicles as well as factors such as compression from surrounding small vessels may have maximized torsion, resulting in the formation of constrictions.
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The purpose of this study was to introduce the technique for distraction lengthening of the traumatic amputation stumps of distal phalanges less than 10 mm long by using the Ilizarov minifixator (Ito Medical Instruments, Tokyo, Japan) and to report the treatment results and the problems we encountered. ⋯ Although this callus distraction method required multiple surgical procedures it is considered worthy of more frequent application especially in young patients.