The Journal of hand surgery
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Randomized Controlled Trial Clinical Trial
Modified transthecal digital block versus traditional digital block for anesthesia of the finger.
This study compared the modified transthecal digital block (MTDB) technique with the traditional digital block (TDB) according to the degree of discomfort caused by injection and to the onset and the duration of anesthesia. ⋯ The effect of MTDB is equal to that of TDB in terms of pain perception. For the dorsal and radial proximal zones, the TDB appears to have better distribution of anesthesia. The MTDB has slower onset to anesthesia than the TDB.
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Comparative Study
Gliding characteristics and gap formation for locking and grasping tendon repairs: a biomechanical study in a human cadaver model.
The purpose of this study was to compare the frictional characteristics and mechanical properties of various locking and grasping suture techniques in a human in vitro model of flexor tendon repair. ⋯ The lack of significant difference in gliding resistance among the similarly designed modified grasping Kessler, Pennington, and modified Pennington repairs (overall mean, 0.87 N; standard deviation, 0.16) suggests that the locking loop configuration itself does not adversely affect tendon gliding resistance. The modified Pennington repair increased not only ultimate strength but also resistance to gap formation more than 1.5 mm.
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Multicenter Study
Condylar blade plate fixation of unstable fractures of the distal ulna associated with fracture of the distal radius.
To review the results of condylar blade plate fixation of unstable fractures of the distal ulna associated with fracture of the distal radius. ⋯ For unstable fractures of the distal ulna associated with fracture of the distal radius, condylar blade plate fixation can achieve healing with good alignment, satisfactory function, and an acceptable rate of secondary surgery.
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Comparative Study
Anatomic tilt x-rays of the distal radius: an ex vivo analysis of surgical fixation.
To compare anatomic tilt radiographs with standard posteroanterior (PA) and lateral radiographs for their efficacy in detecting screw penetration of the distal radius articular surface. ⋯ Anatomic tilt PA and lateral radiographs of the distal radius are an accurate and clinically useful tool for the evaluation of both presence and location of screw penetration of the articular surface after dorsal plating.
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To determine whether the radial nerve should be explored when there is a complete sensory and motor deficit after a high-energy fracture of the humeral diaphysis. ⋯ Transection of the radial nerve is usually associated with open fractures of the humerus that are part of a very complex upper-extremity injury. The results of primary nerve repair in this circumstance are poor, likely related to an extensive zone of injury and the need for nerve grafting. Intact nerves and nerve palsies that are part of a closed fracture nearly always recover, even after high-energy injuries. Because the first signs of nerve recovery and complete recovery of the nerve can be quite delayed, patience is merited before considering tendon transfers.