The Journal of hand surgery
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Patients with bilateral carpal tunnel syndrome (CTS) who had unilateral carpal tunnel surgery usually ask about the prognosis for the non-operated, opposite hand. In this study, we investigated the effects of unilateral carpal tunnel surgery on the clinical course of the non-operated, opposite hand in bilateral idiopathic CTS. ⋯ It seems that unilateral surgery for bilateral idiopathic CTS does not affect the clinical course of the non-operated, opposite hand. We recommend that each hand of patients with bilateral CTS be managed separately, based on their symptoms.
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To explore the course of the radial nerve in the brachium and to identify practical anatomic landmarks that can be used to avoid iatrogenic injury during humerus fracture fixation. ⋯ The radial nerve is at risk of injury with fractures of the humerus and with subsequent operative fixation in 2 areas. The first is along the posterior midshaft region for a distance of 6.3 cm +/- 1.7 centered at the distal aspect of the deltoid tuberosity. The second is along the lateral aspect of the humerus in its distal third from 10.9 cm +/- 1.5 proximal to the lateral epicondyle to the level of the proximal aspect of the metaphyseal flare. The deltoid tuberosity is a consistent and practical anatomic landmark that can be used to determine the level of the radial nerve along the posterior aspect of the humerus during operative fixation from an anterior approach.
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To determine the effectiveness of a protocol for the treatment of fracture-dislocations of the elbow based on the concept that, if dislocation of the elbow with associated fractures can be made to resemble a simple elbow dislocation by repairing or reconstructing the fractured structures, repair of the medial collateral ligament (MCL) will not be necessary. ⋯ MCL repair is unnecessary in the treatment of dislocation of the elbow with associated intra-articular fractures, provided that the articular fractures and the LCL are repaired or reconstructed.
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The purpose of this study is to evaluate the clinical outcome of patients who had excision of a radioulnar heterotopic ossification (HO) as a complication of a distal biceps tendon repair. The hypothesis is that there are no measurable clinical losses that persist after excision. ⋯ When patients develop motion-limiting HO after distal biceps tendon repair, surgical resection can lead to a functional recovery of elbow and forearm motion. Biceps strength can be maintained with no measurable differences in clinical outcome when compared to individuals who do not suffer this complication following distal biceps repair.
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Unstable, dorsal, intra-articular, fracture-dislocations of the proximal interphalangeal (PIP) joint can be difficult to treat and often lead to long-term pain, stiffness, and functional deficit. We present the outcomes of patients sustaining such injuries that were treated by a novel dynamic external fixator. This fixator uses a system of K-wires and rubber bands that maintains a concentrically reduced PIP joint while allowing for early motion. ⋯ The dynamic external fixator studied is an effective method of treating unstable, dorsal fracture-dislocation injuries. Outcomes compared favorably with those of other similar devices studied in the literature.