The Journal of hand surgery
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Randomized Controlled Trial
Dexmedetomidine reduces the ischemia-reperfusion injury markers during upper extremity surgery with tourniquet.
We examined the effect of dexmedetomidine on ischemia-reperfusion injury due to tourniquet application during upper-extremity surgery by determining blood malondialdehyde and hypoxanthine levels. Alterations in aspartate aminotransferase, alanine aminotransferase, creatine phosphokinase, lactate dehydrogenase, uric acid, and creatinine levels were also assessed. ⋯ Prognostic II.
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Comparative Study
Scapholunate interosseous ligament reconstruction: results with a modified Brunelli technique versus four-bone weave.
To compare clinical and radiographic outcomes in patients with chronic scapholunate dissociation treated with a modified Brunelli technique versus a 4-bone tendon weave. ⋯ Therapeutic III.
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Randomized Controlled Trial
Injection of dexamethasone versus placebo for lateral elbow pain: a prospective, double-blind, randomized clinical trial.
We tested the hypothesis that there is no difference in disability, pain, and grip strength 1 and 6 months after corticosteroid and lidocaine injection compared with lidocaine injection alone (placebo). ⋯ Therapeutic I.
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Scaphoid fractures are common but present unique challenges because of the particular geometry of the fractures and the tenuous vascular pattern of the scaphoid. Delays in diagnosis and inadequate treatment for acute scaphoid fractures can lead to nonunions and subsequent degenerative wrist arthritis. Improvements in diagnosis, surgical treatment, and implant materials have encouraged a trend toward early internal fixation, even for nondisplaced scaphoid fractures that could potentially be treated nonoperatively. ⋯ Surgical treatment is directed at correcting the deformity with open reduction and internal fixation with bone grafting. Recently, vascularized bone grafts have gained popularity in the treatment of scaphoid nonunions, particularly in cases with avascular necrosis. This article reviews current concepts regarding the treatment of scaphoid fractures and nonunions.
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Anterior flanges have been added to the humeral components of some total elbow arthroplasty systems to improve load transfer to the humerus and thereby reduce stress shielding in an effort to decrease the incidence of loosening. Either a wedge of bone or bone cement is placed between the anterior surface of the humerus and the flange. The purpose of this study was to quantify the cortical strains in the humerus as a function of these implantation options. ⋯ These results suggest that for the Latitude humeral component studied, the placement of bone or bone cement behind the anterior flange may not influence the cortical strains in the distal humerus under bending loads. However, a flange may still influence cortical strains using another implant with different geometric and material properties than the currently studied design.