The Journal of hand surgery
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Comparative Study
Accuracy and reliability of three different techniques for manual goniometry for wrist motion: a cadaveric study.
Despite the ubiquitous use of manual goniometry in measuring objective outcomes of hand surgery and therapy, there are limited data concerning its accuracy or repeatability for wrist motion. The purpose of this study was to evaluate the accuracy and reliability (both inter- and intra-rater) in measuring wrist flexion and extension using 3 manual goniometric alignment techniques (ulnar, radial, and dorsal-volar) in cadaveric upper extremities, using fluoroscopic verification of posture as a gold standard. In addition, we sought to assess the accuracy and reliability of the dorsal-volar technique for measurement of radioulnar deviation. ⋯ Although each measurement technique demonstrated a similar degree of accuracy and intra-rater reliability, the dorsal-volar technique demonstrates the greatest level of inter-rater reliability for measurement of wrist flexion and extension. This information is important clinically, as measurements are regularly exchanged between hand surgeons and therapists as a basis for decisions regarding patient care.
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The second dorsal metacarpal artery flap from the middle finger is a reconstructive technique that can be used to repair extensive volar defects in a normal-length thumb. However, few reports advocate using it for coverage of volar thumb defects. In this article, an anatomic study of 9 flaps used for resurfacing thumb defects is presented along with the clinical experience of the authors. ⋯ Therapeutic IV.
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We aimed to report by light microscopy the normal histology of the A1 pulley, describe the histologic abnormalities of A1 pulleys in trigger digits, and look for possible correlations between these findings and the severity of the disease. ⋯ The histologic abnormalities observed in the A1 pulley of trigger digits are characteristic and not related to inflammation. As the trigger digit worsens, the gliding surface begins to wear and is gradually replaced by a secondary invasive hyperplasia from the outer layer. These abnormalities could be caused by a modification or an increase of the mechanical stresses along the flexor tendons.
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Comment Letter Comparative Study
Comparative clinical outcomes of submuscular and subcutaneous transposition of the ulnar nerve for cubital tunnel syndrome.