The Journal of hand surgery
-
Randomized Controlled Trial
Dose effectiveness of transthecal digital block.
The optimal volume of local anesthetic for transthecal digital block has not yet been identified. The goal of this study was to understand the effect of different volumes of local anesthetic using a modified transthecal digital block. ⋯ The effectiveness of the 3-mL modified transthecal digital block is greater than the 1- and 2-mL blocks in terms of rapidity of onset, completeness, and duration of anesthesia.
-
Vascularized bone grafting has been proposed as a treatment for scaphoid nonunions with avascular necrosis of the proximal pole. The purpose of this investigation is to report the results of vascularized bone graft and internal fixation for established scaphoid nonunions with proximal pole avascular necrosis as measured by validated outcome instruments. ⋯ The results of this investigation support the use of a vascularized bone graft for the treatment of scaphoid nonunions with avascular necrosis of the proximal pole.
-
Radial nerve damage results in substantial functional limitations of the upper extremity. No detailed data exist regarding long-term results, patient satisfaction, and professional and social reintegration after tendon transfer for irreparable damage to the radial nerve. In this retrospective study, we investigated these data through the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. ⋯ Functional results, adequate patient satisfaction, and sufficient professional and social reintegration can be achieved after modified Brooks and d'Aubigne tendon transfer. Accordingly, the tendon transfer offers an important alternative-possibly the procedure of choice-to microsurgical nerve reconstruction, particularly when early professional and social reintegration is important.