The Journal of hand surgery
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Multicenter Study Comparative Study
Trends in wrist fractures in children and adolescents, 1997-2009.
Distal radius and carpal fractures in children and adolescents represent approximately 25% of all pediatric fractures. Incidence rates and causes of these fractures change over time owing to changes in activities and risk factors. The purpose of this study was to examine recent population-based trends in incidence and causes of wrist fractures in children and adolescents. ⋯ With knowledge of the epidemiology of wrist fractures, prevention programs can be improved. From this study, we know that the incidence rate of wrist fractures in childhood is increasing, mainly as a result of soccer and gymnastics at school. Future sport injury research and surveillance data are necessary to develop new prevention programs based on identifying and addressing specific risk factors, especially in young athletes.
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Comparative Study
Incidence of scaphotrapezial arthritis following volar percutaneous fixation of nondisplaced scaphoid waist fractures using a transtrapezial approach.
To investigate whether volar percutaneous screw fixation of scaphoid waist fractures via a transtrapezial approach causes degenerative changes at the scaphotrapezial (ST) joint at short- to medium-term follow-up. ⋯ Therapeutic IV.
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Some clinical studies have suggested that distal radius plates placed distal to the watershed line have the potential to impinge on the traversing flexor tendons. However, the validity of this theory remains unclear. The purpose of this study was to evaluate the quantitative effect of volar plate position on flexor pollicis longus (FPL) tendon friction by measuring the contact pressure between the FPL tendon and the distal edge of the locking plate. ⋯ This study clarifies a mechanism of FPL tendon irritation after volar plate fixation for distal radius fractures.
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Complex hand injuries can be difficult to dress effectively and achieve adequate splintage of the hand in a functional position. During the past 7 years, we have had a great deal of success with topical negative-pressure dressings in the management of complex blast-related extremity war injuries. We have more recently changed to using a gauze-based system and have found this particularly useful in dressing complex hand injuries. ⋯ This provides an easily applied dressing that, through topical negative pressure, promotes wound healing and ensures a resting functional position, thus minimizing postoperative stiffness. We have not been able to achieve this as efficiently with standard dressings and plaster-of-Paris casts. This article details the technique of functional splinting of complex hand injuries using a gauze-based, topical negative-pressure dressing system.
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Hand transplantation is the most common form of modern composite tissue allotransplantation. Successful application of this technology requires a multidisciplinary approach incorporating not only skilled hand surgeons, transplant surgeons, and transplant immunologists, but also hand therapists, psychiatrists, medical specialists, anesthesiologists, and others. ⋯ Hand transplantation is becoming more common, with more centers offering this relatively new reconstructive modality. Its success depends on proper patient selection, a technically successful operation, postoperative rehabilitation, and an immunotherapy protocol that prevents rejection but has minimal or acceptable morbidity.