The Journal of hand surgery
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Unstable dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint are complex injuries that are difficult to treat and usually require operative fixation. There are a number of surgical techniques for treating these injuries but none has emerged as superior. The purposes of this study were to describe a simple percutaneous technique to treat unstable dorsal fracture-dislocations of the PIP joint and to report short-term postoperative results. ⋯ This percutaneous technique reliably restored stability to the PIP joint, allowed for concentric reduction of the joint, and produced excellent radiographic and clinical outcomes. The postoperative management course with this technique is critical to the outcome.
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Biography Historical Article
A brief report about the concepts of hand disorders in the Canon of Medicine of Avicenna.
Avicenna contributed to development in many fields of medicine. The Canon of Medicine is the masterpiece of Avicenna's medical books in which he wrote on the anatomy of the upper extremity, fractures, dislocations, and nerve and tendon injuries. Reviewing these subjects pertinent to hand disorders reveals Avicenna's concepts about hand disorders a millennium ago.
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The diagnosis and management of complex regional pain syndrome is often challenging. Early diagnosis and intervention improve outcomes in most patients; however, some patients will progress regardless of intervention. Multidisciplinary management facilitates care in complex cases. ⋯ Multimodal treatment with hand therapy, sympatholytic drugs, and stress loading may be augmented with anesthesia blocks. If the dystrophic symptoms are controllable by medications and a nociceptive focus or nerve derangement is correctable, surgery is an appropriate alternative. Chronic sequelae of contracture may also be addressed surgically in patients with controllable sympathetically maintained pain.
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The Michigan hand questionnaire (MHQ) is increasingly being used and has been adapted cross-culturally in some Western and Asian countries, but the validation process for an Asian translation of MHQ has not been well described. In this study, we translated and adapted the original MHQ cross-culturally to produce a Korean version, and then assessed the validity and reliability of the Korean version of the MHQ. ⋯ The Korean version of MHQ showed satisfactory internal consistency, test-retest reliability, and validity and demonstrated a significant correlation with the patient-based upper extremity questionnaire and clinical assessment. We found the application and evaluation of the instrument to be feasible and understandable among patients in Korea.
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The cause of snapping in trigger finger is not clearly understood. The purpose of this study was to investigate the influence of stiffness of the first annular pulley on snapping in trigger finger patients with sonoelastography, a new technique for quantitative assessment of the stiffness of soft tissues. ⋯ Increased stiffness and thickening of the A1 pulley are considered to be causes for snapping in trigger finger, and corticosteroid injection can alleviate snapping by changing these 2 features.