The Journal of hand surgery
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Observational Study
Measurement of upper extremity disability using the Patient-Reported Outcomes Measurement Information System.
Current questionnaires used to measure upper extremity-specific disability can be time-consuming and subject to ceiling effects. The National Institutes of Health developed Patient-Reported Outcomes Measurement Information System (PROMIS) measures based on computer adaptive testing (CAT), a technique that is more efficient and less subject to floor and ceiling effects than traditional questionnaires with a fixed number of questions. This study tested the correlation of the Physical Function-Upper Extremity CAT with the Quick-Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. ⋯ Prognostic I.
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To investigate the course and variability of the radial nerve along the lateral humerus in relation to the center of rotation of the elbow joint in the context of lateral pin placement for hinged external fixation. ⋯ Based on this cadaveric study, it is not possible to define a rational safe zone. The safest method of pin application for dynamic external fixation of the elbow is to perform a mini-open dissection with direct visualization.
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A tension-free coaptation is a key factor for the successful outcome of any nerve repair. A variety of host factors influence the outcome of digital nerve repair more than the type of repair per se. Although autologous graft remains the reference standard for reconstruction of any critical digital nerve defect, allografts and conduits have assumed an increasing role.
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Acute elbow injuries that disrupt the lateral ulnar collateral ligament and result in posterolateral rotatory instability usually require surgical treatment. The 2 technical options reported, direct repair and use of a palmaris longus tendon graft, have usually favored the use of the graft. To balance this emphasis, we report our experience with direct repair of the humeral origin in cases of trauma, whether acute, delayed, or recurrent. It was our hypothesis that because the humeral origin is the point of failure and separation, restoration of this attachment is sufficient to restore stability and durable function without the need for a graft. ⋯ Therapeutic III.
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Comparative Study
Dorsal surgical approaches to the proximal interphalangeal joint: a comparative anatomic study.
Adequate exposure of the articular surface of the head of the proximal phalanx is essential for reduction of intra-articular fractures of the proximal interphalangeal (PIP) joint. We compared the articular exposure obtained by a dorsal extensor-tendon splitting (Swanson), an extensor tendon-reflecting (Chamay), and an extensor mechanism-sparing approach. ⋯ Understanding the limitations inherent in dorsal exposure of the PIP joint may help guide the surgical approach for the individual patient.