The Journal of hand surgery
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Although clinical outcomes of peripheral nerve injuries are often suboptimal, an adherence to well-established basic principles of evaluation and repair can optimize results of even the most complex injuries. Proper assessment of injury patterns both preoperatively and intraoperatively can guide treatment, and multiple repair techniques including strategies for overcoming both small and large gaps offer different advantages and disadvantages. New technologies and ideas address some unsolved problems, but more experience and research is necessary to elucidate fully their roles in the treatment algorithm.
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This case series describes 4 patients with terrible triad injury of the elbow (dislocation with fractures of the radial head and coronoid) who were treated nonsurgically. Following nonsurgical treatment in this select group of patients, the elbow was well aligned, and the patients regained good elbow function. ⋯ One patient had surgery for residual stiffness, ulnar neuropathy, and a radial head deformity. We conclude that, in selected terrible triad cases, when the elbow is well aligned and the radial head and coronoid fractures are relatively small and minimally displaced after closed reduction and there is no mechanical block to motion, patients might regain good elbow function without surgery.
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Trauma to the digits often leaves soft tissue defects with exposed bone, joint, and/or tendon that require soft tissue replacement. The objective of this study was to evaluate the effectiveness of acellular dermal regeneration template combined with full-thickness skin grafting for soft tissue reconstruction in digital injuries with soft tissue defects. ⋯ Therapeutic IV.
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Multicenter Study Comparative Study
Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder, and Hand questionnaire in patients with hand injury.
To compare responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ) with that of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire in patients with hand injuries. We postulated that the MHQ may be more sensitive to functional changes in the hands, whereas the DASH questionnaire would have a closer association with days of disability. ⋯ The MHQ might be slightly more sensitive to functional changes, but the DASH questionnaire seemed more correlated with disability days. Psychological factors are the strongest determinants of the HRQOL and disability.
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Multicenter Study Comparative Study
Comparison of functional outcome after volar plate fixation with 2.4-mm titanium versus 3.5-mm stainless-steel plate for extra-articular fracture of distal radius.
Open reduction and locked volar plate and screw fixation is a popular treatment method for extra-articular distal radius fractures with dorsal metaphyseal comminution. In this study, we compared the use of a titanium 2.4-mm precontoured plate with that of a stainless-steel oblique 3.5-mm T-shaped plate to test the null hypothesis that there would be no difference in wrist function or upper extremity-specific health status in the internal fixation of AO-type A3.2 distal radius fractures. ⋯ Therapeutic III.