The Journal of hand surgery
-
To prospectively determine the results of treatment of distal radius fractures with a volar locking plate system with no bone graft and early mobilization. ⋯ The volar locking plate fixation without bone grafting and early mobilization is a safe and effective treatment for dorsally displaced, unstable fractures of the distal radius.
-
Randomized Controlled Trial Comparative Study
A prospective randomized controlled trial of injection of dexamethasone versus triamcinolone for idiopathic trigger finger.
This study was designed to test the null hypothesis that there is no difference in resolution of triggering 3 months after injection with either a soluble (dexamethasone) or insoluble (triamcinolone) corticosteroid for idiopathic trigger finger. ⋯ Although there were no differences 3 months after injection, our data suggest that triamcinolone may have a more rapid but ultimately less durable effect on idiopathic trigger finger than does dexamethasone.
-
Midcarpal degeneration is well documented after radioscapholunate fusion. This study tested the hypothesis that radioscapholunate fusion alters the kinematic behavior of the remaining lunotriquetral and midcarpal joints, with specific focus on the dart-thrower's motion. ⋯ Simulated radioscapholunate fusion altered midcarpal and lunotriquetral kinematics. The increased rotations across these remaining joints provide one potential explanation for midcarpal degeneration after radioscapholunate fusion. Additionally, this fusion model confirms the dart-thrower's hypothesis, as wrist motion after simulated radioscapholunate fusion was primarily preserved from radial-extension toward ulnar-flexion.
-
Isolated traumatic dislocation of the thumb carpometacarpal joint, also called the trapeziometacarpal joint, is a rare injury. Controversy still exists concerning which ligaments are the true key stabilizers for the joint and therefore need to be damaged to result in dislocation, and optimal treatment strategies for thumb carpometacarpal joint dislocations are the subject of continuing debate. We give a review of the literature concerning traumatic dislocations of the carpometacarpal joint of the thumb and propose a treatment algorithm.
-
Medial collateral ligament injuries are rare and occur almost exclusively in overhand-throwing athletes. The late cocking phase of the overhand throw places a marked valgus moment across the medial elbow. This repetitive force reaches the tensile limits of the medial collateral ligament, subjecting it to microtraumatic injury and attenuation. ⋯ Injury to the medial collateral ligament can be confirmed by physical examination (moving valgus stress test) and appropriate imaging studies (computed tomography arthrogram and magnetic resonance imaging). Reconstructive techniques of the medial collateral ligament have evolved over time and currently provide superior outcomes, with 80% to 90% of athletes returning to the same level of competitive play. As our understanding of the pathoanatomy of medial elbow injuries progresses and newer hybrid techniques evolve, our ability to care for the overhand-throwing athlete can be expected to improve.