The Journal of hand surgery
-
We describe a simple method in which a nearly selective sensory median nerve block is used for early motion exercises. In this method an 18-gauge epidural catheter with 3 side holes in the fine catheter tip is placed proximal to the carpal tunnel. A bolus of 5 mL of 0.25% bupivacaine is injected before a continuous infusion of 3 mL/60 min of 0.125% bupivacaine is started. This method allows a continuous and selective sensory blockade with preservation of motor function and proprioception for early motion after hand surgeries.
-
Case Reports
Transscaphoid transcapitate transtriquetral perilunate fracture-dislocation: a case report.
We present a rare stage III greater arc fracture-dislocation of the carpus including transscaphoid, transcapitate, and transtriquetral dorsal perilunate fracture-dislocation.
-
Four patients with severe contracture of the first web space were treated with an anterolateral thigh perforator flap. The flap size ranged from 10 to 13 cm in length and from 7 to 8 cm in width. The donor site was closed directly and thinning of the flap was performed in all cases. ⋯ Web space opening was maintained over the follow-up period. There was an average postoperative increase of the angle of the first web space of 61 degrees. The thinned anterolateral thigh flap provides a pliable vascularized tissue for resurfacing the skin after release of severe contracture of the first web space and represents a reliable alternative to other flaps.
-
To evaluate the indications and results of complete wrist denervation and to focus on the correlation between results and length of follow-up evaluation. ⋯ Therapeutic, Level IV.
-
Little is known about whether the pressure adjacent to the ulnar nerve actually is increased in patients with cubital tunnel syndrome or if it is a causative factor. We measured the pressure adjacent to the ulnar nerve in patients with cubital tunnel syndrome during surgery and verified whether or not there was an association with patient age, duration of the disease, motor nerve conduction velocity, and severity of the ulnar nerve neuropathy. ⋯ The extraneural pressure within the cubital tunnel actually was increased in the patients and compression of the ulnar nerve might be a causative factor of cubital tunnel syndrome.