The Journal of hand surgery
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Randomized Controlled Trial Clinical Trial
Mini-open blind procedure versus limited open technique for carpal tunnel release: a 30-month follow-up study.
To evaluate prospectively the safety and effectiveness of a mini-open blind technique for carpal tunnel release (group A) when compared with a limited open technique (group B). ⋯ The blind mini-invasive technique has been shown to be as safe as traditional techniques but the recovery period is significantly shortened. With the technique we described a low recurrence rate was observed. All patients in group A reported great reduction in preoperative pain and numbness.
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Surgical repair of closed mallet finger fractures has been favored for displaced injuries involving more than one third of the articular surface and for injuries with palmar subluxation of the distal phalanx. This study analyzed the results of nonsurgical treatment for closed and displaced mallet finger fractures with greater than one-third articular surface damage, comparing cases with and without concomitant terminal joint subluxation. ⋯ This study supports the rationale for nonsurgical treatment of closed and displaced mallet finger fractures with greater than one-third articular surface involvement. Pain likely will be negligible and patient satisfaction with finger function and treatment outcome is projected to be relatively high at 2-year follow-up evaluation. A dorsal joint prominence, terminal joint extensor lag, swan-neck deformity, and degenerative joint changes, however, may develop, particularly in cases with palmar subluxation of the distal phalanx.
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To compare computed tomography (CT) in the sagittal plane and plain film radiography in the diagnosis of scaphoid fracture and displacement. ⋯ Based on these results both CT scans in the sagittal plane and plain films accurately detect fractures with a high degree of interobserver and intraobserver reliability, but they fall short in detecting displacement greater than 1 mm.
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In patients with advanced chronic carpal tunnel syndrome (CTS) the ability of the thumb to abduct and perform functional opposition is impaired greatly, primarily because of denervation and paralysis of the abductor pollicis brevis muscle. The purpose of this study was to evaluate the results of transfer of the flexor digitorum superficialis to the abductor pollicis brevis for restoration of thumb abduction in thenar paralysis caused by advanced chronic CTS. ⋯ Carpal tunnel release with simultaneous flexor digitorum superficialis-to-abductor pollicis brevis transfer provides satisfactory results for patients with profound CTS and thenar paralysis. The use of the small finger superficialis as the donor motor has minor morbidity compared with other methods and has predictable improvement and patient satisfaction. This transfer method is combined easily with endoscopic carpal tunnel release (as in 49 of our 51 cases), 2-portal, or open method releases.
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To investigate the effects of the nitric oxide donor S-nitroso-N-acetylcysteine (SNAC) on motor functional recovery of reperfused rat sciatic nerve. ⋯ Supplementation of nitric oxide is effective in promoting motor functional recovery of the reperfused peripheral nerve and has potential to replace or augment steroids as therapeutic agents in treatment of nervous system ischemia/reperfusion injury.