The Journal of hand surgery
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Comparative Study
Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder and Hand questionnaire in carpal tunnel surgery.
Symptom resolution and functional improvement are the 2 primary reasons for patients to seek treatment for carpal tunnel syndrome (CTS). This study aimed to measure the responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH) when evaluating outcomes after carpal tunnel surgery. ⋯ The MHQ and the DASH are both responsive in measuring outcomes of carpal tunnel surgery. The MHQ has subscales that can measure symptom and function improvement independently. The MHQ and the DASH can be used for outcomes research related to carpal tunnel surgery with the advantage of also being useful for assessing and comparing outcomes for various other hand disorders.
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Case Reports
Isolated scaphoid dislocation associated with axial carpal dissociation: an unusual injury report.
We present a report of a patient with an isolated scaphoid dislocation associated with a hyperextension and axial loading injury of the carpus required a careful and extensive clinical and radiographic evaluation leading to surgical intervention to reduce and stabilize the scaphoid and to reduce and hold internally the axial carpal injury. Knowledge of the anatomy and the potential injury patterns of the carpus will aid the hand surgeon with injury recognition and proper treatment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint: a study of the benefit of ligament reconstruction or tendon interposition.
To investigate whether palmaris longus interposition or flexor carpi radialis ligament reconstruction and tendon interposition improved the outcome of excision of the trapezium for the treatment of painful osteoarthritis of the trapeziometacarpal joint. ⋯ The outcomes of these 3 variations of trapeziectomy were very similar at 1-year follow-up evaluation. In the short term at least there appears to be no benefit to tendon interposition or ligament reconstruction.
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There have been few prospective studies of elderly patients with conservatively treated distal radius fractures and little is known about the relationship between acceptable radiographic reduction and functional outcomes in this population. We hypothesized that acceptable fracture reduction (according to standard radiographic dorsal/volar tilt criteria) would be associated with better functional outcomes and greater satisfaction. ⋯ Contrary to our hypotheses we found that acceptable radiographic reduction (according to dorsal/volar tilt criteria) was not associated with better self-reported functional outcomes or increased satisfaction at 6 months in elderly patients with conservatively treated distal radius fractures.
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We describe a technique for correction of proximal interphalangeal joint (PIP) extensor lag secondary to angulation and/or shortening of proximal phalanx fractures. ⋯ In the cadaver model the PIP extensor lag can be improved substantially by transection of the sagittal bands, release of the EDC insertion on the MCP capsule, transection of the juncturae tendinae, and reapproximation of the sagittal bands to the EDC tendon.