The Journal of hand surgery
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The spatial relationship of the extensor pollicis longus (EPL) to the thumb carpometacarpal (CMC) joint may be altered by its transposition from the third dorsal wrist compartment and by subcutaneous extensor indicis proprius (EIP) to EPL tendon transfer. Changes in tendon position could alter thumb function. This study examined changes in the EPL adduction moment arm after EPL tendon transposition from its extensor compartment or EIP transfer. ⋯ EPL transposition produces a significant decrease of its adduction moment arm at the thumb CMC joint, an effect exacerbated by wrist flexion. The moment arm mechanics of the pulley and subcutaneous EIP tendon transfer resemble those of the intact and transposed EPL, respectively. Diminution of the adduction moment arm could impair thumb function, especially adduction.
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An accurate listing of cited references in journal articles is important for the reader. Many studies have revealed errors in the references cited in a variety of subspecialty journals. We believe that a similar amount of errors, relative to other subspecialty journals, exists in the Journal of Hand Surgery. ⋯ These error rates are similar to those found in studies of other biomedical journals. Perhaps the decrease in the quantity of errors present in 1995 versus that of 1985 is related to the implementation of a more stringent, revised set of instructions to submitting authors imposed in 1995.
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Biography Historical Article
The embryogenesis of the specialty of Hand Surgery: a story of three great Americans--a politician, a general, and a duck hunter: The 2002 Richard J. Smith memorial lecture.
Although the origins of surgery of the hand come from many different countries over several decades, the specialty of Hand Surgery is uniquely American and came out of the experience of the US Army Medical Corps Hand Centers during and immediately after World War II. The circumstances and opportunities that allowed for the development of the specialty, however, were set in motion years before the war. It is a story of friendship, opportunity, ingenuity, and commitment. ⋯ Kirk, and Dr. Asa Sterling Bunnell. These men led fascinating lives and each had personal motivations that made it possible for the specialty to flourish.
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Three patients with nontraumatic anterior interosseous nerve palsy are presented. All patients also had paralysis of the pronator teres, flexor carpi radialis, and/or palmaris longus. One patient also had sensory disturbance and palsy of the thenar muscles. ⋯ All constrictions exhibited approximately 30 degrees of fascicular torsion. Because this nerve section is anatomically proximal to the branching point for the earlier mentioned motor branches and the anterior interosseous nerve, the nerve fascicles may have been structurally twisted before the onset of palsy. Structural abnormalities causing inflammation and edema of nerve fascicles as well as factors such as compression from surrounding small vessels may have maximized torsion, resulting in the formation of constrictions.
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The purpose of this study was to introduce the technique for distraction lengthening of the traumatic amputation stumps of distal phalanges less than 10 mm long by using the Ilizarov minifixator (Ito Medical Instruments, Tokyo, Japan) and to report the treatment results and the problems we encountered. ⋯ Although this callus distraction method required multiple surgical procedures it is considered worthy of more frequent application especially in young patients.