The Journal of hand surgery
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One hundred twenty-eight patients with idiopathic carpal tunnel syndrome were evaluated before surgery and 3 and 6 months after unilateral endoscopic carpal tunnel release. The variables analyzed included patient demographics, symptoms and signs, activities of daily living (ADL), sensibility and strength measurements, preoperative distal motor latency of the median nerve, operating surgeon, postoperative palmar pain and tenderness, return to work, and patient satisfaction with the results of surgery. ⋯ Analysis of all preoperative and 3-month postoperative variables showed heavy vibration exposure, better distal motor latency, and worse 3-month postoperative ADL score to have the strongest independent correlation with patient dissatisfaction at 6 months. No significant independent association was found between any of the preoperative variables studied and the length of time until return to work after surgery.
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Case Reports
Trapeziolunate external fixation for transscaphoid perilunate dislocations of the wrist: report of 2 cases.
Two transscaphoid perilunate dislocations of the wrist, treated by trapeziolunate external fixation--1 after closed and the other after open reduction--are reported.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of transthecal and subcutaneous single-injection digital block techniques.
A randomized double-blinded study was performed on 20 normal volunteers to evaluate 2 different techniques of single-injection digital anesthesia. Single-injection transthecal digital block technique was used to anesthetize 1 index finger and single-injection subcutaneous technique to block the other index finger. Pain and light touch were evaluated and sensory nerve-conduction studies were performed on both index fingers. ⋯ The method of anesthesia was found to have no effect on the distribution, onset, and duration of anesthesia. Median and radial nerve sensory nerve action potential amplitude reductions following digital anesthesia were also not influenced by the technique of anesthesia. Single-injection subcutaneous block was found to be easier to administer and to produce less pain during and 24 hours after injection than did the single-injection transthecal technique.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of transthecal and subcutaneous single-injection digital block techniques in cadaver hands.
A controlled, randomized single-blinded study was performed on the thumbs and little fingers of 20 cadaver hands. The digits were randomly divided into 2 groups. In the transthecal group, 2 mL of 0.5% methylene blue was injected into the tendon sheath at the A1 pulley. ⋯ In the transthecal group, intra-articular staining of the metacarpophalangeal joint was noted in 3 little fingers and 1 thumb. This complication did not occur in the subcutaneous group. This difference was significant (p < .05).