The Journal of hand surgery
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Ganglion cysts of peripheral nerves in the upper extremity are rare. Cysts located in the substance of the nerve and extraneural ganglia that cause symptomatic nerve compression have been reported. ⋯ This case involved a ganglion cyst confined to the epineurium of the ulnar nerve at the elbow. Because of the peripheral location, it was removed without damage to the underlying nerve.
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A case of an isolated, displaced fracture of the capitate is described. This rare carpal injury was treated by internal fixation with two Herbert screws. The fracture united and the patient achieved an excellent range of wrist motion. The Herbert screw is useful in the treatment of displaced fractures of the capitate since the screw maintains reduction, compresses the fracture site, and allows early wrist motion.
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Sesamoid fractures of the metacarpophalangeal joint of the thumb may be classified into two types: (1) with palmar plate intact, and (2) with palmar plate ruptured. In type 1, the patient maintains a normal flexion posture of the metacarpophalangeal joint as well as the ability to flex the metacarpophalangeal joint and interphalangeal joint. In type 2, the metacarpophalangeal joint assumes a hyperextension posture and the patient is unable to flex the metacarpophalangeal joint. ⋯ An open fracture of a thumb sesamoid associated with laceration of the palmar plate in a child was treated by reapproximating the palmar plate and the fracture fragments with sutures. Two additional closed fractures of the thumb sesamoid were treated by splinting the metacarpophalangeal joint in comfortable flexion for 2 to 3 weeks. Normal hand function was restored in all the three patients.
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Three distinct morphologic types of juncturae tendinum of the extensor tendons were identified in the dissection of 40 cadaver hands. Type 1 juncturae consists of filamentous regions within the intertendinous fascia that attached to the extensor tendons on either side of the intermetacarpal space in a transverse or oblique direction. The second type, consists of much thicker and well-defined connecting bands. ⋯ Juncturae were absent in all of the first intermetacarpal spaces and in 12% of the second intermetacarpal spaces; they were present in all other spaces. The extensor indicis proprius did not receive a junctural connection, whereas extensor digiti quinti tendons did receive junctural connections. Intertendinous fascia was present between all extensor digitorum communis tendons regardless of presence of juncturae.
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Review Case Reports
Barber's interdigital pilonidal sinus of the hand: a foreign body hair granuloma.
Interdigital pilonidal sinus of the hand is an occupational disease of male barbers. Customers' hairs penetrate the supple interdigital skin, cause a sinus, and later a cyst. Through the sinus, the hairs get entrapped and may occasionally be expressed. Excision of the sinus or the cyst is curative.