The Journal of hand surgery
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A tension-free coaptation is a key factor for the successful outcome of any nerve repair. A variety of host factors influence the outcome of digital nerve repair more than the type of repair per se. Although autologous graft remains the reference standard for reconstruction of any critical digital nerve defect, allografts and conduits have assumed an increasing role.
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Acute elbow injuries that disrupt the lateral ulnar collateral ligament and result in posterolateral rotatory instability usually require surgical treatment. The 2 technical options reported, direct repair and use of a palmaris longus tendon graft, have usually favored the use of the graft. To balance this emphasis, we report our experience with direct repair of the humeral origin in cases of trauma, whether acute, delayed, or recurrent. It was our hypothesis that because the humeral origin is the point of failure and separation, restoration of this attachment is sufficient to restore stability and durable function without the need for a graft. ⋯ Therapeutic III.
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Comparative Study
Dorsal surgical approaches to the proximal interphalangeal joint: a comparative anatomic study.
Adequate exposure of the articular surface of the head of the proximal phalanx is essential for reduction of intra-articular fractures of the proximal interphalangeal (PIP) joint. We compared the articular exposure obtained by a dorsal extensor-tendon splitting (Swanson), an extensor tendon-reflecting (Chamay), and an extensor mechanism-sparing approach. ⋯ Understanding the limitations inherent in dorsal exposure of the PIP joint may help guide the surgical approach for the individual patient.
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Distal radius volar locking plate design and associated vulnerability of the flexor pollicis longus.
Flexor pollicis longus (FPL) tendon rupture is a well-documented complication related to the use of distal radius volar locking plates (VLPs). The final common pathway of flexor tendon rupture appears to involve implants prominent at the watershed line. We hypothesized that significant differences in VLP prominence exist between various plate designs. ⋯ The results raise concerns regarding interference between all of the analyzed VLP designs and the FPL. This study may help guide both implant design considerations and assist the surgeon in better understanding implant morphology as it relates to iatrogenic flexor tendon injury.
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Randomized Controlled Trial
Povidone-iodine soaks for hand abscesses: a prospective randomized trial.
To determine the effect of povidone-iodine soaks on outcomes of hand infections after operative drainage. ⋯ Therapeutic II.