The Journal of hand surgery
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It has become clear that the stability of the scapholunate joint does not depend wholly on the scapholunate interosseous ligament, but rather on both primary and secondary stabilizers, which form a scapholunate ligament complex. Each case of scapholunate instability is unique and should be treated with tissue-specific repairs, which may partly explain why one procedure cannot successfully restore joint stability in every case. Wrist arthroscopy has a pivotal role in both the assessment and treatment of the scapholunate ligament complex derangements. ⋯ Wrist arthroscopy has gained wider acceptance as a method to fine-tune articular reduction during open and percutaneous fixation of distal radius fractures, and simplifies intra-articular osteotomies for malunion. It can facilitate percutaneous bone grafting of scaphoid nonunions and has a role in the diagnosis and treatment of associated soft tissue lesions. These and other recent developments will be discussed in the following article.
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Motivation, job satisfaction, burnout, and secondary gain are factors that can influence return to work and disability after orthopedic injuries. The current study evaluated the separate effects of job satisfaction, burnout, and secondary gain on arm-specific disability after a finger injury. ⋯ Worker's compensation and pain were more important than job satisfaction and burnout in explaining variations in arm-specific disability in patients with finger injuries.
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Sensate reconstruction with glabrous skin is essential for ideal resurfacing of fingertip and pulp defects. The purpose of this study was to examine the palmar pivot flap as a reconstructive option for fingertip and pulp defects. ⋯ The palmar pivot flap can provide sensate glabrous skin for the effective reconstruction of fingertip and pulp defects, resulting in aesthetically pleasing and good functional outcomes.
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Ulnar-sided carpometacarpal injuries can be difficult to diagnose radiographically. We hypothesized that the resting position of the normal hand during lateral radiography provides a consistent relationship between the rays and that dorsal subluxation of the metacarpal base in fracture-dislocations increases the angle between the uninjured index and long metacarpals and the injured small metacarpal. ⋯ Both the I-S IMA and the L-S IMA were useful screening measurements on lateral hand radiographs for detection of ulnar-sided carpometacarpal fracture-dislocations. When evaluating posttraumatic ulnar-sided hand pain, advanced imaging should be considered if the I-S IMA or the L-S IMA is greater than 10°.
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Comparative Study
Interfragmentary compression profile of 4 headless bone screws: an analysis of the compression lost on reinsertion.
To evaluate the interfragmentary compression force generated by 4 different types of headless compression screws and to examine the effects of removal and reinsertion of the screw. ⋯ Surgeons should be aware of the compression profile of each screw design and the effect of screw removal and reinsertion in the clinical setting of small bone fixation.