The Journal of hand surgery
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Case Reports
Arthroscopic treatment of an osteochondral lesion in a child with chronic wrist pain: case report.
Osteochondral lesions of the wrist are rare in the pediatric and adolescent population. We report a case of an osteochondral lesion of the lunate facet of the radiocarpal joint in a 6-year-old girl with chronic wrist pain after falling on her hand. Arthroscopic debridement of the osteochondral fragment relieved the symptoms and improved wrist function. Osteochondral lesions should be considered in the differential diagnosis of chronic wrist pain in children with a history of trauma.
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Some clinical studies have suggested that distal radius plates placed distal to the watershed line have the potential to impinge on the traversing flexor tendons. However, the validity of this theory remains unclear. The purpose of this study was to evaluate the quantitative effect of volar plate position on flexor pollicis longus (FPL) tendon friction by measuring the contact pressure between the FPL tendon and the distal edge of the locking plate. ⋯ This study clarifies a mechanism of FPL tendon irritation after volar plate fixation for distal radius fractures.
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Multicenter Study Comparative Study
Trends in wrist fractures in children and adolescents, 1997-2009.
Distal radius and carpal fractures in children and adolescents represent approximately 25% of all pediatric fractures. Incidence rates and causes of these fractures change over time owing to changes in activities and risk factors. The purpose of this study was to examine recent population-based trends in incidence and causes of wrist fractures in children and adolescents. ⋯ With knowledge of the epidemiology of wrist fractures, prevention programs can be improved. From this study, we know that the incidence rate of wrist fractures in childhood is increasing, mainly as a result of soccer and gymnastics at school. Future sport injury research and surveillance data are necessary to develop new prevention programs based on identifying and addressing specific risk factors, especially in young athletes.
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Hand transplantation is the most common form of modern composite tissue allotransplantation. Successful application of this technology requires a multidisciplinary approach incorporating not only skilled hand surgeons, transplant surgeons, and transplant immunologists, but also hand therapists, psychiatrists, medical specialists, anesthesiologists, and others. ⋯ Hand transplantation is becoming more common, with more centers offering this relatively new reconstructive modality. Its success depends on proper patient selection, a technically successful operation, postoperative rehabilitation, and an immunotherapy protocol that prevents rejection but has minimal or acceptable morbidity.
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Comparative Study
Assessing the impact of antibiotic prophylaxis in outpatient elective hand surgery: a single-center, retrospective review of 8,850 cases.
Prophylactic antibiotics have been shown to prevent surgical site infection (SSI) after some gastrointestinal, orthopedic, and plastic surgical procedures, but their efficacy in clean, elective hand surgery is unclear. Our aims were to assess the efficacy of preoperative antibiotics in preventing SSI after clean, elective hand surgery, and to identify potential risk factors for SSI. ⋯ Therapeutic III.