The Journal of hand surgery
-
The cause of snapping in trigger finger is not clearly understood. The purpose of this study was to investigate the influence of stiffness of the first annular pulley on snapping in trigger finger patients with sonoelastography, a new technique for quantitative assessment of the stiffness of soft tissues. ⋯ Increased stiffness and thickening of the A1 pulley are considered to be causes for snapping in trigger finger, and corticosteroid injection can alleviate snapping by changing these 2 features.
-
This investigation tested the null hypothesis that psychological factors have no effect on patient satisfaction in a hand and upper limb practice. ⋯ In this study, the provider's sense that the patient was disproportionately uneasy with his or her symptoms was the only significant predictor of patient satisfaction, and this accounted for a small percentage of the variance in responses to these items. Patient satisfaction is complex, and the divide between medical advice and a patient's expectations are not easily reduced to one or more disease-specific or patient-specific factors.
-
The diagnosis and management of complex regional pain syndrome is often challenging. Early diagnosis and intervention improve outcomes in most patients; however, some patients will progress regardless of intervention. Multidisciplinary management facilitates care in complex cases. ⋯ Multimodal treatment with hand therapy, sympatholytic drugs, and stress loading may be augmented with anesthesia blocks. If the dystrophic symptoms are controllable by medications and a nociceptive focus or nerve derangement is correctable, surgery is an appropriate alternative. Chronic sequelae of contracture may also be addressed surgically in patients with controllable sympathetically maintained pain.
-
Biography Historical Article
A brief report about the concepts of hand disorders in the Canon of Medicine of Avicenna.
Avicenna contributed to development in many fields of medicine. The Canon of Medicine is the masterpiece of Avicenna's medical books in which he wrote on the anatomy of the upper extremity, fractures, dislocations, and nerve and tendon injuries. Reviewing these subjects pertinent to hand disorders reveals Avicenna's concepts about hand disorders a millennium ago.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: a prospective, randomized, controlled multicenter study.
We compared saline, corticosteroid, and autologous blood injections for lateral epicondylitis in a prospective, blinded, randomized, controlled trial. The null hypothesis was that patient-rated outcomes after autologous blood injection would not be superior to corticosteroid and saline injections. ⋯ In this prospective, randomized, controlled trial, autologous blood, corticosteroid, and saline injection provide no advantage over placebo saline injections in the treatment of lateral epicondylitis. Patients within each injection group demonstrated improved outcome scores over a 6-month period.