Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand
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Acute carpal tunnel syndrome (CTS) secondary to calcific deposition is rarely reported. In this article we describe a case of acute CTS in the dominant hand of a 94-year-old female patient secondary to calcific tendinitis within the carpal tunnel. Diagnosis was difficult clinically and radiologically. Urgent complete median nerve decompression led to a good clinical recovery.
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The purpose of this study is to present the results of a new intramedullary fixation technique for metacarpal fractures. A J-shaped nail, which is a curved 2.0 mm diameter Kirschner wire sharply bent at the proximal end, was inserted from the dorsal aspect of the metacarpal base. Twenty-one metacarpal fractures (five transverse shaft fractures and 16 neck fractures) in 19 hands of 18 patients with were operated by this technique. ⋯ Clinical and radiographic results were excellent in all ten hands that had excluded concomitant injuries. There was no mechanical irritation of the skin or extensor tendons in any patient. This intramedullary fixation technique is very useful for neck or transverse shaft fractures of the metacarpals without concomitant injuries such as severe soft tissue damage.
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Healed distal radial fractures are frequently complicated by chronic wrist pain which is multifactorial and can be debilitating. An accurate delineation of the pathoanatomy is the key for successful treatment. ⋯ Surgical treatment directed towards identified abnormalities gave satisfactory outcome. At six months after surgery the mean functional score improved 36%, mean pain score decreased 50%, mean grip strength improved 25%, and 64% of patients returned to work.
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The diagnosis of chronic wrist pain is challenging and wrist arthroscopy has been recognised as the "gold standard". The present study investigated the efficacy of adding distal radioulnar joint (DRUJ) arthroscopy to routine wrist arthroscopy. The records of 67 patients who underwent DRUJ arthroscopy were reviewed, and the success rates for visualisation of intra-articular structures were determined. ⋯ The ulnar head and proximal surface of the triangular fibrocartilage complex (TFCC) were visualised in 100% and 99% of patients, respectively, while the foveal insertion of TFCC and sigmoid notch were visualised in 57% and 69%, respectively. Pathological findings of the proximal surface of TFCC tended to relate to ulnar wrist pain (p = 0.06). DRUJ arthroscopy should be included in routine wrist arthroscopy to enhance the accuracy of diagnosis.
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We report a rare occurrence of attritional rupture of flexor tendons caused by protrusion of the screw head of the volar radius plate. The cause of the protrusion was plate placement on the prominent distal volar lip of the radius and secondary loss of the original reduction due to using a non-locking osteosynthesis system for the treatment of displaced intra-articular fracture of the distal radius.