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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Comparative Study
Outcome of unstable distal radius fractures treated with open reduction and internal fixation versus external fixation.
The objective of this study was to compare the clinical results of unstable distal radius fractures treated with ORIF with plate and screws compared to EF. Patients with unstable distal radius fractures treated with ORIF or EF from January 2005 to December 2010 were reviewed in terms of the Modified Mayo Wrist Score, range of motion, pain, grip strength, and radiologic parameters. ⋯ There were no significant differences in terms of radial and ulnar deviation, grip strength, pain and postoperative radiologic parameters (p < 0.05). Better wrist flexion, wrist extension and forearm rotation can be expected in ORIF compared to EF in the management of unstable distal radius fractures.
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We present a case of phalangeal deformity in a 17-year-old boy. The deformity was caused by a neurofibroma associated with neurofibromatosis type 1, affecting the left ring finger. The mass was surgically resected. Recurrence had not occurred at three-year follow-up.
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A rare case of isolated traumatic hamate dislocation combined with fracture of the hamate hook is reported. Plain X-rays revealed a volar dislocation of the hamate, but computed tomography was necessary to recognise the fracture of the hamate hook. The injury was successfully treated with open reduction and internal fixation with Kirschner wires. ⋯ Cone-beam computed tomography, a novel imaging modality in hand surgery, was successfully used during follow-up. We conclude that computed tomography is essential in emergency preoperative planning in this type of uncommon injuries in order to diagnose concomitant bony lesions which can otherwise be overlooked. Alternative treatment options are discussed, and literature is reviewed.
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Comparative Study
Arthroscopic direct repair for radial tear of the triangular fibrocartilage complex.
Although various repair techniques for Palmer type 1B lesions of the triangular fibrocartilage complex (TFCC) have been introduced, arthroscopic repair techniques for Palmer type 1D lesions are still being honed. Until recently, inside-out techniques have commonly been used to repair radial tears of the TFCC. However, that technique has the disadvantages of a requirement for an extra skin incision, pain resulting from prominent subcutaneous suture knot stacks, and peripheral nerve injury. We describe an all-arthroscopic direct-repair technique using a suture hook with 2-0 polydioxanone that is relatively simple and safe and is thus a useful alternative for radial tears of the TFCC.
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To report the epidemiology, mechanism, anatomical location, distribution, and severity of open extensor tendon injuries in the digits, hand, and forearm as well as the frequency of associated injuries to surrounding bone and soft tissue. ⋯ The extensor mechanism is anatomically complex, and open injuries to the dorsum of the hand, wrist, and forearm, especially of crushing nature and those inflicted by saws, must be thoroughly evaluated. Associated injuries should be ruled out in order to customize surgical treatment and optimize outcome.