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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We identified a subset of patients who had posterolateral rotatory instability (PLRI) following corrective osteotomy for asymptomatic cubitus varus deformity. We aimed to identify risk factors for PLRI in such patients by comparing this subgroup to patients who did not demonstrate PLRI following osteotomy. ⋯ This study demonstrates that PLRI can become apparent after corrective osteotomy for cubitus varus in the absence of clinical symptoms of instability preoperatively. We suggest that careful examination for PLRI should be performed after surgical correction for cubitus varus deformity, and surgeons should be prepared to proceed with simultaneous reconstruction of the lateral ligaments of the elbow.
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Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy, is attracting more public attention in Japan which is likely a result of the recent upsurge in lawsuits filed against medical institutes. A recent court ruling over a case of injection-needlestick-injury induced CRPS has touched off serious debates among both medical practitioners and legal professionals. ⋯ As venipuncture is the most frequently conducted and minimally invasive procedure in daily clinical practice, this court decision has attracted tremendous interest throughout the nation, alarming medical practitioners, and encouraging attorneys. The purpose of this article is twofold: to highlight the patient's clinical course in summary based on an unofficial case law report and to provide a scientific perspective on this issue based on recent relevant articles.
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Several techniques are used for fixation of Bennett's fractures. The aim of this study was to assess a technique of arthroscopic-assisted reduction and percutaneous cannulated screw fixation of Bennett's fractures. Seven patients (mean age 29 years) with three fractures Type I and four fractures Type II according to Gedda were operated under arthroscopic lavage, fluoroscopic screw fixation, and arthroscopic control of the joint reduction. ⋯ Compared to the contralateral side, first web opening was 86% (58-100), key pinch 73% (45-89), grip strength, and 85% (40-100). Four secondary displacements were noted, two of which had a step of more than 1 mm. Our results showed that the use of arthroscopy for percutaneous screw fixation of Bennett's fractures facilitates joint reduction but does not guarantee stability of fixation.
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Case Reports
Treatment of hook of the hamate fractures in adults using low-intensity pulsed ultrasound.
Two delayed unions and one nonunion of hook of the hamate fractures in adults aged 31-, 40-, and 41-years-old were treated with low-intensity pulsed ultrasound (LIPUS). Ultrasound treatment was started at three, four, and six months after injury and ultrasound exposure at the hook of the hamate in the hypothenar eminence was carried out for four to five months. During the management period, there was no immobilisation with a cast or brace and limited strain with only routine daily activities allowed. In all cases, bony union was confirmed on carpal tunnel radiographs or computed tomography at the final follow-up time of eight and 36 months after injuries.
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Case Reports
Non-union of isolated radial neck fracture using a bone graft and temporary K-wire fixation: a case report.
Non-union of radial neck fractures is not common in adults, and surgical treatment is rarely required. This case report documents non-union of the radial neck with persistent pain around the elbow joint and tenderness over the neck of the radius, limited range of motion for 12 months. The authors performed an iliac bone graft and temporary K-wire fixation for non-union of the radial neck after an isolated radial neck fracture. ⋯ If elbow joint pain, tenderness, and limitation of range of motion are present in non-union of radial neck fracture, surgical treatment is necessary. If there is no injury to the ligament around the elbow or instability, the authors consider bone graft and temporary K-wire fixation as an excellent treatment option for bony union and early exercise of the joint.