Techniques in hand & upper extremity surgery
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Tech Hand Up Extrem Surg · Sep 2006
ReviewConfirmatory needle placement technique for scalene muscle block in the diagnosis of thoracic outlet syndrome.
Scalene muscle block is often performed to assist with the clinical differentiation of primary sources of pain and weakness in the upper limb when the differential diagnosis includes thoracic outlet syndrome. This presentation offers a simple clinical method to assess needle placement in the scalene muscle before an injection of local anesthetic which, if properly placed, weakens the scalene muscle and often leads to temporary relief of symptoms associated with neurovascular compression. An appropriate scalene block response provides assistance with medical decision making.
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Tech Hand Up Extrem Surg · Sep 2006
ReviewA new modification of trapeziectomy and soft tissue interposition arthroplasty with abductor pollicis longus advancement.
A new modification of trapeziectomy, soft-tissue interposition arthroplasty with a one-half slip of the flexor carpi radialis tendon and advancement of the abductor pollicis longus tendon for treatment of thumb carpometacarpal degenerative arthritis and instability is presented. This procedure facilitates tenodesis of the flexor carpi radialis slip at the first metacarpal and realigns and rebalances the thumb posture by using and advancing the abductor pollicis longus tendon. Therefore, this new modification eliminates the need for perioperative pin fixation of the first metacarpal, offers better soft tissue tenodesis of the ligament reconstruction component of the procedure, and results in improved intraoperative thumb alignment.