Techniques in hand & upper extremity surgery
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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.
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Tech Hand Up Extrem Surg · Mar 2006
ARM: a modular hinged joint for the AO tubular external fixator.
Certain complex traumatic elbow lesions challenge the orthopaedic and trauma surgeon. If they are not treated correctly, they cause a high rate of disability, arising from elbow instablility and stiffness, either by fibrosis or joint incongruity. Injuries such as complex fractures of the proximal third of the ulna, coronoid fractures associated with radial head fractures (the "terrible triad"), are even worse if they are accompanied by soft tissue lesions. ⋯ It can be concluded that good results can be obtained in injuries with severe elbow instability and soft tissue lesions, using this hinged external fixator. With this new clamp, the AO tubular external fixator is transformed into a hinged one and a new use is added to this already very versatile system. This clamp is very easy to apply.
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Tech Hand Up Extrem Surg · Sep 2005
Longitudinal incision in surgical release of De Quervain disease.
The objective of this paper is to contrast the use of a longitudinal incision in surgical decompression of De Quervain disease with a transverse incision. The advantages are ease in recognition of compartment variations and superficial branches of radial nerve and prevention of palmar tendon subluxation by permitting a more dorsal release of the compartment sheath. Since 2002, we have used a longitudinal skin incision instead of the classic transverse incision to release the first dorsal compartment.
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Tech Hand Up Extrem Surg · Mar 2005
ReviewThe reverse radial forearm flap for soft tissue reconstruction of the wrist and hand.
Soft tissue defects of the upper extremity must be carefully assessed to determine the most appropriate method of coverage. Direct closure and local flaps represent the most basic techniques on the reconstructive ladder; however, they are inadequate for large or complex defects. ⋯ The reverse radial forearm flap potentially offers thin, mobile skin with similar characteristics to the skin over the dorsum of the hand. This flap is more versatile than the groin flap and probably more reliable than the posterior interosseous artery flap for coverage of moderate-sized defects of the dorsal or palmar wrist and hand and is specifically indicated for coverage of degloving injuries of the dorsal wrist and hand, after release of thumb-index finger web space, and for coverage of amputations of the thumb in preparation for toe-to-thumb transfer.