Scand J Plast Recons
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Scand J Plast Recons · Jan 2009
Randomized Controlled Trial Comparative StudyModification of the forearm tourniquet techniques of intravenous regional anaesthesia for operations on the distal forearm and hand.
Our aim was to find out if a modified intravenous regional anaesthetic block technique, used for invasive surgical procedures on the distal forearm and hand, results in a drier operative field than traditional methods. Twenty consenting adult (age > 18) patients who were to have an operation on the distal forearm or hand were randomised into two groups (n=10 in each). The first group was using a traditional bier block, with a double upper arm tourniquet. ⋯ This benefit was not sustained postoperatively (p=0.57). Plasma lignocaine concentrations were higher in the conventional group (p=0.004). The modified technique was as safe as the conventional technique but has the benefits of a drier surgical field and improved intraoperative comfort for patients.
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Scand J Plast Recons · Jan 2009
Evaluation of a Swedish version of the patient-rated wrist evaluation outcome questionnaire: good responsiveness, validity, and reliability, in 99 patients recovering from a fracture of the distal radius.
The patient-rated wrist evaluation (PRWE) form is an established outcome questionnaire designed to measure wrist pain and disabilities in activities of daily living. We translated and validated this score for use in Sweden. The original PRWE score was translated forwards and backwards, and then the responsiveness, validity, and reliability of the Swedish version were tested in 99 patients who were recovering from a fracture of the distal radius. ⋯ The PRWE showed a strong correlation with DASH score (Spearman's rank coefficient = 0.86). Intraobserver reliability of the test-retest and internal consistency was good (Kendall W coefficient = 0.79, Spearman's rank coefficient = 0.99, Cronbach's alpha = 0.94-0.97). We found this Swedish version of the PRWE to be responsive, valid, and reliable for evaluating the patient-rated outcome after a fracture of the distal radius.
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Scand J Plast Recons · Jan 2008
Application of infrared thermography for the analysis of rewarming in patients with cold intolerance.
Cold intolerance is a serious long-term problem after injury to the ulnar and median nerves, and its pathophysiology is unclear. We investigated the use of infrared thermography for the analysis of thermoregulation after injury to peripheral nerves. ⋯ At baseline temperature distribution of the hand was symmetrical, but after testing the injured side warmed up much slower. We concluded that the infrared profile of the temperature of the hand after immersion in cold water is helpful to assess thermoregulation after injury to peripheral nerves.
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Scand J Plast Recons · Jan 2008
Comparative StudyComparison of carpal tunnel injection techniques: a cadaver study.
The purpose of the study was to evaluate the accuracy of injections into the carpal tunnel using three different portals in cadavers, and to define safe guidelines. In this study, 150 wrists of 75 cadavers (54 male, 21 female) were included. To compare three injection sites, 50 wrists of 25 cadavers were used for each technique; we used 23 gauge needles, and acrylic dye. ⋯ Median nerve injuries caused by injection was seen mostly with the second technique. Although a steroid injection may provide symptomatic relief in patients with carpal tunnel syndrome, the median nerve and other structures in the carpal tunnel are at risk of injury. Because of that, the injection should be given using the correct technique by physicians skilled in carpal tunnel surgery.
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Scand J Plast Recons · Jan 2008
Case ReportsTranszygomatic coronoidectomy as a treatment for pseudoankylosis of the mandible after transtemporal surgery.
Pseudoankylosis of the mandible after a transtemporal operation is rare. In patients with severely limited mouth opening, a transzygomatic approach is the approach of choice. We report a case of pseudoankylosis of the mandible that was successfully treated by transzygomatic coronoidectomy.