Hand (New York, N.Y.)
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Hand (New York, N.Y.) · Jan 2019
Thirty-Day Outcomes Following Surgical Decompression of Thoracic Outlet Syndrome.
Surgical thoracic outlet syndrome (TOS) management involves decompression of the neurovascular structures by releasing the anterior and/or middle scalene muscles, resection of the first and/or cervical ribs, or a combination. Various surgical approaches (transaxillary, supraclavicular, infraclavicular, and transthoracic) have been used with varying rates of complications. The purpose of this study was to evaluate early postoperative outcomes following surgical decompression for TOS. We hypothesized that first and/or cervical rib resection would be associated with increased 30-day complications and health care utilization. ⋯ Early postoperative complications are infrequent after TOS decompression. Rib resection is associated with longer surgical times and hospital stays. Future studies are needed to assess the association between early and long-term outcomes, surgical procedure, and health care utilization to determine the cost-effectiveness of the various surgical interventions for TOS.
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Hand (New York, N.Y.) · Jan 2019
Surgical Technique and Anatomical Considerations for the Modified L'Episcopo Tendon Transfer.
Birth brachial plexus injury usually affects the upper trunks of the brachial plexus and can cause substantial loss of active shoulder external rotation and abduction. Due to the unbalanced rotational forces acting at the glenohumeral joint, the natural history of the condition involves progressive glenohumeral joint dysplasia with associated upper limb dysfunction. Surgical reconstruction methods have been described previously by Sever and L'Episcopo, and modified by Hoffer and Roper to release the adduction contracture and to restore external rotation and shoulder abduction. ⋯ Transfer of the latissimus dorsi and teres major to the posterior rotator cuff for reanimation of shoulder abduction and external rotation deficits associated with birth brachial plexus injury is a safe and reliable technique. Careful patient selection and attention to surgical detail are critical for optimal outcomes.
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Hand (New York, N.Y.) · Nov 2018
Investigation Into the Optimal Number of Intercostal Nerve Transfers for Musculocutaneous Nerve Reinnervation: A Systematic Review.
The purpose of this study was to systematically review outcomes following intercostal nerve (ICN) transfer for restoration of elbow flexion, with a focus on identifying the optimal number of nerve transfers. ⋯ Previous reports have described 2.5 times increased morbidity with each additional ICN harvest. Based on the equivalent strength of elbow flexion irrespective of the number of nerves transferred, 2 ICNs are recommended to the MCN to avoid further donor-site morbidity.
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Hand (New York, N.Y.) · Nov 2018
Educational Quality of YouTube Videos in Thumb Exercises for Carpometacarpal Osteoarthritis: A Search on Current Practice.
Conservative treatments are commonly performed therapeutic interventions for the management of carpometacarpal (CMC) joint osteoarthritis (OA). Physical and occupational therapies are starting to use video-based online content as both a patient teaching tool and a source for treatment techniques. YouTube is a popular video-sharing website that can be accessed easily. The purpose of this study was to analyze the quality of content and potential sources of bias in videos available on YouTube pertaining to thumb exercises for CMC OA. ⋯ Most of the videos viewed that described conservative interventions for CMC OA management have a low level of evidence to support their use. Although patients and novice hand therapists are using YouTube and other online resources, videos that are produced by expert hand therapists are scarce.
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Hand (New York, N.Y.) · Sep 2018
Reliability and Validation of the Greek Version of the Boston Carpal Tunnel Questionnaire.
The Boston Carpal Tunnel Questionnaire (BCTQ) is an easy, brief, self-administered questionnaire developed by Levine et al for the assessment of severity of symptoms and functional status of patients with carpal tunnel syndrome. The aim of our study was to develop and validate the Greek version of BCTQ. ⋯ The Greek version of the BCTQ is a valid, reliable screening tool for assessment in daily practice of symptoms and functional status in patients with carpal tunnel syndrome.