We report a rare case of radial dislocation of the extensor tendon over the metacarpophalangeal (MCP) joint of the thumb. Ulnar dislocation has been reported, but previous reports have not mentioned radial dislocation of the extensor tendon in the thumb. Radial dislocation of the extensor tendon of the thumb gradually progressed after cerebral hemorrhage and the patient could not extend MCP joint of the thumb. To resolve difficulty in extending the MCP joint, surgical centralization of the extensor tendon and partial resection of the flexor pollicis brevis (FPB) and abductor pollicis brevis (APB) insertions was performed. The patient recovered function of thumb extensors.
PMID: 30760160 [PubMed - in process] (Source: Hand Surgery)
We present the case of a fit and well 62-year-old male with Dupuytren's disease in the right hand who underwent percutaneous needle fasciotomy (PNF) for a moderate flexion contracture of the right little finger. 18 months later he developed a pain-free soft tissue swelling at the distal previous needling site. A fasciectomy procedure identified a cyst within the pre-tendinous cord, which was confirmed as a dermoid inclusion cyst on histological analysis. Dermoid inclusion cysts may occur in the hands at the site of penetrating trauma but we are unaware of any report of an inclusion cyst at the site of PNF surgery. We present this unique case of a dermoid inclusion cyst following percutaneous needle fasciotomy as a novel complication.
PMID: 30760145 [PubMed - in process] (Source: Hand S...
Authors: Kim JY, Kim JH
Giant cell tumour of tendon sheath (GCTTS) is considered benign, but well known for its high recurrence rate. Bone involvement of GCTTS is not uncommon and closely related to local recurrence after surgery. Radiologic findings of bone involvement are pressure erosion, circumscribed cortical destruction and degenerative arthritis. The treatment involves complete resection of tumor including bone lesion. This case presents GCTTS of young male patient with multiple bone destructions of different state, treated by complete excision of the tumor and curettage of bone lesion.
PMID: 30760146 [PubMed - in process] (Source: Hand Surgery)
We report a case of acute compartment syndrome of the forearm following a hematoma after playing golf. A 55-year-old man felt pain in his left forearm while playing golf that gradually worsened. He could not continue to play and visited the emergency department of our hospital. The radial side of his left forearm was markedly swollen on presentation, and he suffered severe pain that worsened with ulnar flexion of the wrist; no paralysis or hypesthesia was observed. A hematoma in the brachioradialis was seen on magnetic resonance imaging, and radial compartment pressure was 120 mmHg. A diagnosis of acute compartment syndrome was made, and urgent fasciotomy was performed. The patient recovered with no dysfunction of the arm.
PMID: 30760147 [PubMed - in process] (Source: Hand Surgery)
CONCLUSIONS: Multiple contracted fingers and involvement of PIP joint contracture are associated with insufficient improvement of joint contracture. Current smoking is associated with delayed wound healing, but not with improvement of joint contracture, after the open palm technique for Dupuytren's disease in men.
PMID: 30760148 [PubMed - in process] (Source: Hand Surgery)
Authors: Beutel BG, Melamed E
Combined simultaneous radial wrist extensor injuries, namely ipsilateral extensor carpi radialis longus (ECRL) and brevis (ECRB) avulsion fractures, are rare. While non-operative management with cast immobilization has been described, most recommend operative intervention in the acute setting. Surgical repair of chronic injuries, however, has received little attention in the literature. This case describes a 50-year-old male who sustained combined ipsilateral ECRL and ECRB avulsion fractures from the bases of the index and middle metacarpals. Five months after the initial trauma, he underwent surgical repair with lengthening of the tendons using a novel technique and suture anchor fixation. This case demonstrates that successful repair of this...
We report a case of complete laceration of both flexor tendons in the dominant ring finger of a young male caused by a closed volar fracture fragment of the proximal phalanx. Careful clinical examination, reasonable index of suspicion and ultrasound confirmation play a pivotal role in the diagnosis and surgical planning of this rare yet consequential injury. Good outcomes can be achieved from the surgical management and rehabilitation of both soft tissue and bony injuries when planning of surgical approaches and fixation techniques are facilitated by an accurate pre-operative diagnosis.
PMID: 30760150 [PubMed - in process] (Source: Hand Surgery)
CONCLUSIONS: Clinical studies related to hand surgery published in general orthopedic journals are most often of lower quality study design. Having a larger sample size or using a comparative study or randomized clinical trial design can improve the quality of study and may ultimately increase the impact factor of hand surgery journals.
PMID: 30760151 [PubMed - in process] (Source: Hand Surgery)
Authors: Head LK, Wolff G, Boyd KU
A 25-year-old man sustained a right-sided brachial plexus injury from a high-velocity motocross accident. Physical examination and electromyography were consistent with a pan-brachial plexopathy with no evidence of axonal continuity. The patient underwent a spinal accessory to suprascapular nerve transfer and an intercostal to musculocutaneous nerve transfer with interpositional sural nerve grafts. He recovered MRC 4/5 elbow flexion and MRC 2/5 shoulder abduction and external rotation. Twenty-two months post-injury the patient displayed a flicker of flexion of his flexor pollicis longus and flexor digitorum profundus to his index finger - he went on to recover a functional pinch. Thirty-six months post-injury the patient displayed a flick...
CONCLUSIONS: According to this study, patients with scaphoid fractures are significantly more likely to show a negative UV than matched patients with wrist contusions.
PMID: 30760152 [PubMed - in process] (Source: Hand Surgery)