Journal of the American Society for Surgery of the Hand最新文献

Disability of the proximal interphalangeal (PIP) joint often is secondary to traumatic and nontraumatic arthritis. Symptoms include pain, weakness, deformity, and stiffness that frequently affect adjacent fingers on the ulnar side of the hand. Although many patients respond to conservative treatment including activity modification, splinting, and medication, some patients require surgical management including arthroplasty. Despite shortcomings of current designs, arthroplasty of the PIP joint is an excellent procedure for pain relief and restoration of functional motion in patients who have good bone stock, minimal deformity, and preserved flexor and extensor function.

The Bunnell Traveling Fellowship is awarded to a member of the American Society for Surgery of the Hand (ASSH). The fellow acts as an ambassador of the ASSH and visits centers of excellence around the world. The fellowship is devoted to a particular area of interest and designed to be a rewarding personal and professional experience to the recipient. The 2002 Bunnell Traveling Fellowship concentrated on the fields of congenital hand anomalies and spinal cord injury. This article highlights the travels of the fellow and provides valuable information concerning illnesses, diseases, and differences that affect children.

The use of bone graft substitutes has expanded rapidly with advances in product type and availability. Their use in the upper extremity has centered mostly on the distal radius because fractures at this location are often associated with poor bone quality and loss of support. With newer types of bone substitutes becoming commercially available, the applications to other reconstructive issues in the upper limb has expanded. This article identifies the major types of graft substitutes available or in development, and reviews their unique features and capabilities. The indications and potential indications for graft substitutes in the distal radius and the upper limb are discussed, as well as the future directions of graft substitutes.

The diagnosis and treatment of compartment syndrome remains a challenging problem in orthopedic surgery. Compartment syndrome defines a condition that occurs when the interstitial tissue pressures increase within an enclosed fascial space, preventing adequate tissue oxygenation leading to cellular necrosis of the compartments contents. The broad spectrum of causes and associated limb trauma may make assessment difficult with variable treatment outcomes. Poor outcomes of delayed treatment have contributed to compartment syndrome being one of the most common causes of litigation. We provide an overview of the history, causes, diagnosis, and treatment of compartment syndrome of the hand and forearm.

Elbow arthroscopy has evolved over the past several years. Initially used for simple loose body removal or examination of a painful joint, now it is being used with greater frequency for arthritic procedures and contractures. As more indications are developed for elbow arthroscopy, the potential for surgical injury to neurovascular structures increases. This article reviews the indications for elbow arthroscopy and describes the basic operating room set-up. The various portals used for joint inspection are described and techniques for different conditions are explained. An emphasis is placed on the neurovascular anatomy and how to avoid potential complications.