Pub Date : 2018-07-25DOI: 10.5772/INTECHOPEN.76786
H. Shanthanna, Manikandan Rajarathinam
Anesthesia for hand surgeries is one of the domains of regional anesthesia, where it plays the role, not only as a viable alternative to GA but also as an adjunct to it. The efficacy and inherent advantages of regional anesthesia techniques are widely made use of by the hand and upper limb surgical centers across the world. There are a variety of established regional techniques ranging from major plexus blocks to local infiltration techniques and intra venous regional anesthesia for hand surgeries. The peripheral nerve blocks are recently being performed with ultrasound guidance which is undoubtedly the greatest influence till date in the practice of modern regional anesthesia. There is also a recent trend in the performance of certain minor hand surgeries (e.g., carpal tunnel release) under infiltrative techniques in office-like settings for rapid turnover. This chapter discusses concisely the selection and execution of such techniques in day-to-day practice.
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Pub Date : 2018-07-25DOI: 10.5772/INTECHOPEN.78298
R. Ahmad, P. Heng
This chapter details crush injuries of the hand as opposed to crush syndrome. The defini - tion along with the spectrum of injury is described including a historical review of the causative mechanisms to help in the understanding of basic pathomechanics. The main menu comprises Clinical Assessment, Management and Outcomes, where the reader is taken through the steps one by one on how to approach such an injury, from the history, examination and investigations pointing out important aspects. Basic facts and figures to know and memorize have been placed in an easy-to-absorb format of tables and highlighted boxes. Key points are emphasized, and important aspects of management as well as those simple tips to improve outcome are given to ease the novice as well as the tempered surgeon’s encounter. A special section on management of specialized tissue is given toward the end after the basic management is dealt with so that a deeper understanding is gained and applied. Possible outcomes would alert the surgeon on both adverse events to avoid and excellent results to aim for. As always, good functional out- come is sought after but a good cosmetic appearance should be constantly filed away in mind’s eye to enhance the final result.
{"title":"Crush Injuries of the Hand Part II: Clinical Assessment, Management and Outcomes","authors":"R. Ahmad, P. Heng","doi":"10.5772/INTECHOPEN.78298","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.78298","url":null,"abstract":"This chapter details crush injuries of the hand as opposed to crush syndrome. The defini - tion along with the spectrum of injury is described including a historical review of the causative mechanisms to help in the understanding of basic pathomechanics. The main menu comprises Clinical Assessment, Management and Outcomes, where the reader is taken through the steps one by one on how to approach such an injury, from the history, examination and investigations pointing out important aspects. Basic facts and figures to know and memorize have been placed in an easy-to-absorb format of tables and highlighted boxes. Key points are emphasized, and important aspects of management as well as those simple tips to improve outcome are given to ease the novice as well as the tempered surgeon’s encounter. A special section on management of specialized tissue is given toward the end after the basic management is dealt with so that a deeper understanding is gained and applied. Possible outcomes would alert the surgeon on both adverse events to avoid and excellent results to aim for. As always, good functional out- come is sought after but a good cosmetic appearance should be constantly filed away in mind’s eye to enhance the final result.","PeriodicalId":200658,"journal":{"name":"Essentials of Hand Surgery","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130504305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-25DOI: 10.5772/INTECHOPEN.76668
A. Aguilera
{"title":"Introductory Chapter: The Art of Hand Surgery","authors":"A. Aguilera","doi":"10.5772/INTECHOPEN.76668","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.76668","url":null,"abstract":"","PeriodicalId":200658,"journal":{"name":"Essentials of Hand Surgery","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129777242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-25DOI: 10.5772/intechopen.73392
Justin Yousef, Sarah Anthony
Even though flexor tendon injury is common, much remains to be elucidated about the best way to facilitate the intrinsic healing process and to minimise scarring. This chapter will comprise flexor tendon anatomy, types of flexor tendon injury, modes of healing, molecular updates, repair techniques and post-operative rehabilitation.
{"title":"Flexor Tendon Injuries","authors":"Justin Yousef, Sarah Anthony","doi":"10.5772/intechopen.73392","DOIUrl":"https://doi.org/10.5772/intechopen.73392","url":null,"abstract":"Even though flexor tendon injury is common, much remains to be elucidated about the best way to facilitate the intrinsic healing process and to minimise scarring. This chapter will comprise flexor tendon anatomy, types of flexor tendon injury, modes of healing, molecular updates, repair techniques and post-operative rehabilitation.","PeriodicalId":200658,"journal":{"name":"Essentials of Hand Surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130381543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-25DOI: 10.5772/INTECHOPEN.76658
R. Ahmad, P. Heng
This chapter, the first of two; deals with the basics of crush injuries of the hand as opposed to crush syndrome. The definition is explained and the differences are outlined. A journey through the historical review of the causative mechanisms gives the reader an insight into the machines inflicting a spectrum of injuries and their sequelae. We see how the tools either remain the same or change with time, exacting similar types of injuries but in a different manner and timescale due to mechanisation. Thus it is vital to grasp the mechanics to get a basic understanding of the pathomechanics, enabling one to address the injury by reversing the inflictive force while maintaining respect for the machine. These are humbling injuries that require experience, expertise and enterprise by a dedi - cated and cohesive team always open to learning.
{"title":"Crush Injuries of the Hand Part I: History, Mechanism and Pathomechanics","authors":"R. Ahmad, P. Heng","doi":"10.5772/INTECHOPEN.76658","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.76658","url":null,"abstract":"This chapter, the first of two; deals with the basics of crush injuries of the hand as opposed to crush syndrome. The definition is explained and the differences are outlined. A journey through the historical review of the causative mechanisms gives the reader an insight into the machines inflicting a spectrum of injuries and their sequelae. We see how the tools either remain the same or change with time, exacting similar types of injuries but in a different manner and timescale due to mechanisation. Thus it is vital to grasp the mechanics to get a basic understanding of the pathomechanics, enabling one to address the injury by reversing the inflictive force while maintaining respect for the machine. These are humbling injuries that require experience, expertise and enterprise by a dedi - cated and cohesive team always open to learning.","PeriodicalId":200658,"journal":{"name":"Essentials of Hand Surgery","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132112453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-28DOI: 10.5772/INTECHOPEN.72759
Jeremiah D. Johnson, Colin Pavano, Craig M. Rodner
Dupuytren’s disease is a fibroproliferative disease affecting the palmar fascia of the hand and leading to flexion contractures of the digits. It was first described in Northern European populations and derived its namesake from Dr. Baron Dupuytren, a French sur - geon, who was one of the first to lecture on the disease. The etiology of Dupuytren’s dis ease is unclear but is likely influenced by both genetic and environmental factors. Older individuals and men are most at risk of developing the disease. Dupuytren’s disease is a clinical diagnosis and patients often present with gradually worsening flexion contrac - tures. Mild disease is usually observed, but surgical treatment is preferred for debilitat ing contractures. A variety of surgical techniques have been described involving either incising or excising diseased fascia. Overall, surgery is effective in correcting contractures and improving function, but despite successful treatment some patients still experience recurrence. More recently, collagenase injections and percutaneous procedures have been utilized to treat Dupuytren’s disease and have yielded promising results in select patients.
{"title":"Dupuytren’s Disease","authors":"Jeremiah D. Johnson, Colin Pavano, Craig M. Rodner","doi":"10.5772/INTECHOPEN.72759","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.72759","url":null,"abstract":"Dupuytren’s disease is a fibroproliferative disease affecting the palmar fascia of the hand and leading to flexion contractures of the digits. It was first described in Northern European populations and derived its namesake from Dr. Baron Dupuytren, a French sur - geon, who was one of the first to lecture on the disease. The etiology of Dupuytren’s dis ease is unclear but is likely influenced by both genetic and environmental factors. Older individuals and men are most at risk of developing the disease. Dupuytren’s disease is a clinical diagnosis and patients often present with gradually worsening flexion contrac - tures. Mild disease is usually observed, but surgical treatment is preferred for debilitat ing contractures. A variety of surgical techniques have been described involving either incising or excising diseased fascia. Overall, surgery is effective in correcting contractures and improving function, but despite successful treatment some patients still experience recurrence. More recently, collagenase injections and percutaneous procedures have been utilized to treat Dupuytren’s disease and have yielded promising results in select patients.","PeriodicalId":200658,"journal":{"name":"Essentials of Hand Surgery","volume":"265 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132157172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-20DOI: 10.5772/INTECHOPEN.72946
L. G. Benavides, S. T. Sutto, Leonel GarciaValdes, S. Lara, G. Gallardo, AnaRosa Ambriz Plascencia, M. M. Villar
The combination of surgical procedure (open or endoscopic techniques), rehabilitation and antioxidant therapy (Alpha lipoic acid, curcumin) is superior to monotherapies in the prognosis and recovery of patients with this pathology. The prescription of these medications by their mechanisms of action should be allocated prior to decompression surgery and should continue receiving medication during the rehabilitation time. Clinical and electrophysiological follow-ups are required to verify the improvement.
{"title":"Current Treatment for Carpal Tunnel Syndrome","authors":"L. G. Benavides, S. T. Sutto, Leonel GarciaValdes, S. Lara, G. Gallardo, AnaRosa Ambriz Plascencia, M. M. Villar","doi":"10.5772/INTECHOPEN.72946","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.72946","url":null,"abstract":"The combination of surgical procedure (open or endoscopic techniques), rehabilitation and antioxidant therapy (Alpha lipoic acid, curcumin) is superior to monotherapies in the prognosis and recovery of patients with this pathology. The prescription of these medications by their mechanisms of action should be allocated prior to decompression surgery and should continue receiving medication during the rehabilitation time. Clinical and electrophysiological follow-ups are required to verify the improvement.","PeriodicalId":200658,"journal":{"name":"Essentials of Hand Surgery","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121238106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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