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Journal of hand surgery (Edinburgh, Scotland)最新文献

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Prophylactic internal fixation of the scaphoid to treat impending stress fracture in an athlete 预防性舟骨内固定治疗运动员即将发生的应力性骨折
Pub Date : 2022-04-11 DOI: 10.1177/17531934221093289
Stuart W. Jones, Fiona C. Campbell, Doug A. Campbell
Cox CA, Zlotolow DA, Yao J. Suture button suspensionplasty after arthroscopic hemitrapeziectomy for treatment of thumb carpometacarpal arthritis. Arthroscopy. 2010, 26: 1395–403. De Smet L, Sioen W, Spaepen D, Van Ransbeeck H. Treatment of basal joint arthritis of the thumb: trapeziectomy with or without tendon interposition/ligament reconstruction. Hand Surg. 2004, 9: 5–9. Park MJ, Lichtman G, Christian JB et al. Surgical treatment of thumb carpometacarpal joint arthritis: a single institution experience from 1995–2005. Hand (NY). 2008, 3: 304–10. Wajon A, Vinycomb T, Carr E, Edmunds I, Ada L. Surgery for thumb (trapeziometacarpal joint) osteoarthritis. Cochrane Database Syst Rev. 2015, CD004631.
Cox CA, Zlotolow DA, Yao J.关节镜半骨切除术后缝合扣悬吊成形术治疗拇指腕掌骨关节炎。关节镜。2010,26:1395-403。李建军,李建军,李建军,等。大拇基底关节关节炎的临床研究进展。手外科,2004,9:5-9。Park MJ, Lichtman G, Christian JB等。拇指腕掌关节关节炎的手术治疗:1995-2005年单一机构的经验。手(纽约)。2008, 3: 304-10。Wajon A, Vinycomb T, Carr E, Edmunds I, Ada L.拇指(斜跖关节)骨关节炎的手术治疗。Cochrane数据库系统,2015,CD004631。
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引用次数: 0
The incidence and spectrum of congenital hand differences in patients with Fanconi anaemia: analysis of 48 patients 范可尼贫血患者先天性手的发生率及频谱差异:48例分析
Pub Date : 2022-03-31 DOI: 10.1177/17531934221087521
G. Bourke, D. Wilks, S. Kinsey, R. Feltbower, N. Giri, B. Alter
We analysed the spectrum of congenital hand differences in a cohort of patients with Fanconi anaemia (FA). Data of 48 FA patients at the National Cancer Institute were reviewed focusing on age at diagnosis, type and severity of limb difference and any potential association with other known clinical anomalies that are part of the FA phenotype, specifically VACTERL-H and PHENOS. Twenty-eight patients had an upper limb difference, which always included thumb hypoplasia. Twenty-three patients had bilateral upper limb differences, including varying combinations and severities of thumb hypoplasia, radial dysplasia and thumb duplication. Patients with a limb difference were diagnosed at a younger age (<2 years: 15/28 with limb anomaly versus 4/20 without a limb anomaly). However, 7/28 with limb anomalies, usually thumb hypoplasia, were not diagnosed until after 6 years of age. This study demonstrates the broad spectrum of radial ray anomalies within the FA phenotype along with the possibility of either unilateral or bilateral upper limb differences and adds further merit to consideration of screening for FA in all cases of radial ray anomaly. Level of evidence: II
我们分析了范可尼贫血(FA)患者的先天性手谱差异。我们回顾了美国国家癌症研究所48例FA患者的数据,重点关注诊断时的年龄、肢体差异的类型和严重程度,以及与FA表型(特别是VACTERL-H和PHENOS)中其他已知临床异常的潜在关联。28例患者有上肢差异,其中包括拇指发育不全。23例患者存在双侧上肢差异,包括不同组合和严重程度的拇指发育不全、桡侧发育不良和拇指重复。有肢体差异的患者被诊断的年龄更小(<2岁:有肢体异常的15/28 vs无肢体异常的4/20)。然而,7/28的肢体异常,通常是拇指发育不全,直到6岁后才被诊断出来。本研究证明了FA表型中桡骨异常的广谱,以及单侧或双侧上肢差异的可能性,并进一步说明了在所有桡骨异常病例中考虑筛查FA的优点。证据水平:II
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引用次数: 3
Residual stability of the distal radioulnar joint following ulnar styloid fracture: influence of the remnant distal radioulnar ligaments 尺茎突骨折后远端尺桡关节的剩余稳定性:残余远端尺桡韧带的影响
Pub Date : 2022-03-31 DOI: 10.1177/17531934221088508
M. Maniglio, Il-Jung Park, M. Kuenzler, Matthias A Zumstein, M. McGarry, T. Lee
Clinical studies suggest that even untreated basal ulnar styloid fractures may not affect patient outcomes. This may be due to the remaining parts of the distal radioulnar ligament still attached providing sufficient residual stability of the distal radioulnar joint. We tested this hypothesis in a biomechanical cadaveric model. Dorsopalmar translation of the distal radioulnar joint and forearm rotation were measured. Seventeen specimens were tested after a simulated ulnar styloid fracture including the fovea, followed by transection of the remaining palmar (n = 9) or dorsal (n = 8) portions of the distal radioulnar ligament and finally with all remnants transected. Rotation and translation both increased significantly after the final transection compared with the foveal fracture. The increase in translation was larger after transection of the dorsal remnants. We conclude that in an ulnar styloid fracture including the fovea, some ligament components are still attached to the ulnar head, giving residual stability to the distal radioulnar joint.
临床研究表明,即使未经治疗的基底尺骨茎突骨折也可能不会影响患者的预后。这可能是由于远端尺桡韧带的剩余部分仍然附着,为远端尺桡关节提供了足够的残余稳定性。我们在生物力学尸体模型中验证了这一假设。测量远端尺桡关节的背掌平移和前臂旋转。17个标本在模拟尺茎突骨折(包括中央窝)后进行测试,然后横切剩余的远端桡尺韧带掌部(n = 9)或背侧(n = 8)部分,最后横切所有残余。与中央凹骨折相比,最后横断后旋转和平移均显著增加。背侧残体横切后,平移量增加更大。我们的结论是,在包括中央窝在内的尺茎突骨折中,一些韧带成分仍然附着在尺头上,为远端尺桡关节提供了剩余的稳定性。
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引用次数: 0
Sum of parts: an approach to reconstruction for Type A postaxial polydactyly using metacarpal transposition 部分总和:一种利用掌骨转位重建A型轴后多指畸形的方法
Pub Date : 2022-03-28 DOI: 10.1177/17531934221088272
Neel Vishwanath, Vinay Rao, Reena A. Bhatt
runs under the fascia. A second 2 cm incision is made in the crease of the popliteal fossa where identification of the proximal SN can be facilitated by gently moving the distal SN. Absence of motor response upon direct electrical stimulation is used for positive SN identification. The tibial and peroneal nerves are identified. The SN is dissected as far proximally as possible and then cut. The SN is then gently lead through the ankle incision and cut as far distally as possible. Both incisions are closed in a subcuticular fashion. A third mid-calf incision may be required for neurolysis at the level where the SN crosses through the fascia if it cannot be reached through the ankle incision. Since January 2000 we have used this technique to harvest one or two SNs as needed in approximately 400 infants with BPBI. Due to incomplete coding in our database, the exact number of patients or the number of SNs harvested per patient cannot be provided. Our surgical time to harvest one SN graft of 10–13 cm, from incision to wound dressing, has ranged between 35 to 55 minutes. We have found paracetamol to be sufficient in controlling postoperative pain in our series. Surgical scars have been barely visible using skin line incisions and subcuticular closure. Our postoperative complications included one superficial wound infection and one partial palsy of foot extension that resolved spontaneously. None of the patients required conversion to open dissection. Our modifications of supine positioning of the child allows synchronous brachial plexus exploration and SN nerve harvesting, thus reducing operating time. The decision to harvest one or two SNs can be made after assessment of the severity of the nerve lesion. The use of a Kilian nasal speculum provides an ideal working corridor to neurolyse the SN and helps to minimize the number of skin incisions.
在筋膜下运行。在腘窝的皱褶处做第二个2厘米的切口,在那里轻轻移动远端SN可以方便地识别近端SN。在直接电刺激下缺乏运动反应用于阳性SN识别。胫骨神经和腓神经被识别出来。将SN尽可能近地剥离,然后切开。然后轻轻地穿过踝关节切口,并尽可能远地切开。两个切口均以皮下方式闭合。如果不能通过踝关节切口到达SN穿过筋膜处,则可能需要在SN穿过筋膜处进行第三个小腿中部切口进行神经松解。自2000年1月以来,我们已经使用这种技术在大约400名BPBI婴儿中根据需要收集了一到两个SNs。由于我们的数据库编码不完整,无法提供确切的患者数量或每个患者收获的SNs数量。从切口到伤口敷料,我们的手术时间在35到55分钟之间。我们发现扑热息痛足以控制我们系列的术后疼痛。手术疤痕几乎不可见使用皮肤线切口和皮下封闭。我们的术后并发症包括一例浅表伤口感染和一例局部足部伸展性麻痹,这些麻痹自行消退。没有患者需要转换为开放式解剖。我们对患儿的仰卧位进行了修改,使其可以同步进行臂丛探查和SN神经采集,从而缩短了手术时间。在评估神经损伤的严重程度后,可以决定采集一个或两个SNs。Kilian鼻窥器的使用提供了一个理想的工作通道来神经溶解鼻窦,并有助于减少皮肤切口的数量。
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引用次数: 0
The use of wide awake local anaesthesia initially applied tourniquet (WALAIAT) in flexor tendon surgery: a randomized controlled trial 宽清醒局部麻醉最初应用止血带(WALAIAT)在屈肌腱手术中的应用:一项随机对照试验
Pub Date : 2022-03-18 DOI: 10.1177/17531934221087579
M. Abdelshaheed
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引用次数: 1
Surgical resection of venous malformations of the forearm 前臂静脉畸形的外科切除
Pub Date : 2022-03-16 DOI: 10.1177/17531934221086889
C. Laurian, A. Bisdorff, Claudine Masonni, P. Cerceau, N. Paraskevas
We retrospectively reviewed 35 patients with venous malformations located in the forearm and treated by surgery in a single institution during the period 2010–19. The common complaints were pain and swelling (34 patients) and impaired function with contractures of fingers (15 patients). Twenty-four had complete resection and 11 had an incomplete resection. Associated procedures were reconstruction or lengthening of tendons in 17 patients. At the last follow-up (mean 61 months), 32 of the 35 had no residual pain and 27 had no functional sequelae. On MRI follow-up exams, 27 had no residual venous malformations. Venous malformations in the anterior compartment of the forearm can impair the function of the hand. They are developed almost exclusively in the connective tissue around tendons and muscles, deforming the musculotendinous structures and involving nerves. Surgery seems an appropriate option for the condition in this area. Level of evidence: IV
我们回顾性回顾了2010-2019年间在一家机构接受手术治疗的35名前臂静脉畸形患者。常见的主诉是疼痛和肿胀(34名患者)以及手指挛缩功能受损(15名患者)。24例完全切除,11例不完全切除。17名患者的相关程序为肌腱重建或延长。在最后一次随访(平均61个月),35人中有32人没有残余疼痛,27人没有功能后遗症。在MRI随访检查中,27例患者无残余静脉畸形。前臂前室的静脉畸形会损害手的功能。它们几乎只在肌腱和肌肉周围的结缔组织中发育,使肌肉腱结构变形并涉及神经。对于这个地区的情况,手术似乎是一个合适的选择。证据级别:IV
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引用次数: 0
Dysfunctional movement patterning in the hand: an unrecognized entity? 手部功能失调的运动模式:一个未被识别的实体?
Pub Date : 2022-03-13 DOI: 10.1177/17531934221085838
Daniel J Brown, S. Gillespie, G. Cheung
Following injury or surgery to the hand, most patients undergo an uneventful recovery, with or without the need for hand therapy. Those that do not, usually display common and predictable patterns of stiffness, caused by intrinsic or extrinsic soft tissue tightness, or weakness caused by either neuromuscular pathology or disuse. A smaller group may develop complex regional pain syndrome (CRPS). Finally, there are a small number of patients that do not follow any of these recognized paths and present instead with painless (usually), abnormal patterns of movement that can have significant effects on hand function. Although this abnormal ‘patterning’ is not well recognized or described in the hand literature, it has been described as a cause of chronic functional problems in the cervical spine, lumbar spine and knee (Hodges and Tucker, 2011; Sterling et al., 2001); and in the shoulder where it is known to be one of the causes of instability (Lewis et al., 2004).
在手部受伤或手术后,大多数患者都经历了平稳的恢复,无论是否需要手部治疗。那些不这样做的,通常表现出常见的和可预测的僵硬模式,由内在或外在的软组织紧绷引起,或由神经肌肉病理或不使用引起的虚弱。一小部分人可能会发展为复杂的局部疼痛综合征(CRPS)。最后,有少数患者不遵循这些公认的途径,而是表现为无痛(通常),异常的运动模式,这可能对手部功能产生重大影响。尽管这种异常的“模式”在手部文献中没有得到很好的认识或描述,但它已被描述为颈椎、腰椎和膝关节慢性功能问题的原因(Hodges和Tucker, 2011;Sterling et al., 2001);在肩部,已知它是导致不稳定的原因之一(Lewis et al., 2004)。
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引用次数: 0
Management of digital amputations: commentary and personal opinions 数字截肢的管理:评论和个人意见
Pub Date : 2022-03-13 DOI: 10.1177/17531934221085806
P. Tos
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引用次数: 0
Factors associated with self-reported pain and hand function following surgical A1 pulley release 手术解除A1滑轮后自我报告疼痛和手功能相关因素
Pub Date : 2022-03-10 DOI: 10.1177/17531934221085401
J. E. Koopman, C. Hundepool, R. Wouters, L. Duraku, J. Smit, R. Selles, J. Zuidam
Surgical A1 pulley release can considerably reduce pain and improve hand function, but individual outcomes are highly variable. This study aimed to identify factors contributing to self-reported pain and hand function 3 months postoperatively. We included 2681 patients who had received surgical treatment for a trigger finger or thumb and who completed the Michigan Hand outcomes Questionnaire (MHQ). Hierarchical linear regression models were used to investigate patient and clinical characteristics associated with postoperative pain and hand function. For both pain and hand function, the most influential factors associated with worse outcomes were worse MHQ scores at baseline (β 0.38 and 0.33, respectively) and ≥3 preoperative steroid injections (β –0.36 and –0.35). These factors indicated that patients with severe preoperative symptoms represent a group with a more advanced disease that is more difficult to treat. These findings can assist clinicians in patient counselling, expectation management and decision-making about the timing of the intervention. Level of evidence: II
手术A1滑轮释放可以显著减轻疼痛并改善手部功能,但个体结果差异很大。本研究旨在确定导致术后3个月自我报告疼痛和手功能的因素。我们纳入了2681名接受过扳机指或拇指手术治疗并完成了密歇根手部结果问卷(MHQ)的患者。使用分层线性回归模型来研究与术后疼痛和手功能相关的患者和临床特征。就疼痛和手功能而言,与较差结果相关的最有影响的因素是基线时MHQ评分较差(分别为β0.38和0.33)和术前类固醇注射≥3次(β-0.36和-0.35)。这些因素表明,术前症状严重的患者代表了一个更难治疗的晚期疾病组。这些发现可以帮助临床医生进行患者咨询、期望管理和干预时机的决策。证据级别:二
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引用次数: 3
Frequency of amyloid deposition in idiopathic carpal tunnel syndrome 特发性腕管综合征中淀粉样蛋白沉积的频率
Pub Date : 2022-03-09 DOI: 10.1177/17531934221085542
A. Afshar, Shiva Sohrabi, A. Tabrizi, Siamak Kazemi-Sufi, A. Abbasi
Abdelshaheed ME. Classification and clinical evaluation of ‘‘spare parts’’ procedures in mutilating hand injuries. Hand Surg Rehabil. 2021, 40: 75–80. Alter TH, Warrender WJ, Liss FE, Ilyas AM. A cost analysis of carpal tunnel release surgery performed wide awake versus under sedation. Plast Reconstr Surg. 2018, 142: 1532–8. Lalonde DH. Reconstruction of the hand with wide awake surgery. Clin Plastic Surg. 2011, 38: 761–9. Shulman BS, Rettig M, Yang SS, Sapienza A, Bosco J, Paksima N. Tourniquet use for short hand surgery procedures done under local anesthesia without epinephrine. J Hand Surg Am. 2020, 45: 554.e1–6.
Abdelshaheed我。残害手部“备件”手术的分类与临床评价。中华手外科杂志,2017,40:75-80。Alter TH, warrendwj, Liss FE, Ilyas AM。完全清醒与镇静状态下腕管释放手术的成本分析。中华整形外科杂志,2018,32(2):532 - 538。Lalonde DH。全清醒手术重建手部。临床整形外科,2011,38:761-9。Shulman BS, Rettig M, Yang SS, Sapienza A, Bosco J, Paksima N.局部麻醉下不使用肾上腺素的短手手术止血带的应用。中华手外科杂志,2020,45(5):554 - 561。
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引用次数: 1
期刊
Journal of hand surgery (Edinburgh, Scotland)
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