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Neurophysiologie Clinique = Clinical... Nov 2016
Topics: Electric Stimulation; Evoked Potentials, Somatosensory; Humans; Median Nerve; Medulla Oblongata; Neural Pathways; Pedunculopontine Tegmental Nucleus; Tibial Nerve
PubMed: 26919890
DOI: 10.1016/j.neucli.2016.01.002 -
The Archives of Bone and Joint Surgery Oct 2016Ganglion cysts are the most common wrist tumors, and 60 -70% originate dorsally from the scapholunate interval. Ossification of these lesions is exceedingly rare, with...
Ganglion cysts are the most common wrist tumors, and 60 -70% originate dorsally from the scapholunate interval. Ossification of these lesions is exceedingly rare, with only one such lesion located in the finger reported in the literature. We present a case of an ossified dorsal wrist ganglion in a 68-year-old woman.
PubMed: 27847858
DOI: No ID Found -
Der Unfallchirurg Aug 2017
Topics: Atlanto-Axial Joint; Humans; Internal Fixators
PubMed: 28766087
DOI: 10.1007/s00113-017-0381-7 -
Journal of Wrist Surgery Mar 2016Background In intra-articular fracture of distal radius, the intra-articular fragments can be divided into some specific fragments. In particular, the poor outcomes...
Background In intra-articular fracture of distal radius, the intra-articular fragments can be divided into some specific fragments. In particular, the poor outcomes have been well documented for reduction loss of the volar lunate facet, but the effect of a displaced dorsal rim fracture has rarely been addressed. Materials and Methods The records of 26 patients with dorsal rim fragment displaced by more than 2 mm after volar locking plate (VLP) fixation for a dorsally displaced distal radius fracture (DRF) treated from March 2006 to March 2009 were retrospectively reviewed. Clinical assessments including grip strengths, wrist range of motions, and Disabilities of Arm, Shoulder, and Hand (DASH) scores were performed at 12 months postoperatively. Widths of the distal ends of dorsal rims were determined by preoperative computed tomography (CT). Dorsal rim fragment displacements were measured in immediate postoperative plain lateral radiographs. Radial inclination, volar tilt, and ulnar variance were measured on immediate postoperative wrist radiographs. Arthritic changes of radiocarpal joints were graded using radiographs obtained at 12 months postoperatively. Description of Technique DRFs were fixed using a VLP in the usual manner. Although DRF displacement was noticed after plate fixation, no further procedure was performed. The sizes of articular portions of dorsal rim fragments were measured arthroscopically in 5 of the 26 patients at the time of plate fixation. Results At 12 months postoperatively, mean grip strength, wrist flexion arc, and mean wrist extension arc were 86 ± 13, 87 ± 11, and 91 ± 10%, respectively, of contralateral sides. Mean forearm supination and pronation were 96 ± 8 and 99 ± 5%, respectively, of contralateral sides. Mean DASH score was 11 ± 10 points. Preoperatively, mean width of the distal end of dorsal rim fragments and mean displacements of dorsal rim fragments were 2.0 ± 0.6 and 3.0 ± 0.9 mm, respectively. Mean width of the articular portions of dorsal rim fragment by arthroscopic examination was 1.0 ± 0.4 mm. Mean radial inclination was 21 ± 4.8 degrees, mean volar angulation was 4.8 ± 3.9 degrees, and mean ulnar variance was 0.6 ± 1.8 mm at immediate postoperatively. Two patients showed grade I arthritic changes at 12 months postoperatively. Conclusions The articular portions of dorsal rim fragments measured arthroscopically were smaller than determined by CT. Furthermore, the study shows that displaced dorsal rim fragments in dorsally displaced DRFs treated by VLP do not adversely affect wrist clinical outcomes.
PubMed: 26855833
DOI: 10.1055/s-0035-1571184 -
Hand Surgery & Rehabilitation Jan 2023The present study aimed to examine the dorsal approach to complex MCP joint dislocation and to compare our clinical results with others reported in the literature.
PURPOSE
The present study aimed to examine the dorsal approach to complex MCP joint dislocation and to compare our clinical results with others reported in the literature.
UNLABELLED
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal
PubMed: 36690298
DOI: 10.1016/j.hansur.2023.01.003 -
Handchirurgie, Mikrochirurgie,... Feb 2017
Topics: Humans; Joint Dislocations; Trapezoid Bone; Wrist Injuries
PubMed: 28423446
DOI: 10.1055/s-0043-102688 -
The Journal of Hand Surgery, European... Oct 2020In this cadaveric study of anterior plating of the distal radius, we aimed to determine the interobserver agreement and diagnostic performance for detecting dorsally...
In this cadaveric study of anterior plating of the distal radius, we aimed to determine the interobserver agreement and diagnostic performance for detecting dorsally protruding screws using the dorsal tangential radiographic view before and after specific training. Without prior instruction, 13 observers interpreted the dorsal tangential view of cadaveric specimens, in which anterior radial plates were placed. After seeing a training video on the dorsal tangential view, they repeated the task. Though we found that accuracy and interobserver agreement was lower than described in some other clinical series, training led to statistically significant improvements of (1) the interobserver agreement on the decision to exchange screws, (2) the self-confidence of the surgeon in obtaining adequate views, and (3) the number of fluoroscopic images required to obtain these views. After training, the number of protruding screws missed was reduced by 36%, but 7% of dorsally protruding screws was still missed.
Topics: Bone Plates; Bone Screws; Cadaver; Fracture Fixation, Internal; Humans; Radius; Radius Fractures
PubMed: 32041470
DOI: 10.1177/1753193419898060 -
Techniques in Hand & Upper Extremity... Jun 2014Three commonly used approaches for the proximal interphalangeal joint replacement are volar, lateral, and dorsal approach. The advantages and disadvantages of these...
Three commonly used approaches for the proximal interphalangeal joint replacement are volar, lateral, and dorsal approach. The advantages and disadvantages of these techniques are discussed. We describe a new option for approaching the proximal interphalangeal joint dorsally that has the advantage of maintaining near complete extensor apparatus integrity, and therefore allows early mobilization.
Topics: Arthritis; Arthroplasty, Replacement, Finger; Finger Joint; Humans
PubMed: 24637742
DOI: 10.1097/BTH.0000000000000042 -
Hand Surgery & Rehabilitation Oct 2020The pedicled flap from the first dorsal branch of the proper palmar digital artery (FBPPDA) of the fingers is an option for reconstructing digital skin defects. It has...
The pedicled flap from the first dorsal branch of the proper palmar digital artery (FBPPDA) of the fingers is an option for reconstructing digital skin defects. It has the advantage of being innervated by the dorsal branch of the proper palmar digital nerve (DBPPDN) associated with the artery. However, no studies on the anatomical variations of the neurovascular pedicle have been performed yet. The objective of our study was to evaluate the anatomical variations in the neurovascular pedicle, determine its relationships with other anatomical structures, describe the dissection technique for the FBPPDA and explore potential indications. We conducted an anatomical study with eight upper limbs from fresh adult cadavers. Twenty-six fingers (6 index, 6 middle, 8 ring, 8 little) were dissected after intra-arterial silicone injection. We found a pedicle composed of the FBPPDA and the DBPPDN in all fingers. The artery arises an average 19mm from the bifurcation of the common palmar digital artery. The DBPPDN's configuration relative to the FBPPDA varied; in the main variant - found in 58% of cases - the nerve was superficial and proximal position to the artery. After its origin, the pedicle ran on the superficial aspect of the extensor hood along an oblique path from proximal to distal and from palmar to dorsal. Its path ended with its penetration into the skin paddle of the flap just upstream the proximal interphalangeal (PIP) joint. The skin paddle corresponded to the functional skin unit represented by the dorsal surface of the middle phalanx and that of the PIP joint. Its average length was 33mm (26-40) and its average width was 21mm (15-30). The arc of rotation was sufficient to reach homodigital and heterodigital cutaneous defects. Based on our findings, this flap is a reliable and reproducible option for finger skin defects. The size of its paddle and its innervation make it an interesting alternative to conventional flaps.
Topics: Cadaver; Fingers; Humans; Surgical Flaps
PubMed: 32408007
DOI: 10.1016/j.hansur.2020.03.008 -
The Journal of Hand Surgery Apr 2020Intraoperative assessment of distal radioulnar joint (DRUJ) alignment is often based on lateral radiographs whose interpretation is dependent upon positioning the...
PURPOSE
Intraoperative assessment of distal radioulnar joint (DRUJ) alignment is often based on lateral radiographs whose interpretation is dependent upon positioning the forearm in neutral rotation. The dorsal tangential view (DTV) is a near-axial view of the dorsal wrist used in assessing dorsal screw penetration during radius fixation. The purpose of this study was to determine whether the DTV can also reliably assess DRUJ alignment in multiple forearm positions.
METHODS
Four transhumeral cadaveric specimens were used to simulate an unstable DRUJ. The stabilizing soft tissue structures of the DRUJ were sectioned. Fluoroscopic DTV images were obtained with the DRUJ of each specimen held in 5 positions: dorsally dislocated, dorsally subluxated, reduced, volarly subluxated, and volarly dislocated. In each position, images were taken with the forearm in neutral rotation, full pronation, and full supination. Three observers independently assessed DRUJ position on DTV images. Intra- and interobserver reliability were assessed in each forearm position.
RESULTS
Observers correctly identified DRUJ position as reduced, volarly malreduced, or dorsally malreduced on 94% of the DTV images (97%, 95%, and 92% in the neutral, supinated, and pronated forearm positions, respectively). Weighted kappa values for intraobserver reliability were 0.965, 0.964, and 0.965 for the 3 observers. The mean kappas for intraobserver reliability were 1.000, 0.967, and 0.930 with the forearm in neutral, supinated, and pronated positions, respectively. Weighted kappa values for interobserver reliability between paired observers were 0.948, 0.912, and 0.929. The mean kappa for interobserver reliability was 0.926, 0.931, and 0.930 for the forearm in neutral, supinated, and pronated positions, respectively.
CONCLUSIONS
The DTV reliably demonstrated the position of the DRUJ independent of forearm rotation in a cadaveric model.
CLINICAL RELEVANCE
Surgeons may consider the DTV as another tool for fluoroscopic verification of the DRUJ reduction in the operating room or clinic.
Topics: Biomechanical Phenomena; Cadaver; Forearm; Humans; Joint Instability; Pronation; Radius; Reproducibility of Results; Supination; Ulna; Wrist Joint
PubMed: 31537400
DOI: 10.1016/j.jhsa.2019.08.004