The Journal of hand surgery
-
We describe a simple method in which a nearly selective sensory median nerve block is used for early motion exercises. In this method an 18-gauge epidural catheter with 3 side holes in the fine catheter tip is placed proximal to the carpal tunnel. A bolus of 5 mL of 0.25% bupivacaine is injected before a continuous infusion of 3 mL/60 min of 0.125% bupivacaine is started. This method allows a continuous and selective sensory blockade with preservation of motor function and proprioception for early motion after hand surgeries.
-
To study the vascularization of the fourth dorsal intermetacarpal space and to determine the contribution of the dorsal metacarpal artery and the interosseous muscle fascia to flap viability. The fourth dorsal intermetacarpal space is considered to be less reliable as a donor site because of previously reported vascular variations. ⋯ Reliable flaps can be raised from the fourth dorsal intermetacarpal space based solely on the distal recurrent branch, excluding the dorsal metacarpal artery and interosseous muscle fascia.
-
Randomized Controlled Trial Comparative Study
A comparison of immediate postreduction splinting constructs for controlling initial displacement of fractures of the distal radius: a prospective randomized study of long-arm versus short-arm splinting.
To compare, in a prospective, randomized manner, the sugar tong splint with a short-arm radial gutter splint in terms of patient satisfaction and the ability to maintain reduction of distal radius fractures. ⋯ Prognostic, level II.
-
Comparative Study
Volar fixation for dorsally angulated extra-articular fractures of the distal radius: a biomechanical study.
To compare the biomechanical properties of 10 volar plate-fixation designs in 2 fracture models (dorsal wedge osteotomy, segmental resection osteotomy models). ⋯ All of the plate-fixation systems delivered sufficient stability to permit the simulated postoperative regimen of 1 week of immobilization followed by 5 weeks of early mobilization until expected union at 6 weeks after surgery. Based on these results a preferable volar fixation system would appear to benefit from the following: (1) sufficient plate strength to support the distal fragment from the volar side, (2) a locking system with sufficient strength to remain locked during the healing process, and (3) a distal design that does not affect the bone adversely. The anatomic reduction of the volar cortex in the wedge osteotomy specimens added stability to the construct.