The Journal of hand surgery
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Comparative Study
Accuracy of fluoroscopy in closed reduction and percutaneous fixation of simulated Bennett's fracture.
Restoration of joint congruity has been shown to be an important factor in the prevention of arthritis in patients with Bennett's fracture. It is for this reason that surgical management is generally recommended for displaced intra-articular fractures of the base of the thumb metacarpal. Adequacy of closed reduction after pinning of Bennett's fracture is usually evaluated by fluoroscopic examination. The purpose of this study is to determine the accuracy of fluoroscopic examination compared to plain radiographs and direct visualization in closed reduction and percutaneous pin fixation of simulated Bennett's fractures. ⋯ After closed reduction and percutaneous pinning of simulated Bennett's fractures in a cadaver model, the assessment of the articular gap, stepoff, and displacement as detected by fluoroscopy is often in error compared to that detected by plain radiographs and direct examination.
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Radial head arthroplasty has developed into a reliable procedure to address fractures of the radial head not amenable to reconstruction, particularly when associated with an unstable elbow or forearm. Good to excellent results can be anticipated when used for the correct indications and when care is taken to understand and address the concomitant injuries. This article will discuss the technique of radial head arthroplasty in the context of the injuries that often accompany radial head fractures.
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A patient's reaction to a perceived increase in work demand may be related to his or her upper limb symptoms. The purpose of this study was to determine whether a brief measure of a patient's perception of how they respond to perceived increases in demands at work predicts pain levels and work status 6 months after an initial consultation with a hand surgeon. ⋯ Prognostic IV.