The Journal of hand surgery
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Arthroscopic-assisted reduction and fixation of Bennett-type fractures of the thumb metacarpal allow for the confirmation of reduction as well as the assessment of the degree of chondral damage. With use of a 1.9-mm arthroscope and a traction tower, direct visualization and reduction is possible. ⋯ Postoperative rehabilitation follows the usual protocol used in both open and percutaneous techniques. However, the potential to obtain and confirm a more accurate articular reduction may reduce the incidence of late arthritis of the thumb carpometacarpal articulation.
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The Essex-Lopresti lesion, or radioulnar longitudinal dissociation, results from an axial load to the forearm with injury to the radial head and disruption of the interosseous membrane and the distal radioulnar joint. Unfortunately, an appreciation of the true extent of injury is not always realized in the acute setting, and patients present later with persistent or new reports of forearm discomfort and wrist and elbow pain. Reconstruction of the central band of the interosseous membrane with a bone-patellar tendon-bone graft is useful in the chronic setting and is described.