The Journal of hand surgery
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Comparative Study
Treatment of unstable distal ulna fractures associated with distal radius fractures in patients 65 years and older.
To prospectively compare the clinical and radiological outcomes of 2 treatment methods for unstable distal ulna fractures associated with distal radius fractures in patients 65 years of age and older. ⋯ In this population distal ulna fractures can be successfully managed nonoperatively when they occur in combination with distal radius fractures.
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Regional anesthesia has become the preferred method of anesthesia for many upper extremity operations and generally results in decreased hospital stays, postoperative opioid requirement, and postoperative nausea. Complications of regional anesthesia are rarely reported in the literature, possibly because of limited anesthesiologist-patient follow-up. ⋯ One case resulted in ipsilateral phrenic nerve palsy as well. A review of the literature on the subject accompanies the report of these 3 cases.
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Previous studies have investigated the long-term outcomes of ulnar shortening osteotomy (USO) in the treatment of ulnocarpal abutment syndrome (UCA), but none have used arthroscopic assessments. The purpose of this study was to investigate the long-term clinical outcomes of USO with patient-based, arthroscopic, and radiographic assessments. ⋯ Ulnar shortening osteotomy achieved excellent long-term results in most cases. Most TFCC disc tears identified at the initial surgery had healed by long-term arthroscopic follow-up. We suggest that UCA with a TFCC disc tear is a good indication for USO.
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Cartilage damage of the carpals is a contraindication for corrective osteotomy of the malunited intra-articular distal radius fracture and typically is treated in the symptomatic patient with a salvage procedure. Here, we present our experience and early results with arthroscopic resection arthroplasty of the radiocarpal joint. ⋯ The aim of the operation was to relieve patients' pain by providing a smooth, although fibrocartilaginous, surface for the carpus to glide on the radius. The follow-up was short and the results may be short-lived. However, for the younger patient, it may provide a temporary alternative to partial wrist arthrodesis with minimal morbidity, and for the less demanding patients, it may be a definitive procedure.
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To determine (1) the most distal site at which a tension band construct can maintain bony alignment during dynamic loading of a transverse, length-stable olecranon osteotomy; (2) the location of displacement during cyclical loading; and (3) the ultimate load to failure of the fixation. ⋯ Based on this biomechanical study, when it is properly executed, tension band wire fixation may be used effectively for transverse, length-stable fractures of the olecranon regardless of the amount of articular surface included on the proximal fragment.