The Journal of hand surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of transthecal and subcutaneous single-injection digital block techniques.
A randomized double-blinded study was performed on 20 normal volunteers to evaluate 2 different techniques of single-injection digital anesthesia. Single-injection transthecal digital block technique was used to anesthetize 1 index finger and single-injection subcutaneous technique to block the other index finger. Pain and light touch were evaluated and sensory nerve-conduction studies were performed on both index fingers. ⋯ The method of anesthesia was found to have no effect on the distribution, onset, and duration of anesthesia. Median and radial nerve sensory nerve action potential amplitude reductions following digital anesthesia were also not influenced by the technique of anesthesia. Single-injection subcutaneous block was found to be easier to administer and to produce less pain during and 24 hours after injection than did the single-injection transthecal technique.
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Randomized Controlled Trial Clinical Trial
Identification of low-effort patients through dynamometry.
In recent years researchers have devised a number of methods to detect patients who purposely exert low effort during grip evaluations. This study further defines the five-rung grip test introduced by Stokes and subsequently challenged by Niebuhr and Marion. New data are presented on the rapid exchange grip test. ⋯ No statistical difference between peak scores on five-rung and rapid exchange grip tests in sincere subjects was found. A statistical difference between peak scores in the low-effort groups was shown. A model has been developed that can be used to categorize patients into low effort or sincere groups.
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Randomized Controlled Trial Clinical Trial
Exogenous hyaluronate as an adjunct in the prevention of adhesions after flexor tendon surgery: a controlled clinical trial.
Postoperative adhesions that restrict tendon gliding are a major cause of failure after tendon repair and grafting in zone II. Several experimental reports have claimed that exogenously administered sodium hyaluronate helps to prevent the formation of such adhesions. In a prospective double-blind, randomized, clinical study with open therapeutic control sodium hyaluronate or physiologic saline solution was injected into the tendon sheath after completion of tenorrhaphy or tendon grafting in 120 digits. Sodium hyaluronate had no statistically significant effect as evaluated on total active motion at follow-up.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bupivacaine: a safe local anesthetic for wrist blocks.
Seventy-one patients having minor hand surgical procedures under wrist block anesthesia were studied, with the goal of identifying a possible neurotoxic potential of bupivacaine when used according to standard clinical practice. This drug was compared with lidocaine at equipotent analgesic concentrations (bupivacaine: 5 mg/ml; lidocaine: 20 mg/ml) by use of a double-blind randomized protocol. ⋯ In the remaining patient, anesthesia was induced with lidocaine, and no cause could be identified. It was concluded that bupivacaine, when used in clinical concentrations, is not associated with an increased incidence of neural complications.