The Journal of hand surgery
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Fractures of the scaphoid are the most common surgically treated carpal fracture, and early diagnosis is critical to minimize complications including osteonecrosis. If the initial radiographs after the injury are inconclusive, early magnetic resonance imaging (MRI) provides an immediate diagnosis to allow for proper management. This has been shown to be cost effective both in direct measureable costs and likely in difficult-to-measure indirect costs related to lost productivity. ⋯ MRI is the best imaging modality for assessing osteonecrosis of the proximal pole in a scaphoid nonunion. Unfortunately, the most useful imaging sequences remain controversial. My institution relies on the noncontrast T1-weighted images for the primary diagnosis of osteonecrosis with dynamic contrast enhancement used in a supplemental fashion.
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Fractures of the tubular bones of the hand are common and potentially debilitating. The majority of these injuries may be treated without an operation. ⋯ The history and mechanisms of these fractures are discussed, as are treatment options and common complications. Early mobilization of the fractured hand is emphasized because soft tissue recovery may be more problematic than that of bone.
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Review Case Reports
Iatrogenic burn caused by an operating microscope: case report.
We present a patient who experienced a burn from an operating microscope during surgery for a brachial plexus birth palsy, a literature review, and recommendations on how to avoid such injuries.