Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand
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Pathological lesions of long bones increase the morbidity of many common cancers. The orthopedic management of metastatic skeletal lesions can be challenging. The ultimate aim is to provide patients with a painless, functional limb. We present a report of two cases were a novel minimally invasive long bone nailing technique has been utilized to achieve skeletal stability and alleviation of symptoms.
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Randomized Controlled Trial Comparative Study
Proximal phalanx injection for trigger finger: randomized controlled trial.
Trigger finger is one of the most common upper extremity problems in the outpatient department. Conservative treatment is the mainstay for management of trigger digits especially steroid injection with highly satisfactory outcome and minimal complication. Conventional injection technique (CI) that approaches flexor tendon sheath over metacarpal head directly causes pain for most patients. ⋯ The P1I technique group had a significantly lower pain score than CI technique group (p < 0.001). The recurrence rate was 15% in the CI technique when compared to 25% in the P1I technique which was not significant (p = 0.685). We concluded that the P1I technique is less painful than the CI technique without any significant difference in recurrence rate between the two groups at three months follow-up.
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Comparative Study
Use of the volar fixed angle plate for comminuted distal radius fractures and augmentation with a hydroxyapatite bone graft substitute.
Treatment of distal radius fractures with a volar fixed angle plate achieves sufficient stabilisation and permits early physical exercise. However, secondary displacement after surgery sometimes occurs in elderly patients with a metaphyseal comminution and/or cases in which the subchondral support pegs were not placed immediately below the subchondral zone. ⋯ There were no significant differences between the two groups in terms of palmar tilt (P = 0.80) and radial inclination (P = 0.17); however, ulnar variance increased significantly in the group treated with a volar fixed angle plate without augmentation (P < 0.05). It might be useful to use a combination technique of a locking plate system and the hydroxyapatite bone graft substitute as augmentation to treat distal radius comminuted fractures in elderly patients.
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Wrist arthroscopy has been successfully used with many modifications and improvements. However, distal radioulnar joint (DRUJ) arthroscopy is still uncommon. We experienced 2 cases of ulnar-sided wrist pain due to isolated triangular fibrocartilage complex (TFCC) disk tear within the DRUJ. ⋯ Foveal attachment was intact in both cases. These were treated with debridement, which relieved pain after surgery and achieved good functional recovery. Although DRUJ arthroscopy is technically difficult, it is mandatory for making a diagnosis and treating ulnar-sided wrist pain.
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When tendons, bones or joints are exposed in infected digits, functional and cosmetic sequelae are frequent. We propose continuous negative pressure therapy with irrigation (NPI) for an infected digit with an open wound. ⋯ Acceptable functional and cosmetic results were obtained without any problems when continuous NPI was performed in the clinical case. Continuous NPI may be a useful alternative for treatment of an infected digit with an open wound.