Words to Avoid During Wide-awake Local Anesthesia No Tourniquet Surgery to Enhance Patient Experience.

In the evolving landscape of ambulatory surgery, wide-awake local anesthesia no tourniquet (WALANT) surgery has emerged as a preferred approach due to its efficacy, cost-effectiveness, and patient satisfaction. This paradigm shift places the patient at the center of intraoperative communication, requiring a significant change in the dialogue within the operating room (OR). Traditional conversations, which often exclude the unconscious patient, must evolve to accommodate and prioritize the psychological comfort of the conscious patient.

Management of Lacertus syndrome: Perspectives for hand therapists.

Lacertus syndrome presents a diagnostic and therapeutic challenge for hand therapists, requiring a comprehensive understanding of its clinical manifestations, diagnostic considerations and evidence-based therapeutic interventions. The present article aims to provide hand therapists with practical insights into recognizing and treating Lacertus syndrome, highlighting nerve gliding exercises, muscle stretching and ergonomic education. By addressing symptom management and preventive strategies, therapists can help patients relieve lacertus syndrome symptoms, optimize functional outcome and improve occupational status.

Bilateral hand dystonia following high-velocity thrust manipulation: a case report.

Thrust manipulation is one of the most commonly used techniques for managing musculoskeletal pain in clinical practice. This involves the application of a high-velocity, low-amplitude force directed to the joints with the intent of achieving joint cavitation. This current case report describes a female in her mid-20s who presented with excessive bilateral and involuntary hand muscle contractions after bilateral thrust manipulation.

Elevating patient experience: Transformative strategies in hand therapy.

This paper explores transformative strategies in hand therapy aimed at improving the patient experience - a critical factor linked to improved clinical outcomes and increased satisfaction for patients and therapists. The focus is on three key areas: personalized interactions, empathic communication, and sensory engagement. Personalized interactions ensure therapy is uniquely tailored to each patient' needs, fostering a sense of individual attention and care.

"Pronation Compensation Sign" as a New Diagnostic Tool for Carpal Tunnel Syndrome: A Prospective Preliminary Study.

Purpose: Carpal tunnel syndrome (CTS) is commonly encountered in clinical practice. Diagnostic tools that currently exist include painful provocative maneuvers, invasive nerve conduction studies and the use of tests that require physician's direct participation in an era of sanitary crisis and virtual consultations. Therefore, having an easily accessible, reliable and practical tool for diagnosing CTS would be highly beneficial.

Lacertus notch as a sign of lacertus syndrome.

Objective: Many clinicians are unfamiliar with a diagnosis of lacertus syndrome (LS). We investigated the value of the lacertus notch sign in diagnosing LS.

Methods: We included 56 consecutive patients (112 upper extremities) who had neuropathic pain and neurological symptoms of the hand.

Description of WALANT technique in open bone and ligament wrist surgery.

The gold-standard for bone, ligament and joint surgery in the wrist is locoregional anesthesia in most countries. Wide-Awake Local Anesthesia No Tourniquet (WALANT) is commonly used for simple soft-tissue hand surgery procedures such as carpal tunnel or trigger finger release, and can now also be safely used in procedures such as proximal row carpectomy, scapholunate ligament repair or partial wrist fusion, to name but a few. This article describes the use of WALANT for complex surgery in the wrist.

Tips, Tricks, and Pearls for a Superior Patient and Surgeon Experience for Wide-awake Dupuytren Surgery.

Fasciectomy for Dupuytren disease is a common procedure traditionally performed with a tourniquet under general or regional anesthesia. Since the year 2001, the wide-awake local anesthesia no tourniquet (WALANT) approach has been applied successfully to Dupuytren surgery, with current excellent surgeon and patient satisfaction. However, using WALANT for Dupuytren surgery may be intimidating for hand surgeons who want to begin using this method.

Tremor Induced by Focal Peripheral Nerve Entrapment: A Case Series.

Little is known about tremors caused by peripheral nerve entrapment. We report two cases of tremors caused by peripheral nerve compressions. Two patients presented with intentional tremors combined with peripheral nerve compression symptoms on their affected hand.

How to Create an Exceptional Hand Surgery Patient Experience with WALANT.

This article provides practical tips that surgeons can use to improve their patient experience with wide awake local anesthesia no tourniquet hand surgery. The difference between patient satisfaction and patient experience is explained. Delivering a superior patient experience leads to better outcomes for patients, less postoperative complications, and a better quality of life and practice for the surgeon.

Long lifetime of bialkali photocathodes operating in high gradient superconducting radio frequency gun.

High brightness, high charge electron beams are critical for a number of advanced accelerator applications. The initial emittance of the electron beam, which is determined by the mean transverse energy (MTE) and laser spot size, is one of the most important parameters determining the beam quality. The bialkali photocathodes illuminated by a visible laser have the advantages of high quantum efficiency (QE) and low MTE.

High-Brightness Continuous-Wave Electron Beams from Superconducting Radio-Frequency Photoemission Gun.

Continuous-wave photoinjectors operating at high accelerating gradients promise to revolutionize many areas of science and applications. They can establish the basis for a new generation of monochromatic x-ray free electron lasers, high-brightness hadron beams, or a new generation of microchip production. In this Letter we report on the record-performing superconducting rf electron gun with CsK_{2}Sb photocathode.

Design of a high-bunch-charge 112-MHz superconducting RF photoemission electron source.

High-bunch-charge photoemission electron-sources operating in a continuous wave (CW) mode are required for many advanced applications of particle accelerators, such as electron coolers for hadron beams, electron-ion colliders, and free-electron lasers. Superconducting RF (SRF) has several advantages over other electron-gun technologies in CW mode as it offers higher acceleration rate and potentially can generate higher bunch charges and average beam currents. A 112 MHz SRF electron photoinjector (gun) was developed at Brookhaven National Laboratory to produce high-brightness and high-bunch-charge bunches for the coherent electron cooling proof-of-principle experiment.

Evaluation of factors influencing confidence and trust in the patient-physician relationship: a survey of patient in a hand clinic.

Objectives: The purpose of this study was to identify the skills found most important to gain patient's trust from a patient's perspective.

Methods: One hundred and twenty-two patients were surveyed prospectively using a questionnaire assessing professionalism, physical environment, verbal and non-verbal communication skills. Factors required to establish a trusting patient-surgeon relationship were ranked in order of importance before and after initial consultation with a surgeon in a hand surgery clinic model.

Wound healing assessment: does the ideal methodology for a research setting exist?

Introduction: Studies on dressings frequently measure wound healing to demonstrate performance. Knowledge of existing methodologies available for wound healing assessment, including their advantages and limitations, is paramount when evaluating the literature on dressings.

Methodology: Medline and Cochrane databases were searched for wound healing assessment methodologies used in research or in clinical practice.

Mechanical failure of a Fogarty catheter in a microsurgical procedure: a case report.

Although microvascular free-tissue transfer has become a reliable reconstructive method, vascular compromise of the flap necessitating surgical exploration and attempts at flap salvage commonly occurs. Thrombectomy using Fogarty vascular catheters can be used in the setting of vascular pedicle thrombosis. However, this is not without potential complications.

Modified flexor digitorum superficialis slip technique for A4 pulley reconstruction.

We describe a variation in the A4 pulley reconstruction technique using one slip of the flexor digitorum superficialis insertion and report the results of a biomechanical analysis of this reconstruction in cadavers. While conserving the distal bony insertion, one slip of flexor digitorum superficialis is transferred over the flexor digitorum profundus tendon and sutured to the contralateral superficialis slip insertion. This creates a new pulley at the base of the original A4 pulley that can be adjusted to accommodate an FDP repair of increased bulk.

Merkel cell carcinoma of the hand: case report and literature review.

We are reporting on a 72-year-old male who was diagnosed with Merkel cell carcinoma on the dorsal aspect of his left index finger. This rare highly aggressive malignancy of the skin has only exceptionally been described on the finger or hand. This case report helps review important findings associated with this rare malignancy and reviews the pertinent literature.