Pain Relief after Surgical Decompression of the Distal Brachial Plexus.

 Brachial plexopathy causes pain and loss of function in the affected extremity. Entrapment of the brachial plexus terminal branches within the surrounding connective tissue, or medial brachial fascial compartment, may manifest in debilitating symptoms. Open fasciotomy and external neurolysis of the neurovascular bundle in the medial brachial fascial compartment were performed as a surgical treatment for pain and functional decline in the upper extremity.

Surgical Intervention for Spastic Upper Extremity Improves Lower Extremity Kinematics in Spastic Adults: A Collection of Case Studies.

Background: Spasticity of the upper extremity often occurs after injury to the upper motor neurons (UMN). This condition can greatly interfere with the hand positioning in space and the functional use of the arm, affecting many daily living activities including walking. As gait and balance involve the coordination of all segments of the body, the control of upper limbs movement is necessary for smooth motion and stability.

Multimodality Approach to a Stener Lesion: Radiographic, Ultrasound, Magnetic Resonance Imaging, and Surgical Correlation.

The ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint is a static stabilizer that may rupture from a hyperabduction injury. Although some UCL tears may heal with immobilization, outcomes are worse for Stener lesions, in which the proximal ligament stump slips out from beneath the adductor pollicis aponeurosis and is entrapped proximal and superficial to the aponeurosis, preventing primary healing. We report the case of a patient with a Stener lesion with radiographic, ultrasound, and magnetic resonance imaging correlation, subsequently confirmed with intraoperative photographs.

Acute compartment syndrome of the upper extremity.

Acute compartment syndrome occurs when pressure within a fibro-osseous space increases to a level that results in a decreased perfusion gradient across tissue capillary beds. Compartment syndromes of the hand, forearm, and upper arm can result in tissue necrosis, which can lead to devastating loss of function. The etiology of acute compartment syndrome in the upper extremity is diverse, and a high index of suspicion must be maintained.

Acute pediatric upper extremity compartment syndrome in the absence of fracture.

Background: To determine the etiologies and outcomes associated with acute pediatric upper extremity compartment syndrome in the absence of fracture.

Methods: A retrospective review was performed looking at children treated for acute upper extremity compartment syndrome in the absence of fracture at a major teaching hospital. Reason for admission, age, etiology, sensorium, time to fasciotomy, involved compartments, secondary procedures, and functional outcome were recorded.

Extensor retinaculum capsulorrhaphy for ulnocarpal and distal radioulnar instability: the Herbert sling.

Wrist pain and instability are challenging problems that may be the result of pathology at the distal radioulnar (DRUJ) or ulnocarpal joints or both. Instability of the wrist can often be attributed to a compromise of the integrity of the triangular fibrocartilage complex (TFCC), a key soft tissue stabilizer of the DRUJ and ulnocarpal articulations. Subsequently, when surgical reconstruction is indicated, techniques should strive to restore the biarthrodial function of the TFCC.

The Injury Distress Index: development and validation.

Objective: To develop and validate a new measurement tool designed to assess self-reported distress responses after traumatic physical injury.

Design: A mixed-methods study design was used. Development of the Injury Distress Index (IDI) included input from patients and experts and a comprehensive literature review.

The use of tricorticocancellous bone graft in severely comminuted intra-articular fractures of the distal radius.

Purpose: We report the results of a retrospective study of the use of tricorticocancellous iliac crest bone graft in 12 patients with acute AO type C3.2 or type C3.3 fractures of the distal radius who were followed up for at least 1 year.

Imaging of athletic wrist and hand injuries.

Sports-related injuries of the wrist and hand are commonly encountered in clinical practice. Athletic injuries create special challenges for the orthopedic surgeon and radiologist, as these patients expect to recover quickly and return to the same athletic endeavors that caused their original injuries. A thorough understanding of the mechanism of injury and imaging findings are necessary for accurate diagnosis and effective therapy.

The role of soft tissues in plate fixation of proximal phalanx fractures.

The tension band effect of plate fixation and the contribution of soft tissues to that effect was examined biomechanically in human proximal phalanges. Forty-six proximal phalanges in whole cadaver hands with all soft tissues in place (intact) and 43 proximal phalanges stripped of soft tissues (denuded) were tested. After midshaft osteotomy, each proximal phalanx was fixed internally with a dorsal minicondylar plate, a lateral minicondylar plate, a dorsal straight plate, or a lateral straight plate.

Role of soft tissues in metacarpal fracture fixation.

The contribution of soft tissues in stabilizing fracture fixation in metacarpals is appreciated clinically, but no quantitative biomechanical study of their role has been done. All previous studies of fracture fixation in vitro have been done on metacarpals denuded of soft tissues. To quantify the role of soft tissues in metacarpal fracture fixation, the biomechanical effectiveness of four fixation devices was examined in human cadaver metacarpals with and without soft tissues.