Dual Construct Fixation of the Scaphoid.

Dual construct fixation has been increasingly used in complex peri-articular or peri-prosthetic long bone fractures, those with poor bone quality and in revision situations. We describe the utilisation of a screw-plate construct in the setting of a juxta-articular distal pole scaphoid fracture, review the literature and provide recommendations for future use. Level V (Therapeutic).

Acute Mallet Finger Injuries-A Review.

Acute disruptions of the terminal extensor tendon are common and can result in significant dysfunction if not recognized and treated appropriately. This article provides a topical review of the contemporary literature concerning acute mallet finger injuries. It also proposes a modification to the Doyle classification to make it more encompassing and less prone to interobserver error.

The Anatomy of Nerve Transfers Used in Tetraplegic Hand Reconstruction.

Purpose: To evaluate the anatomy of nerve transfers used to reconstruct wrist extension, hand opening, and hand closing in tetraplegic patients.

Methods: Nerve transfers were completed on 18 paired cadaveric upper limbs. The overlap of donor and recipient nerves was measured, as well as the distance to the target muscle.

Evidence for efficacy of new developments in reconstructive upper limb surgery for tetraplegia.

Nerve transfers are increasingly utilized for upper limb reconstruction in tetraplegia. We reviewed the literature for results achieved by nerve transfers for elbow extension, wrist control and finger and thumb flexion and extension. Muscle strength grading was the only outcome measure consistently reported.

Midcarpal Arthrodesis Biomechanics: Memory Staples versus Cannulated Screws.

Background: Midcarpal arthrodesis is a treatment of choice in patients with midcarpal arthritis. Traditionally a four corner fusion has been favoured, however recent research has shown improved results when the triquetrum and scaphoid are excised. There is no clear evidence as to which remaining bones should be fused or which implants should be used.

An assessment of 2 objective measurements of web space position.

Purpose: To describe 2 simple objective clinical methods of measuring the web position between fingers and to determine their intra-observer and inter-observer reliabilities.

Methods: Two observers examined the second, third, and fourth web spaces on both hands of 30 adult healthy volunteers. The web index measured the web height as a relative ratio to constant anatomical landmarks on both fingers subtending the web.

Simultaneous four finger metacarpophalangeal joint fusions - indications and results.

Purpose: To review the results and indications of simultaneous four finger metacarpophalangeal joint fusions.

Methods: The clinical records and X-rays of nine patients undergoing the above procedure were reviewed. The indication for surgery was to reverse severe metacarpophalangeal joint flexion deformities in eight patients, and following a traumatic four finger amputation in one.

Rehabilitation of speech and swallowing after burns reconstructive surgery of the lips and nose.

Rehabilitation of speech and swallowing postburns reconstructive surgery has not been previously described in detail in the literature. Severe facial burn injury requiring subsequent reconstructive surgery may result in complications including circumoral contracture and aesthetic and functional irregularities. These complications may manifest as facial and labial sensation deficits, poor oral access for intubation and oral/dental hygiene, and inadequate oral competence causing chronic drooling and poor articulation.

Massive hemorrhage in facial fracture patients: definition, incidence, and management.

Background: Significant hemorrhage from fractures of the midface is a recognized phenomenon, but because it is an uncommon occurrence, there is little in the literature to guide management of these patients.

Methods: The authors performed a retrospective study of life-threatening hemorrhage in facial fracture patients attending the Royal Adelaide Hospital over 20 years and report four recent cases.

Results: The incidence of massive hemorrhage was found to be 0.

An effective automated nutrition screen for hospitalized patients.

Objective: Screening for malnutrition-related complications (MRCs) in hospitalized patients would identify those requiring nutritional intervention and improve resource allocation. Brugler's simplified screening tool (MRCS) ranks the binary pattern of six readily available variables (categorical cutoff values for serum albumin [<31.5 g/L], lymphocyte count [<1.

Primary cutaneous zygomycosis in a burns patient: a review.

Cutaneous zygomycosis is an uncommon but potentially fatal disease. An illustrative case is used to highlight the difficulties in managing these burns patients followed by a review of the literature with special emphasis on the surgical management and outcomes in these patients. English language articles were identified using the MEDLINE database from 1966 to 2006, using key words zygomycosis and mucormycosis.