Accuracy of in-office nerve conduction studies for median neuropathy: a meta-analysis.

Purpose: Carpal tunnel syndrome is the most common focal neuropathy. It is typically diagnosed clinically and confirmed by abnormal median nerve conduction across the wrist (median neuropathy [MN]). In-office nerve conduction testing devices facilitate performance of nerve conduction studies (NCS) and are used by hand surgeons in the evaluation of patients with upper extremity symptoms.

The scientific basis for advances in flexor tendon surgery.

During the last 40 years, there has been an enormous amount of basic scientific research designed to improve our knowledge of the structure of tendons, the biomechanics of their action, their biologic response to injury and repair, the mechanical characteristics of various tendon suture methods, and the effect of postrepair motion stress on tendon strength and healing. These investigative efforts have given rise to improved methods of tendon repair and protocols for the early application of passive and active wrist and digital motion as a means to more rapidly increase the strength and gliding of repaired tendons. The surgical techniques of hand surgeons and the rehabilitation protocols of hand therapists have improved enormously from these scientific efforts and the results of flexor tendon repair have become much more reliable.

Delayed treatment of flexor tendon injuries including grafting.

This article synthesizes an enormous amount of peer reviewed articles, book chapters, and anecdotal clinical information regarding the late management of flexor tendon injuries by free-tendon grafting, tenolysis, and staged reconstruction. Some of the most pertinent historical contributions to these subjects have been reviewed in concert with an update regarding the most widely used current clinical methods for performing these procedures. This article points out areas of controversy and references the dissenting opinions from those presented here.

Flexor tendon repair and rehabilitation: state of the art in 2002.

Basic science and clinical investigation have advanced significantly the treatment and the outcome following intrasynovial flexor tendon repair and rehabilitation and reconstruction over the past 30 years. The application of modern multistrand suture repair techniques as well as postoperative rehabilitation protocols emphasizing the application of intrasynovial repair site excursion has led to a protocol for treatment of intrasynovial flexor tendon lacerations emphasizing a strong initial repair followed by the application of postoperative passive motion rehabilitation. Protocols for the reconstruction of failed initial treatment have likewise undergone modification given new findings on the biologic and clinical behavior of flexor tendon grafts.