Interdisciplinary consensus statements on imaging of DRUJ instability and TFCC injuries.

Objectives: The purpose of this agreement was to establish evidence-based consensus statements on imaging of distal radioulnar joint (DRUJ) instability and triangular fibrocartilage complex (TFCC) injuries by an expert group using the Delphi technique.

Methods: Nineteen hand surgeons developed a preliminary list of questions on DRUJ instability and TFCC injuries. Radiologists created statements based on the literature and the authors' clinical experience.

Benign subcutaneous emphysema: a rare and challenging entity .

We report the case of a craftsman who developed a rapidly progressive subcutaneous emphysema of his forearm after a minor stab injury into the palm of his hand. Based on our case report we discuss differential diagnosis and management of acute subcutaneous emphysema.

The Microvascular Peroneal Artery Perforator Flap as a "Lifeboat" for Pedicled Flaps.

Unlabelled: Pedicled perforator flaps have expanded reconstructive options in extremity reconstruction. Despite preoperative mapping, intraoperative findings may require microvascular tissue transfer when no adequate perforators can be found. The free peroneal artery perforator flap may serve as a reliable back-up plan in small defects.

Acute A4 Pulley Reconstruction with a First Extensor Compartment Onlay Graft.

Background: The integrity of the flexor tendon pulley apparatus is crucial for unimpaired function of the digits. Although secondary reconstruction is an established procedure in multi-pulley injuries, acute reconstruction of isolated, closed pulley ruptures is a rare occurrence. There are 3 factors influencing the functional outcome of a reconstruction: gapping distance between tendon and bone (E-space), bulkiness of the reconstruction, and stability.

Kirschner wire fixations for scapholunate dissociation: a cadaveric, biomechanical study.

Purpose: To compare 5 different Kirschner wire fixation techniques in terms of the failure loads seen as scapholunate (SL) dissociation in a cadaveric, biomechanical study.

Methods: 10 fresh-frozen, finger-amputated wrists with sectioned SL ligaments from 3 male and 2 female cadavers were tested. The change of SL angle, SL dissociation, and the load to failure of the 5 different Kirschner wire fixation techniques (using 1.

Palmar and dorsal fixed-angle plates in AO C-type fractures of the distal radius: is there an advantage of palmar plates in the long term?

Background: Current surgical approaches to the distal radius include dorsal and palmar plate fixation. While palmar plates have gained widespread popularity, few reports have provided data on long term clinical outcomes in comparison. This paper reports the result of a randomised clinical study comparing dorsal Pi plates and palmar, angle-stable plates for treatment of comminuted, intraarticular fractures of the distal radius over the course of twelve months.

The use of beta-tricalcium phosphate bone graft substitute in dorsally plated, comminuted distal radius fractures.

Background: Intraarticular distal radius fractures can be treated with many methods. While internal fixation with angle stable implants has become increasingly popular, the use of bone graft substitutes has also been recommended to address comminution zones and thus increase stability. Whether a combination of both methods will improve clinical outcomes was the purpose of the study

Methods: The study was thus conducted as a prospective randomized clinical trial.

Adequacy of palmaris longus and plantaris tendons for tendon grafting.

Purpose: The reconstruction of tendon defects is challenging. The palmaris longus and plantaris tendon are generally considered best for tendon grafting. Only a few studies have examined whether these tendons, when present, meet criteria for successful grafting.

Breast reduction by liposuction in females.

Background: Breast reduction by liposuction alone is an appealing technique that has failed to gain widespread acceptance. Despite numerous studies on liposuction, the majority of surgeons remain skeptical. This study aimed to review the indication and limitations of this procedure.

Reconstruction of soft tissue defects of the Achilles tendon with rotation flaps, pedicled propeller flaps and free perforator flaps.

Introduction: Soft tissue defects exposing the Achilles tendon are challenging. Local perforator flaps represent a valuable option gaining increasing popularity. Despite preoperative planning an adequate perforator cannot always be found intraoperatively.

Combination of a total free forearm flap and a sensate local flap for preservation of the shoulder girdle in massive, nonreplantable upper extremity injuries.

Background: After massive upper extremity injuries, prosthetic use might be complicated by the formation of pressure ulcerations. Especially the coverage with insensate free flaps may predispose the patient for developing chronic ulcerations when using an upper extremity prosthesis. This complication may be reduced when sensate local flaps are used to cover bony prominences.

The ageing hand. A study to evaluate the chronological ageing process of the hand.

The rejuvenation of the hand has received increased attention recently. Although many different methods have been advocated, only little is known about the chronological ageing process of the Caucasian hand. A qualitative study was performed to evaluate ageing changes.

The 180-degree perforator-based propeller flap for soft tissue coverage of the distal, lower extremity: a new method to achieve reliable coverage of the distal lower extremity with a local, fasciocutaneous perforator flap.

Background: Traumatic and nontraumatic defects of the distal third of the tibia are challenging in regard to soft tissue coverage. While local, pedicled fasciocutaneous perforator flaps allow adequate coverage, the donor site often requires skin grafting. When a local perforator flap is designed as a 180-degree propeller flap, an excellent esthetic result and direct closure of the donor site can be achieved, with minimal morbidity.

Digital amputation caused by climbing-rope entanglement.

Digital avulsions and amputations are not uncommon in outdoor activities. Rope entanglement is often the cause, though specific descriptions of the mechanism of injury have not been reported. We report a common scenario where entanglement during a fall resulted in an amputation injury.

Defining the basic aesthetics of the hand.

Background: Hand aesthetics have been poorly described because function is the main reason why patients consult a surgeon about their hands. Ideal proportions are based on normal anatomy, which is a prerequisite for aesthetics.

Methods: A literature review was performed.