Comparison of patient preferences and responsiveness among common patient-reported outcome measures for hand/wrist injuries or disorders.

Background: Patient-reported outcome measures (PROMs) were developed to examine patients' perceptions of functional health. Most studies compare the responsiveness of each type of questionnaire. However, reports of patient preferences among PROMs commonly used with patients with hand/wrist injuries or disorders are limited.

Dynamic analysis of the ulnar nerve and cubital tunnel morphology using ultrasonography: a cadaveric study.

Background: The causes of ulnar neuropathy at the elbow are unclear. The authors hypothesized that the humeral trochlea protrudes into the cubital tunnel during elbow flexion and causes a dynamic morphologic change of the ulnar nerve in the cubital tunnel.

Methods: An ultrasonic probe was fixed to the ulnar shafts of 10 fresh cadavers with an external fixator, and dynamic morphology of the cubital tunnel and ulnar nerve was observed.

A reverse form of Linburg-Comstock variation with comments on its etiology and demonstration of interactive 3D portable document format.

Purpose: Two most common variations of flexor pollicis longus include its accessory head and its connection with the flexor digitorum profundus of the index (Linburg-Comstock variation). In addition, while three-dimensional (3D) screening has widely been used in anatomical education, its use as reporting tool in anatomical research is still limited. The objective of this study is to report a previously unrecognized form of the accessory head of flexor pollicis longus, discuss the potential etiology of Linburg-Comstock variation, and pilot the 3D scanning of a large-scale anatomical structure.

Treatment of painful median nerve neuroma using pedicled vascularized lateral antebrachial cutaneous nerve with adipofascial flap: a cadaveric study and exploration of clinical application.

The most common procedure for the treatment of painful median nerve neuroma is coverage with vascularized soft tissue following external neurolysis. However, the ideal treatment should include reconnecting the proximal and distal stumps of the damaged nerve to allow the growth of regenerating axons to their proper targets for a functional recovery. We developed a useful technique employing radial artery perforator adipofascial flap including the lateral antebrachial cutaneous nerve (LABCN) to repair the median nerve by vascularized nerve grafting and to achieve coverage of the nerve with vascularized soft tissue.

Osteocutaneous proximal fibular flap: an anatomical and computed tomographic angiographic study of skin and bone perforators.

Introduction: Vascularized proximal fibular epiphyseal transfer is a reconstruction method for joints and growing bones. The authors investigated the vascular supply of the proximal fibula, including skin perforators, for suitability in creating an osteocutaneous flap.

Methods: Twenty fresh cadaveric knees were studied using computed tomographic angiography combined with anatomical dissection.

Vascularized pedicled bone graft from the distal radius supplied by the anterior interosseous artery for treatment of ulnar shaft nonunion: An anatomical study of cadavers and a case report.

Background: A vascularized distal radius graft can be a reliable solution for the treatment of refractory ulnar nonunion. The aim of this study is to establish the anatomical basis of a vascularized bone graft pedicled by the anterior interosseous artery and report its clinical application, using cadaveric studies and a case report.

Methods: Fourteen fresh frozen cadaveric upper limbs were used.

Reverse vascularized bone graft of the lateral distal humerus for non-union of the radial neck fracture: anatomical study and case report.

A few treatment options for radial neck non-union have been reported, including radial head excision, radial head replacement, and internal fixation with a bone graft. We describe a new treatment for radial neck non-union using a reverse vascularized bone graft of the lateral distal humerus. In the anatomical study, the posterior radial collateral artery (PRCA) was dissected in eight fresh-frozen cadaver arms.

Double Motor Nerve Transfer for All Finger Flexion in Cervical Spinal Cord Injury: An Anatomical Study and a Clinical Report.

Purpose: To explore the feasibility of restoring all finger flexion after a cervical spinal cord injury.

Methods: Double nerve transfer was conducted in 22 cadaver upper extremities. Donor nerves were the brachialis branch of the musculocutaneous nerve and the extensor carpi radialis brevis (ECRB) branches of the radial nerve.

Anatomical Study of the Popliteal Artery Perforator-Based Propeller Flap and Its Clinical Application.

There is lack of anatomical information regarding the cutaneous perforator of the popliteal artery and its connections with the descending branch of the inferior gluteal and profunda femoris arteries. The authors aimed to evaluate the anatomical basis of the popliteal artery perforator-based propeller flap from the posterior thigh region and to demonstrate their experience using this flap. Ten fresh cadaveric lower extremities were dissected following injection of a silicone compound into the femoral artery.

Descending genicular artery free flaps: Multi-purpose tissue transfers in limb reconstruction.

Background: The descending genicular artery supplies skin, muscle, tendon, and bone structures in the medial knee area. Three types of skin perforator including musculocutaneous perforators through the vastus medialis (descending genicular artery perforator (DGAP)-vm), direct cutaneous perforators (DGAP), and saphenous artery perforators (SAP) can be elevated for the skin flap component.

Methods: This study included a prospective cohort of all patients in whom a descending genicular artery free flap was attempted in our center since January 2009.

Wide awake technique versus local anesthesia with tourniquet application for minor orthopedic hand surgery: a prospective clinical trial.

Background: Most minor hand operations can be performed with local anesthesia and tourniquet. Some literature supports this concept based on the believe that the "patient can tolerate it". Nowadays, the wide-awake technique with epinephrine- contained lidocaine is safe.

Pull-out strength of 0°/30° Kirschner wire syringe external fixators with and without polymer augmentation: a biomechanical study.

Background: Hand external fixators are in use worldwide and insulin syringes can generally be found in an operating room.

Objective: To compare the pull-out strength between degrees of Kirschner wire fixation (0° and 30°) and the effect of filling an insulin syringe with polymer

Material And Method: Pull-out strength was compared between a syringe externalfixator and a bone or plastic tube model. Fifty-two plastic tube models and 20 dry phalangeal bones were included The syringe external fixator was attached via two Kirschner wires.

Cadaveric study of superficial palmar arch variations in northern Thai population by using epoxy resin injection technique.

Background: Superficial palmer arch (SPA) is the main source of arterial supply to the palm whileprincepspollicis artery is the main source of arterial supply to the thumb. The details about their possible variations are important for the reconstructive hand surgeons.

Objective: To find out the SPA patterns and arterial supply of thumb variations in Thai population by using epoxy resin injection technique.

Biceps femoris musculocutaneous flap for reconstruction of refractory ulceration at the popliteal fossa.

Background: There is a lack of information about the possibility of transfer of the long head of the biceps femoris (LHBF) musculocutaneous flap to the knee area. We discuss the use of the LHBF musculocutaneous flap to treat refractory ulceration at the popliteal fossa and the results of a preliminary study investigating the anatomical possibility of transferring this flap to the popliteal region.

Methods: Five lower extremities of 5 fresh cadaveric specimens were dissected following injection of a silicone compound into the deep femoral artery.

Anatomical variations of the saphenous and descending genicular artery perforators: cadaveric study and clinical implications for vascular flaps.

Background: With increasing use of free vascular flaps of the saphenous artery and descending genicular artery, the authors investigated the anatomical variations in cadavers.

Methods: Thirty-one fresh cadaveric thighs were studied by anatomical dissection. The perforators and their source arteries were skeletonized along their courses to the superficial femoral artery and measured.

Reconstruction of limb soft-tissue defects: using pedicle perforator flaps with preservation of major vessels, a report of 45 cases.

We report on 45 pedicle perforator flaps without harvesting major vessels in limb reconstruction. Of our patients, 25 had major vessel injury resulting from their initial injury. In the upper extremities, there were 13 posterior interosseous artery perforator flaps, four ulnar artery perforator flaps and three radial artery perforator flaps.

Flow-through anterolateral thigh flap for simultaneous soft tissue and long vascular gap reconstruction in extremity injuries: anatomical study and case report.

47 dissections of cadaver thigh were studied to investigate pedicle configurations in the lateral descending branch of the lateral circumflex femoral arterial system, which can be used in harvesting a flow-through anterolateral thigh flap. The descending branch arose from the lateral circumflex femoral artery in 38 of the dissections, and the mean diameter at its origin was 3.0mm (range, 2.

Soft-tissue injury in orthopaedic trauma.

This paper reviews the current concepts of soft-tissue injury in orthopaedic trauma. Six topics are described in this Injury Supplement, including influencing factors and mechanisms, co-morbidities, biological responses, diagnosis and treatment of closed soft-tissue injury, compartment syndrome and gunshot wounds. Since one of the current AO principles emphasises respect for soft tissue when performing open reduction and internal fixation, this article further discusses the pathophysiology of soft-tissue injury and the specific concerns in treating compartment syndrome and gunshot injury.

Anatomic variance in common vascular pedicle of the gracilis and adductor longus muscles: feasibility of double functioning free muscle transplantation with single pedicle anastomosis.

Fifty thighs from fresh human cadavers were studied to evaluate the feasibility of a double functioning free muscle transfer of the gracilis and adductor longus with single common vascular pedicle anastomosis. Methylene blue intra-arterial injection and loupe-magnified dissection were used to demonstrate three groups of vascular patterns in these two muscles. The common vascular pedicles of 88% of our specimen muscles were long enough for possible anastomosis.

Quantitative characterization of regenerating axons after end-to-side and end-to-end coaptation in a rat brachial plexus model: a retrograde tracer study.

The efficacy of end-to-side repair as a method of nerve reconstruction has been questioned, and most studies that characterize the mode of re-innervation are marred by inappropriate experimental design and lack quantitative analysis. This makes characterization of re-innervating neurons confusing and consequently controversy remains as to the extent and source of reinnervating axons. In an experimental brachial plexus rat model, we transected the musculocutaneous nerve, labeled its neuron pool with Fast-Blue and joined the distal stump to the side of the intact ulnar nerve, or to the proximal stump of the divided ulnar nerve, to characterize neurons that reinnervate the recipient nerve.

Chinese herbal recipe versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial [ISRCTN70292892].

Background: Duhuo Jisheng Wan (DJW) is perhaps the best known and most widely used Chinese herbal recipe for arthralgia, but the clinical study to verify its efficacy is lacking. The purpose of this study was to compare the efficacy of DJW versus diclofenac in symptomatic treatment of osteoarthritis (OA) of the knee.

Methods: This study was a randomized, double-blind, double-dummy, controlled trial.

Microsurgical second toe-metatarsal bone transfer for reconstructing congenital radial deficiency with hypoplastic thumb.

This study describes a consecutive series of 11 children who received a microsurgical second toe-metatarsal bone transfer for reconstructing a hypoplastic thumb associated with radial club hand, between 1996 and 2000. The parents refused pollicization in all cases for aesthetic and cultural reasons. Surgery was intended to improve hand function and cosmetic appearance.

Electroacupuncture versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial.

Background: The purpose of this study was to compare the efficacy of electroacupuncture (EA), diclofenac and their combination in symptomatic treatment of osteoarthritis (OA) of the knee.

Methods: This study was a randomized, single-blind, placebo controlled trial. The 193 out-patients with OA of the knee were randomized into four groups: placebo, diclofenac, EA and combined (diclofenac plus EA).