Return to Play After Forearm and Hand Injuries in the National Basketball Association.

Background: Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described.

Purpose: To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period.

Diagnosis, Treatment, and Return to Play for Four Common Sports Injuries of the Hand and Wrist.

Hand and wrist injuries in the high-level athlete are challenging because they may be underestimated by the patient, family, and team, and return to play may be longer than desired. The needs of the player and the team must be balanced with the long-term functional ramifications of the injury. Four common soft-tissue sports injuries are flexor digitorum profundus avulsion, flexor pulley rupture, extensor carpi ulnaris dislocation, and thumb metacarpophalangeal joint ulnar collateral ligament injury.

Treatment of swan neck deformity in cerebral palsy.

Swan neck deformity in patients with cerebral palsy can result from hand intrinsic muscle spasticity or overpull of the digital extensors. After accurate identification of the etiology of the deformity, surgical treatment is directed at correcting the underlying muscle imbalance. Intrinsic lengthening can be used to treat intrinsic muscle spasticity, whereas central slip tenotomy is employed when digital extensor overpull is the deforming force.

Long-term results following surgical treatment of elbow deformity in patients with cerebral palsy.

Purpose: To evaluate the long-term results of surgical intervention for elbow flexion deformity in cerebral palsy. We hypothesized that improvements in elbow extension and flexion posture angle at ambulation would be maintained over time with preservation of active flexion.

Methods: A total of 23 patients (23 elbows) were available for long-term follow-up.

Comparison of in vitro motion and stability between techniques for index metacarpophalangeal joint radial collateral ligament reconstruction.

Purpose: To evaluate a technique using interference screws to secure a tendon graft for reconstruction of the radial collateral ligament (RCL) of the index finger metacarpophalangeal (MCP) joint. We hypothesized that this technique would provide equivalent stability and flexion as a 4-tunnel reconstruction.

Methods: We isolated the RCL in 17 cadaveric index fingers.

Opinions regarding the management of hand and wrist injuries in elite athletes.

Injuries to the hand and wrist are commonly encountered in athletes. Decisions regarding the most appropriate treatment, the timing of treatment, and return to play are made while balancing desires to resume athletic activities and sound orthopedic principles. Little recognition in the literature exists regarding the need for a different approach when treating these injuries in elite athletes and the timing to return to play.

Anatomy of the radial collateral ligament of the index metacarpophalangeal joint.

Purpose: To describe the origin and insertion of the radial collateral ligament (RCL) of the index metacarpophalangeal (MP) joint, relative to the MP joint line and other landmarks readily discernible intraoperatively.

Methods: We dissected 17 fresh-frozen human cadaveric index fingers. We removed all overlying soft tissue from the MP joint except for the proper RCL.

Mechanics of an anatomical reconstruction for the thumb metacarpophalangeal collateral ligaments.

Purpose: This study biomechanically evaluated a technically easy variation of anatomical reconstruction of the thumb metacarpophalangeal (MCP) joint ulnar (UCL) and radial (RCL) collateral ligaments. Based on previous work describing the anatomical origin and insertion of these ligaments, we hypothesized that, using these attachment points, joint stability would be restored without significant loss of MCP flexion.

Methods: The collateral ligaments were isolated in 30 cadaveric thumbs (15 UCLs and 15 RCLs).

Anatomy of the thumb metacarpophalangeal ulnar and radial collateral ligaments.

Purpose: To describe the origin and insertion of the ulnar (UCL) and radial collateral ligaments (RCL) of the thumb metacarpophalangeal (MCP) joint.

Methods: We dissected 18 UCLs and 18 RCLs from fresh-frozen human cadaveric thumbs. We removed all soft tissue overlying the MCP joint, isolating the proper collateral ligaments.

Removal of locked volar plates after distal radius fractures.

Purpose: We present our experience with removal of locked volar distal radius plates and screws and note the indications for removal, types of plates removed, completeness of hardware removal, and complications occurring during plate removal.

Methods: We reviewed all distal radial volar locking plates removed at our institution from 2004 to 2009. A total of 28 patients operated on by 5 hand surgeons were identified.

The effect of altered hand position and motor skills on stereognosis.

Purpose: Poor stereognosis has been considered to be indicative of abnormal cerebral sensory function, and therefore a relative contraindication for upper extremity surgery in hemiplegic cerebral palsy. The effect of hand position and motor function on stereognosis has not been studied; decreased hand mobility can decrease a person's ability to recognize objects in the hand and can be an important component of stereognosis.

Methods: Twenty-one normal subjects had their nondominant arm positioned to simulate the hemiplegic hand posture of forearm pronation and wrist and digital flexion.

Surgical treatment of swan-neck deformity in hemiplegic cerebral palsy.

Purpose: Previously described surgical treatments for dynamic swan-neck deformity in cerebral palsy are technically difficult and time consuming. Typically only a few fingers could be addressed at one sitting, and postoperative swelling and stiffness were often incurred. An easy procedure of central slip tenotomy is described that allows for multiple fingers to be addressed, with minimal postoperative morbidity.