Comparison of the anatomical dimensions and mechanical properties of the dorsoradial and anterior oblique ligaments of the trapeziometacarpal joint.

Purpose: The respective roles of the dorsoradial (DRL) and anterior oblique (AOL) ligaments in stability of the highly mobile trapeziometacarpal (TMC) joint remain disputed. Earlier publications have pointed to the AOL as the key stabilizing structure; yet, more recent publications have challenged the stabilizing role of the AOL, favoring the DRL as the main TMC joint stabilizer. We executed an anatomical study of the ligaments, including detailed dissection to quantify the length, width, and thickness of the AOL and DRL and tested the material properties of these ligaments.

Ulna-shortening osteotomy: subjective appreciation and long-term functional outcome.

Ulna-shortening osteotomy is a therapeutic option for ulnar impaction syndrome. We aimed to assess the long-term subjective and functional outcome after ulna-shorteming osteotomy. We conducted a retrospective study of 18 patients presenting with ulnar impaction syndrome of various aetiologies, with an average follow-up of 5.

Arthrographic and CT arthrographic findings in dorsal peripheral detachment of the triangular fibrocartilaginous complex.

Arthrography and CT arthrogram were evaluated in the diagnosis of dorsal peripheral detachment of the triangular fibrocartilaginous complex (TFCC) in the wrist. The imaging findings and medical records of 19 patients, who underwent surgical repair of a dorsal peripheral detachment of the TFCC, were retrospectively studied. Diagnoses were based on the results of the arthrography and CT arthrogram as well as on the clinical examination.

A severe complication of muscle transfer: clostridial myonecrosis.

We present a case of gas gangrene as a severe complication of muscle transfer for opponensplasty. After debridement, the extensive palmar wound was covered by a free gracilis muscle transfer. This complication of muscle transfer has to our knowledge never been reported previously.

Giant cell tumours of the tendon sheath: lack of correlation between nm23-H1 expression and recurrence.

Some authors attribute recurrences of giant cell tumours to biological factors which are only expressed in some tumours. Grover et al. (1998) suggested that the risk for recurrence is associated with the down-regulation of the nm23-H1 gene.

Reducing patient discomfort during digital blockade: The subcutaneous single injection digital block - A simple, safe and fast procedure.

Background: Regional anesthesia of a single finger is commonly achieved by the traditional ring block, which requires at least two painful injections in the digit. Single injection digital block techniques have been described to avoid this problem. Among these, the subcutaneous technique described by Harbison appears to be safe and to allow most procedures to be carried out with good tolerance.

Percutaneous Herbert screw fixation for fractures of the scaphoid: review of 30 cases.

Introduction: The purpose of this study was to evaluate the results of percutaneous fixation of undisplaced or minimally displaced fractures of the scaphoid using the first generation Herbert screw in terms of union, functional results and scaphoid mobility.

Methods: 30 of the 50 patients operated on in our department between 1995 and 2000 were available for evaluation by an independent observer. Wrist mobility, grip strength and key pinch were measured.

Single injection digital block: comparison between three techniques.

Introduction: Regional anesthesia of a single finger is commonly achieved by the traditional ring block. The major drawback of this technique is the need for at least two painful injections in the digit. Single injection techniques have been described.

Atypical mycobacterial infections of the hand: report of eight cases and literature review.

Introduction: Atypical mycobacteria are an uncommon cause of hand infections in immunocompetent patients. Diagnosis is often delayed, with consequent increased morbidity. Better awareness would allow earlier diagnosis and treatment.

Long-term results after segmental aponeurectomy for Dupuytren's disease.

Segmental aponeurectomy has been proposed as a less extensive procedure for the treatment of Dupuytren's disease to limit the incidence of wound complications and stiffness associated with wide dissections. Analysis of the late results showed that the operation brought a lasting correction of the contracture. In hands which did not show any sign of progression of the disease, the follow-up values were even slightly better than the immediate postoperative measurements.

Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint of the thumb.

We assessed the results of 86 trapeziectomies in 83 patients. Simple excision of the trapezium was performed in 54 thumbs. This was combined with shortening of the abductor pollicis longus tendon in 14 thumbs and with soft-tissue interposition and/or ligamentous reconstruction in 17 thumbs.

Glomus tumours of the hand. A retrospective study of 51 cases.

The authors report a series of 51 patients with glomus tumours in the hand. The duration of symptoms before treatment averaged 10 years. No one site or finger was more commonly involved.

[Percutaneous Herbert screw osteosynthesis of the scaphoid bone].

Scaphoid fractures are the most common carpal fractures. Conservative treatment is long, and non-union is frequent after immobilization in a cast. The Herbert procedure is an improvement, but access to the scaphoid is through an extensive open exposure that damages the blood vessels and the anterior radiocarpal ligaments.

Segmental aponeurectomy in Dupuytren's disease.

We report 213 consecutive segmental aponeurectomies in 175 patients. Through several small curved skin incisions, segments of diseased tissue about 1 cm long were excised. No attempts were made to remove all the Dupuytren's tissue, the aim being to achieve discontinuity.

[Comparison between trapezectomy and silicon implant in the treatment of rhizarthrosis].

Among 19 cases of arthritis of the basal joint of the thumb, 12 were operated according to the technique of Swanson, and 7 by simple trapezectomy. Similar results were observed with both techniques.

Fingertip amputations: distal or advancement flaps.

Fingertip amputations treated with conventional flaps gave consistently good coverage, but the recovery of sensibility was superior in advancement flaps. Residual pain, however, was less frequent in distal flaps. Work incapacity averaged between 6 and 8 weeks.

False aneurysm of the radial artery.

A 22-year-old man presented a large false aneurysm of the radial artery in the middle third of the forearm. A segment of the artery was resected and replaced with a vein graft. This lesion is uncommon, but should always be treated early because complications can be severe.

Carpal tunnel syndrome: postsurgical course of symptoms.

The authors analyse the results obtained by the surgical treatment of 113 carpal tunnel syndromes. Performed under locoregional anesthesia, the operation has always been the same: transsection of the volar carpal ligament and epineurolysis on the volar aspect of the median nerve. The results obtained were excellent concerning paresthesia and hypoesthesia.