Volar locking plate fixation versus external fixation of distal radius fractures: a meta-analysis.

This meta-analysis evaluates reported outcomes of volar locking plates versus external fixation for management of distal radius fractures. A comprehensive literature search was carried out using PubMed, embase, MEDLINE, and the Cochrane Library. Multiple outcomes were analysed: study characteristics, objective/subjective outcome measures, radiographic parameters, and complication rates.

Tissue Engineering in Hand Surgery: A Technology Update.

The field of hand surgery is constantly evolving to meet the challenges of repairing intricate anatomical structures with limited availability of donor tissue. The past 10 years have seen an exponential growth in tissue engineering, which has broadened the perspectives of tackling these age-old problems. Various fabrication techniques such as melt electrospinning and fused deposition modelling have been employed to synthesize 3-dimensional bioscaffolds that can be used to replace lost tissue.

Rerouting extensor pollicis longus tendon transfer.

Following radial nerve palsy, loss of the extensor pollicis longus (EPL), abductor pollicis longus and extensor pollicis brevis tendons results in loss of thumb extension and radial abduction. Multiple tendon transfers are described to address the loss of thumb extension following radial palsy utilizing the palmaris longus or flexor digitorum sublimis transferred to the EPL tendon. Owing to its ulnar vector of pull, the EPL tendon is a secondary adductor of the thumb, and in order to mitigate the tendency for thumb adduction, the EPL tendon is divided at the wrist and brought subcutaneously to the radial side of the wrist for repair to the donor tendon to improve the line of pull for the donor tendon.

Large solitary glomus tumor of the wrist involving the radial artery.

Glomus tumors are neuromyoarterial glomus body neoplasms that most commonly occur in the subungual areas of the hand. These tumors typically present as painful solitary lesions with localized tenderness. Extradigital glomus tumors are rare and difficult to diagnose because of their varying symptoms and presentation.

Juvenile Dermatomyositis: A Case of Calcinosis Cutis of the Elbow and Review of the Literature.

Juvenile dermatomyositis is a rare, chronic autoimmune disorder commonly associated with calcinosis cutis. Although great advances have been made in the treatment of juvenile dermatomyositis, little progress has been made in the treatment of calcinosis cutis. It remains resistant to medical treatment and surgical intervention has long been avoided due to early reports of poor wound healing and sinus track formation associated with the surgical excision of calcinosis cutis.

Chondroblastoma-like chondroma of the hand: case report.

Chondroblastoma-like chondroma is a rare tumor that almost exclusively manifests in the hand and presents with a set of unique diagnostic features. This tumor has been described in only a limited number of publications and is thus commonly omitted in the differential diagnosis of hand tumors. The diagnostic imaging and histological specimens may initially appear consistent with a number of relatively more common hand tumors, thereby delaying the diagnosis.

Late reconstruction of ulnar nerve palsy.

Ulnar nerve palsy results in significant loss of sensation and profound weakness, leading to a dysfunctional hand. Typical clinical findings include loss of key pinch, clawing, loss of normal flexion sequence of the digits, loss of the metacarpal arch, and abduction of the small finger. Further deficits in hand/wrist function are seen in high-level ulnar nerve palsy, including loss of ring- and small-finger distal interphalangeal flexion, decreased wrist flexion, and loss of dorsal sensory innervation.

Epiphyseal bar resection and fat interposition for clinodactyly.

Clinodactyly, the angulation of a digit in the anteroposterior plane, is often due to a longitudinal epiphyseal bracket on the radial side of the middle phalanx of the little finger. Treatment options include observation, osteotomy, and epiphyseal bar resection. Epiphyseal bar resection is a simple surgery that requires neither postoperative pin fixation nor immobilization.

Metacarpal osteotomy for correction of acquired phalangeal rotational deformity.

Symptomatic phalangeal rotation deformities require corrective osteotomy. Surgery at the phalangeal level is technically demanding and has a higher complication rate. We describe the surgical technique of metacarpal base osteotomy for rotation correction of the digit.

Brodie's abscess of the distal radius: an unusual complication after percutaneous pinning.

We report a case of Brodie's abscess of the distal radius that presented 4 years after closed reduction and percutaneous pinning for a closed distal radius fracture. This condition has not been previously reported in the adult distal radius and we detail the clinical features and imaging findings. We also present a new way of management of Brodie's abscess using injectable bone substitute along with adjunctive parenteral antibiotic therapy.

Ipsilateral heterodigital artery transfer for finger revascularization.

We report a case of digital revascularization in a child's small finger by using a digital artery from the adjacent uninjured digit. Reconstruction of a defect in the digital artery with a vein graft is technically challenging in a child and has a higher risk of failure due to anastomoses at 2 levels and possible size mismatch. We detail the technique of heterodigital artery transfer from the ring finger to revascularize the small finger with segmental loss of both digital arteries.

Volar wedge grafting for scaphoid nonunion with collapse.

Fractures of the scaphoid waist that fail to heal tend to collapse into a flexed posture. The so-called "humpback deformity" of the bone is accompanied by collapse of the proximal carpal row with dorsal tilt of the lunate. It is possible to restore scaphoid height and carpal alignment by insertion of a tricortical wedge of graft from the iliac crest.

Idiopathic avascular necrosis of the metacarpal head.

Avascular necrosis of the metacarpal head is a rare condition. Although the condition is associated with trauma, systemic lupus erythematosus, and steroid use, it can occur spontaneously without any obvious cause. Any metacarpal may be affected and the pathologic changes are similar to those described in other bones such as the femur.