Evidence-Based Medicine: Thumb Basal Joint Arthritis.

Learning Objectives: After studying this article, the participant should be able to: 1. Assess the patient's history, clinical examination, and radiographic findings to diagnose and stage basilar joint arthritis. 2.

Segmental V-Y flaps for reconstruction of longitudinal defects in the digit.

Longitudinal defects of the finger that extend beyond 1 phalangeal segment such as wounds that expose the flexor tendon are challenging to reconstruct because of their elongated shape. We present the use of segmental V-Y flaps to reconstruct these defects. These are ≥2 V-Y flaps orientated transversely and advanced segmentally to close the defect avoiding a linear scar.

A new technique of first carpometacarpal joint suspension arthroplasty with palmaris longus tendon graft.

This article describes a novel technique of suspending the first metacarpal after trapeziectomy with a palmaris longus tendon graft in the specific situation of a patient with Eaton and Lambert stage IV thumb base osteoarthritis with proximal subluxation of the first metacarpal and ulnar translation of the carpus on the radius, such that without suspension the first metacarpal would articulate with the radial styloid after trapeziectomy. The advantage of the palmaris longus tendon graft as opposed to techniques using the flexor carpi radialis or abductor pollicis longus tendons is that this technique anchors the first metacarpal in a more distal position than the latter techniques allow. No complications were encountered and the patient remains pain-free at 6 months with improved pinch and grip strength and function.

A novel technique of harvesting temporalis fascia autografts for correction of recurrent blepharoptosis.

Patients with poor levator function require ptosis correction by a sling procedure. A variety of synthetic materials are available for this suspension, but there is a recognized complication rate. Autografts are less prone to infection and extrusion than alloplastic materials.