Low-caliber gunshot wounds in the hand a report of three cases.

Introduction: Low-caliber gunshot wounds (GSW) to the hand are common and their incidence is increasing. Most low-caliber GSW's are treated in the emergency department (ED) with washout, intravenous antibiotics and any further follow-up treatment usually performed in an outpatient capacity. Treatment of these injuries specifically to the hand may be controversial in terms of timing and extent of washout, debridement, and fixation.

Streptococcus pyogenes flexor tenosynovitis.

We describe a case of Group A streptococcal infection originally presenting as flexor tenosynovitis. Group A outbreaks have been recently described in developed countries, which constitutes an epidemiological shift that hand surgeons should be aware of.

The Relationship between Structure of the Wrist and Function in a Japanese and Caucasian Population.

Factors such as age and joint structure affect normal wrist motion. The midcarpal joint participates in flexion/extension, radial-ulnar/deviation (RUD), and since lunate/wrist type-2 is likely more stable than a lunate/wrist type-1, we suggest that midcarpal joint structure will affect wrist motion. Our purpose was to compare wrist motion in Caucasian and Japanese populations and to associate motion with midcarpal joint morphology.

[ISOLATED FOURTH EXTENSOR COMPARTMENT TENOSYNOVITIS DUE TO EPIDEMIC RELATED CHANGES IN THE WORKPLACE].

We report on cases of isolated fourth extensor compartment tenosynovitis without evidence of systemic inflammation that occurred in the context of alteration in the work environment due to the COVID-19 epidemic. Early identification of the deleterious effects of virtual/technologically-dependent work from home can aid in treatment and prevention of these conditions. We describe the phenomenon and suggest a treatment approach.

Association Between Thenar Musculature and Carpal Tunnel Syndrome.

Dynamic forces acting on the transverse carpal ligament (TCL) may influence the mechanics of the carpal tunnel (CT), thus affecting the occurrence of CT syndrome (CTS). Previous studies demonstrated an association between muscle overlying the CT and the diagnosis of CTS. Understanding the location of insertion/origin of the thenar musculature will allow mechanical analysis of the forces applied to the TCL during performance of individual tasks.

Finite Element Modeling of the Human Wrist: A Review.

 Understanding wrist biomechanics is important to appreciate and treat the wrist joint. Numerical methods, specifically, finite element method (FEM), have been used to overcome experimental methods' limitations. Due to the complexity of the wrist and difficulty in modeling, there is heterogeneity and lack of consistent methodology in the published studies, challenging our ability to incorporate information gleaned from the various studies.

Force Transfer through the Scaphotrapeziotrapezoid (STT) Joint.

 The scaphotrapeziotrapezoidal (STT) joint transfers forces to the proximal carpal row from the thumb and fingers. Clinically, STT joint osteoarthritis is frequently observed on plain radiographs though its role in the mechanics of the wrist joint remains unclear.  Our purpose was to use a model of normal wrist types, to predict STT motion upon load.

Treatment of Intractable Pillar Pain With Excision of the Hook of Hamate.

A common consequence of carpal tunnel release (CTR) is ulnar palmar pain termed pillar pain. Some (very rare) patients do not improve with conservative treatment. We have been treating recalcitrant pain with excision of hook of the hamate.

Does Midcarpal Joint Structure Affect Development of Arthritis in the Wrist.

 Degenerative wrist arthritis develops in specific patterns because of forces acting on existing structural configurations. The most common pattern of wrist osteoarthritis is scapholunate advanced collapse (SLAC). Other patterns include isolated scaphotrapezial trapezoid (STT) joint and isolated midcarpal or radiolunate joint arthritis.

Wrist angle measurements in predicting the presence of a displaced scaphoid fracture.

Purpose: Early diagnosis and treatment of scaphoid fractures is critical to achieve union and prevent wrist degenerative arthritis. Plain radiographic measurements can guide the early approach to suspected fractures. Specifically, the ability to predict fracture or fracture stability from plain radiographs may allow the traumatologist to expand initial referral to three-dimensional imaging.

An Approach to Surgery for Cubital Tunnel Syndrome A Pilot Series.

Background: Cubital tunnel syndrome and the resulting loss of hand dexterity and strength may necessitate surgical management. Studies have demonstrated no difference in outcome between surgical techniques. In an attempt to leave more ulnar nerves in situ while providing for stability within the cubital tunnel, we suggest a surgical treatment approach.

Comparison of Wrist Motion and Grip Strength between Normal Caucasian, Southern Chinese and Japanese Populations.

Differences in structure and function of the hand and wrist between distinct populations affect our approach to treatment, expectations and functional outcomes. The aim of this study is to compare wrist motion and grip strength in Caucasian, Chinese and Japanese populations. A total of 424 normal wrists were evaluated that included 99 Japanese, 139 Caucasian and 186 Southern Chinese.

Flexor Carpi Radialis Tendon Rupture in a Distal Radius Malunion.

We describe a rare case of complete rupture of the flexor carpi radialis in a distal radius malunion. Though the tendon was not repaired, the functional result was acceptable. The coronavirus disease-19 epidemic highlights delayed treatment for routine orthopedic trauma and its complications.

The Use of Ultrasound to Differentiate Between Gout and Infection in the Wrist.

Background: Gout is a common condition and its prevalence is increasing. In the wrist, acute gouty arthritis is difficult to distinguish from infection and may occur concomitantly. Though aspiration is helpful, it is not always technically feasible or definitive.

Fracture Prevention Clinic Targeting Patients with Fragility Fracture of the Distal Radius: A Pilot Study.

Background: Identifying and treating patients with fragility fractures may be effective in prevention of subsequent fractures because a first fragility fracture often predicts a second fracture.

Objectives: To evaluate a multidisciplinary anti-osteoporotic clinic for patients with prior distal radius fragility fractures (DRFF). To assess whether addressing this early fracture may prevent a second fracture.

A Preliminary Model of the Wrist Midcarpal Joint.

 A challenge to deciphering the effect of structure on function in the wrist involves difficulty in obtaining in-vivo information. To provide a platform to study wrist mechanics using in vivo acquired forces, we developed a model of the midcarpal joint based on computed tomography (CT) scans of normal wrists. Finite element analysis (FEA) can enable application of in vivo collected information to an ex vivo model.

The Influence of Hand Dominance in Wrist Fracture Post-Operative Functional Evaluation.

Sensorimotor testing is used to measure outcomes in surgery, to document results of treatment and rehabilitation, and to compare results between surgeons, therapists, and institutions. When performing sensorimotor testing, failure to address dominant side differences may cause a bias in evaluation of outcomes. This study evaluated the effect of hand dominance on outcomes testing performed on patients following surgery for distal radius fractures (DRF).

Palmar Musculature: Does It Affect the Development of Carpal Tunnel Syndrome? A Pilot Study.

 The etiology of carpal tunnel syndrome (CTS) is multifactorial. Static mechanical characteristics of CTS have been described, but dynamic (muscular) parameters remain obscure. We believe that musculature overlying the transverse carpal ligament may have an effect on carpal tunnel pressure and may explain the prevalence of CTS in manual workers.

Trigger Fingers After Open Carpal Tunnel Release.

Trigger finger (TF) and carpal tunnel syndrome (CTS) are common conditions often occurring together with an unclear relationship. While some studies conclude that TFs occur as a result of carpal tunnel release (CTR), others have not established a causal relationship. Our purpose was to evaluate the prevalence and timing of TF development in the same hand after open CTR in our population.

Using Extensor Retinaculum to Reconstruct the Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament.

Chronic complete tears of the ulnar collateral ligament of the thumb metacarpophalangeal joint often require surgical reconstruction. The indications, materials used, and the methods for reconstruction remain controversial. We describe a technique for reconstruction that utilizes a slip of the extensor retinaculum for reconstruction.

Epidermoid Cyst in an Infected Olecranon Bursa.

Epidermoid cysts are common, benign cysts that form due to follicular epithelium implanting into the dermis. Although these cysts are often painless, they can incite an inflammatory process as well as abscess formation, especially if ruptured. Our case involves a 59-year-old woman with a history of remote elbow trauma diagnosed with septic olecranon bursitis with concomitant epidermoid cyst found on histology following incision and drainage (I&D).

Translation of 2-Dimensional Wrist Radiographic Measurements to 3-Dimensional CT Scans.

Anatomical structure affects function. The morphology of articulations dictates the way forces will travel through the joint. A better understanding of the structure and function of the wrist will enhance our ability to diagnose and treat wrist conditions.