Management of osteoarthrosis of the thumb joints.

We present current concepts and evidence to optimize diagnosis and management of osteoarthritis in the thumb joints. Numerous options and controversies exist for surgical treatment of carpometacarpal joint arthritis. Fewer options exist for metacarpophalangeal joint arthritis.

Technical tips for collagenase injection treatment for Dupuytren contracture.

We describe technical tips for injecting collagenase into Dupuytren cords based on experience acquired during the prerelease Food and Drug Administration clinical trials and with subsequent clinical practice. These tips include techniques for extracting the reconstituted enzyme efficiently from the vial, injecting the cord(s) with increased safety to the tendons, and anesthetizing the hand before manipulation. The tips are intended to supplement but by no means replace the manufacturer's prescribing information and training video.

How to establish an interactive eConference and eJournal Club.

With our hand team scattered across several different locations, it is difficult to find a time to get together for our weekly didactic hand conference and monthly hand journal club. In addition, traffic and tight clinical schedules sometimes force conferences to start late or be canceled. Our solution was to set up an on-line conference.

Tendon versus nerve transfers in elbow, wrist, and hand reconstruction: a literature review.

Upper extremity reconstruction forces the surgeon to chose between several available procedures, among them tendon and nerve transfer. Few guidelines exist to assist the surgeon in this regard, and the authors, therefore, undertook a retrospective review of case series describing tendon and nerve transfer. The authors discovered a scarcity of robust reporting, particularly in regard to tendon transfer, making an objective comparison between the two techniques difficult.

Hand fractures: a review of current treatment strategies.

Fractures of the tubular bones of the hand are common and potentially debilitating. The majority of these injuries may be treated without an operation. Surgery, however, offers distinct advantages in properly selected cases.

Peripheral neuropathy of the upper extremity: medical comorbidity that confounds common orthopedic pathology.

In the orthopedic patient, the diagnosis of a compression neuropathy may be straightforward. However, various medical comorbidities can obscure this diagnosis. It is paramount for the practicing orthopedic surgeon to have an appreciation for the medical pathology of common axonal neuropathies to properly diagnose, treat, and refer a patient with altered sensation in the upper extremity.

Injectable collagenase clostridium histolyticum for Dupuytren's contracture.

Background: Dupuytren's disease limits hand function, diminishes the quality of life, and may ultimately disable the hand. Surgery followed by hand therapy is standard treatment, but it is associated with serious potential complications. Injection of collagenase clostridium histolyticum, an office-based, nonsurgical option, may reduce joint contractures caused by Dupuytren's disease.

A history of surgery in the instrument tray: eponymous tools used in hand surgery.

Hand surgery emerged as a specialty after World War II, and early hand surgeons borrowed tools from established fields of the time. These tools remain in common use today, and many are identified by the names of the men who created them. Because these men did not specialize in surgery of the hand, their history remains obscure to modern surgeons who do.