Does the severity of bilateral carpal tunnel syndrome influence the timing of staged bilateral release?

A retrospective chart analysis was performed of 66 patients with bilateral carpal tunnel syndrome (CTS) who underwent either single endoscopic carpal tunnel release (ECTR) or staged bilateral ECTR to determine the frequency and timing of contralateral surgery. Bilateral CTS patients with contralateral severe CTS underwent bilateral staged ECTR 86% of the time and the second operation was performed 6 ± 5 weeks after the initial ECTR. Patients with contralateral moderate CTS underwent bilateral staged ECTR 74% of the time with a mean of 11 ± 3 months between operations.

Perioperative management of antidepressants and herbal medications in elective plastic surgery.

Background: Patients seeking elective aesthetic surgery often use herbal medications and/or antidepressants. As the popularity of these medications grows, the plastic surgeon must become familiar with these drugs and their potentially harmful effects during the perioperative period.

Methods: The authors performed a PubMed search to identify commonly used herbs and antidepressants and their effects on patients during elective cosmetic surgery.

Capitate shortening osteotomy with vascularized bone grafting for the treatment of Kienböck's disease in the ulnar positive wrist.

Purpose: Decompression surgery combined with revascularization surgery may provide better results than either alone in the treatment of Kienböck's disease. This study describes our experience with capitate shortening combined with vascularized bone grafting for the treatment of Kienböck's disease in ulnar neutral and ulnar positive variant patients.

Methods: Between 1996 and 2004, patients diagnosed with Lichtman stage II or stage IIIA Kienböck's disease with ulnar neutral or ulnar positive wrists were enrolled in this prospective study and had capitate shortening osteotomy with concurrent vascularized bone grafting.

Scapholunate interosseous ligament reconstruction: results with a modified Brunelli technique versus four-bone weave.

Purpose: To compare clinical and radiographic outcomes in patients with chronic scapholunate dissociation treated with a modified Brunelli technique versus a 4-bone tendon weave.

Methods: A retrospective cohort study was performed. Twenty-three patients presented with chronic scapholunate dissociation and were treated with the 4-bone tendon weave technique as described by Almquist and colleagues.

The detailed anatomy of the 1,2 intercompartmental supraretinacular artery for vascularized bone grafting of scaphoid nonunions.

Purpose: To describe the configuration of the 1,2 intercompartmental supraretinacular artery (1,2 ICSRA), including the location of the perforators, and to discuss the clinical use of the 1,2 ICSRA for vascularized bone grafting of scaphoid nonunions.

Methods: Thirteen fresh-frozen cadaveric forearms were used to evaluate the variations in the anatomy of the 1,2 ICSRA. After injection of red latex, the 1,2 ICSRA and its perforators were characterized and measured.

MOC-PSSM CME article: Metacarpal fractures.

Learning Objectives: After reading this article, the participant should be able to: 1. Identify the fracture patterns and types of metacarpal fractures. 2.

A comparison of polyglycolic acid versus type 1 collagen bioabsorbable nerve conduits in a rat model: an alternative to autografting.

Purpose: Severe nerve injury with segmental loss requires nerve graft or conduit repair. We compared 2 synthetic, bioabsorbable nerve conduits with the gold standard of autogenous nerve grafting using histopathologic and neurophysiologic analyses.

Methods: A 10-mm segment of the sciatic nerve of 45 Sprague-Dawley rats was resected, leaving a gap defect.

Wrist level and proximal-upper extremity replantation.

Since Malt and McKhan's first successful arm replantation in 1962, upper extremity replantation surgery techniques have been refined and spread worldwide. Nevertheless, replantation at or proximal to the wrist, referred to as wrist-proximal replants, remains a daunting challenge that presents the hand surgeon with an array of difficulties distinct from digital replantation.

Alloderm stabilization of zygomatic arch fractures.

Zygomatic arch fractures, particularly when comminuted, are unstable fractures that may lose their reduction after operative manipulation. This case study describes the use of Alloderm as a postoperative stabilizing agent in two patients.