Effect of Intravenous Dexamethasone Dose on the Occurrence of Rebound Pain after Axillary Plexus Block in Ambulatory Surgery.

Rebound pain (RP) remains a challenge in ambulatory surgery, characterized by severe pain upon resolution of a peripheral nerve block (PNB). Intravenous (IV) administration of Dexamethasone (DEXA) potentiates PNB analgesic effect and reduces RP incidence although preventive effective dose remains undetermined. This retrospective analysis evaluates the preventive effect of IV DEXA on RP in outpatients undergoing upper limb surgery under axillary block.

Characterizing biased visuospatial perception in complex regional pain syndrome.

Background: Patients suffering from complex regional pain syndrome (CRPS) are increasingly shown to be affected by cognitive difficulties. While these cognitive symptoms were initially described as limited to the perception, representation and use of the body, that is, the somatic space, they were recently shown to also extend to the perception of extra-somatic space. CRPS patients seem indeed to pay less attention to visual stimuli occurring in the same side of space as their affected limb and especially those occurring close to that limb.

Forearm deformity in multiple hereditary exostosis. Radiologic predictors of radial head dislocation.

Introduction: Radial head dislocation in patients with multiple hereditary exostosis (MHE) can lead to functional deficit. We investigated whether the location of the exostosis and certain radiological criteria predict risk of radial head dislocation/subluxation.

Hypothesis: We hypothesized that the radiological criteria differentiate between patients who need closer follow-up of the forearm and others for whom multiple radiographs are superfluous.

Intensive hands-on microsurgery course provides a solid foundation for performing clinical microvascular surgery.

Purpose: Microvascular surgery requires highly specialized and individualized training; most surgical residency training programs are not equipped with microsurgery teaching expertise and/or facilities. The aim of this manuscript was to describe the methodology and clinical effectiveness of an international microsurgery course, currently taught year-round in eight countries.

Methods: In the 5-day microsurgery course trainees perform arterial and venous end-to-end, end-to-side, one-way-up, and continuous suture anastomoses and vein graft techniques in live animals, supported by video demonstrations and hands-on guidance by a full-time instructor.

Use of a 3D-printed splint for the treatment of distal radius fractures: A randomized controlled trial.

Background: Management of distal radius fractures typically includes a period of immobilization with either a cast or a splint. Traditional immobilization methods can have inconveniences such as poor resistance to water and poor ventilation, which can result in skin maceration, skin breakdown, and infection in case of wetting.

Hypothesis: 3D-printed splints could potentially overcome the inconveniences of traditional casts.

Evaluation of intraoperative ketamine on the prevention of severe rebound pain upon cessation of peripheral nerve block: a prospective randomised, double-blind, placebo-controlled study.

Background: Pain after resolution of peripheral nerve block, known as 'rebound pain' (RP), is a major problem in outpatient surgery. The primary objective was to evaluate the benefit of intraoperative ketamine at an anti-hyperalgesic dose on the incidence of rebound pain after upper limb surgery under axillary plexus block in ambulatory patients. The secondary objective was to better understand the rebound pain phenomenon (individual risk factors).

Recognizing Manual Activities Using Wearable Inertial Measurement Units: Clinical Application for Outcome Measurement.

The ability to monitor activities of daily living in the natural environments of patients could become a valuable tool for various clinical applications. In this paper, we show that a simple algorithm is capable of classifying manual activities of daily living (ADL) into categories using data from wrist- and finger-worn sensors. Six participants without pathology of the upper limb performed 14 ADL.

Instability of the extensor digitorum tendons in Jaccoud arthropathy assessed by semi-dynamic MRI of the metacarpophalangeal joints.

Purpose: The purpose of this study was to test the hypothesis that Jaccoud arthropathy (JA) in patients with systemic lupus erythematosus (SLE) is associated with instability of the extensor digitorum (ED) tendons during flexion of the metacarpophalangeal (MCP) joints by comparing the position of the ED tendons between SLE patients with JA and control subjects on hand MRI obtained with flexed and extended MCP joints.

Materials And Methods: Thirty-two hands of SLE patients with JA (13 women and 3 men; mean age, 50.0±12.

Manual ability in hand surgery patients: Validation of the ABILHAND scale in four diagnostic groups.

Background: Patients treated in hand surgery (HS) belong to different demographic groups and have varying impairments related to different pathologies. HS outcomes are measured to assess treatment results, complication risks and intervention reliability. A one-dimensional and linear measure would allow for unbiased comparisons of manual ability between patients and different treatment effects.

Visuomotor impairments in complex regional pain syndrome during pointing tasks.

Complex regional pain syndrome (CRPS) is thought to be characterized by cognitive deficits affecting patients' ability to represent, perceive, and use their affected limb as well as its surrounding space. This has been tested, among others, by straight-ahead tasks testing oneself's egocentric representation, but such experiments lead to inconsistent results. Because spatial cognitive abilities encompass various processes, we completed such evaluations by varying the sensory inputs used to perform the task.

Robot-assisted line bisection in patients with Complex Regional Pain Syndrome.

Complex Regional Pain Syndrome (CRPS) is characterized by pain, motor and inflammatory symptoms usually affecting one limb. Cognitive difficulties have been reported to affect patients' ability to represent, perceive and use their affected limb. It is debated whether these difficulties result from deficits in controlling goal-directed movements in space or from a learned strategy to protect the affected limb.

Biased visuospatial perception in complex regional pain syndrome.

Complex regional pain syndrome (CRPS) is a chronic pain condition associating sensory, motor, trophic and autonomic symptoms in one limb. Cognitive difficulties have also been reported, affecting the patients' ability to mentally represent, perceive and use their affected limb. However, the nature of these deficits is still a matter of debate.

Tactile roughness discrimination of the finger pad relies primarily on vibration sensitive afferents not necessarily located in the hand.

This study aims to investigate the relative contribution of remote mechanoreceptors to perception of roughness and spatial acuity. We examined two unilateral pathological conditions affecting differently innervation of the index finger: unilateral carpal tunnel syndrome (n=12) and surgically repaired complete traumatic median nerve section at the wrist following surgical repair (n=4). We employed a control condition consisting of ring-block anesthesia of the entire index in 10 healthy subjects to model pathological denervation of the fingertip.

Tactile roughness discrimination threshold is unrelated to tactile spatial acuity.

The present study examined the relationship between the tactile roughness discrimination threshold (TRDT) and the tactile spatial resolution threshold (TSRT) at the index fingertip in humans. A new device was built for measuring TRDT, allowing pair-wise presentations of two sets of six different sandpaper grits. The smoothest grits ranged from 18 to 40 microm and the roughest grits ranged from 50 to 195 microm particle size.

Particle size influence in an impaction bone grafting model. Comparison of fresh-frozen and freeze-dried allografts.

Background: Impaction bone grafting with large particles is considered as mechanically superior to smaller morsels. Interest of freeze-dried irradiated bone for impaction bone grafting has been observed with small particles. Influence of bone process on other particle sizes still needed to be assessed.

Freeze-dried irradiated bone brittleness improves compactness in an impaction bone grafting model.

Background: Defatted bone chips with or without freeze-drying and irradiation have mechanical advantages as compared to fresh-frozen controls in in vitro models of impaction. These improved results have been ascribed to replacement of viscous bone marrow by saline and embrittlement of the freeze-dried bone by irradiation.

Material And Methods: To determine which of these hypotheses is correct, we compared the development of stiffness and compactness of morselized bone graft that had been: 1) fat-reduced with saline, and 2) fresh-frozen, solvent-detergent defatted, 3) freeze-dried irradiated and 4) not irradiated.