Dorsal Cortical Screw Penetration in Volar Distal Radius Plating: Comparison of 3 Fluoroscopic Views.

Background: The skyline or dorsal tangential view (DTV) and the carpal shoot-through (CST) have been developed to enhance the intraoperative examination of the distal radius's dorsal cortex during open reduction and internal fixation with volar plates. This study aimed to assess the lateral view (LV), DTV, and CST's effectiveness in showcasing screws that penetrate the dorsal cortex.

Methods: Eighty patients, comprised of 42 women and 38 men with an average age of 53 years, underwent volar locking plate fixation for displaced distal radius fractures.

Complications after volar plate synthesis for distal radius fractures.

Purpose: Distal radius fractures (DRFs) represent up to 18% of all fractures in the elderly population, yet studies on the rate of complications following surgery are lacking in the literature. This systematic review aimed to quantify the rate of complications and reinterventions in patients treated with volar plate for distal radius fractures, and analyze if there was any predisposing factor.

Methods: A comprehensive literature search was performed on three databases up to January 2023, following PRISMA guidelines.

Multifactorial Analysis of Treatment of Long-Bone Nonunion with Vascularized and Nonvascularized Bone Grafts.

 The purpose of the study was to evaluate the results of treatment of the nonunion of long bones using nonvascularized iliac crest grafts (ICGs) or vascularized bone grafts (VBGs), such as medial femoral condyle corticoperiosteal flaps (MFCFs) and fibula flaps (FFs). Although some studies have examined the results of these techniques, there are no reports that compare these treatments and perform a multifactorial analysis.  The study retrospectively examined 28 patients comprising 9 women and 19 men with an average age of 49.

A Helpful Assistant for Disinfection in Hand Surgery Procedures: The LocArm Holder.

Background: Although there is no consensus regarding the best skin disinfection technique, whatever antiseptic solution is used, the "prep and drape" portion of most upper extremity procedures requires the presence of at least one operative room assistant or scrub nurse to elevate and hold the hand and forearm. Nonetheless, especially in a busy hand surgery practice and during fast procedures, an operative room assistant or scrub nurse are frequently not available leading to a reduced time efficiency between procedures.

Purpose: This article describes an innovative easy-to-use and hands-free device that helps the surgeon during disinfection of the skin and the setup of the surgical field by keeping elevated the upper limb with respect for tissues.

Volar locking plate vs cast immobilization for distal radius fractures: a systematic review and meta-analysis.

Introduction: The aim of this systematic review and meta-analysis was to evaluate whether volar locking plate (VLP) fixation leads to better clinical and radiological outcomes than those of closed reduction and cast immobilization for the treatment of distal radius fractures (DRFs).

Materials And Methods: A comprehensive literature search was performed in PubMed, Web of Science, and Cochrane databases up to January 2022. Inclusion criteria included randomized controlled trial (RCT) studies comparing VLP fixation with cast immobilization for DRFs.

Is a Vascularized Interphalangeal Unicondylar Transfer Worth the Efforts? Surgical Technique and Clinical Application.

Interphalangeal joints (IPJ) play a key role in hand function for performing activities of daily living and are frequently involved in complicated injuries resulting in significant functional limitations such as secondary arthritis and stiffness being the most challenging. In adult patients with more than 5 mm bone loss of the proximal articular surface who request a functional interphalangeal joint with minimal pain a vascularized joint transfer is a treatment choice. A unicondylar loss more than 5 mm wide in a 22-year-old carpenter is reported and illustrates our experience with a vascularized unicondylar transfer showing the advantages compared to the "classic" total joint transfer or distal interphalangeal (DIP) joint arthrodesis.

Finger Amputation after Pinning of the Distal Interphalangeal Joint for Acute Closed Tendinous Mallet Finger: A Rare but Devastating Complication.

The best treatment for mallet fingers is still a matter of debate. Numerous splints with different designs to keep the distal interphalangeal (DIP) joint in extension have been described in literature. The outcomes of splint treatment are generally good with occasional reports of minor skin complications.

Distraction Arthroplasty for Basal Thumb Osteoarthritis: 10-Year Follow-Up.

Purpose: Trapeziectomy has frequently been used to treat basal thumb osteoarthritis. However, complications, such as shortening of the thumb ray and reduced mobility and strength, can occur. The aim of this study was to present a 10-year follow-up of distraction arthroplasty without trapeziectomy.

An Atypical Lipomatous Tumor of the Forearm: A Case Report.

Introduction: Atypical lipomatous tumor (ALT) is a rare, well-differentiated and low-grade liposarcoma originating in deep soft tissue compartments of extremities and trunk. The optimal surgical treatment in the upper extremity is still controversial. Some Authors suggest the wide excision of the mass including the sacrifice of the muscle-surrounding tumor, others recommend the marginal resection of the lesion.

Metallic foreign body in the ulnar nerve in the Guyon's canal and Review of the Literature.

The authors present a rare case of a 61-year-old patient with a metal foreign body inside the ulnar nerve in the Guyon's canal. After the surgical removal the motor function was not impaired. At 6-month follow up from the surgical removal, the patient showed a complete motor and sensory function.

The Influence of Low- and High-Negative-Pressure Liposuction and Different Harvesting Sites on the Viability and Yield of Adipocytes and Other Nucleated Cells.

Background: The volume effect of fat grafting is highly dependent on the presence of viable adipocytes and other nucleated cells within the lipoaspirate. We suspected that one of the crucial factors influencing cell viability is the negative pressure applied during the fat graft harvesting and the suitability of various harvest sites when compared to others. Despite much discussion, there is no consensus on the optimal negative pressure or the best site for harvesting so we designed an experiment to test this.

The Influence of High and Low Negative Pressure Liposuction and Various Harvesting Techniques on the Viability and Function of Harvested Cells-a Systematic Review of Animal and Human Studies.

Background: An understanding of fat grafting methodology, techniques and patient-related factors is crucial when considering fat grafting. Multiple factors can influence the success of a fat graft and consequently the outcome of the procedure. The aim of this systematic review is to elucidate the influence of negative pressure and various techniques of fat harvesting on the viability and function of cells, particularly adipocytes and adipose-derived stem cells.

The use of sentinel skin islands for monitoring buried and semi-buried micro-vascular flaps. Part II: Clinical application.

Despite the high success rate of micro-vascular flaps, anastomosis compromise occurs in 5-10% and that can lead to flap failure. Reliable monitoring of the flap is therefore of similar importance to that of the precise surgical procedure itself. Multiple methods have been reported for monitoring of the flap vitality, the first one being direct visual monitoring.

The use of sentinel skin islands for monitoring buried and semi-buried micro-vascular flaps. Part I: Summary and brief description of monitoring methods.

Micro-vascular flaps have been used for the repair of challenging defects for over 45 years. The risk of failure is reported to be around 5-10% which despite medical and technical advances in recent years remains essentially unchanged. Precise, continuous, sensitive and specific monitoring together with prompt notification of vascular compromise is crucial for the success of the procedure.

Evaluation of carpal tunnel release outcomes by the Japanese version of the carpal tunnel syndrome questionnaire compared to an electrophysiological severity grade.

Background: The outcome of carpal tunnel release (CTR) one year postoperatively was assessed by the Japanese version of Carpal tunnel syndrome questionnaire, CTSI-JSSH. Patients were further graded by the electrophysiological severity scale and the CTSI-JSSH scores were compared amongst the Stages before surgery and one-year postoperatively.

Methods: This study included 247 hands and the mean age of the patients was 68 years (range:26-91).

The Use of an Adipofascial Flap to Prevent Extensor Tendon Adhesions After Plating of the Proximal Phalanx of the Fingers: A Comparative Study.

Background: Extensor tendon adhesions occurring after proximal phalangeal (P1) fractures are not uncommon. A previous report described the use of an adipofascial flap (AFF) to prevent adhesions after dorsal plating of the P1. The purpose of the study is to examine the results of open reduction and internal fixation with the use of an AFF (F group) and without (N group, that is, no flap used) in a larger group of patients.

End-to-side innervated sensate radial forearm flap in the hand: A 5-year follow-up.

Optimal functional reconstruction of the palmar surface of the hand requires good sensibility especially for the thumb and the radial side of the fingers. We report the long-term results of a distally based radial forearm flap (RFF) used for soft tissue coverage in the palm, index and middle finger and an end-to-side neurorrhaphy between the lateral antebrachial cutaneous nerve (LACN) and the proper palmar digital nerve of the middle finger to restore sensation. At 5 years' follow-up, the patient's sensory recovery was assessed through static and moving two-point discrimination, light touch sensation, pain perception, hot and cold temperature perception, an electrophysiological study and sweat test.

Can an adipofascial flap be used to prevent adhesions after plating of the proximal phalanx? A case report.

Tendon adhesions in zone IV after proximal phalangeal fractures are common and may lead to loss of range of motion at the proximal interphalangeal joint. The type of fracture, surgical technique and rehabilitation strategy also influence the final functional outcome. Plate fixation is a reliable solution in cases of comminuted phalangeal fracture.

Is Masson's tumour only a slow-growing benign neoplasm? A case report.

Masson's tumour is a rare benign neoplasm of vascular origin characterized histologically by papillary endothelial hyperplasia. Unlike previous scientific articles we report a case of a "rapid growing" lesion in a 73-year-old man underlining the clinical features to distinguish this uncommon lesion from other neoplasms of vascular origin.