Subject(s)
Foreign Bodies/diagnostic imaging , Hand Injuries/diagnostic imaging , Hand , Adult , Glass , Hand/diagnostic imaging , Humans , Male , Radiography , UltrasonographyABSTRACT
Over the years various treatment options for scaphoid nonunions have been proposed. We present as a historical note the long-term follow-up of one such treatment, the insertion of a vitallium scaphoid.
Subject(s)
Joint Prosthesis , Vitallium , Wrist Joint/surgery , Adult , Carpal Bones/diagnostic imaging , Carpal Bones/injuries , Carpal Bones/surgery , Fractures, Ununited/diagnostic imaging , Fractures, Ununited/surgery , Humans , Male , Radiography , Wrist Joint/diagnostic imagingABSTRACT
Distal ulna resections that are done in patients with rheumatoid arthritis to alleviate pain, correct alignment, and prevent tendon rupture may contribute to distal ulnar instability. A distally based slip of the extensor carpi ulnaris tendon has been used to both stabilize the distal ulnar remnant and to prevent recurrent deformity in 26 rheumatoid wrists, with an average follow-up of 3.5 years. In all postoperative cases, the distal ulna was no longer prominent and the wrist was well aligned. The distal ulna was stabilized in 96% of the patients. Subjectively, pain was relieved in 85% and grip strength improved in 77%.
Subject(s)
Arthritis, Rheumatoid/surgery , Tendons/surgery , Ulna/surgery , Wrist Joint/surgery , Follow-Up Studies , Humans , Movement , Pain, Postoperative/physiopathology , Wrist Joint/physiopathologyABSTRACT
A septum is not unusual within the first dorsal compartment of the wrist. The right and left forearms of 50 cadavers were dissected. A septum was identified 34% of the time. The septum separated the abductor pollicis longus tendon from the extensor pollicis brevis tendon. If the septum was present on one side, it was usually present on the other side. The septum created a separate compartment for the extensor pollicis brevis tendon. The effect of a separate compartment on the operative and nonoperative treatment of de Quervain's disease is discussed.
Subject(s)
Tendons/anatomy & histology , Wrist Joint/anatomy & histology , HumansABSTRACT
Septic arthritis of the shoulder is uncommon in adults. We reviewed the cases of eighteen patients who were followed for a minimum of one year. The patients ranged in age from forty-two to eighty-nine years. All but one patient had at least one serious associated disease. Eight patients had had an injection or aspiration of the shoulder before development of the infection. All but one patient had had a delay in diagnosis. At the time of admission to the hospital, the erythrocyte sedimentation rate was always elevated, but the body temperature and white blood-cell count were not. After treatment, the functional result was usually poor: only five patients regained forward flexion to 90 degrees or more, eight patients had no active motion of the glenohumeral joint, and two patients died. Arthrotomy appeared to afford a better result than did repeated aspiration.
Subject(s)
Arthritis, Infectious/diagnosis , Shoulder Joint , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/microbiology , Arthritis, Infectious/therapy , Bacteria/isolation & purification , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Radiography , Shoulder Joint/diagnostic imaging , SuctionABSTRACT
Rheumatoid tendon ruptures occur primarily by the effect of the tenosynovium on the tendon or secondarily by the effect of the tenosynovium on the bone. An understanding of these complications combined with a knowledge of the anatomy helps to explain the pathology and suggest possible treatments.
Subject(s)
Arthritis, Rheumatoid/surgery , Hand/surgery , Tendon Injuries/surgery , Humans , RuptureABSTRACT
Normal functional variations of the flexor digitorum superficialis were clinically determined by use of the standard and modified superficialis flexion tests in 50 normal subjects. Forty hands of 20 cadavers were dissected to correlate the anatomic variations with the clinical findings. A flexor digitorum superficialis-independent pattern was found 58% of the time. A flexor digitorum superficialis-common pattern was found 21% of the time. A flexor digitorum superficialis-absent pattern was found 21% of the time. The right and left hands were asymmetric 26% of the time. All cadaver hands had a flexor digitorum superficialis tendon present in the palm and finger. The variability in flexor digitorum superficialis function may be explained by interconnections between the flexor digitorum superficialis of the small finger and either the flexor digitorum superficialis of the ring finger or the flexor digitorum profundus of the small finger.
Subject(s)
Fingers/physiology , Movement , Muscle Contraction , Muscles/physiology , Fingers/anatomy & histology , Functional Laterality , Humans , Muscles/anatomy & histologySubject(s)
Adenocarcinoma/secondary , Bone Neoplasms/secondary , Sweat Gland Neoplasms , Tibia , Adenocarcinoma/pathology , Adenocarcinoma/therapy , Aged , Bone Neoplasms/pathology , Bone Neoplasms/therapy , Humans , Male , Sweat Gland Neoplasms/pathology , Sweat Gland Neoplasms/therapy , Tibia/pathologyABSTRACT
A 41-year-old man who was taking 60 mg of prednisone a day for dermatomyositis developed a wound dehiscence following a carpal tunnel release and flexor tenosynovectomy. Coverage of the exposed carpal contents was provided by using the abductor digiti minimi as a local transposition flap.
Subject(s)
Carpal Tunnel Syndrome/surgery , Surgical Flaps , Surgical Wound Dehiscence/surgery , Adult , Humans , Male , ReoperationABSTRACT
Patients with old scaphoid nonunion have a high risk of developing wrist arthritis. Although some patients remain asymptomatic, some will have pain sufficient to seek treatment. There are several treatment options available. The authors prefer wrist arthrodesis for most of these patients.
Subject(s)
Carpal Bones/injuries , Fractures, Ununited/complications , Osteoarthritis/etiology , Wrist Joint , Arthrodesis/methods , Arthroplasty/methods , Carpal Bones/surgery , Fractures, Ununited/surgery , Humans , Osteoarthritis/surgery , Wrist Joint/surgeryABSTRACT
This study measured the diameter of the arteries at the level of the diaphysis of the proximal phalanges of the index, long, ring, and small fingers. We measured the diameter of the vessel on ten normal arteriograms and on six amputated specimens. The larger vessel was usually on the ulnar border of the index and long fingers and on the radial border of the ring and small fingers. By the Hagen-Poiseuille equation, we assume that the larger vessel has the greater flow and, therefore, represents the dominant vessel to the digit. This observation may have clinical relevance in the reimplantation and revascularization of digits.
Subject(s)
Arteries/anatomy & histology , Fingers/blood supply , Angiography , Fingers/diagnostic imaging , HumansABSTRACT
Ten patients with moderately to severely displaced supracondylar fractures were retrospectively reviewed. All were treated with skeletal traction with the arm positioned at the side. As a result of this treatment, eight of the ten patients had an excellent result, with restoration of both full range of motion and normal carrying angle.
Subject(s)
Humeral Fractures/therapy , Traction/methods , Bone Nails , Child , Child, Preschool , Elbow , Female , Humans , Humeral Fractures/diagnostic imaging , Male , Radiography , Retrospective StudiesABSTRACT
A boy with bilateral idiopathic congenital carpal tunnel syndrome was first seen at the age 4 years 6 months. He presented with triggering of the finger flexors at the wrist, abnormal posturing of the fingers and inability to pinch on one side. The triggering was relieved by transection of the transverse retinaculum. Pinch was restored by a tendon transfer. There have been no previous reports of idiopathic carpal tunnel syndrome present since birth. The literature and case are reviewed.
