The radial sensory nerve. An anatomic study.

The superficial branch of the radial nerve was dissected using loupe magnification in 20 cadaver forearms. The nerve was found to arise between the tendons of the branchioradialis and extensor carpi radialis longus 8.6 cm proximal to the radial styloid, piercing the forearm fascia 6.0 cm from the radial styloid. An average of 5.8 branches crossed the wrist joint. Innervation to the dorsum of the digits was variable, with 45% of specimens innervating the radial 2 1/2 digits and 30% innervating the radial 3 1/2 digits. Sixteen specimens had branches directly overlying the typical transverse incision for De Quervain's release and 12 specimens had branches directly overlying the 3-4 wrist arthroscopy portal. An appreciation for the location of the superficial radial nerve in the forearm, the variation of its digital innervation, and the proximity of branches to commonly used surgical incisions is important when performing surgical procedures over the dorsum of the hand and wrist.

Advances in carpal bone injury and disease.

This article has reviewed many of the landmark discoveries in the diagnosis and management of carpal injuries and disease. It is apparent that much investigation remains to be done to advance our understanding of this complex joint.

Acute vascular compromise after avulsion of the distal phalanx with the flexor digitorum profundus tendon.

An unusual case of avulsion fracture of the insertion of the flexor digitorum profundus tendon is presented. In most such avulsion fractures a small amount of fractured bone may remain with the tendon. In this case almost the entire distal phalanx was avulsed, and vascular compromise of the digit then occurred. Prompt reduction restored vascularity.

Skeletal stabilization for digital replantation surgery. Use of intraosseous wiring.

Bony fixation is the first priority in any digital replantation procedure. Because of time considerations, however, fracture stabilization is frequently less than optimal and impairs mobilization and rehabilitation significantly. Ordinary methods of digital fracture stabilization have proven inadequate when they are applied to replantation surgery. The technique of intraosseous wiring provides an additional option in the management of bone fixation in certain circumstances, and it may be used alone or in conjunction with a variety of other methods. Familiarity with the advantages and disadvantages of different fixation techniques allows for optimal intraoperative planning and helps maximize the chances for an optimally functional result.

Isolated blastomycotic osteomyelitis: a case simulating a malignant tumor of the distal radius.

Blastomycosis osteomyelitis frequently complicates systemic blastomycosis, but it is unusual as an isolated osteolytic lesion in the asymptomatic patient. An isolated blastomycotic osteomyelitis of the distal radius was the initial manifestation of blastomycosis in a healthy young man. The lesion was originally interpreted as a sarcoma. Fungal osteomyelitis must be differentiated from radiologically similar bone neoplasms.