RESUMO
We present current concepts and evidence to optimize diagnosis and management of osteoarthritis in the thumb joints. Numerous options and controversies exist for surgical treatment of carpometacarpal joint arthritis. Fewer options exist for metacarpophalangeal joint arthritis. Surgical treatment for interphalangeal arthritis is mainly arthrodesis.
Assuntos
Articulações Carpometacarpais/cirurgia , Osteoartrite/cirurgia , Polegar/cirurgia , Artrodese , Artroscopia , Desbridamento , Humanos , Ligamentos Articulares/cirurgia , Ossos Metacarpais/cirurgia , Osteotomia , Resultado do TratamentoRESUMO
We describe technical tips for injecting collagenase into Dupuytren cords based on experience acquired during the prerelease Food and Drug Administration clinical trials and with subsequent clinical practice. These tips include techniques for extracting the reconstituted enzyme efficiently from the vial, injecting the cord(s) with increased safety to the tendons, and anesthetizing the hand before manipulation. The tips are intended to supplement but by no means replace the manufacturer's prescribing information and training video.
Assuntos
Clostridium histolyticum/enzimologia , Contratura de Dupuytren/tratamento farmacológico , Colagenase Microbiana/administração & dosagem , Humanos , Injeções Intralesionais , Resultado do Tratamento , Estados Unidos , United States Food and Drug AdministrationRESUMO
With our hand team scattered across several different locations, it is difficult to find a time to get together for our weekly didactic hand conference and monthly hand journal club. In addition, traffic and tight clinical schedules sometimes force conferences to start late or be canceled. Our solution was to set up an on-line conference. Using TeamViewer to host our conference and Skype to host our journal clubs, we experienced increased attendance by both faculty and residents in our meetings. In this article, we establish a method of hosting effective on-line videoconferences to facilitate nearly universal participation of our hand team, and we hope to assist others who wish to establish similar setups in their communities.
Assuntos
Educação Médica Continuada/organização & administração , Educação de Pós-Graduação em Medicina , Mãos/cirurgia , Equipe de Assistência ao Paciente/organização & administração , Publicações Periódicas como Assunto , Comunicação por Videoconferência/organização & administração , Redes de Comunicação de Computadores/organização & administração , Computadores , Docentes de Medicina , Humanos , Internato e Residência , SoftwareRESUMO
Upper extremity reconstruction forces the surgeon to chose between several available procedures, among them tendon and nerve transfer. Few guidelines exist to assist the surgeon in this regard, and the authors, therefore, undertook a retrospective review of case series describing tendon and nerve transfer. The authors discovered a scarcity of robust reporting, particularly in regard to tendon transfer, making an objective comparison between the two techniques difficult. Tendon transfers are popular and familiar. Nerve transfers promise distinct advantages; however, excellent evidence of their superiority is lacking.
Assuntos
Plexo Braquial/lesões , Plexo Braquial/cirurgia , Transferência de Nervo , Transferência Tendinosa , Extremidade Superior/cirurgia , História do Século XIX , História do Século XX , Humanos , Força Muscular/fisiologia , Transferência de Nervo/tendências , Recuperação de Função Fisiológica/fisiologia , Transferência Tendinosa/tendências , Extremidade Superior/inervaçãoRESUMO
Fractures of the tubular bones of the hand are common and potentially debilitating. The majority of these injuries may be treated without an operation. Surgery, however, offers distinct advantages in properly selected cases. We present a review of hand fracture management, with special attention paid to advances since 2008. The history and mechanisms of these fractures are discussed, as are treatment options and common complications. Early mobilization of the fractured hand is emphasized because soft tissue recovery may be more problematic than that of bone.
