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At least 613 records · Page 34Linked to original sources

End-to-side neurorrhaphy for defects of palmar sensory digital nerves.

Ten traumatic nerve defects at the palm or digit level were treated by end-to-side (ETS) neurorrhaphy. The technique included removal of an epineurial window on the donor nerve and coaptation of the sharply cut distal end of the injured nerve by epineurial stitches under microscopic magnification. At final follow-up, the static two-point discrimination test (2 pd) scored at an average of 9.1 mm (range, 6-12 mm) on the repaired nerve, compared to an average of 4.6 mm (range, 4-6 mm) on the contralateral uninjured control side. Moving 2 pd scored at an average of 7 mm (range, 4-9 mm) on the repaired nerve compared to an average of 2.6 mm (range, 2-4 mm) on the control side. This short series showed that ETS neurorrhaphies are effective and give comparable results with those of nerve grafts or vein conduits.

Adolescent↗

Ochronotic stenosing flexor tenosynovitis--case report.

Localized deposition of ochronotic pigment in the flexor digitorum profundus tendons was associated with triggering of the fingers in one patient. The case history and histologic studies suggest that repetitive trauma might be a major factor in initiating a localized reaction enhancing pigment deposition in the flexor tendon.

Finger Injuries↗

Late rupture of the flexor tendons as a complication of replacement arthroplasty.

A case of attritional rupture of the flexor tendons secondary to metacarpophalangeal (MP) replacement arthroplasty for treatment of rheumatoid arthritis is reported. This complication is thought to be the result of resection of the palmar plate during the arthroplasty that was performed 5 1/4 years previously. Although not previously reported, it could be an expected late result if the palmar plate is excised during arthroplasty.

Adult↗

[Experiences with the alloplastic joint prosthesis of the interphalangeal joint].

The replacement of finger joints, especially of the proximal interphalangeal joint (PIP), remains an unsolved problem. Long-term results of conventional reconstructive procedures as well as previously available artificial joint implants have been disappointing. In a controlled study, 12 PIP-joints were replaced by a new type of total endoprosthesis as an alternative to joint fusion. The cementless prosthesis is unhinged and consists of metal joint surfaces. After a follow-up of 18 months, implantation of this metal prosthesis resulted in almost complete pain relief and an active range of movement of 58 degrees. The absolute gain in mobility, however, was only 6 degrees. A swan-neck deformity was found in nine out of 12 cases but corrective surgery was not required. The proximal half of the implant had to be exchanged in two cases due to loosening. All patients were satisfied with the result. The disparity between subjective acceptance by the patients, who clearly prefer joint replacement to fusion, and objective results demonstrates the necessity for further development in this field. The type of prosthesis used in this study seems to be a useful baseline tool which could be turned into a ingenious PIP-joint replacement by further development aiming at reduced abrasion, increased initial stability, a more individual configuration, to name just a few goals.

Equipment Failure Analysis↗

Subepineural pacinian corpuscle: a cause of digital pain.

A patient is presented who had chronic digital pain as a result of an abnormally located subepineural pacinian corpuscle. The patient had complete relief of her symptoms and return of normal digital function following removal of the pacinian corpuscle. A review of the literature concerning this entity revealed very few reported cases. However, these cases shared many of the same symptoms, as well as both physical and operative findings. It is suggested that patients suffering from digital pain of unknown etiology with a previous history of direct or indirect trauma may benefit from a localized operative exploration of the digit to remove an abnormally located pacinian corpuscle affecting the digital nerve.

Adolescent↗

[Thermography as an additional study method in the follow-up of reconstructive operations of the hand].

The hand is very accessible to thermography. Disturbed circulation, vascular disease, tissue damage, or other causes of change in thermoproduction lead to deviation from a normal temperature chart. We found a high correlation between thermographic readings and prognosis after replantation. Thermography is, therefore, a method of examination that can be recommended.

Amputation, Traumatic↗