bluuebunny/crossref_metadata_2025 huggingface dataset:
Value of the Carpal Compression Test in the Diagnosis of Carpal Tunnel Syndrome
Authors: GONZÁLEZ DEL PINO J. , DELGADO-MARTÍNEZ A. D. , GONZÁLEZ GONZÁLEZ I. , LOVIC A.
Published: September 2005

In order to determine the efficacy of the carpal compression test (CCT) in the diagnosis of the carpal tunnel syndrome (CTS), we conducted a prospective study on 200 consecutive hands diagnosed as having CTS. A control group of 100 healthy volunteers with no symptoms of CTS were also assessed. The results of the CCT in the patients and controls were compared with those obtained with Phalen’s and Tinel’s tests. CCT achieved a sensitivity of 87%, and a specificity of 95%. It is a simple, fast and very reliable provocative test, and should be routinely used in the diagnosis of CTS. This test is also an appropriate manoeuvre in wrists with limited range of motion or pain that cannot be assessed with Phalen’s wrist flexion test.
Ulnar Dimelia
Authors: CHINEGWUNDOH J. O. M. , GUPTA M. , SCOTT W. A.
Published: September 2005

Ulnar dimelia (mirror hand) is a rare congenital disorder, characterized by duplication of the ulna, absence of the radius and polydactyly. Approximately 60 cases have been reported worldwide. We present a new case, with its own distinguishing features. These features illustrate that the aetiology of ulnar dimelia is probably failure of differentiation of a part of the ray rather than its pure duplication.
Palmar Plate Interposition (Tupper) Arthroplasty for Post-Traumatic Metacarpophalangeal Osteoarthritis
Authors: BOLIS G. U. , ONI J. A. , DAVIS T. R. C.
Published: September 2005

We report the results of five interposition palmar plate (Tupper) arthroplasties for post-traumatic or post-infection osteoarthritis of metacarpophalangeal joints. All were pain free at a median follow-up of 4 years. The mean arc of joint flexion was 55° and finger to thumb tip pinch was 60% of normal. All patients had reduced grip strength, but were satisfied with the procedure.
The Central Slip Attachment Fracture
Authors: IMATAMI J. , HASHIZUME H. , WAKE H. , MORITO Y. , INOUE H.
Published: September 2005

Eight displaced central slip attachment fractures were treated by open reduction and internal fixation to avoid boutonnière deformity, to reduce the fracture anatomically and to allow early mobilization of the joint. This injury should be recognized as a disruption of the dynamic extensor mechanism associated with an intraarticular fracture, fracture-dislocation or soft tissue injury of the PIP joint. We have grouped central slip attachment fractures into three types according to the mechanism of injury, with suggested methods of treatment.
A Non-Invasive Method for Studying in Vivo Carpal Kinematics
Authors: WOLFE S. W. , CRISCO J. J. , KATZ L. D.
Published: September 2005

Seven uninjured and three injured patients were studied using midsagittal computed tomographic (CT) images at 10° increments from full extension to full flexion. Each injured patient had a confirmed scapholunate ligament tear and normal radiographs. CT bony contours were digitized, and incremental motion determined using a specifically designed automated contour-matching algorithm. We expressed wrist motion as a ratio of lunocapitate (midcarpal) motion, and radiolunate (radiocarpal) motion. In normal wrists, motion occurred equally at the midcarpal and radiocarpal joints. In wrists with scapholunate ligament disruption, lunocapitate motion increased significantly throughout the arc of motion.
Registration Bone Scan in the Evaluation of Wrist Pain
Authors: MOHAMED A. , RYAN P. , LEWIS M. , JAROSZ J. M. , FOGELMAN I. , SPENCER J. D. , CLARKE S. E. M.
Published: September 2005

We assessed the value of bone scintigraphy combined with X-ray registration for the diagnosis and management of wrist pain in 65 patients. Studies were reported independently by two observers before and after registration. Registration improved localization of scan abnormalities in 53% (observer 1) and 61% (observer 2). In these patients, the bone scan contributed to the diagnosis independently of the X-ray in 37% and the management was altered in 31%. The value of the bone scan in the early diagnosis and management of wrist pain is increased when it is registered with X-rays.
Scapholunate Dissociation in the Skeletally Immature Carpus
Authors: DAUTEL G. , MERLE M.
Published: September 2005

Scapholunate dissociation is well documented as a condition occurring in adult patients. We report it in a 14-year-old female patient. Persistent wrist pain 9 months after a well healed fracture of the distal radius triggered further investigation. Dynamic clinical and radiological studies demonstrated the instability.
Skin Replacement in Dupuytren’s Disease
Authors: HALL P. N. , FITZGERALD A. , STERNE G. D. , LOGAN A. M.
Published: September 2005

We have reviewed 90 rays in 67 patients who had undergone radical digital dermofasciectomy. Follow-up was from 24 to 100 months. Problems with skin grafts, moving two-point discrimination and active range of joint movement were noted. The recurrence rate in this series was 8%, a very much better figure for disease control than has been reported for standard approaches for Dupuytren’s disease. Radical digital dermofasciectomy is strongly recommended for all cases of recurrent Dupuytren’s disease requiring reoperation and as a primary procedure when there is significant skin involvement.
A Historical Record of Traumatic Rupture of Dupuytren’s Contracture
Authors: SIROTAKOVA M. , ELLIOT D.
Published: September 2005

Traumatic rupture of Dupuytren’s contracture is rare. It has been reported only twice in recent times and only on four previous occasions over the last millenium. These cases are reported and the forces involved in rupturing Dupuytren’s contracture are discussed.
Improving the Results of Ganglion Aspiration by the Use of Hyaluronidase
Authors: PAUL A. S. , SOCHART D. H.
Published: September 2005

We present the results of a prospective randomized trial comparing the treatment of ganglia by aspiration under local anaesthetic and either instillation of steroid alone or with the prior use of hyaluronidase. Thirty-five patients were treated in each group and followed up for 2 years. The cure rate with the combined use of hyaluronidase and methylprednisolone was 89%, compared to 57% when treated by aspiration and instillation of methylprednisolone alone.
The Distribution of Fibrous Flexor Sheath Ganglions
Authors: AL-KHAWASHKI H. , HOOPER G.
Published: September 2005

The distribution of fibrous flexor sheath ganglions was studied in 57 patients. They were found to be more common in the third decade and in the middle finger. Both hands were equally affected. There was no clear relationship to occupation or repeated trauma. The striking finding in our study was the male predominance.
Complete Avulsion of the Extensor Apparatus of the Little Finger
Authors: WATANABE K. , URASAKI T. , NISHIKIMI J.
Published: September 2005

We report a case of simultaneous closed avulsions of the terminal extensor insertion and the central slip of the little finger which required operative treatment.
The Different Types of Algodystrophy after Fracture of the Distal Radius
Authors: LAULAN J. , BISMUTH J-P. , SICRE G. , GARAUD P.
Published: September 2005

A prospective study of algodystrophy after fracture of the distal radius was carried out to search for early diagnostic and prognostic criteria. One hundred consecutive patients were assessed by a radiographic score and by a semi-quantitative clinical score at 1, 6 and 12 weeks and 1 year after fracture. The reactive disorders observed could be classified in four groups, each with a different course. There was a close link between patient satisfaction at 1 year and the group to which the patient belonged. Algodystrophy was diagnosed in 26% of cases. Of these, 58% were active and left sequelae at 1 year. A clinical score greater than 7 at 6 weeks predicted 96% of these cases of active algodystrophy. Active algodystrophy was more likely after a severe initial injury and if there was pain at the distal radioulnar joint.
Ulnar Shortening Osteotomy for Ulnar Carpal Instability and Ulnar Carpal Impaction
Authors: KÖPPEL M. , HARGREAVES I. C. , HERBERT T. J.
Published: September 2005

We report the results of a retrospective review of 47 ulnar shortening osteotomies carried out for ulnar carpal impaction and/or ulnar carpal instability. The average follow-up was 18 months. Wrist function was graded preoperatively and postoperatively using an assessment system modified from Chun and Palmer (1993) . The results show that distal ulnar shortening osteotomy successfully reduces pain and improves wrist function both for ulnar carpal instability (UCI) and ulnar impaction syndrome (UIS) and is equally effective for those patients with combined UIS and UCI. Grip strength and wrist stability were significantly improved and range of wrist and forearm motion was little affected by the procedure. Oblique osteotomies were found to heal faster and to have a lower non-union rate than transverse osteotomies. Although radiographs did show adaptive changes of the distal radioulnar joint in a significant number of patients, there is no evidence (as yet) to suggest that this leads to the development of secondary osteoarthritis.
Treatment of Enchondromas of the Hand with Bone Substitute
Authors: JACOULET P. , FAURE P.
Published: September 2005

We report five patients with enchondromas of long bones in the hand. They were successfully treated by curettage and implantation of a biodegradable bone substitute (calcium phosphate). Bone regained normal X-ray appearance by 9 months. The full range of motion and normal function of the hand were restored. There were no complications and no recurrence at follow-up visits 28 months after operation. There are several advantages to this technique. The operative procedure may be performed under local anaesthesia on an out-patient basis and the operative time is shortened. Complications of a cancellous bone donor site are avoided, as are the potential infectious complications of allogenic bone implantation.
Flexor Digitorum Tendon Transection As A Complication of Endoscopic Carpal Tunnel Release
Authors: POSCH N. A. S. , BOS K. E.
Published: September 2005

A complete laceration of the flexor digitorum profundus tendon of the middle finger following endoscopic carpal tunnel release is reported. In a cadaver study the mechanism that could have led to this complication was investigated.
A Comparison of Replantation and Terminalization after Distal Finger Amputation
Authors: ELLIOT D. , SOOD M. K. , FLEMMING A. F. S. , SWAIN B.
Published: September 2005

This study records the subjective opinion of 30 patients who sustained a distal amputation of a single finger beyond the FDS tendon insertion which was treated by replantation, successfully or unsuccessfully, or by terminalization. All other patients who underwent replantation or terminalization of a single distal finger amputation but also had other injuries of the hand or fingers were excluded. Eleven patients had successful replantation, nine in whom replantation was not possible or was not successful had subsequent terminalization and ten had primary terminalization without attempting replantation. Only seven of the patients undergoing terminalization had further shortening of bone, the remainder being treated with homodigital neurovascular advancement flaps. Replantation was favoured by patients for sensory and motor functional reasons as well as for cosmetic reasons. Cold intolerance was less common in the successfully replanted fingers.
Operative Correction of Radial Club Hand
Authors: LAMB D. W. , SCOTT H. , LAM W. L. , GILLESPIE W. J. , HOOPER G.
Published: September 2005

We have reviewed the clinical and functional results of 21 centralizations for radial club hand in 17 patients, 21 to 31 (mean 27) years after operation. There were 13 associated pollicizations. Although the ulna was always short, no premature fusions of the distal ulnar epiphysis were found. Overall upper limb function was assessed by grip strengths and Moberg and Jebsen tests of manual dexterity and was satisfactory. This review emphasizes the important roles of centralization and pollicization in the surgical management of children with radial absence.
Ulnar Polydactyly in Apert’s Syndrome
Authors: AL-QATTAN M. M.
Published: September 2005

Finger duplication is not a known feature of Apert’s syndrome. A case of Apert’s syndrome with unilateral duplication of the little finger is described. The literature is reviewed and similar cases are discussed.
Another Type of Profundus Tendon Avulsion
Authors: KATZMAN B. M. , CALIGIURI D. A. , KLEIN D. M.
Published: September 2005

A different variant of a profundus tendon avulsion is described, in which the avulsed tendon injury (Leddy and Packer Type I, II, or III) is associated with an extraarticular fracture of the distal phalanx.
Portals for Arthroscopy of the Trapeziometacarpal Joint
Authors: GONZALEZ M. H. , KEMMLER J. , WEINZWEIG N. , RINELLA A.
Published: September 2005

We have studied the anatomy of the structures superficial to the trapeziometacarpal joint in cadavers in order to define safe entry points for arthroscopy of the joint.
Early Active Mobilization for Extensor Tendon Injuries
Authors: SYLAIDIS P. , YOUATT M. , LOGAN A.
Published: September 2005

Dynamic splinting following extensor tendon repair gives better results than static splinting, but involves cumbersome splints and recommended protocols are often complicated. We prefer controlled active mobilization of extensor tendon repairs without dynamic splinting. Six weeks after repair, excellent or good function was obtained in 22 out of 24 simple extensor tendon injuries and in 11 out of 13 complex injuries. The results of this prospective study are comparable with those reported after dynamic splinting; this regime does not require outrigger splintage and is simple to follow.
Sensory Function after Median Nerve Decompression in Carpal Tunnel Syndrome
Authors: ROSÉN B. , LUNDBORG G. , ABRAHAMSSON S. O. , HAGBERG L. , ROSÉN I.
Published: September 2005

The sensory recovery was monitored for up to 1 year after decompression of the median nerve in 69 patients with carpal tunnel syndrome. Special attention was paid to the rate of recovery, the importance of constant or intermittent numbness or paraesthesiae preoperatively and the influence of gender.

Most patients with numbness/paraesthesiae and those with abnormal two-point discrimination recovered within 10 days. Perception of touch and vibration recovered within 3 weeks in most patients but those with abnormal nerve conduction/sensory amplitude recovered slowly during follow-up.

After 1 year patients with intermittent preoperative symptoms were significantly more likely to achieve normal nerve conduction and perception of touch. Women were more likely to achieve normal nerve conduction and perception of touch. A comparison of recovery between matched men and women with identical preoperative status showed no significant difference. The results indicate the importance of early treatment of carpal tunnel syndrome.
Management of Acute Perilunate Dislocations without Fracture of the Scaphoid
Authors: INOUE G. , KUWAHATA Y.
Published: September 2005

A retrospective review of 14 cases of acute perilunate dislocations without fracture of the scaphoid managed by three different forms of treatment was conducted at an average follow-up of 29 months. Treatment included closed or open reduction with cast immobilization only ( n=2), closed reduction followed by percutaneous K-wire fixation of the carpus ( n=4), and open reduction with repair of the torn scapholunate ligaments and K-wire fixation of the carpus ( n=8). Based on Cooney’s clinical scoring system, there were five excellent, five good, two fair and two poor results. The patients without ligamentous repair did as well as those with ligamentous repair when the scaphoid was reduced anatomically and stabilized with K-wires. In the latter, however, the scapholounate relationship was maintained more consistently. We believe that open reduction through a dorsal approach, direct repair of the scapholunate ligaments, and K-wire fixation of the carpus is a reliable method for obtaining satisfactory clinical and radiographic results in the management of acute perilunate dislocations without fracture of the scaphoid.
Operative Fluoroscopy in Hand and Upper Limb Surgery
Authors: BAIN G. I. , HUNT J. , MEHTA J. A.
Published: September 2005

We reviewed the use of a low radiation portable fluoroscopy unit in 100 patients. The most common indication was closed reduction of distal radial fractures. Fracture and joint stability were assessed on the real-time monitor and stored on videotape. Static images were stored on thermographic paper. Fluoroscopically guided joint injections and localization of implants, foreign bodies and bone tumours were performed. Fluoroscopy is a useful adjunct to arthroscopic assisted fracture reduction and other arthroscopic procedures such as distal ulnar resection. These new generation units produce superior resolution images, are easy to manoeuvre and do not require a radiographer.
Multiple Schwannomas in the Radial Nerve
Authors: TANABE K. , TADA K. , NINOMIYA H.
Published: September 2005

We present a case of multiple schwannomas in the radial nerve. The occurrence of multiple schwannomas in a single major nerve is very rare. Magnetic resonance imaging was useful in detecting the tumours. As schwannomas may be multiple without clinical symptoms, we recommend MR imaging of the entire limb when schwannomas occur in a major nerve in the upper extremity.
Carpal Tunnel Decompression Under Local Anaesthetic and Tourniquet Control
Authors: BAGUNEID M. S. , SOCHART D. H. , DUNLOP D. , KENNY N. W.
Published: September 2005

A postal survey within the North West Region (UK) revealed that 66% of the consultant orthopaedic surgeons did not use local anaesthesia routinely for carpal tunnel decompression. This prospective study was set up to assess the effectiveness, safety and patient tolerance of performing this procedure using local anaesthesia and upper arm tourniquet control. Eighty-six carpal tunnel decompressions were performed on 75 consecutive and unselected patients with confirmed carpal tunnel syndrome over a 6-month period. Completed questionnaires were obtained before discharge. None or only slight discomfort was experienced for all aspects of the operation in at least 94%. None of the patients reported severe and unbearable discomfort. At review, 3 months postoperatively, all patients with the exception of two reported complete resolution of preoperative symptoms. The use of local anaesthesia and a tourniquet is safe, effective and well-tolerated in carpal tunnel decompressions.
Composite Graft Replacement of Digital Tips
Authors: ELLIOT D. , MOIEMEN N. S.
Published: September 2005

The successes of composite grafting of fingertips in the early years of plastic surgery have been repeated in the few studies of this treatment which have been reported during the last 50 years. The early and recent history of this subject are reviewed in the light of the increasingly pessimistic view of composite graft replacement of fingertips taken by recent reviewers.
False Aneurysm and Brachial Plexus Palsy Complicating a Proximal Humeral Exostosis
Authors: GERRAND C. H.
Published: September 2005

An unusual case is described in which a false aneurysm of the brachial artery secondary to an exostosis of the proximal humerus caused a compressive lesion of the brachial plexus. Surgical treatment of the exostosis and the false aneurysm relieved the symptoms.
Traumatic Aneurysm of a Common Digital Artery
Authors: CROMHEECKE M. , van STRAALEN A. M. , DAMEN A.
Published: September 2005

We describe a false aneurysm of a common digital artery. Diagnosis and choice of treatment were largely determined by ultrasonography which proved to be a reliable and easy to use diagnostic tool.
Corrective Osteotomies after Injuries of the Distal Radial Physis in Children
Authors: HOVE L. M. , ENGESÆTER L. B.
Published: September 2005

Six children had corrective osteotomies of the distal forearm because of growth disturbance from post-traumatic closure of the distal radial physis. Lengthening osteotomy of the radius was performed in three patients with grafts from the iliac crest. All osteotomies healed in a satisfactory position. Three patients had only moderate mal-angulation of the radius and were treated by shortening of the ulna. The median postoperative palmar angulation of the distal radius was 4 (0–13)°, the radial inclination 22 (15–28)°, and the ulnar variance was –2 (–4 – +2) mm. The postoperative pain relief was complete in all patients and the total range of motion was 96 (93–100)% compared with the opposite side.
Long-Term Results of Radioscapholunate Fusion Following Fractures of the Distal Radius
Authors: NAGY L. , BÜCHLER U.
Published: September 2005

Fifteen patients with radioscapholunate (RSL) fusion for traumatic lesions of the radiocarpal junction, whose short-term results have been previously reported, were reassessed after an average follow-up time of 8 years. Five patients had undergone wrist fusion because of non-union or early progressive arthritis. Of the ten wrists with retained mobility, eight continued to function satisfactorily. Two wrists were painful for reasons other than secondary midcarpal arthritis. Patient satisfaction was comparable in both groups with the wrist score better for wrists with residual motion. The survival of RSL partial wrist fusion corresponded inversely with the number of preceding operations and the range of motion before partial fusion. Secondary midcarpal arthritis, if present, arose early and was well tolerated. Failures were strongly linked to technical mistakes and complications.
The Ulnocarpal Stress Test in the Diagnosis of Ulnar-Sided Wrist Pain
Authors: NAKAMURA R. , HORII E. , IMAEDA T. , NAKAO E. , KATO H. , WATANABE K.
Published: September 2005

Forty-five patients with persistent ulnar-sided wrist pain and a positive ulnocarpal stress test were investigated by X-ray, arthrography, 99mTechnetium bone scanning, magnetic resonance imaging and wrist arthroscopy. Ulnar wrist pathology was positively identified in nine of 45 patients by X-ray, 18 of 37 by arthrography, 19 of 27 by bone scan, four of 33 by MRI, and in all 45 patients by arthroscopy. The final diagnosis was ulnocarpal abutment syndrome in 28 patients, traumatic triangular fibro-cartilage (TFC) tear in six, lunotriquetral (LT) ligament tear in five, TFC and LT ligament tear in one, wrist arthritis in four and cartilaginous free body in one. The ulnocarpal stress test is a useful provocative test, and a positive test suggests the presence of ulnar-sided wrist pathology. The test is sufficiently sensitive to warrant further investigation by arthroscopy.
Lack of Difference in Sensibility between the Dominant and Non-Dominant Hands as Tested with Semmes-Weinstein Monofilaments
Authors: VAN TURNHOUT A. A. W. M. , HAGE J. J. , DE GROOT P. J. M. , DE LANGE-DE KLERK E. S. M.
Published: September 2005

The sensibility of the dominant hand was compared with that of the non-dominant hand using Semmes-Weinstein monofilaments in each of 22 bilateral palmar sites in 50 healthy volunteers. No difference in sensibility was found in 51% of all 2,200 tested palmar sites. Statistically significant superior sensibility was found in the non-dominant hand at 34% of all sites, whereas the dominant side showed superior sensibility in the remaining 15%.
Pattern Recognition In Post-Traumatic Cold Intolerance
Authors: LITHELL M. , BACKMAN C. , NYSTRÖM Å.
Published: September 2005

The subjective symptoms called “post-traumatic cold intolerance” were analysed in a study of 40 patients with a history of digital trauma (amputation, neurovascular laceration, or comminuted fracture requiring surgical reconstruction). The patients were individually interviewed to obtain detailed information about perception of each symptom as well as the pattern of symptoms of posttraumatic cold intolerance. The study confirmed the high incidence of the condition and its potentially disabling nature. Although the individual symptoms described by the patients have a limited number of categories, the subjective expression of cold intolerance is too varied to allow an adequate definition or assessment to be based on any single symptom or group of symptoms.
Ulnar Nerve Injury Following Midshaft Forearm Fractures in Children
Authors: STAHL S. , ROZEN N. , MICHAELSON M.
Published: September 2005

We report three cases of ulnar nerve deficit in children following closed fractures of the forearm bones. Significant anterior angulation and displacement of the ulna was noted in all patients. Two patients were operated on at a later stage when no evidence of recovery was demonstrated; the ulnar nerve was found to be embedded in dense scar tissue. One patient was operated on at the time of injury; entrapment of the nerve on the anterior spike and partial transection was found. Early exploration is indicated in such cases and may result in full recovery.
Painless Osteoid Osteoma of the Middle Phalanx
Authors: REX C. , JACOBS L. , NUR Z.
Published: September 2005

A 12-year-old girl with a painless swollen finger was a clinical puzzle as her presentation and X-rays were not typical of osteoid osteoma. Computed tomography and histology confirmed the diagnosis. This case is reported for its atypical presentation, difficulty in diagnosis and rare occurrence in the middle phalanx.
Intraneural Mucoid Cysts of the Upper Limb
Authors: GIELE H. , LE VIET D.
Published: September 2005

Intraneural mucoid cysts are uncommon. They usually affect middle-aged men, presenting with pain and symptoms of nerve compression. We report on our series of six patients, three of whom had cysts involving the digital nerves. We compare our series with others and discuss controversies concerning the existence, aetiology, treatment and outcome of these cysts. We believe MR scans can aid in the preoperative diagnosis and follow-up of these patients and that, if possible, careful cyst excision using an operative microscope is the treatment of choice.
The Use of the Second Dorsal Metacarpal Artery for Vascularized Bone Graft
Authors: KHAN K. , RIAZ M. , SMALL J.O.
Published: September 2005

We present the results of fresh cadaver hand dissections and dye injection studies to help in raising a vascularized bone graft from the index or middle metacarpals based on the second dorsal metacarpal artery. This vascularized bone graft could be used for treating nonunion of the scaphoid and other carpal bones.
Further Experience with the Index Metacarpal Vascularized Bone Graft
Authors: MATHOULIN C. , BRUNELLI E
Published: September 2005

We report our experience in the use of a vascularized bone graft harvested from the head of the index metacarpal to treat scaphoid nonunion after failure of other techniques. Only 15 patients were treated between 1988 and 1994, showing the scarcity of indications for the operation. Union was obtained in 14 cases but the functional results were acceptable in ten cases only. This was due to previously unnoticed degenerative lesions.
Surgery of the Spastic Hand in Cerebral Palsy
Authors: DAHLIN L. B. , KOMOTO-TUFVESSON Y. , SÄLGEBACK S.
Published: September 2005

Thirty-six patients with hemiplegic cerebral palsy had surgical treatment for the upper limb and were followed up for 18 months postoperatively. Various operations were done. A striking finding was a significant improvement of stereognosis (ability to describe and recognize objects without vision). Most patients had improvement in different functional grasps following surgical reconstruction. Range of movement in the forearm and wrist also increased in most patients. The thumb-in-palm deformity was completely corrected in 31 of the patients and improved in the other five. Most patients had some or all of their expectations of the procedure fulfilled.
The Detailed Anatomy of the Palmar Cutaneous Nerves and its Clinical Implications
Authors: MATLOUB H. S. , YAN J-G. , MINK VAN DER MOLEN A. B. , ZHANG L-L. , SANGER J. R.
Published: September 2005

The forearms and hands of 40 fresh-frozen cadavers were dissected under the microscope to study the palmar cutaneous branch of the median nerve (PCBm) and the palmar cutaneous branch of the ulnar nerve (PCBu). Branches of the PCBm innervating the scaphoid were typically found, but in no specimen did we find a ‘typical’ cutaneous branch of the ulnar nerve. According to our findings, standard incisions for open carpal tunnel release carry a significant risk of damaging branches of the PCBm or PCBu. The chance of injury to these sensory nerves can be minimized by using a short incision in the proximal palm or a twin incision approach, which we describe. Because the PCBm is closely associated with the ulnar side of the flexor carpi radialis (FCR) sheath, this sheath should be opened on the radial side during harvest of the FCR tendon for transfer. When transferring the palmaris longus tendon, it should be cut proximal to the distal wrist crease to avoid possible damage to the PCBm.
The Blood Supply of the Lumbrical Muscles
Authors: ZBRODOWSKI A. , MARIÉTHOZ E. , BEDNARKIEWICZ M. , GAJISIN S.
Published: September 2005

The blood supply of the lumbrical muscles was studied in 100 upper extremities from fresh human cadavers. Layer by layer dissection revealed the existence of different types of vascularity for the four muscles. The injection of coloured latex or Indian ink solution with gelatin showed the complex arterial network of these muscles together with their various sources of blood supply. Four separate sources of blood supply for each of the muscles were found: the superficial palmar arch (SPA), the common palmar digital artery, the deep palmar arch (DPA) and the dorsal digital artery. It was established that there were no anastomoses between the blood vessels of the tendons of the flexor digitorum profundus muscle and those of the lumbrical muscles. Considerable differences were observed in the details of the blood supply of the individual lumbrical muscles.
Silicone Replacement Arthroplasty for Kienböck’s Disease
Authors: KAARELA O. I. , RAATIKAINEN T. K. , TORNIAINEN P. J.
Published: September 2005

Thirty-nine patients with Kienböck’s disease underwent silicone replacement arthroplasty between 1979 and 1994. The patients were followed-up from 1 to 8 years (mean, 8 years). Sixteen prostheses (41%) have had to be removed, from 1 to 18 years postoperatively (mean, 5.6 years), 15 of them because of pain and silicone synovitis or cysts. It appears that silicone synovitis with cyst formation is an inevitable problem in the wrist after silicone replacement arthroplasty of the lunate, and this procedure is only a temporary solution for Kienböck’s disease.
Distraction-Lengthening of Digital Rays Using a Small External Fixator
Authors: SALOM M. , AROCA J. E. , CHOVER V. , ALONSO R. , VILAR R.
Published: September 2005

We present 19 ray lengthenings in 14 patients done with a small external fixator. In six cases the thumb was lengthened and in the other 13 cases, other digital rays. The most frequent reason for lengthening was an amputation sustained in a work accident.

All the lengthenings were done by an osteotomy and subsequent gradual distraction with a small external fixator. The mean lengthening achieved was 20 mm (range, 0–32). An iliac-crest graft was needed in nine cases, corrective osteotomy in five cases and a deepening of the web in the six cases of thumb lengthening. In five cases an additional technique was needed to achieve bony consolidation. We have analysed the functional results and the ability to perform activities of daily living and resume employment. Although most of the patients had multiples injuries, the results have been very favourable, achieving a very high level of patient satisfaction.
Rotational Salter–Harris Type I Fracture of the Proximal Phalanx
Authors: BLAGG S. E. , GIDDINS G. E. B.
Published: September 2005

A purely rotational Salter-Harris type I fracture of the proximal phalanx of the middle finger is described. This injury presents diagnostic problems as the radiographs do not show the displacement. Accurate clinical examination is essential, in particular checking for rotation of the finger.
The Radial Forearm Fascial Flap as a Salvage Procedure for Chronic Tuberculosis of the Hand and Wrist
Authors: CEDIDI C. , RAFF T. , GERMANN G.
Published: September 2005

A patient with tuberculous infection of the hand and wrist developed a recurrent draining wound of the right forearm. After recurrent failure of surgical débridement and wound closure under antituberculous therapy, wound closure was established by means of a radial forearm fascial flap with an excellent functional and cosmetic result. Extra-pulmonary tuberculosis must be kept in mind in the diagnosis of slowly growing tumours and chronic wounds in the upper extremity.
Outcome Following the Rehabilitation of Hand Trauma Patients
Authors: WATTS A. M. I. , GREENSTOCK M. , COLE R. P.
Published: September 2005

Objective measures of hand function have been used to assess the outcome of rehabilitation following trauma. However, subjective assessments of function have been avoided by clinicians due to the difficulty in proving their validity and reliability. We have developed a subjective hand function scoring system (HFS), based on an activities of daily living assessment, which is used in planning and monitoring progress through rehabilitation. The HFS for 64 traumatic hand injuries were assessed on admission and discharge, and a significant improvement was found. There was a positive correlation between the HFS on admission and both the severity of injury, and the length of time off work. This scoring system is not validated, but this study illustrates the use of subjective functional scoring systems in the planning, delivery and evaluation of rehabilitation.
Transthecal Digital Nerve Block
Authors: SARHADI N. S. , SHAW-DUNN J.
Published: September 2005

Injection studies using methylene blue and latex were used in 60 digits from 40 cadavers to study how anaesthetic fluid injected into the flexor tendon sheath might spread around the proximal part of the finger. The injected solution escaped from the flexor tendon sheath around the vincular vessels which are present near the base and head of the proximal phalanx. Outside the digital canal, the dye flowed smoothly through the perivascular loose areolar tissue and spread alongside the main digital vessels and nerves and their palmar and dorsal branches.
The Importance of the Distal Radioulnar Joint in Distal Radial Fractures
Authors: STOFFELEN D. , DE SMET L. , BROOS P.
Published: September 2005

In a prospective study we evaluated the results of 272 distal radial fractures by their involvement of the distal radioulnar joint. Impaired function following altered anatomy at the distal radius can be explained by dysfunction of the distal radioulnar joint. Ulnar styloid avulsions contribute to a poorer result because of their effect on distal radioulnar joint function.
Distal Ulnar Tumours
Authors: FERRACINI R. , MASTERSON E. L. , BELL R. S. , WUNDER J. S.
Published: September 2005

A variety of reconstructive procedures have been suggested for stabilizing the ulnar shaft following resection of the distal ulna for tumour. We present the results of a series of nine distal ulnar tumour resections in which four different stabilization techniques were employed. We based our results on an evaluation of function, pain, motion, strength and instability. We obtained good or excellent results in seven patients treated with a soft tissue stabilization of the ulnar stump. One patient did not undergo any stabilization procedure and scored fair in our system. A further patient who required a radiocarpal arthrodesis also had an inferior result. These results suggest that soft tissue stabilization of the ulnar stump should be performed whenever possible.
Morphology and Distribution of Nerve Endings in the Human Triangular Fibrocartilage Complex
Authors: OHMORI M. , AZUMA H.
Published: September 2005

We studied the morphology and distribution of nerve endings in the human triangular fibrocartilage complex using both silver staining and immunohistochemical staining using a protein specific to nerve fibres.

Free nerve endings were found in the ulnar side of the triangular fibrocartilage complex, especially in the ulnar collateral ligament, meniscus homologue and the adjacent collagen fibre area of the peripheral part of the ulnar side of the articular disc. Meissner’s and Krause’s corpuscles were observed in the ulnar collateral ligament and meniscus homologue.

The fact that free nerve endings were observed in the meniscus homologue and adjacent collagen fibre area of the peripheral part of the ulnar side of the articular disc suggests that this disc may be a source of wrist pain. The presence of nerve end bulbs in the triangular fibrocartilage complex also suggests a possible role for corpuscles as mechanoreceptors.
Psychomotor Development in Children with Triphalangeal Thumbs
Authors: ZGURICAS J. , DE RAEYMAECKER D. M. J. , SNIJDERS P. J. L. M. , HOEKSTRA A. , LINDHOUT D. , HOVIUS S. E. R.
Published: September 2005

In order to explore the influence of an isolated congenital hand malformation on psychomotor development, we performed an exploratory, observational study on 18 children with triphalangeal thumbs. The investigative procedure consisted of a hand function examination, a semi-structured interview with the mother about the development of the child, the so-called “Hand test”, and the “Child Behaviour Check List”.

Our observations suggest specific developmental difficulties in fine motor skills and language development, but the children showed no signs of behavioural psychopathology.
An Unusual Carpal Coalition Associated with Fifth Ray Anomalies in the Hand
Authors: ROBLEDO J. GÓMEZ
Published: September 2005

I report the case of a 15-year-old white girl with an asymptomatic scapholunotriquetral fusion associated with a capitometacarpal coalition in the right wrist. She had additional anomalies of the fifth ray including shortening and ulnar deviation of the fifth metacarpal, brachydactyly of the little finger, fusion of the fourth and fifth metacarpals and absence of the ulnar styloid.
Is Occupation an Aetiological Factor in the Development of Trigger Finger?
Authors: TREZIES A. J. H. , LYONS A. R. , FIELDING K. , DAVIS T. R. C.
Published: September 2005

We investigated the occupation histories of 178 patients with idiopathic trigger finger. When compared with the 1991 Census data, the distribution of their occupations was not significantly different from the local general population. It is concluded that the vast majority of trigger fingers develop for reasons other than occupation.
A Rare Combined Fracture and Ligamentous Injury of the Thumb
Authors: SMITH I. , JAMIESON A.
Published: September 2005

Bennett’s fracture of the base of the metacarpal of the thumb and avulsion of the ulnar collateral ligament of the thumb are both relatively common injuries. It is, however, rare for the two lesions to occur simultaneously and we report such a case.
Rupture of the Tendon of Flexor Digitorum Profundus in Association with an Endchondroma of the Terminal Phalanx
Authors: VAZ F. M. , BELCHER H. J. C. R.
Published: September 2005

We report a case of avulsion of the insertion of flexor digitorum profundus (FDP) tendon from a distal phalangeal enchondroma.
The Outcome of Tendon Transfers for C6-Spared Quadriplegics
Authors: LO I. K. Y. , TURNER R. , CONNOLLY S. , DELANEY G. , ROTH J. H.
Published: September 2005

The purpose of this study was to review retrospectively and evaluate a uniform group of C6-spared quadriplegics who had similar surgical procedures. Eight patients undergoing 12 procedures were reviewed at an average of 3.8 years follow-up. There were three bilateral procedures. All patients had extensor carpi radialis longus to flexor digitorum profundus and brachioradialis to flexor pollicis longus transfers to improve grip strength and key pinch. All patients reported subjective improvements in quality of life, activities of daily living and patient-centred goals. There were six excellent and two good results. Objective improvements included mild improvements in key pinch and grip strength.
Normal Digital Contribution to Grip Strength Assessed by a Computerized Digital Dynamometer
Authors: TALSANIA J. S. , KOZIN S. H.
Published: September 2005

A computerized digital dynamometer was used to assess the contribution of individual fingers to total grip strength in 100 hands from 50 randomly selected healthy subjects. The dynamometer simultaneously recorded force data from each digit (index, long, ring, and small) and cumulative grip directly to a laptop computer. The percentage contribution of each finger force to total grip force was calculated at three successive handle sizes for dominant and non-dominant hands.

Individual digital contributions to total grip strength were approximately 25%, 35%, 26% and 15% for the index, long, ring, and small fingers respectively. This pattern was consistent irrespective of handle size, hand dominance, and grip strength.
The Innervation Pattern of the Radial Nerve at the Elbow and in the Forearm
Authors: BRANOVACKI G. , HANSON M. , CASH R. , GONZALEZ M.
Published: September 2005

Sixty paired cadaver forearms were dissected to examine the distribution of the radial nerve branches to the muscles at the elbow and forearm. Emphasis was placed on the innervation of the extensor carpi radialis brevis and the supinator muscles because of discrepancies in the literature concerning these muscles. The most common branching pattern (from proximal to distal) was to brachioradialis, extensor carpi radialis longus, superficial sensory, extensor carpi radialis brevis, supinator, extensor digitorum/extensor carpi ulnaris, extensor digiti minimi, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus and extensor indicis. The branch to extensor digitorum and extensor carpi ulnaris came off as a common stem often with the branch to extensor digiti minimi. The branch to the ECRB muscle was noted to arise from the posterior interosseous nerve in 45%, superficial sensory nerve in 25% and at the bifurcation of the posterior interosseous and superficial sensory nerves in 30% of specimens. The supinator had an average of 2.3 branches from the posterior interosseous nerve (range 1–6). The branches to the supinator showed a wide variability proximal to and within the supinator.
Evaluation of Five Different Incisions for Correction of Radial Dysplasia
Authors: PILZ S. M. , MURADIN M. S. M. , VAN DER MEULEN J. J. N. M. , HOVIUS S. E. R.
Published: September 2005

The complications of the five different incisions used for centralization from 1970 to 1996 were evaluated. In five cases access was by an S- shaped incision, in one with a transposition flap. Sixteen centralizations were done using a radial Z-plasty in combination with an ulnar excision and four by using two opposite Z-plasties, preserving wrist mobility as much as possible. In 1995 and 1996 a bilobed flap was used in seven cases. No complications occurred with the primary procedures prior to 1995. In all seven cases where the bilobed flap was used venous congestion was seen. In four out of these seven superficial necrosis of parts of the flaps occurred. In all cases though wound healing occurred spontaneously by delayed primary healing after the standard 8 weeks of cast immobilization.
A Biomechanical Analysis of Intrascaphoid Compression Using the Herbert Scaphoid Screw System
Authors: LO I. K. Y. , KING G. J. W. , MILNE A. D. , JOHNSON J. A. , CHESS D. C.
Published: September 2005

The purpose of this study was to evaluate the compressive capabilities of the Herbert scaphoid screw system. A transverse osteotomy was performed at the waist of eight scaphoids removing a 3 mm wafer of bone. A custom-designed load washer was inserted within this defect to measure intrascaphoid compression during Huene guide application, during screw insertion, after screw insertion and after guide release. The intrascaphoid compression was noted to peak during screw insertion; however it dramatically decreased without any clinical subjective evidence of decreased insertional torque by the surgeon. The average final compression as a percentage of maximal compression was 38 (SD 26) %.
Colour Doppler Analysis of Tendon and Muscle Movements
Authors: SUGAMOTO K. , OCHI T.
Published: September 2005

We have examined and successfully visualized active and passive movement of tendons and muscles using colour Doppler ultrasound. This preliminary study suggests that colour Doppler may be very useful to examine the movements of tendons and muscles.
Acute Transient Bilateral Trigger Fingers
Authors: GILES S. N. , GOSLING T. , HAY S. M.
Published: September 2005

A 30-year-old man presented with bilateral, simultaneous, transient triggering of the middle digits which developed acutely after prolonged and sustained use of a garden rotavator. He was asymptomatic in the period before presentation and has remained so 7 years since.
Proximal and Palmar Dislocation of the Lunate and Proximal Scaphoid as a Unit in a Case of Scaphocapitate Syndrome
Authors: PANDIT R.
Published: September 2005

Various patterns of transscaphoid, transcapitate fracture-dislocations have been described in the literature. There is little information on the method of management and the long-term results of such severe and rare injuries. The case described here involved a transscaphoid, transcapitate, palmar perilunate fracture-dislocation with ejection of the proximal pole of the scaphoid and lunate into the palmar aspect of the forearm. The functional result 32 months after delayed open reduction and internal fixation is reported.
Recurrent Metacarpal Giant Cell Tumour Treated by En Bloc Resection and Metatarsal Transfer
Authors: PARDO-MONTANER J. , PINA-MEDINA A. , BARCELO-ALCAIÑIZ M.
Published: September 2005

Recurrent giant-cell tumours of bone have a higher risk of malignancy than primary giant-cell tumours of bone, and giant-cell tumours of bone in the hand are more likely to recur than those that arise elsewhere. Therefore, en bloc resection and reconstruction, or amputation, have been the accepted treatments for recurrent giant-cell tumours of bone in the hand. We describe two cases of successful transplantion of a metatarsal to a metacarpal, which was the site of a recurrent giant-cell tumour. The patients had satisfactory results 3 years later without problems in the foot. En bloc resection of the tumour and reconstruction with an autograft should be considered in the treatment of recurrent giant cell tumour of the hand.
Gilthead seabream (Sparus aurataL.) innate defence against the parasiteEnteromyxum leei(Myxozoa)
Authors: CUESTA A. , MUÑOZ P. , RODRÍGUEZ A. , SALINAS I. , SITJÀ-BOBADILLA A. , ÁLVAREZ-PELLITERO P. , ESTEBAN M. A. , MESEGUER J.
Published: September 2005

The humoral innate immune response of gilthead seabream (Sparus aurataL.) against the myxozoanEnteromyxum leeihas been studied. At 10, 22, 38, 52 and 108 days of cohabitation fish were sampled to examine gut histology and to determine serum innate immune parameters and the mRNA expression of pro-inflammatory cytokines (IL-1β and TNFα) in head-kidney. The parasite was successfully transmitted to 45% of the recipient fish and prevalence reached a maximum (62·5%) at the last sampling time (108 days). Recipient fish started to die after 74 days of cohabitation. In general, alternative complement activity was higher whereas the peroxidase level was lower in recipient fish than in controls. Moreover, IL-1β mRNA expression increased while the TNFα gene expression decreased in recipient fish. These data demonstrate the involvement of complement activity in the defence mechanisms of the gilthead seabream against the myxosporeanE. leei. Within the recipient fish group, few differences were observed in the studied immune parameters betweenE. leei-parasitized and non-parasitized recipient fish. Parasitological and immunological implications ofE. leeiinfections in Mediterranean fish farms are discussed.