bluuebunny/crossref_metadata_2025 huggingface dataset:
Rupture of the Extensor Pollicis Longus Tendon after Fracture of the Lower End of the Radius — a Clinical and Microangiography Study
Authors: Engkvist Ove , Lundborg Göran
Published: March 2006

The pathogenesis of the late post-traumatic rupture of the extensor pollicis longus tendon has never been satisfactorily explained. In the present series of fifty-nine ruptures two were partial, making possible an exact localization of the rupture. Microangiographic studies performed on amputated arms showed that this part of the tendon was poorly vascularized. Our study confirms earlier observations that ruptures most commonly occur after undisplaced fractures. It is suggested that increased pressure within the non-ruptured tendon sheath jeopardizes the blood flow in the already poorly vascularized parts of the tendon, leading to degeneration and rupture, usually within eight weeks. An haematoma inside the sheath interfering with the production of synovial fluid, could deprive the tendon of an alternative nutrition via diffusional pathways.
Surgical Repair of the Boutonnière Deformity of the Fingers
Authors: Pardini A. G. , Costa R. D. , Morais M. S.
Published: March 2006

Boutonnière deformity is discussed. The results of twenty-seven digits operated on are presented. The operative technique used was that directed to the central tendon. The results were analysed according to the digit affected, to the type of lesion, if closed or opened, to the association with other lesions and to the time between the lesion and the surgery.
Triggering Due to De Quervain's Disease
Authors: Chow S. P.
Published: March 2006

Triggering of the thumb due to de Quervain's disease is a rarity. When it occurs in a boy of seven years old, it has never been reported before in the English literature.
Bilateral Ulnar “Thumbs”
Authors: Harvey Francis J.
Published: March 2006

Congenital fusion of the carpal bones is fairly common and may be associated with other congenital deformities in the hand. This report deals with an unusual congenital anomaly of the little fingers associated with fusion of the triquetrum and lunate. Both little fingers were adducted and rotated giving crude resemblance to thumbs on the ulnar borders of the hands. The deformity was easily corrected by osteotomy through the base of the fifth metacarpals.
The Basal Cell Naevus Syndrome and Palmar Cysts
Authors: Nicolai J. P.
Published: March 2006

A patient is described with multiple cysts in the palms of both hands in association with the basal cell naevus syndrome. A cause for the origin of the cysts is postulated.
Osteoid Osteoma of the Capitate Bone
Authors: Jensen E. Gert
Published: March 2006

A case of osteoid osteoma of the capitate bone is presented. The osteoma was accompanied by synovial changes in the neighbouring intercarpal joint, and this characterized the clinical features. Resection of the osteoma afforded relief from symptoms.
Malignant Histiocytoma of the Arm in a Four Year Old Boy
Authors: Karev Avner
Published: March 2006

Malignant histiocytoma in childhood is extremely rare, and a case of a malignant histiocytoma of the arm of a four year old boy is herewith reported.
The Histomorphology of the Elastic Tissue System in the Skin of the Human Hand
Authors: Enna Carl D. , Dyer Robert F.
Published: March 2006

This study compares the effectiveness of the Verhoeff and Puchtler-Sweat resorcin fuschin methods of staining the elastic tissue of palmar and dorsal skin specimens of the human hand.

The resorcin fuschin stain demonstrates the “oxytalan” fibres of the elastic tissue system in the dermal papillary layer of the palmar skin. Oxytalan fibres are not generally demonstrated by the Verhoeff method and are not demonstrated in the dorsal skin specimens.

These studies substantiate the existence of a system of elastic tissue fibres in the skin of the hand. The inter-relationship of the elastic and collagenous fibres appears to complement each of their functions; namely, in anchoring the dermo-epidermal junction, absorbing the stresses of stretch and compressive forces and return the tissues to their original state of tension, and providing protection to the dermal appendages in addition to lending a gradient mobility transmitted through the dermis to the subcutaneous layer to give suppleness and mobility to the skin.
Re-Alignment Procedure for Ulnar Drift of the Metacarpophalangeal Joint in Rheumatoid Arthritis
Authors: Harrison D. H. , Harrison S. H. , Smith P.
Published: March 2006

An operation for correcting ulnar deviation in rheumatoid arthritis, by employing local tendon transfers at an early stage in the developing deformity, is described. The pathology, clinical staging and results in 103 joints are presented.
Interpositional Arthroplasty of the Wrist in Rheumatoid Arthritis
Authors: Jackson I. T. , Simpson R. G.
Published: March 2006

The procedure of interpositional arthroplasty of the wrist joint in rheumatoid arthritis, using silicone sheeting, is described. The results and complications of sixty arthroplasties are presented.
The Pathogenesis of the Rheumatoid Swan Neck Deformity
Authors: Heywood A. W. B.
Published: March 2006

Disappointment with the late results of intrinsic release for the rheumatoid “intrinsic-plus” hand has led to a re-appraisal of the role of intrinsic muscle contracture in the pathogenesis of the rheumatoid swan neck deformity. In cadaveric fingers, a properly placed suture tying the lateral band to the middle slip insertion causes a swan neck deformity. It is suggested that the usual “intrinsic-plus” hand and the fixed swan neck deformity of rheumatoid arthritis is caused by adhesions between the extensor tendons on the dorsum of the proximal interphalangeal joint, rather than by intrinsic muscle contracture and/or metacarpo-phalangeal dislocation.
Silicone Rubber Cuffs — A Cause of Nerve Compression
Authors: Birch Rolfe
Published: March 2006

We report two cases of nerve compression at the wrist, caused by the silicone rubber cuff used in primary repair.
Transverse Volar Skin Laceration of the Finger: A Sign of Volar Plate Injury
Authors: Zook Elvin G. , Van Beek Allen L. , Wavak Paul
Published: March 2006

Transverse tears of the volar skin of a finger with a hyper-extension injury is associated with frequent volar plate tears or avulsions. Recognition is essential for surgical exploration of the volar plate and supporting joint structures and, if injured, surgical repair should be carried out at the time of skin suturing.
Extensor Digitorum Brevis Manus: A Case Report and Review
Authors: Stith Jennifer S. , Browne Phyllis A.
Published: March 2006

A detailed description of bilateral extensor digitorum brevis manus (EDBM) present in a female cadaver is presented. The need for clinical recognition is emphasized. Prevalence, morphological variability and theories of ontogeny are reviewed. Clinical significance and possible function are discussed. Since misdiagnosis may result from the anatomical variability and lack of clinical awareness, the need for further study is emphasized.
Eikenella Corrodens Infection of the Hand
Authors: Mcdonald Ian
Published: March 2006

The clinical presentation and course of two patients with Eikenella corrodens infection of the hand is recorded. This recently recognised organism must not be regarded as a harmless commensal and should be differentiated from the Bacteroides group because of its resistance to clindamycin. Radical surgical debridement is the most important aspect of therapy.
Causes of Locking Metacarpophalangeal Joint of the Thumb and Its Non-Operative Treatment
Authors: Kojima Tadao , Nagano Tetsuya , Kohno Toshihiko
Published: March 2006

The non-operative method of reduction of locking metacarpophalangeal joint of the thumb is described, and illustrated by four case reports. Experimental studies in the hands of a fresh cadaver are also described.

Locking of the metacarpophalangeal joint of the thumb can be produced by slight external forces, insufficient to damage strong tissues. Incarceration of the sesamoid bone is anatomically impossible, but incarceration of the proximal portion of the volar plate is believed to be the true cause. This incarceration can be reduced easily by our non-operative method along with intra-articular injection of local anaesthetics.
Ulnar Neuropathy at the Elbow
Authors: Reikerås Olav
Published: March 2006

In the years 1961–1975 we have treated thirty-one men and twenty-four women for ulnar nerve palsy at Kronprinsesse Märthas Institutt. The age ranged from sixteen to seventy-eight, the majority were in mid-adult life. Thirty-four nerves on the right arm and twenty-seven on the left were operated on with anterior transposition. This clinical material has been analysed regarding aetiology and management. The neuropathy was secondary to trauma or disease at the elbow in thirty-five cases and primary with a normal elbow in twenty-six cases. At operation it was found that the neuropathy was due to fibrous compression in 36 per cent and to hypermobility in 21 per cent. In 43 per cent there were no macroscopic reasons for neuropathy. We have re-examined fifty-two patients at an average time of seven and a half years after the operation. The results were found to be excellent in 47 per cent, good in 30 per cent and poor in 23 per cent. The results were independent of duration of symptoms before the operation and independent of the surgical findings at the operation. The results were also the same whether the nerve at the transposition was put intramuscularly or just subcutanously.
Habitual Extensor Tendon Dislocation
Authors: Bracey D.J. , Jeffreys T. E.
Published: March 2006

Dislocated tendons are frequently seen in the rheumatoid hand. Habitual dislocation is rare. Five patients, all sero-negative with this problem, are described. The causation of the deformity and its treatment is discussed in relation to other cases reported in the literature. An extensor loop operation is recommended.
Stenosing Tenovaginitis Affecting the Tendon of Extensor Digiti Minimi at the Wrist
Authors: Hooper G. , Mcmaster M. J.
Published: March 2006

We report a patient with stenosing tenovaginitis affecting the sheath of the tendon of extensor digiti minimi. The similarities to typical de Quervain's disease are discussed.
Thumb Reconstruction after Amputation at the Interphalangeal Joint by Gradual Lengthening of the Proximal Phalanx
Authors: Matev Ivan B.
Published: March 2006

A case of thumb amputation at the interphalangeal joint and reconstruction by gradual lengthening of the proximal phalanx is described. As a result of the treatment the amputation stump was lengthened 2cms which means a 70 per cent increase of the original length of the proximal phalanx. The quality of sensibility of the stump has been preserved.
The Effect of Intermittent Pneumatic Compression on the Hand after Fasciectomy
Authors: Hazarika E. Z. , Knight M. T. N. , Frazer-Moodie A.
Published: March 2006

Thirty-nine patients undergoing surgery for Dupuytren's contracture were included in a fully randomised, matched, prospective trial to evaluate the effect of intermittent compression on the post-operative hand.

The study revealed a definite improvement in the treated, over the control patients. There was a distinct decrease in oedema with almost immediate return to normal hand function in the group treated by compression. Other benefits accrued from the earlier subsidence of pain in treated hands requiring reduced or no analgesia and from the earlier expression of fluid discharge from the wound thus preventing haematoma formation and the consequent ills.
Free Groin Flap Transfer to the Upper Extremity
Authors: Shah K. G. , Garrett John C. , Buncke Harry J.
Published: March 2006

Seven patients underwent free groin flap transfer to the first web space, palm, wrist or elbow. Six of the seven were successful. The seventh developed acute venous occlusion and superficial necrosis of part of the flap, receiving split thickness skin grafts to salvage the dermal portion. Transfer is offered as an alternative to more conventional flaps for coverage of defects of the upper extremity.
Isolated Pathological Fracture of the Capitate Bone
Authors: Enna Carl D.
Published: March 2006

Isolated fracture of the capitate bone is rare, but an isolated pathological fracture due to leprosy has not been previously reported. Although varying degrees of trauma is implied to be associated with fractures, this case illustrates a pathological fracture of the capitate apparently due solely to a specific disease. Fracture has occurred without a history of trauma and there has been no displacement of the fragments on x-rays over a period exceeding ten years even though it has been subjected to unrestricted activities by the patient who has clinically inactive disease.
Perichondrial Grafting in Rheumatoid Metacarpophalangeal Joints
Authors: Sully L. , Jackson I. T. , Sommerlad B. C.
Published: March 2006

A pilot study of perichondrial grafting in rheumatoid metacarpophalangeal joints is presented. Eighteen separate joints have been grafted with a mean follow-up time of eighteen months. Results and indications for this method of joint reconstruction in rheumatoid patients are discussed.
Spontaneous Rupture of all Three Extensor Tendons to the Thumb in Rheumatoid Arthritis
Authors: Rudge S. R.
Published: March 2006

A case of spontaneous rupture of all three extensor tendons to the thumb in a patient with Rheumatoid Arthritis is described.
Delayed Primary Suture of Flexor Tendons Cut in the Digital Theca
Authors: Matev I. , Karagancheva S. , Trichkova P. , Tsekov P.
Published: March 2006

The results of delayed primary suture of flexor tendons cut in the digital theca in twenty five patients, thirty three affected fingers, are given. The patients had their skin closed at another hospital immediately after the injury. One to six days later the skin stitches were removed and tendon suture was performed.

Excellent and very good results are obtained in 78.7% of all thirty three fingers operated upon.
Pigmented Villonodular Synovitis of the Hand
Authors: Fyfe I. S. , Macfarlane A.
Published: March 2006

A series of fifty one lesions arising in the hand is reviewed. Fifty nine per cent of the lesions arose from the joints of the hand which are also frequently the site of degenerative changes. Twenty five per cent of available radiographs also showed such changes. The aetiology and diagnosis of this condition, the treatment and the results are discussed.
Digital Nerves in the Terminal Phalangeal Region of the Thumb
Authors: Chow S. P.
Published: March 2006

Microscopic dissection of the digital nerve in the terminal phalangeal region of ten specimens of the thumb revealed that it divided into three main branches just before entering the terminal pad. They had a rather constant topographic distribution and were situated in a very deep position.
Hand Injuries in Professional Musicians a Report of Six Cases
Authors: Crabb David J. M.
Published: March 2006

The manner in which hand injuries affected six professional musicians and their music making is described. The need to take into account the particular requirement of hand function in each musician, when planning reconstructive surgery, is emphasised.
Closed Rupture of Extensor Digitorum Communis Tendon following Fracture of the Radius
Authors: Mackay Iain , Simpson Robert G.
Published: March 2006

A case of closed rupture of the extensor digitorum communis tendon following a fracture of the lower end of the radius with anterior displacement, is described. This rare complication was treated successfully by abductor pollicis longus tendon transfer.
Experimental Studies on Cellular Mechanisms Involved in Healing of Animal and Human Flexor Tendon in Synovial Environment
Authors: Lundborg Göran , Rank Fritz
Published: March 2006

An experimental model is presented to study superficial healing of animal and human flexor tendon in a synovial environment. The results indicate that in a synovial environment a cut and resutured flexor tendon may heal in its superficial parts without adhesion formation. When cell seeding via the synovial fluid is prevented by a dialysing membrane the picture, as revealed by light microscopy, is little changed. When the model is modified so that the central cells of the tendon are exposed to the synovial fluid, these cells become activated. The results indicate that superficial as well as deep cells of the tendon possess a potential for repair if they are adequately nourished, and that cell seeding plays no major role in the process of proliferation and repair. The picture of intrinsic repair potential in a synovial environment seems to be valid also for human flexor tendons.
An Analysis of Complications in Digital Replantations
Authors: Leung P. C.
Published: March 2006

Twenty digital replantations were done in the Princess Margaret Hospital, Hong Kong in the year from August 1977 to August 1978.

The complications encountered in the post-operative period and later stages are discussed. Some of the measures that might contribute towards the prevention and treatment of these complications are analysed.
Complete Carpal Disruption of the Hand
Authors: Mullan G. B. , Lloyd G. J.
Published: March 2006

A case of radiocarpal and inter-carpal dislocations associated with a fracture-dislocation of the ulnar four carpo-metacarpal joints is presented, with a description of treatment and long term follow-up. A review of the literature shows this to be a unique combination of injuries.
Post-Traumatic Instability of the Metacarpophalangeal Joint of the Thumb
Authors: Mogensen Brynjolfur A. , Mattsson Hållbus S.
Published: March 2006

Post-traumatic instability of the metacarpophalangeal joint of the thumb has been treated surgically in sixty-six patients. The results in eighty per cent were excellent or good.
Ligament Augmentation with Replacement Arthroplasty of the Carpometacarpal Joint
Authors: Crawford Gary P.
Published: March 2006

A method of ligament augmentation at the time of Swanson silicone replacement arthroplasty of the trapezium is presented. This has effectively solved the problem of prosthetic dislocation. One of the twenty-six patients had a prosthesis dislocate and this was felt to be due to improper positioning of the thumb post-operatively. A successful closed reduction and subsequent prosthetic stability was achieved. All twenty-six patients had stable and pain free thumbs with good range of motion.
Tourniquet Time — how Long?
Authors: Klenerman Leslie
Published: March 2006

Tourniquet pressure rather than prolonged ischaemia is the main factor responsible for nerve palsies. It is essential to check the accuracy of the gauge of a pneumatic tourniquet against a mercury manometer regularly, as the commonest cause of a tourniquet paralysis is a faulty gauge. With regard to ischaemia three hours should be regarded as the upper limit of safety.
The Effect of Tourniquet Ischaemia on Intact, Tenotomized and Motor Nerve Injured Human Hand Muscles
Authors: Józsa Lászlo , Renner Antal , Sántha Ernö
Published: March 2006

Ultrastructural examination of the intrinsic hand muscles was performed on young healthy patients undergoing reconstructive operations following tendon or nerve lesions. The muscle specimens were taken at the start and then every fifteen to twenty minutes until the end of the tourniquet ischaemia. The authors have not found any morphological alterations following the use of a tourniquet up to two hours in either the intact or previously injured muscles.
Conservative Management of Finger Tip Injuries in Adults
Authors: Allen M. J.
Published: March 2006

A prospective trial was undertaken on fifty consecutive patients with a total of sixty finger tip injuries treated by conservative means at the Leicester Royal Infirmary Accident and Emergency Department. The injuries have been classified into groups and results reviewed after a period of one year.
Traumatic Aneurysm of the Radial Artery in the Anatomical Snuff Box — a Report of two Cases
Authors: Wenger Dennis R. , Boyer David W. , Sandzén Sigurd C.
Published: March 2006

Two cases of radial artery aneurysm in the anatomical snuff box are described, together with the clinical features which should differentiate this rare lesion from the much more common ganglion in the same location.
Abnormal Course of the Median Nerve Associated with an Anomalous Belly of Flexor Digitorum Superficialis
Authors: Figueiredo U. M. , Hooper G.
Published: March 2006

We report an anomalous muscle belly of the flexor digitorum superficialis acting on the right index finger. The median nerve lay superficial to the muscle in the forearm and at the wrist.
Glomus Tumours in the Hand
Authors: Varian John P. W. , Cleak David K.
Published: March 2006

The experience of the Hand unit at the Derbyshire Royal Infirmary in dealing with this rare condition in twenty one patients has been reviewed and conclusions drawn. It was found that symptomatology varied a little more than is generally described in the textbooks. Recurrence of symptoms is common and this fact is not given its due attention in the literature. Recurrent symptoms can be due either to a recurrence of tumour or to a different tumour in the same site. A more radical resection may achieve more first time cures.
Ewing's Sarcoma of the Hand following Recurrent Trauma a Case Report
Authors: Dreyfuss Uriel Y. , Auslander Lya , Bialik Victor , Fishman Joseph
Published: March 2006

A case of Ewing's Sarcoma of the thumb is described. Four years after a fracture of the first metacarpal, followed by a series of repeated traumata to the area, a tumour was discovered. According to Ewing's criteria of trauma induced malignancy, this case is highly suggestive to have been caused by trauma.
Melanin Containing Clear Cell Sarcoma in a Fingertip Case Report and Review of the Literature
Authors: Tyler George , Wirman John , Neale Henry W.
Published: March 2006

A case is described of a clear cell sarcoma with ultrastructural evidence of melanin production. The tumour appeared on the distal portion of the index finger of a thirteen-year-old girl and showed little change in size over seven years of observation by the patient. At age twenty she required hospital admission at which time clinical evidence of metastases to axillary nodes, lungs and bone was found and the patient died within two months. The previous cases reported in the literature are discussed.
Isolated Finger Flexion Force—a Methodological Study
Authors: Ejeskär A. , örtengren R.
Published: March 2006

A method is presented for measuring isolated finger flexion force in a transverse volar grip in a standardized manner. Normal values for forty healthy subjects are given. The mean force of the digits varied from 5.9 to 10.6kp, the middle finger being the strongest, followed by the index, ring and little finger. Large individual variations were observed, especially among men. Men were significantly stronger than women in corresponding digits. The symmetry between the hands, judged by the order of strength of the fingers, was good in both sexes but expecially in women. It is suggested that the strength ratio between dominant and non-dominant might be used to assess the recovery of finger flexion force after, for instance, tendon surgery. Although a correlation exists between isolated finger flexion force and vigorimetric values of the hand grip strength, it is of little value in evaluation of tin individual patient.
The Results of Excision of the Trapezium
Authors: Iyer K. Mohan
Published: March 2006

A clinical review of patients treated by excision of the trapezium for carpometacarpal arthritis of the thumb is presented. Excision of the trapezium gave good results, particularly with respect to relief of pain. Hand function was good following excision of the trapezium, though there was some reduction in the power of opposition grip and pinch grip in three-quarters of the patients. This weakness may be due to the carpal instability that exists following the operative procedure.
Arthrography of the Metacarpo-Scaphoid Joint Following Excision of the Trapezium
Authors: Iyer K. Mohan , Whitehouse Graham H.
Published: March 2006

Arthrograms were performed on twenty-five metacarpo-scaphoid joints following excision of the trapezium. The joint space was usually irregular and of small capacity within six months of surgery, but became larger and smoother in time. Sometimes the joint space communicated directly with the midcarpal joint or the extensor pollicis longus sheath. The arthrographic appearance did not provide an indication as to the clinical outcome, but marked subluxation of the first metacarpal on the scaphoid during abduction correlated with a less successful outcome.
Congenital Hand Anomalies, and Their Association with other Congenital Abnormalities
Authors: Miura T.
Published: March 2006

Congenital abnormalities of other parts occurring in patients with congenital abnormalities of the hand were studied. Hands and feet often showed similar anomalies, but there were some cases in which the hands and feet had different kinds of deformity. Anomalies of the internal organs were associated with anomalies of the thumb. Cleft lip and palate occurred in combination with syndactyly, split hand, preaxial Polydactyly and constriction ring syndrome.

Combined anomalies may be the result of a genetic or environmental factor interfering with parts developing during the same critical period. The critical period and probable pathogenesis are discussed and the conclusion reached that mesenchymal necrosis, abnormal distribution of mesenchyme and tissue necrosis after mesenchymal condensation may be the pathological changes which lead to abnormal development of the hand.
Subungual Bowen's Disease
Authors: Stilwell J. H. , Maisels D. O.
Published: March 2006

Bowen's disease affecting the nail bed is extremely uncommon. Two further cases are described and the literature reviewed.
Phalangeal Osteoid Osteoma in the Hand
Authors: Lamb D. W. , Del Castillo F.
Published: March 2006

Three examples of osteoid osteoma of the phalanges have presented in our clinic in one year. The pain was the most significant clinical feature. The pain was either unrelieved or incompletely relieved by aspirin. Routine x-rays in the early stages of the disease were unhelpful in diagnosis. It is recommended that bone scanning is a useful diagnostic aid.
Multiple Glomus Tumours in One Digit
Authors: Cornell S. J.
Published: March 2006

This is a case report of a lady with multiple glomus tumours in the same finger together with a classification of glomus tumours.
Scaphoid and Lunate Dislocation a Report on a Case
Authors: Brown R. H. L. , Muddu B. N.
Published: March 2006

A case of scaphoid and lunate dislocation is presented. The literature on the subject is reviewed. Certain features of this case which are common with those of reported cases are discussed.
Ulnar Nerve Palsy as a Complication of Synovial Osteochondromatosis of the Elbow
Authors: Fahmy N. R. M. , Noble J.
Published: March 2006

Synovial osteochondromatosis is a rare disease which usually runs a benign course. The knee, hip, elbow and the small joints of the hands and the wrists are the joints most affected, (Chadwick, 1977; Milgram, 1977; Murphy, 1962) and the common complaints are of swelling and stiffness, sometimes associated with locking and pain. We present a case with symptoms and signs of ulnar nerve palsy, due to synovial osteochondromatosis of the elbow.
The Thumb Web Expanding Splint: Dynamic Splintage for Traumatic Web Contracture
Authors: Leung P. C. , Hui K. M.
Published: March 2006

A dynamic method of holding the thumb into abduction and opposition is described, for the prevention and treatment of thumb web contracture, using percutaneous Kirschner wires. Cases are illustrated.
A Quantitative Allen's Test
Authors: Scavenius M. , Fauner M. , Walther-Larsen S. , Buchwald C. , Nielsen S. L.
Published: March 2006

Allen's test has been performed quantitatively by measuring digital systolic pressure during compression of the radial or ulnar artery at the wrist. The reduction of pressure in normal subjects was less than 25 per cent. Insufficiency of the arterial supply to the hand from the radial artery, the ulnar artery or the palmar arcades can easily be diagnosed from an abnormal reduction in digital systolic pressure during arterial compression.
Sensation in Cross-Finger Flaps
Authors: Nicolai J. P. A. , Hentenaar G.
Published: March 2006

Cross-finger flaps in fiftyone patients were examined one to six years postoperatively, with particular reference to two-point discrimination. Patients less than twenty years old have the best chance of achieving good sensation. Two-point discrimination seems to reach its maximum within one year after the operation.
The Anatomy of the Incision for Carpal Tunnel Decompression
Authors: Denman E. E.
Published: March 2006

The coarse fibrous pattern of the roots of the palmar aponeurosis and of the flexor retinaculum, comprising the roof of the carpal tunnel, is described, to define the structures incised in the operation to relieve carpal tunnel compression syndrome.
The Value of Plain Radiographs in Treating Grease-Gun Injuries
Authors: Crabb David J. M.
Published: March 2006

All grease-gun injuries to the hand should be X-rayed to determine the extent of contamination, as many types of grease are radio-opaque. If the grease is not radio-opaque a Xeroradiograph should be performed. Further X-ray films may be taken during the operation to ensure complete removal.
Surgical Correction of Thumb Deformity in Arthrogryposis Multiplex Congenita
Authors: Dangles Chris J. , Bilos Z. John
Published: March 2006

Four patients underwent surgical correction of five thumb deformities due to arthrogryposis. Although varying degrees of deformity were present, all exhibited adduction contracture, laxity of the ulnar collateral ligament at the metacarpophalangeal joint and absence of the abductor pollicis brevis.

Techniques for release of the adduction contracture included Z-plasties or a local flap. Four thumbs had simultaneous opponensplasties performed and repair of the ulnar collateral ligament of the metacarpophalangeal joint. The patients have now been followed for an average of twenty-eight months (range 1 1/2 to 3 years). Parents and patients have been pleased with the results.
Dermatoglyphics in Typical Cleft Hand
Authors: Suzuki T. , Tsuchiya K. , Takazawa H. , Matsui I.
Published: March 2006

Dermatoglyphic prints of the typical cleft hand with a rudiment of the middle metacarpal showed that a whorl pattern was present on the ulnar margin of the V-shaped defect, suggesting the fingertip pattern of the middle finger.
Transverse Deficiency of the Hand in one of Monozygotic Twins
Authors: Ogino T. , Ishii S. , Shiono H.
Published: March 2006

In this paper, we report on one male infant of twins with a left hand anomaly. The hand deformities were diagnosed as so called “congenital amputation” which is a synonym of “transverse deficiency” in Swanson's classification. The left hand showed spontaneous amputation at the level of the palm. There were two rudimentary digits on the stump, and an extremely hypoplastic thumb and little finger. The other twin had no anomaly. The results of laboratory findings on blood groups and HLA types suggest that these twins are monozygotic. From these facts, we considered that environmental factors are more important than genetic ones in the pathogenesis of transverse deficiency and symbrachydactyly of the hand.
An Anomalous Flexor Digitorum Superficialis Indicis Muscle Presenting as Carpal Tunnel Syndrome
Authors: Hutton P. , Kernohan J. , Birch R.
Published: March 2006

The description is given of an anomalous muscle arising from the flexor digitorum superficialis indicis tendon distal to the transverse carpal ligament which presented as carpal tunnel syndrome.
Carpal Tunnel Syndrome Produced by an Organising Haematoma Within the Anomalous Second Lumbrical Muscle
Authors: Nather A. , Pho R. W. H.
Published: March 2006

A rare case of carpal tunnel syndrome due to an anomalous second lumbrical muscle passing through the carpal tunnel is described. Its presentation as an organising haematoma in the anomalous muscle due to trauma precipitating the syndrome has not been reported in the literature previously. The anomalous muscle with its contained haematoma was excised with complete relief of symptom.
Effect of Continuous Load on the Mechanical Properties of Tendon Adhesions
Authors: Wray R. C. , Ollinger H. , Lowrey R. , Weeks P. M.
Published: March 2006

The restoration of tendon gliding after tendon repair or grafting is dependent upon alteration of the scar about the tendon. Application of a load (active range of motion exercises) is used clinically to effect this alteration. Using the chicken as a model, we are attempting to define the optimal timing, quantity and duration of the load. In these initial experiments, the effects of application of a continuous load for forty eight hours were evaluated in eighty nine chickens. A continuous load applied for forty eight hours had no significant effect on motion of repaired tendons or the scar “stiffness”.
Locking of the Metacarpophalangeal Joints in Degenerative Disease
Authors: Stewart G. J. , Williams E. A.
Published: March 2006

Nine cases of locking of the metacarpophalangeal joint are described. The previously asymptomatic middle finger joint in an elderly person was most likely to be affected. Radiology of the joint has shown degenerative changes in all cases. In two patients, spontaneous unlocking of the joint occurred and in a further six operative release was undertaken. The important anatomical features of the condition are discussed in relation to the mechanism of locking and the surgical treatment.
An Interpositional Elastomeric Cap for Metacarpophalangeal Joint Perichondrioplasty in Rheumatoid Arthritis
Authors: Jackson I. T. , Sully L. , Tanner N. S. B. , Mcglynn M. J.
Published: March 2006

A new interpositional elastomeric cap was developed and used for perichondrioplasty in six rheumatoid metacarpophalangeal joints. Adequate cartilage formation occurred, and the joint contours were more normal than those achieved by previous methods.
Tumours of Hand
Authors: Leung P. C.
Published: March 2006

198 hand tumours were found among 7,552 new cases seen within a period of four years.

The diagnostic problems are discussed, and the treatment of the different types of tumour described.

The ganglia were specially followed-up for 1–4 years in order to detect the rate of early recurrence. This is found to occur in 8% of cases.

Careful planning and adequate local excision were emphasised.
Chemosurgical Excision of Subungual Squamous Cell Carcinoma
Authors: Tomsick R. , Menn H.
Published: March 2006

Chemosurgery and wound healing by secondary intention is an excellent method of treatment for subungual carcinoma. It allows for complete ablation of the tumour with maximal preservation of tissue, eliminating the need for amputation, in the absence of bone involvement. As most nail bed carcinomas occur on the thumb, by avoiding distal phalanx amputation one can prevent considerable disability. Because chemosurgery traces out every infiltrating band of tumour, bone involvement can be accurately detected. Amputation, if necessary, could then be carried out to achieve cure. Despite the age of our patients (average age 64.6 years), all surgical sites healed well with good range of motion at the adjecent interphalangeal joint.
The Results of Treatment of two Hundred and Seventy-Three Carcinomas of the Hand
Authors: Rayner C. R. W.
Published: March 2006

Squamous carcinoma of the hand behaves more aggressively, and is more difficult to cure by non-surgical means, when it arises in the interdigital clefts or adjacent skin over the metacarpo phalangeal joints.
Dermatofibrosarcoma Protruberans Arising on the Hand
Authors: Wirman J. A. , Sherman S. , Sullivan M. R.
Published: March 2006

Dermatofibrosarcoma is a relatively common, locally aggressive, soft tissue fibrous histiocytoma. Ignorance of its marked propensity for locally invasive growth can lead to inadequate excision, and patients often suffer multiple recurrences.

We present a case of dermatofibrosarcoma arising on the hand, and discuss its natural history and proper surgical therapy.
Intravenous Regional Anaesthesia in Hand Surgery — Experience with 632 Cases
Authors: Chan K. M. , Ma G. F. Y. , Chow Y. N. , Leung P. C.
Published: March 2006

Practical experience in the use of intravenous regional anaesthesia in hand surgery on 632 patients is reported. The safety of the anaesthesia, the efficacy of the procedure and the patient-comfort are well attested in this study. We recommend that its role should be established particularly in busy orthopaedic surgery departments where both elective and emergency work-loads on hand surgery are heavy.
A Rare Finger Injury
Authors: Yadav S. S. , Rajagopal N. , Thomas S.
Published: March 2006

A closed injury of the left index finger displacing the skeleton out of its soft tissue bed is reported. Reduction of the displaced segments in place resulted in normal function of the finger.
“The Vibrometer” an Electro Magnetic Transducer as an Attempt to Examine Sensibility of the Hand In Quantitative Terms
Authors: Mansat M. , Delprat J. , Delprat J. M.
Published: March 2006

Large myelinated nerve fibres are quick adapting, and mediate moving touch or vibration sensation. The study of their junction is valuable in sensory evaluation and re-education.

An instrument is described which allows measurement in terms of decibels of the thresholds at which the sensation is felt in the skin of the hand. This is done for value of thirty and two hundred and fifty six cycles per second.

Improvement of sensation as recovery progresses can be recorded as the decibel values fall.
The use of Modified A.O. Reduction Forceps in Percutaneous Fracture Fixation
Authors: Glasgow M. , Lloyd G. J.
Published: March 2006

A simple modification of standard A.O. reduction forceps is described. This instrument has greatly facilitated the management of fractures in the hand that require percutaneous wire fixation.
Effect of the Immunological Antigenicity of the Allogeneic Tendons on Tendon Grafting
Authors: Minami A. , Ishii S. , Ogino T. , Oikawa T. , Kobayashi H.
Published: March 2006

The authors have investigated the immunological rejection responses against allogeneic tendon tissue using two strains of inbred rats.

A complement dependent cytotoxicity test and an absorbing test were used. The results indicate that the rat tendon tissue contained major histo-compatibility antigens, that this was largely present in tendon cell components, and that collagen showed little or no response.
Continuous Brachial Plexus Block for Replantation in the Upper Extremity
Authors: Matsuda M. , Kato N. , Hosoi M.
Published: March 2006

For replantation surgery, continuous brachial plexus block was employed using supraclavicular or axillary approach. Of a total of fifty blocks, forty-seven (94%) gave adequate surgical analgesia throughout the operations. No serious complication appeared in this series. Pneumothorax was detected in one supraclavicular block, but no surgical drainage was required. One patient had paraesthesia in the blocked arm, but it subsided within a month. No toxic reaction was recognised in spite of high dose of anaesthetic agents. Thus continuous brachial plexus block has been ascertained to be safe, reliable, and useful for the replantation and other prolonged operations in the upper extremity.
Retrograde Cross-Pinning of Transverse Metacarpal and Phalangeal Fractures
Authors: Edwards G. S. , O'brien E. T. , Heckman M. M.
Published: March 2006

Six different techniques of Kirschner wire fixation are compared in experimental transverse diaphyseal fractures of metacarpals and phalanges. Open retrograde cross-pinning provides a relatively simple means of obtaining consistently accurate pin placement with maximal stability. The technique is described, and the use of a preview pin and hypodermic needle guide are introduced. The indications, advantages, potential complications and clinical application are discussed.
The Significance of the Retrograde Patency Test in Microarterial Anastomosis
Authors: Chow S. P.
Published: March 2006

The patency of a microarterial anastomosis was tested both in the antegrade and retrograde directions. Experimental and clinical observations showed that if patency was achieved in both directions, the subsequent result was much better than in those where patency was demonstrated only in the antegrade, but not in the retrograde direction.
Conservative Management of a High Pressure Injection Injury to the Hand
Authors: Kendrick R. W. , Colville J.
Published: March 2006

A farm labourer suffered a high pressure injection injury to the palm of his right hand when the hydraulic drive of his tractor developed a leak. On the basis of the type of fluid injected, the clinical findings and the relatively favourable site of the injection, the patient was able to return to work in four weeks with a functional hand. It is suggested this type of management should-be considered only in suitable cases where experienced care is available.
Late Complications of Neonatal Volkmann's Ischaemia
Authors: Engel J. , Heim M. , Tsur H.
Published: March 2006

A child was born with ischaemic damage to the skin and muscles of the left upper limb. Repeated surgery of the soft tissues resulted in a functional limb. Recent röentgenograms show extensive metaphyseal and epiphyseal damage. This case is reported for its uniqueness and to stress the necessity of long term follow-up.
Acute Garpal Tunnel Syndrome a Rare Complication of Chondrocalcinosis
Authors: Lewis S. L. , Fiddian N. J.
Published: March 2006

Acute carpal tunnel syndrome is rare and usually is secondary to trauma, burns, infection or acute rheumatoid arthritis. A case is presented in which the acute syndrome was produced by Chondrocalcinosis (pseudogout or calcium pyrophosphate disease) of the wrist.
Mallet-Finger Injuries: A Prospective, Controlled Trial of Internal and External Splintage.
Authors: Auchincloss J. M.
Published: March 2006

A prospective controlled trial of mallet-finger injuries treated by internal fixation or external splintage of the distal interphalangeal joint showed no particular advantages for either method, but suggested that patients presenting after some delay may achieve better results after internal fixation.
Treatment of Mallet Fingers by Tenodermodesis
Authors: Kon M. , Bloem J. J. A. M.
Published: March 2006

Recurrent and chronic mallet fingers were treated by tenodermodesis. The results of this simple and reliable technique are reviewed over a period of two and a half years in twenty-seven patients.
False Aneurysms due to Trauma to the Hand
Authors: Walsh M. J. , Conolly W. B.
Published: March 2006

This paper reviews five cases of partial arterial division illustrating various stages in the evolution of false traumatic aneurysms.
Kienböck's Disease of the Wrist in an Elderly Female
Authors: Jain A. S.
Published: March 2006

A case is presented of Kienböck's Disease of the left wrist in a seventy-one year old lady, believed to be the oldest reported patient with this condition.
Kienböck's Disease in Association with Carpal Coalition M. F. Macnicol, Edinburgh
Authors: Macnicol M. F.
Published: March 2006

Coalition between the capitate and trapezoid is extremely rare and is reported here because of an unusual association with Kienböck's disease of the lunate in the nondominant wrist.
Actinomycosis of the Hand
Authors: Rushforth G. F. , Eykyn Susannah J.
Published: March 2006

A patient with actinomycosis of the wrist and hand with marked involvement of the carpal bones is recorded. The delay in diagnosis and difficulties of cultural isolation of the organism are discussed.
Synovial Sarcoma of the Finger
Authors: Goodwin D. R. A. , Salama R.
Published: March 2006

Synovial sarcoma is a rare tumour in the hand. We report an unusual case of such a tumour that was located in the distal phalanx of a finger of an elderly woman. A synovial tumour in this location and at such an age seems to be unique.
A Finger Support for Operations on the Dorsal Aspect of the Finger
Authors: Barfod B.
Published: March 2006

An adjustable finger support has been constructed allowing the finger in question to rest in position suitable for operations on the dorsal structures.
Extraneural Pressures Affecting the Ulnar Nerve at the Elbow
Authors: Macnicol M. F.
Published: March 2006

Using fresh cadaveric arms, extraneural pressures were recorded along the path of the ulnar nerve at the elbow using a fine silastic cannula. Significant pressure increases occurred when the elbow was flexed beyond a right angle, and concomitant shoulder abduction further raised the pressures recorded at the cubital tunnel and postcondylar groove. Surgical release of the cubital tunnel decreased pressures in the post-condylar groove by approximately 50 per cent when the elbow was fully flexed, whereas clamping the flexor carpi aponeurotic arch significantly increased extraneural pressures in the groove, presumably, by preventing accommodative changes in neural relationships.
The Effect of Ultrasound on Flexor Tendon Repairs in The Rabbit
Authors: Roberts M. , Rutherford J. H. , Harris D.
Published: March 2006

This study investigates the effects of ultrasound on fresh tendon repairs in rabbits. It is our conclusion that ultrasound adversely affects the early healing process.
Functional Results in Replantation at the Distal Forearm: A Case Report
Authors: Nye J. E.
Published: March 2006

Complete amputation at the forearm level is an infrequent injury. Despite many reports of successful replantation of the hand and fingers, there are few papers discussing the results of reattachment at the forearm level. The results of this case are reported to reaffirm the fact that replantation at this level can be a rewarding experience. The results also question the reliability of two point discrimination as the major indication of satisfactory reinnervation.
A Simple Method for the Treatment of Finger Tip Injuries Involving the Nail Bed
Authors: Matthews P.
Published: March 2006

Difficulties encountered in the management of nail bed injuries are outlined and a simple method of treatment described.
A Salvage Procedure in the Treatment of the Boutonnière Deformity Caused by Contact Burn and Friction Injury
Authors: Joshi B. B.
Published: March 2006

Contact burns and friction injuries to the dorsum of the finger denude it of full thickness of skin and central extensor tendon tissue, rendering the primary repair of the resultant boutonnière deformity difficult. A salvage procedure that offers both functional restoration and cosmesis is described. Here the unaffected lateral band aattachments are transposed en-masse, as a composite flap, to the dorsum of the finger to establish active extension of the proximal interphalangeal joint.
Compression of the Distal Ulnar Nerve with Clawing of the Index Finger
Authors: Packer N. P. , Fisk G. R.
Published: March 2006

A compression lesion of the distal part of the terminal motor branch of the ulnar nerve is presented. One similar case has been previously described (McDowell, 1977) but some unusual features are recorded here. The reported clinical varieties of lesions of the ulnar nerve in the hand are listed (Table 1).
Rupture of the Extensor Pollicis Longus Tendon in Undisplaced Colles’ Type of Fracture
Authors: Helal B. , Chen S. C. , Iwegbu G.
Published: March 2006

There is a higher risk that the tendon of extensor pollicis longus will rupture in undisplaced Colles’ type of fracture than in those which are displaced. This difference in incidence is due to the integrity of the extensor retinaculum in undisplaced Colles’ type of fracture causing the tendon to be held tight against the fracture callus in the floor of the tunnel which may result in an attrition rupture. In the displaced Colles’ fracture the extensor retinaculum is torn from the bone and thus permits the tendon to escape from contact with the fracture site.
Triggering of the Finger at the Flexor Retinaculum
Authors: Iqbal Q. M.
Published: March 2006

An unusual case of trigger finger associated with paraesthesia of the hand is described. The site of triggering was at the flexor retinaculum consequent upon a tumour of the profundus tendon. Nerve conduction study of the median nerve revealed a co-existing incipient median neuritis.