bluuebunny/crossref_metadata_2025 huggingface dataset:
The Pursuit of Effective Working Memory Training: a Pre-registered Randomised Controlled Trial with a Novel Varied Training Protocol
Authors: Ritakallio Liisa , Fellman Daniel , Jylkkä Jussi , Waris Otto , Lönnroth Nelly , Nervander Reidar , Salmi Juha , Laine Matti
Published: December 2021

Working memory (WM) training, typically entailing repetitive practice with one or two tasks, has mostly yielded only limited task-specific transfer effects. We developed and tested a new WM training approach where the task paradigm, stimulus type, and predictability of the stimulus sequence were constantly altered during the 4-week training period. We expected that this varied training protocol would generate more extensive transfer by facilitating the use of more general strategies that could be applied to a range of WM tasks. Pre-post transfer effects following varied training (VT group, n = 60) were compared against traditional training (TT group, training a single adaptive WM task, n = 63), and active controls (AC, n = 65). As expected, TT evidenced strong task-specific near transfer as compared to AC. In turn, VT exhibited task-specific near transfer only on one of the measures, and only as compared to the TT group. Critically, no evidence for task-general near transfer or far transfer effects was observed. In sum, the present form of VT failed to demonstrate broader transfer. Nevertheless, as VT has met with success in other cognitive domains, future studies should probe if and how it would be possible to design WM training protocols that promote structural learning where common features of specific tasks would be identified and utilised when selecting strategies for novel memory tasks.
Theta Neurofeedback Training Supports Motor Performance and Flow Experience
Authors: Eschmann Kathrin C. J. , Riedel Lisa , Mecklinger Axel
Published: December 2021

Flow is defined as a cognitive state that is associated with a feeling of automatic and effortless control, enabling peak performance in highly challenging situations. In sports, flow can be enhanced by mindfulness training, which has been associated with frontal theta activity (4-8 Hz). Moreover, frontal-midline theta oscillations were shown to subserve control processes in a large variety of cognitive tasks. Based on previous theta neurofeedback training studies, which revealed that one training session is sufficient to enhance motor performance, the present study investigated whether one 30-minute session of frontal-midline theta neurofeedback training (1) enhances flow experience additionally to motor performance in a finger tapping task, and (2) transfers to cognitive control processes in ann-back task. Participants, who were able to successfully upregulate their theta activity during neurofeedback training (responders), showed better motor performance and flow experience after training than participants, who did not enhance their theta activity (non-responders). Across all participants, increase of theta activity during training was associated with motor performance enhancement from pretest to posttest irrespective of pre-training performance. Interestingly, theta training gains were also linked to the increase of flow experience, even when corresponding increases in motor performance were controlled for. Results for then-back task were not significant. Even though these findings are mainly correlational in nature and additional flow-promoting influences need to be investigated, the present findings suggest that frontal-midline theta neurofeedback training is a promising tool to support flow experience with additional relevance for performance enhancement.
Effects of Regional Intravenous Guanethidine Block in Posttraumatic Cold Intolerance in Hand Amputees.
Authors: ENGKVIST O. , WAHREN LIS KARIN , WALLIN G. , TOREBJÓRK E. , NYSTRÓM B.
Published: December 2021

In twenty-four patients with intolerance to cold after partial or complete finger amputations, lower skin temperature together with cold and vibration allodynia (allodynia = pain due to a non-noxious stimulus to neural skin) were found in the cold intolerant area compared with the corresponding area in the uninjured hand. When treated with regional intravenous guanethidine block nine patients became free from symptoms for up to twelve weeks, which is longer than would be expected from the duration of the known pharmacological effects of guanethidine. The patients had several features in common with reflex sympathetic dystrophies, and we suggest that neurogenic rather than vascular disturbances are mainly involved in the post-traumatic cold intolerance syndrome.
Sensitivity Following Volar V-Y Plasty for Fingertip Amputations
Authors: TUPPER JACK , MILLER GARY
Published: December 2021

The volar V-Y plasty is a well accepted method of management for transverse fingertip amputations. It has been suggested by some authors and assumed by some surgeons that fingertip sensation is nearly normal following the procedure. Sixteen patients with twenty fingertip injuries in our series reported an average estimate of sensitivity of 73% of normal. There was diminished sensation to testing by two-point discrimination and/or von Frey monofilament testing in all fingertips when compared to the contralateral digit. Eight patients (twelve fingertips) reported hypersensitivity, particularly cryalgia. We conclude that sensation is not normal in almost all fingertips treated by V-Y plasty for transverse amputations.
The Triradiate Incision
Authors: GRUNDBERG A. B. , REAGAN D. S.
Published: December 2021

An incision for improved exposure of circumscribed problems is described.
Treatment of Scaphoid Nonunion by Volar Inlay Distal Radius Bone Graft
Authors: ANDREWS J. , MILLER G. , HADDAD R.
Published: December 2021

Volar inlay corticocancellous bone grafting is an accepted method of treatment for symptomatic nonunion of the carpal scaphoid. Performance of this procedure with a radial graft without styloidectomy yields results comparable to those obtained with iliac grafting. This permits the operation to be performed through a single incision. The elimination of the need for iliac dissection avoids morbidity associated with the iliac exposure.
Synovial Sarcoma: with Radial Nerve Involvement.
Authors: CUGOLA L. , PISA R.
Published: December 2021

An unusual case of radial nerve involvement at the elbow by a synovial sarcoma is reported. The patient was a 16-year-old Caucasian girl presenting with signs of a radial nerve palsy. Treatment was by surgical excision of the tumour and grafting the defect in the radial nerve. The histological diagnosis was a synovial sarcoma. Recovery of function was almost complete eight months later.
Congenital Absence of the Scaphoid in the “VATER” Association
Authors: TREBLE N. J.
Published: December 2021

A rare carpal anomaly is reported in a patient with multiple congenital abnormalities.

A literature search reveals few such cases, but a characteristic clinical picture emerges. Patients with this deformity should be carefully examined to exclude other congenital abnormalities.
An Unusual Hand Infection in a Child—Remember Herpes!
Authors: NORRIS R. W.
Published: December 2021

An unusual form of herpetic infection of the hand in a nine month old child is described. The diagnosis, mode of spread and management is discussed.
Continuous Passive Motion as an Adjunct Therapy for Tenolysis
Authors: McCARTHY J. A. , LESKER PEGGY A. , PETERSON W. W. , MANSKE P. R.
Published: December 2021

A model was developed to evaluate continuous passive motion as an adjunct to tenolysis. The use of continuous passive motion after tenolysis was associated with a significant increase in tendon rupture and the terminal force necessary to flex the phalanx actively. Also, there was a decrease in the passive range of motion in the continuous passive motion group which appeared to be the result of increased granulation tissue which formed around tenolysed tendon.
The Early Experience of Silastic Trapezium Implants
Authors: HOOK W. E. , STANLEY J. K.
Published: December 2021

This paper reports the early results of thirteen total trapezium replacements and seven partial trapezium replacements in the treatment of pantrapezial disease and first carpometacarpal arthritis. The results showed satisfactory relief of pain with good function of the thumb. This review highlights the difficulty in achieving implant stability and suggests the cause of this problem.
Simultaneous Fracture of Carpal Scaphoid and Trapezium
Authors: VAN SCHIL P. , DE SMET C.
Published: December 2021

A previously undescribed simultaneous fracture of carpal scaphoid and trapezium (greater multangular) is reported. A short discussion on fractures of the trapezium together with the reported associated scaphoid fracture is given and the probable mechanism of injury is considered.
Effect of Submuscular Versus Intramuscular Placement of Ulnar Nerve: Experimental Model in the Primate
Authors: DELLON A. L. , MACKINNON S. E. , HUDSON A. R. , HUNTER D. A.
Published: December 2021

A primate model was developed to study the effect of submuscular versus intramuscular placement upon the development of ulnar nerve fibrosis. No significant adherence was found in either location between the ulnar nerve and the flexor-pronator muscle mass. There was no significant difference in the mean nerve fibre diameter or in the percent neural tissue between the ulnar nerves in the two different locations. It is suggested that it is the interaction of the transposed ulnar nerve with other fibrous anatomical structures proximal to, across, and distal to the elbow that causes failure in ulnar nerve transposition procedures, rather than an adverse reaction between the incised flexor-pronator muscle mass and the ulnar nerve.
Use of Bromphenol Blue Printing Method for Detecting Sweat on the Palm
Authors: SAKURAI M.
Published: December 2021

Sympathetic nerve fibres innervating the sweat glands in the skin are known to accompany sensory nerve fibres closely. Examination of sudorific function, therefore, is a useful aid in making a diagnosis of severed peripheral nerve and also provides valuable information on nerve function in the recovery stage following injury and surgery such as neurorrhaphy. Among the many methods which have been used clinically, the one employing bromphenol blue is thought to be the most simple and accurate.
An Unusual Foreign Body in Hand a Case Report
Authors: MATHUR N. , SHARMA K. K. R. , TIWARI V. K.
Published: December 2021

Small sharp foreign bodies are common in dominant hand. A case of an unusual, large, blunt, metallic foreign body in the non-dominant hand, with treatment and result, is reported.
Chondromyxoid Fibroma of the Proximal Phalanx. A Tumour that may be Confused with Chondrosarcoma
Authors: ANDERSON W. J. , BOWERS W. H.
Published: December 2021

Chondromyxoid fibroma is a rare benign tumour of chondral origin. The diagnosis is difficult, but as Jaffe emphasized, “its recognition is of some importance in that pathologically it may be mistaken for sarcoma and, as such, treated more radically than is necessary” (Jaffe, 1948). Salzer (1965) found only 136 cases in the world literature since 1948 when Jaffe defined the criteria for their histological diagnosis. Only six cases of chondromyxoid fibroma have been reported involving the hand (Frank, Rockwood, 1969; Zatyepin, Klimova, Lipkin, Perety, 1979).
Trigger Wrist due to Idiopathic Synovial Hypertrophy
Authors: POPLE I. K.
Published: December 2021

The phenomenon of “trigger wrist” has been reported several times since 1961, when it was first described (Eifel, 1961). Most of these cases related to patients suffering from “triggering” at the wrist associated with carpal tunnel compression. Below is a hitherto undescribed case of trigger wrist occurring in a fit girl, without carpal tunnel syndrome, due to idiopathic synovial hypertrophy.
Acute Carpal Tunnel Syndrome Resulting from Haemorrhage into the Carpal Tunnel in a Patient on Warfarin
Authors: NKELE C.
Published: December 2021

A case of acute compression neuropathy of the median nerve associated with haemorrhage into the carpal tunnel is presented. The condition occurred spontaneously in a patient on Warfarin for previous deep venous thrombosis. The signs and symptoms were those of acute tenosynovitis originating in the common flexor synovial sheath at the wrist with associated paraesthesia in the distribution area of the median nerve in the hand. The patient was afebrile and blood tests were normal.
Leukonychia Totalis
Authors: KATES S. L. , HARRIS G. D. , NAGLE D. J.
Published: December 2021

A case with a marked family history of Leukonychia Totalis is described.
Trapezio-Metacarpal Arthrodesis Today Why?
Authors: CAVALLAZZI R.M. , SPREAFICO GISELLA
Published: December 2021

A ten-year follow-up on forty-two patients (a total of forty-three hands) operated on by arthrodesis of the trapeziometacarpal joint for degenerative arthritis shows relief of pain, maintenance of stability and mobility of the first ray and good function of the operated hands. Patients were pleased with the results. Arthrodesis is a safe and conservative method of treatment.
A Comparative Controlled Trial of a New Perforated Splint and a Traditional Splint in the Treatment of Mallet Finger
Authors: KINNINMONTH A. W. G. , HOLBURN F.
Published: December 2021

A perforated mallet finger splint is described and the results of a controlled trial comparing its use with a conventional splint are presented. The perforated splint gives superior results by virtue of the fact that it does not require to be removed for purposes of hygiene and can thus produce a satisfactory result even in those patients who fail to grasp the technique of removal and replacement of the splint.
Aspiration of Ganglia
Authors: NIELD D. V. , EVANS D. M.
Published: December 2021

Thirty four patients with a simple ganglion have been treated by aspiration alone, using a short-bevel wide-bore needle. In 41% there was no recurrence after more than one year, and most of the remaining 59% recurred with three months.
Benign Tendon Sheath Chondroma
Authors: JONES W. A. , GHORBAL M. S.
Published: December 2021

Soft tissue chondromas are uncommon tumours but when they do occur the hands and the feet are a common site (Lichtenstein, 1964; Dahlin, 1974; Chung, 1978).

We have experience in the management of two cases each of whom had a chondromatous lesion in the index finger of the left hand which exhibited features that could have been considered sinister to those unfamiliar with this lesion and could lead to over treatment.
Giant Cell Tumour of the Triquetrum
Authors: LOUIS D.S. , HANKIN F.M. , BKAUNSTEIN E.M.
Published: December 2021

A case of giant cell tumour involving the triquetrum is reported. Treatment consisted of resection of the triquetrum, followed by intercarpal arthrodesis.
Double Toe Transfers
Authors: LEUNG P. C.
Published: December 2021

Ten double toe transfers for mutilating hand injuries have been studied. In two patients with total loss of all digits, pincer pinch was restored by the transfer of two separate toes, one to each side of the stump. Seven patients had survival of the thumb and a three-point chuck pinch was provided by transfer of a second toe plus a wrap-around flap over a bone graft to create a third, but stiff digit. One patient required three fingers and was treated by one single toe transfer and one double toe transfer.
Diffuse Cavernous Haemangiomas of the Upper Limb
Authors: MILNER R. H. , SYKES P. J.
Published: December 2021

In the upper limb, diffuse cavernous haemangiomas occur infrequently but their treatment is often unsatisfactory and the result of surgical excision disappointing. Four cases of these diffuse haemangiomas are described and their management discussed.
Vascularised Versus Conventional Nerve Grafting: A Case Report
Authors: BOOBMAN J. G. , SYKES P. J.
Published: December 2021

A case is described in which two lengths of the lateral cutaneous nerve of the forearm were used, one vascularised and the other not, to reconstruct the two digital nerves of the thumb. The sensory recovery of the two nerves was compared, and the vascularised nerve graft found to result in better sensation. This finding provides further support for the value of vascularised nerve grafts.
Traumatic Rupture of Median Artery an Unusual Cause for Acute Median Nerve Compression
Authors: FAITHFULL D. K. , WALLACE R. F.
Published: December 2021

Previous case reports of haemorrhage into the carpal tunnel causing median nerve compression were extraneural and usually associated with a blood dyscrasia although Watson Jones reported one due to direct trauma and Hayden recorded spontaneous intraneural haemorrhage not associated with trauma. We describe a case of intraneural haemorrhage, involving the median nerve in the carpal tunnel, due to indirect trauma and not associated with a blood dyscrasia. The condition required intraneural decompression to obtain relief.
Hand Function after Injuries to the Collateral Ligaments of the Metacarpophalangeal Joint of the Thumb
Authors: HELM R. H.
Published: December 2021

An assessment was made of 34 patients who had sustained injuries to collateral ligaments of the metacarpophalaageal joint of the thumb. 23 patients had symptoms in the thumb, when seen at a mean of 38.7 months later, but these were minor in all but one patient. Assessment of pinch strength revealed that 43% of patients had less than 80% of the strength of the opposite side. This was not related to the presence of symptoms or to demonstrable instability of the joint, but the incidence of such weakness was greater when the operation had been delayed by more than three weeks. Pinch strength should be measured in two positions (key pinch and lateral pinch) as there is occasionally a large discrepancy between the two.
Complex Dislocation of the Metacarpophalangeal Joint of the Little Finger
Authors: ANDERSEN J. A. , GJERLØFF C. C.
Published: December 2021

Complex dislocation of the little finger metacarpophalangeal joint is very rare.

In the English literature, we have found only ten published cases. The condition usually requires open reduction, and most authors advocate a dorsal incision.

We report two additional cases, treated by the volar approach, which makes a direct access to the incarcerated structures possible.
Micro-Surgical Fascicular Nerve Repair: A Morphological Study of the Endoneurial Bulge
Authors: ARCHIBALD S. J. , FISHER T. R.
Published: December 2021

The phenomenon of ‘endoneurial bulging’ from the cut end of the divided nerve fasciculus in the rat sciatic nerve has been examined with light and scanning electron microscopy and the morphological changes compared when dividing the fasciculus with either micro-scissors or a sharp razor blade.
Avulsion Fracture of the Index Metacarpal
Authors: TREBLE N. , ARIF S.
Published: December 2021

A case is reported of the avulsion of the insertion of Extensor Carpi Radialis Longus, an injury that has been reported only once before. The anatomy of the region and mechanism of injury are discussed, as is the importance of open reduction with internal fixation.
Fracture Dislocation of the Trapezio-Scaphoid Joint — The Missing Link?
Authors: HOLDSWORTH B. J. , SHACKLEFORD I.
Published: December 2021

Fracture-dislocation of the trapezio-scaphoid joint is an extremely rare injury. We report a case treated using Herbert’s compression screw technique.
Ultrasound in the Diagnosis of Scaphoid Fractures
Authors: SHENOUDA N. A. , ENGLAND J. P. S.
Published: December 2021

A prospective study of the possibilty of confirming clinically suspected scaphoid fractures was carried out over one year.

Analysis of the results suggest that ultrasound scanning of suspect scaphoid fractures is a reliable method of assessing this condition. It has one weakness in that the diagnosis is based on subjective sensation and this may at times be faulty. Our results, however, suggest that once practice in the technique has been achieved, then mistakes are rarely made.
Volar Intercalary Carpal Instability Following a Seemingly Innocent Wrist Fracture
Authors: BROWN. I. W.
Published: December 2021

A case of volar of intercalary carpal instability following a radial fracture is described and the mechanics of injury examined.

Such an injury is rare and the type of radial fracture which produced it unusual. Continued instability of the carpus produces late degenerative changes. In contrast to the many reports of early and persistent pain and functional limitation this patient’s wrist settled rapidly.
Rupture of Flexor Digitorum Profundus to the Index Finger after a Distal Radial Fracture
Authors: RYMASZEWSKI L. A. , WALKER A. P.
Published: December 2021

Attrition ruptures of flexor tendons to the fingers following Colles’ fractures are very rare. In the case reported here, a protruding bony fragment caused a delayed rupture of the flexor digitorum profundus tendon to the index finger one year after a fracture of the distal end of the radius. Suture of the distal end of the tendon to the adjacent profundus tendon two years after the fracture produced a successful result.
Antibiotics in Open Fractures of the Distal Phalanx?
Authors: SLOAN J. P. , DOVE A. F. , MAHESON M. , COPE A. N. , WELSH. K. R.
Published: December 2021

A prospective trial was undertaken on 85 adult patients with open fractures of the distal phalanges of less than 6 hours duration, treated by conventional surgery. They either received no antibiotic therapy, or cephradine in short or long courses. The infection rate was 30% in the group without antibiotics and less than 3% in the treated groups. Three different antibiotics regimes were compared, with no difference in the infection rate: therefore the simplest and surest method, a single pre-operative dose and a single post-operative dose, is recommended.
KienbÖck’s Disease — The Influence of Arthrosis on Ulnar Variance Measurements
Authors: KRISTENSEN S. S. , SØBALLE K.
Published: December 2021

The individual difference in ulnar variance measurements between diseased and unaffected wrists in 38 patients with unilateral Kienböck’s disease was determined and related to the degree of arthrosis in the affected wrists.

In patients without arthrosis there was no difference in measurements. With increasing arthrosis there was a progressive increase of patients with individual difference in ulnar variance measurements: up to 50% in those with severe arthrosis. Where a difference in ulnar variance was encountered, the wrist with Kienböck’s disease represented the more negative value in 90%. It is concluded that over-representation of the so-called “ulnar minus variant” in Kienböck’s disease is based on osteo-arthritic changes in the wrist, resulting in a pseudo-lengthening of the distal radius, and that this is therefore a consequence of the disease. The “ulnar minus variant” seems to have no bearing on the cause of Kienbüock’s disease.
Conservative Surgery for Dupuytren’s Contracture
Authors: THURSTON A. J.
Published: December 2021

The trend towards conservativism in the management of Dupuytren’s contracture has resulted in less radical surgery than was previously advocated to release disabling contractures of the fingers.

38 cases of Dupuytren’s contracture in the palm have been treated by Z-plasty of skin and underlying contracted band without fasciectomy. Proximal interphalangeal joint contractures were treated by fasciectomy and skin closure with Z-plasties as required. Only one of 16 patients reviewed after two years had evidence of recurrence.

Skin compliance has been measured and a return to near-normal levels was found in all but the one patient with a recurrence.
Reverse Madelung’s Deformity with Nerve Compression
Authors: FAGG P. S.
Published: December 2021

A case of reversed Madelung’s deformity with compression of the median nerve at the wrist and the ulnar nerve at the elbow is reported and the relevant literature reviewed.
Some Aspects of Lumbrical Function
Authors: CITRON N. , FOSTER A.
Published: December 2021

An electromyographic investigation was performed on the hands of six volunteers. The functioning of the lumbrical and flexor digitorum profundus muscles during resisted and unresisted extension was studied. No subject showed much simultaneous contraction of the two muscles in unresisted extension of the interphalangeal joints, but some showed marked simultaneous contraction during resisted extension. We suggest that, in these individuals, the profundus is acting to steady the origin of the lumbrical so that it can act more efficiently.
Long Term Hand Function without Long Finger Extensors: A Clinical Study
Authors: QUABA A. A. , ELLIOT D. , SOMMERLAD B. C.
Published: December 2021

This study examines the premise that, following severe injuries to the dorsum of the hand, reconstruction of the long extensor tendons of the fingers may not be necessary for many patients. The long-term hand function of nine patients who sustained such injuries and had operations to provide skin cover only, has been comprehensively assessed using objective tests and a detailed questionnaire. It is concluded that provision of skin cover followed by intensive early mobilisation may be an adequate management of these injuries.
Clinical Fracture of the Carpal Scaphoid—Supportive Bandage or Plaster Cast Immobilization?
Authors: SJØLIN S. U. , ANDERSEN J. C.
Published: December 2021

In a prospective study of 108 patients with a clinical diagnosis of fracture of the carpal scaphoid, but without radiological evidence of fracture, the patients were randomised to treatment with either a supportive bandage or a dorsal plaster cast. Four patients proved to have incomplete fractures and three to have avulsions from the scaphoid tuberosity. Two of the fractures had been suspected radiologically at the primary investigation. No complete fractures of the scaphoid were seen.

The average time in plaster was 15 days and in a bandage 12.2 days. The average sick leave for manual workers was 14 days in plaster and 4 days in a bandage, a difference that represents a significant loss of productivity. Since these fractures almost always heal irrespective of treatment, they may as well be treated as a soft tissue injury with a supportive bandage.
Rupture of the Flexor Pollicis Longus Tendon Resulting from the Non-Union of a Scaphoid Fracture
Authors: CROSS A. B.
Published: December 2021

A case is described in which a patient presented with a rupture of the flexor pollicis longus tendon resulting from an ununited scaphoid fracture. No similar case appears to have been reported in the literature. This was not an attrition rupture and the mechanism is explained. The proximal pole of the scaphoid was removed and the tendon repaired. The patient regained good movement at the interphalangeal joint of the thumb.
Non-Union of the Scaphoid: Russe Graft vs Herbert Screw
Authors: WARREN-SMITH C. D. , BARTON N. J.
Published: December 2021

The results of treatment in 50 consecutive patients with established non-union of the scaphoid are presented. All patients were treated under the care of a single consultant, for the same indications. Russe bone graft is compared with wedge bone graft plus Herbert screw fixation, in terms of union and function. Overall, a higher success rate was obtained by wedge graft plus Herbert screw, and a significantly better range of movement. However, Russe bone graft appears equally satisfactory for fibrous non-union.
The Influence of Wrist Position on the Minimum Force Required For Active Movement of the Interphalangeal Joints
Authors: SAVAGE R.
Published: December 2021

Active and passive muscle tension is discussed in relation to finger flexor and extensor tendons. Minimising active tension required to produce finger movement is seen as an important part of post-operative finger mobilisation following flexor tendon repair in which active movement is used. It is argued that “minimal active tension” in the flexors is equal to, or just exceeds, the passive tension in the extensors. A method of measuring passive tension in finger tendons has been described. In 24 volunteers, it has been used to determine that if the metacarpo-phalangeal joints are held flexed, there is least “minimal active tension” in the flexor tendons when the wrist is splinted in extension.
Flexor Tendon Injuries: The Results of Primary Repair
Authors: SINGER M. , MALOON S.
Published: December 2021

This study is a critical analysis of results obtained following primary repair and post-operative controlled mobilisation of flexor tendon injuries which were treated by registrars with up to six months experience in hand surgery. 70 (55%) of 125 patients who underwent repair of a complete flexor digitorum profundus or flexor pollicis longus tendon injury during a 14-month period attended for review and these had a total of 140 injured digits. 93 (67%) were rated Lister’s standards as an “excellent” or “good” result. 39 (28%) occurred in “no man’s land” (Zone 2) and only 19 (49%) in this area were rated “excellent” or “good”. Isolated flexor digitorum superficialis tendon injuries have been excluded from this study, as have partial tendon injuries.
The Modified Kleinert Splint in Zone II Flexor Tendon Injuries
Authors: SLATTERY P. G.
Published: December 2021

The Kleinert controlled passive mobilisation splint has been modified to increase the passive range of motion of the proximal and distal interphalangeal joints to near normal. 12 fingers with complete divisions of both flexor tendons in Zone II treated by this method have been reviewed after six months. Nine regained full motion and two good motion while one, with an associated crush compound fracture of the proximal phalanx, had a poor result. The increased mobilisation did not adversely affect wound healing or associated repair of digital nerves.
Osteosarcoma of the Carpus
Authors: BICKERSTAFF D. R. , HARRIS S. C. , KAY N. R. M.
Published: December 2021

A case of osteosarcoma of the carpus is reported and the relevant literature reviewed.
Metastatic Adenocarcinoma of the Carpus: A Case Report
Authors: CRAIGEN M. A. C. , CHESNEY R. B.
Published: December 2021

A patient is described who presented with a painful swelling on the dorsum of the hand which arose from the hamate and proved histologically to be a secondary from a previously resected gastric adenocarcinoma.
A Mycobacterium Malmoense Infection of the Hand Presenting as Carpal Tunnel Syndrome
Authors: PRINCE HEATHER , ISPAHANI PURVIN , BAKER M.
Published: December 2021

We report an atypical tuberculous infection by Mycobacterium Malmoense of the synovium of the flexor tendons at the wrist presenting as carpal tunnel syndrome. This is the first time this organism has been described in a site other than the lungs or the cervical lymph nodes.
Synovial Hand Infection from Mycobacterium Terrae
Authors: DEENSTRA W.
Published: December 2021

A case of extensive synovial infection in the hand due to Mycobacterium terrae is described. The infection is resistant to drug therapy but appears to remain localised.
The First Dorsal Metacarpal Artery Neurovascular Island Flap
Authors: SMALL J. O. , BRENNEN M. D.
Published: December 2021

A first dorsal metacarpal artery island flap from the index finger was used in 20 cases for reconstruction of defects in the hand. In six cases it was used as a neurovascular flap for sensory resurfacing of the thumb and in five cases for release of a contracted first web. One flap underwent necrosis and there was a complication in one donor site.
Mallet Finger: A Trial of Two Splints
Authors: WARREN R. A. , NORRIS S. H. , FERGUSON D. G.
Published: December 2021

Over a period of twelve months, 116 cases of mallet finger were allocated randomly to treatment with either a Stack or Abouna splint. The two splints were equally effective, producing a cure or a significant improvement in approximately 50% of cases. However, the Stack splint was much preferred by the patients, who found it more comfortable, more robust and easier to keep clean.
The Pipflex Splint for Treatment of Mallet Finger
Authors: EVANS D. , WEIGHTMAN B.
Published: December 2021

A new splint is described for the treatment of mallet finger deformity. The splint is in two separate parts which maintain extension of the DIP joint and flexion of the PIP joint respectively. The results of treatment in 25 patients are presented, and are superior in our hands to those resulting from other methods of splintage. The period of treatment is shorter.
Occupation as a Risk Factor for Impaired Sensory Conduction of the Median Nerve at the Carpal Tunnel
Authors: NATHAN P. A. , MEADOWS K. D. , DOYLE LINDA S.
Published: December 2021

471 industrial employees from 27 occupations in four industries were surveyed to evaluate the role of occupational hand activity as a risk factor for slowing of sensory conduction of the median nerve at the carpal tunnel. After age-adjusting the latency values, slowing of the sensory fibres of the median nerve was found in 39% of the subjects and in 26% of the hands. No consistent association was found between the type and the level of occupational hand activity and the prevalence or the severity of slowing. In addition, the prevalence of bilateral slowing of conduction of the median nerve was not associated with bimanual occupational hand activity, and the length of employment of the subjects in the current industry did not influence the occurrence of impaired sensory conduction of the median nerve at the carpal tunnel.
Carcinoma Cuniculatum of the Hand
Authors: NEILSON D. , DUNDAS S. , PAGE R. E.
Published: December 2021

Carcinoma (epithelioma) cuniculatum is an uncommon variety of squamous cell carcinoma formerly considered to be limited to the foot. It has recently been reported in other parts of the body. We report a case in the hand and describe its management.
Beau’s Lines following Hand Trauma
Authors: WARD D. J. , HUDSON I. , JEFFS J. V.
Published: December 2021

Six cases are described of Beau’s lines (transverse grooves in the fingernails) developing after injuries to the hand involving damage to nerves and flexor tendons. The literature is reviewed.
Silastic Replacement of the Trapezium for Arthrosis—A Twelve Year Follow-Up Study
Authors: SOLLERMAN C. , HERRLIN K. , ABRAHAMSSON S-O. , LINDHOLM A.
Published: December 2021

Thirty-three patients with 39 Swanson silastic trapezium implants have been studied. Three years after operation no dislocation or evidence of implant wear was found, but re-examination at an average of 12 years after operation revealed dislocations and implant wear in about half of the cases. Cyst formation in surrounding carpal bones was found in twenty cases. The result in terms of pain relief and thumb function was good and comparable to the three-year follow-up. A significant correlation was found between weakness of the pinch grip and dislocation of the implant. No correlation was found between pain and dislocation of the implants, nor between pain and presence of intraosseous cysts.
Hands Up? A Preliminary Study on the Effect of Post-Operative Hand Elevation
Authors: MARS M.
Published: December 2021

Intra-compartmental pressures of up to 30 mmHg may be generated by compression bandaging following upper limb surgery. Compression bandaging and hand elevation are both shown to diminish skin blood-flow as measured by transcutaneous oxygen pressures. Hand elevation following post-operative compression bandaging is potentially hazardous.
Locked Metacarpo-Phalangeal Joint of the Thumb
Authors: INOUE G. , MIURA T.
Published: December 2021

16 patients developed locking of the M.P. joint of the thumb as the result of a hyperextension injury. Four were successfully treated by manipulation under an intra-articular injection of a local anaesthetic, while the remaining twelve required open reduction. All were examined 4 to 48 months after treatment (average 12 months).

The torn palmar plate and the accessory collateral ligament, which acted as a constrictive band, were trapped on the prominence of the radial condyle of the metacarpal. Four of the twelve surgically-treated patients had a deformity which we believe was congential: a transverse groove over the radial condyle of the metacarpal.

No patients had a recurrence of the locked joint.
Bone Infarction as a Cause of Painful Fingers in a Child
Authors: FOY M. A. , BRAUER S. E.
Published: December 2021

An unusual case of painful fingers in a two-year-old child is described. The possible aetiolgy is discussed. The condition normally runs a self-limiting course.
Aneurysmal Bone Cyst in the Metacarpal of a Child: A Case Report
Authors: KOTWAL P. P. , JAYASWAL A. , SINGH M. K. , DAVE P. K.
Published: December 2021

An unusual case of aneurysmal bone cyst in the metacarpal of a five-year-old girl is described. The lesion was initially diagnosed and treated as a simple bone cyst. Subsequently the affected metacarpal was excised and replaced by an autogenous fibular graft, with good results. A discussion of the pathogenesis of the lesion is given, with a review of the literature.
Radio-Lunate Arthrodesis
Authors: STANLEY J. K. , BOOT D. A.
Published: December 2021

Radio-lunate arthrodesis has been carried out in 15 rheumatoid patients whose radiographs showed localised arthritis around the radio-lunate joint. Six patients had insertion of a Stanley-Shelley plate. The results were assessed from 1 to 3½ years after operation and were excellent in nine wrists, good in three, fair in one and poor in three wrists. Continued carpal degeneration in 12 wrists suggests that long-term follow-up is required before this procedure can be generally recommended.
Arthrodesis of the Metacarpo-Phalangeal Joint of the Thumb: A Review of 42 Cases
Authors: STANLEY J. K. , SMITH E. J. , MUIRHEAD A. G.
Published: December 2021

42 arthrodeses of the metacarpo-phalangeal joint of the thumb in 34 patients have been reviewed at a mean of 22.5 months after operation. Where bone stock allowed, Omer’s chevron arthrodesis was used. 83% of these operations were judged to have been successful by our patients, most of whom were suffering from inflammatory joint disease. Some patients had very poor pinch pressures when reviewed, but only those with persistent instability or pain were disappointed. All arthrodeses were fixed in flexion; although the angle varied, no ideal position was identified.
The Anatomical Fat Pad and the Radiological “Scaphoid Fat Stripe”
Authors: CORFITSEN M. , CHRISTENSEN S. E. , CETTI R.
Published: December 2021

The diagnostic value of the “scaphoid fat stripe” seen on X-rays in association with fractures of the scaphoid bone in the wrist is reviewed. The anatomical basis for these soft tissue radiological changes was investigated by dissection of the anatomical snuff-box and by injection studies. It is concluded that the snuffbox fat is part of a major fat-pad located in a recess radio-dorsally on the wrist. However the radiological structure named the “scaphoid fat stripe” was found to be the highly radiolucent common tendon sheath of the extensor pollicis brevis and the abductor pollicis longus muscles. Limitations in diagnostic sensitivity and specificity are discussed.
Nail Retention Cyst: A Late Complication of Digital Reconstruction Using Pedicle Flaps
Authors: PENNY I. , HOOPER G.
Published: December 2021

We report two patients who presented with large nail retention cysts, 17 and 22 years after digital reconstructions using pedicled flaps.
Traumatic Dislocation of the Extensor Tendons over the Fifth Metacarpo-Phalangeal Joint
Authors: VAN MEIRHAEGHE J. , VERCAUTEREN M.
Published: December 2021

An unusual traumatic dislocation of the extensor tendons of the fifth metacarpo-phalangeal joint is reported. The extensor hood and capsule were split longitudinally in the mid-line dorsally and the extensor tendons separated, displacing in opposite directions onto the side of the metacarpal head.
Treatment of Unstable Colles’ Fractures by External Fixation
Authors: RIIS J. , FRUENSGAARD S.
Published: December 2021

Twenty-six patients with unstable comminuted fracture of the distal part of the radius were treated with external fixation using Hoffmanns external fixation device. The average follow-up was 29 months. The anatomical results were 85% good or excellent, 10% fair and 5% poor. Functionally, 60% were good or excellent, 25% fair and 15% poor. There were three major complications and nine minor complications, the overall complication rate being 60%, though only 15% were major. The method is recommended when dealing with fractures of type VII and VIII, but not as a general routine.
Dorsal Dislocation of the D.I.P. Joint with Fracture of the Volar Base of the Distal Phalanx
Authors: HORIUCHI Y. , ITOH Y. , SASAKI T. , TASAKI K. , IIJIMA K. , UCHINISHI K.
Published: December 2021

Between 1978 and 1985, we treated 12 cases of dorsally displaced fracture-dislocation of the I.P. joint of the thumb or of the D.I.P. joint of the finger, with a volar bony fragment. All were treated surgically, active exercise being started three to five weeks later. At the last follow-up, averaging 6.4 years (range 4.3–10 years) after operation, none of the joints was painful but the range of motion was somewhat limited.
Mechano-Receptors in the Flexor Tendons of the Hand
Authors: ZIMNY MARILYN L. , DePAOLO C. , DABEZIES E.
Published: December 2021

Flexor tendons of the hand obtained fresh at autopsy were studied histologically for free nerves and mechano-receptors. In addition to free nerves, Ruffini endings, Pacinian corpuscles and Golgi tendon organs were found throughout the tendons. Golgi tendon organs and Pacinian corpuscles were subjectively in greater numbers than Ruffini endings. The predominance of these two mechano-receptors indicates that position sense and kinetic activities of the fingers are well-served; as evidenced in hand movements.
The Effect of Ultrasound on the Healing of Repaired Cockerel Tendon: Is Collagen Crosslinkage a Factor?
Authors: TURNER S. M. , POWELL E. S. , NG C. S. S.
Published: December 2021

The acid solubility of the collagen of cockerel tendon demonstrates a similar degree of intermolecular acid-labile cross-linkage to that found in adult human tendon, implying similar maturity of the collagen. By contrast, rabbit tendon collagen demonstrates a dissimilar degree of cross-linkage suggesting immaturity of the collagen. Since this cross-linkage is likely to be related to mechanical properties, the cockerel may well be a better animal model than the rabbit for the study of tendon healing.

The application of ultrasound to sutured cockerel tendons produced no change in the mechanical strength of the tendon at six weeks, or its propensity to form adhesions, relative to untreated control sutured tendons. This contrasts with the decrease in strength after ultrasound found by previous workers using rabbits.
Herpetic Whitlow of the Digits
Authors: HAEDICKE G. J. , GROSSMAN J. A. I. , FISHER A. E.
Published: December 2021

Herpes simplex viral infection of the digits, also known as herpetic whitlow, is a rather common hand problem encountered in dental and medical personnel. Treatment is controversial. This report summarises the author’s successful experience in a series of ten patients using a non-operative local care technique, supplemented when indicated by a systemic antiviral agent.
Subungual Melanoma of the Hand
Authors: HUDSON D. A. , KRIGE J. E. J. , STROVER R. M. , KING HELEN S.
Published: December 2021

Thirteen patients with subungual melanoma on the fingers had a mean delay before diagnosis of 1.2 years. Four patients presented with local recurrence after inadequate initial treatment and two presented with systemic metastases. Mean primary subungual melanoma thickness was 6.1 mm. and nine patients had Clark level IV or V disease. All patients underwent digital amputation. Two of seven patients who had localised disease initially are alive at 29 and 44 months. One of four patients who had locally recurrent melanoma is alive at 36 months. Both patients with systemic disease at presentation died. Advanced disease and delayed presentation contributed to the poor prognosis of subungual melanoma in our patients.
The Stockport Serpentine Spring System for the Treatment of Displaced Comminuted Intra-Articular Phalangeal Fractures
Authors: FAHMY N. R. M.
Published: December 2021

A new system has been designed to treat displaced comminuted intra-articular phalangeal fractures and 20 such fracture-dislocations were treated by it. Nineteen of the patients were satisfied at an average follow-up period of 13.6 months, with a mean total active motion of 226°. The results are rewarding considering the gravity of the injuries.
Brachioradialis Forearm Flap in a Case of Traumatic Bone and Skin Loss at the Elbow
Authors: BINNS M. , KUEH K. A. , PHO R. W. H.
Published: December 2021

A case of traumatic skin and bone loss at the elbow is described. This was treated by a long brachioradialis flap, allowing early movements with thick and sensate cover. Anatomical studies delineate the extent of this flap.
On the Treatment of Enchondroma
Authors: WULLE CHRISTHILD
Published: December 2021

We recommend simply removing an enchondroma without filling the cavity with cancellous bone or plaster-of-Paris. This method can also be applied to other benign bone conditions, such as aseptic necrosis.
Properties of the Fibrous Structures of the Wrist
Authors: KUHLMANN J N , LUBOINSKI J. , LAUDET C. , BOABIGHI A. , LANDJERIT B. , GUERIN-SURVILLE H. , BAUX S.
Published: December 2021

Every fibrous structure of ten wrists of fresh cadavers has been the object of an elastometric study. The opposite wrists have been studied surgically and then histologically with the optical microscope. Comparison between the two shows a close relationship between the mechanical features and the morphology of the bundles, which proved also to be perfectly measurable. It also displays the great differences between ligaments and tendons. Histological study of the tendons and ligaments of four other wrists subjected to manoeuvres of axial loading, rupture and bending, reinforces these statements. The therapeutic consequences are considered.
Volar Wrist Ganglia Cured by Carpal Tunnel Decompression
Authors: COBB J.
Published: December 2021

Three patients are described, each of whom had both carpal tunnel syndrome and a volar wrist ganglion. Carpal tunnel decompression caused resolution of the ganglion. This suggests that both disorders may be caused by the same pressure phenomenon.
Ice-Skating Injuries to the Hand
Authors: MURPHY N. M. , RILEY P. , KEYS C.
Published: December 2021

166 patients with injuries due to ice-skating were seen in the local accident and emergency department over a six-month period; 60% of these involved the upper limb. 28 of the upper limb injuries were closed fractures and 24 were lacerations, almost all to the dorsum of the hand. The use of protective gloves would help to prevent these potentially avoidable injuries. “On-site” first-aid facilities help to reduce the demand on the local accident service.
Painful Hypertrophic Non-Union of the Ulnar Styloid
Authors: MAFFULLI N. , FIXSEN J. A.
Published: December 2021

We report the case of a 16-year-old girl suffering from painful hypertrophic non-union of the ulnar styloid. She fractured the distal end of the radius four years before and had been treated conservatively. The non-union was painful and severely limited the range of movement of the wrist. Excision of the hypertrophied styloid was performed and the patient promptly resumed her activities. We believe this is the first such case reported in an adolescent.
A Study of Age-Related Changes of the Articular Disc of the Wrist in Hong Kong Chinese
Authors: KINNINMONTH A. W. G. , CHAN K. M.
Published: December 2021

A cadaveric study of age-related changes in the triangular fibrocartilage of the wrist in Hong Kong Chinese confirms the high incidence of tears with increasing age. There appears to be two distinct types, linear and degenerate, with no clear evidence that the former is simply a precursor of the latter.