bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on the optimal design of volume fracturing for shale gas based on evaluating the fracturing effect—A case study on the Zhao Tong shale gas demonstration zone in Sichuan, China
Authors: Lin Yongxue , Liu Shanyong , Gao Shuyang , Yuan Yuan , Wang Jia , Xia Siqi
Published: December 2021

Hydraulic fracturing is the key technology in the development of shale gas reservoirs, and it mainly adopts volume fracturing technology to communicate hydraulic fractures with natural fractures to increase the drainage area. In view of the difficulty in characterizing the complex fractures created by multistaged fracturing in horizontal shale gas wells and the immaturity of fracturing optimization design methods, this study first evaluated the stimulation effect of fracturing technology based on treatment data and microseismic data. Then, the fracture characteristics after frac were considered, and a post-frac simulation was studied based on the discrete fracture network (DFN) model and the microseismic monitoring data as constraints. Finally, from the simulation results, an optimal design method of volume fracturing for shale gas was proposed based on the evaluation of the frac effects. The National Shale Gas Demonstration Zone in Zhaotong, Sichuan Basin was used as an example to study the optimal frac design of shale gas wells. The results show that (1) after optimizing the design, the optimal interval range is 50–70 m, the liquid volume of a single stage is 1800–2200 m3, the amount of sand is 80 m~120 t, and the slurry rate is 10–12 m3/min. (2) Two different frac design schemes were implemented in two wells on the same platform, and the production of the optimized design scheme was 14.7% greater than the original scheme. Therefore, the frac optimization design based on evaluating the fracturing effect can better guide the development of subsequent shale gas wells in this area.
Numerical forward modelling of the overpressure build-up in the Cenozoic section of the Central Graben in the North Sea
Authors: Orozova-Bekkevold Ivanka , Petersen Thomas Guldborg
Published: December 2021

One of the most widespread hypotheses for the origin of the present-day overpressure in the shale Post-Chalk section in the North Sea is the very rapid sedimentation from Neogene to present day. We tested this hypothesis by the means of numerical forward finite elements modelling and successfully simulated the overpressure build-up during the Cenozoic filling of the North Sea with relatively simple model set-up. Our model shows that overpressure of approximately 28% above hydrostatic developed in the Neogene, while during the Quaternary, it reached up to 36% above hydrostatic. At present day, the predicted onset of overpressure starts at about 800–1000 m below seafloor, while the maximum (magnitude about 1.36 sg, i.e. 36% above the normal hydrostatic pressure) is at approximately 2100 m. This overpressure profile fits reasonably well with data from wells drilled in the Central Graben. The exact magnitude of the overpressure depends on the used assumptions, the model set-up and the values of the input parameters. Especially the dynamic interaction between high sedimentation rates, clay permeability and low horizontal pressure gradient seems to be a key factor in the efficiency of dewatering of saturated clays during burial. The results indicate that, the assumption of horizontal stress isotropy results in nearly no horizontal fluid flow, despite the same magnitude for the vertical and the horizontal permeability. In these conditions, the vertical permeability plays much bigger role than the horizontal one in the effective de-watering of the sediments during burial. Further investigation is needed to explore the role of horizontal pressure gradient in fluid migration in passive sedimentary basins.
Structural interpretation of High-resolution aeromagnetic data over the Dahomey basin, Nigeria: implications for hydrocarbon prospectivity
Authors: Okoro E. M , Onuoha K. M , Okeugo C. G , Dim C. I. P.
Published: December 2021

The renewed quest to boost Nigeria’s dwindling reserves through aggressive search for oil and gas deposits in Cretaceous sedimentary basins has re-ignited the need to re-evaluate the hydrocarbon potentials of the Dahomey Basin. Aeromagnetic data are a low-cost geophysical tool deployed in mapping regional basement structures and determination of basement depths and sedimentary thickness in frontier basin exploration. In this study, high-resolution aeromagnetic (HRAM) data covering the Dahomey Basin Nigeria have been interpreted to map the basement structural configuration and to identify mini-basins favorable for hydrocarbon prospectivity. The total magnetic intensity grid was reduced to the equator (RTE) and edge detection filters including first vertical derivative (FVD), total horizontal derivative (THDR), tilt derivative (TDR) and total horizontal derivative of upward continuation (THDR_UC)) were applied to the RTE grid to locate the edges and contacts of geological structures in the basin. Depth to magnetic sources were estimated using the source parameter imaging (SPI) method. Data interpretation results revealed shallow and deep-seated linear features trending in the NNE-SSW, NE-SW, NW-SE and WNW-ESE directions. The SPI map showed a rugged basement topography which depicted a horst-graben architecture on 2D forward models along some selected profiles. Two mini-basins ranging in basement depths between 4.5 – 6.3km were mapped offshore of the study area. It appears the offshore Dahomey Basin holds greater promises for hydrocarbon occurrence due to the presence of thicker succession of sedimentary deposits in the identified mini-basins.
Evaluation of anionic and non-ionic surfactant performance for Montney shale gas hydraulic fracturing fluids
Authors: Chee Sheau Chien , Hidayat Belladonna Maulianda , Mohshim Dzeti Farhah , Md Zain Zahidah , Chai Ivy Ching Hsia , Borhan Norazleenawati , Ismail Hasnol Hady , Adam Matt
Published: December 2021

Hydraulic fracturing is often used in unconventional shale reservoirs, and 50%–95% of the injected hydraulic fracturing fluid remains in the formation due to the capillary effect. This phenomenon has been observed in the Montney shale formation, Canada, where the flowback water recovery is generally less than 25%. Surfactant is one of the hydraulic fracturing fluid additives for reducing surface tension and capillary forces to facilitate water flowback recovery. Surfactant loss due to adsorption by the reservoir rocks reduces the chemical’s efficiency, and this causes water retention in the formation and reduces water flowback recovery. The compatibility of surfactant with reservoir rock is critical to minimize surfactant adsorption on the rock surface because this diminishes the primary function of the surfactant hydraulic fracturing fluid additive and to ensure cost-effectiveness. This study evaluates surfactant efficiency to improve flowback recovery for the Montney shale formation based on IFT, surface tension, and adsorption. This study evaluates surfactant performance and performs a fluid–fluid interaction experiment and fluid-rock compatibility investigation. Several commercial surfactants are screened for low interfacial tension and surface tension. Further analysis is carried out by evaluating the fluid-rock compatibility using the static soaking test at reservoir pressure and temperature. The pre-soaking and post-soaking test fluids were analyzed for water composition, liquid–liquid interfacial tension, surface tension, and pH. Results showed that the selected surfactant is a critical determiner of the hydraulic fracturing fluid performance. SOLOTERRA 938 is an anionic surfactant that has good compatibility with Montney shale formation. Unlike other non-ionic surfactants, SOLOTERRA 938 retains the interfacial tension and surface tension after seven days of interaction with reservoir rock. The interfacial tension remained unchanged at 0.1 mN/m. The surface tension decreased from 28.4 to 27.5 mN/m with air and from 21.7 to 20.8 mN/m with hydrocarbon because surfactant behavior changes with pH change. The surfactant concentration was measured using high-pressure liquid chromatography, and the loss was 12% after seven days of interaction with the reservoir rock (from 0.1 to 0.088wt%). The adsorption calculated based on the concentration volume showed a low value of between 0.43 and 0.97 mg/g rock.
Examination of behavior of lysine on methane (95%)–propane (5%) hydrate formation by the use of different impellers
Authors: Longinos Sotirios Nik. , Parlaktuna Mahmut
Published: December 2021

Hydrate formation characteristics and hydrodynamic behavior have been investigated for mixture of methane–propane hydrate formation with pure water and with the amino acid of lysine 1.5 wt% at 24.5 bars and 2 °C. There were total 12 experiments with full and no baffle estimating the induction time, rate of hydrate formation, hydrate productivity and power consumption. The outcomes showed that radial flow experiments with radial flow have better behavior compared to mixed flow ones due to better interaction between gas and liquid. Furthermore, lysine experiments formed hydrates more quickly compared to pure water experiments showing that lysine functions as promoter and not as inhibitor. RT experiments consume more energy compared to PBT ones, while induction time is always smaller in RT experiments compared to PBT ones.
State of the art of advanced spectral noise and high-precision temperature logging technology utilization in Iraqi oil fields: an integration approach to diagnose wells performance complications
Authors: Zeinalabideen Mohammed Jawad , Al-Hilali Mazin Mohlab , Savinkov Andrey
Published: December 2021

In this study, an integrated approach of advanced spectral noise and high-precision temperature logging with production logging tool was used for the understanding of leak detection, fluid cross-flow, flow below spinner threshold, packer failure, fluid channeling in patchy and bad cement bond behind the casing, flow quantification in complex SSD completion, production detection and quantification in recirculation intervals in deviated wells. Various case studies from Southern and Northern Iraqi oil fields have been presented in this paper.
Experimental investigation of chemical solutions effects on wettability alteration and interfacial tension reduction using nano-alkaline–surfactant fluid: an EOR application in carbonate reservoirs
Authors: Rajabi M. Sadegh , Moradi Rasoul , Mehrizadeh Masoud
Published: December 2021

The wettability preference of carbonate reservoirs is neutral-wet or oil-wet as the prevailing of hydrocarbon reserves that affects approximately half of the total production of hydrocarbons of the world. Therefore, due to surface wettability of carbonate rocks the notable fraction of oil is held inside their pores in comparison with sandstones. Since shifting the wettability preference toward water-wet system is of great interest, numerous components were used for this purpose. In this experimental research, the wettability alteration of dolomite surface by interacting with a novel nano-surfactant–alkaline fluid has been investigated in order to diminish its adhesion to crude oil droplets. The solutions were prepared by homogenous mixing of nanosilica particles with cetyl trimethyl ammonium bromide and sodium carbonate, respectively, as a cationic surfactant and alkaline agent. The maximum wettability alteration from oil-wet to water system was obtained by employing a mixture of nanoparticles in association with surfactant–alkaline. Then, the fluids were employed in core-surface from detached and attached forms to compare their interfacial effects on saturated thin sections by crude oil and to measure the wettability. In addition, the interfacial tension (IFT) between solutions and crude oil was investigated and the maximum IFT reduction was obtained from nano-surfactant. Finally, all chemical solutions were flooded to the dolomite plugs separately after water flooding in order to evaluate the maximum oil recovery factor acquired by nano-surfactant.
Nanoemulsion-based dissolving microneedle arrays for enhanced intradermal and transdermal delivery
Authors: Nasiri Muhammad Iqbal , Vora Lalitkumar K. , Ershaid Juhaina Abu , Peng Ke , Tekko Ismaiel A. , Donnelly Ryan F.
Published: December 2021

The development of dissolving microneedles (DMN) is one of the advanced technologies in transdermal drug delivery systems, which precisely deliver the drugs through a rapid dissolution of polymers after insertion into the skin. In this study, we fabricated nanoemulsion-loaded dissolving microneedle (DMN) arrays for intradermal and transdermal drug delivery. For this task, model drug (amphotericin B, AmB)-loaded nanoemulsion (NE) were prepared by the probe-sonication method. AmB-loaded-NE was prepared using Capmul MCM C-8 EP/NF, Tween® 80, poly(vinyl alcohol) (PVA-10 kDa), and poly (vinyl pyrrolidone) (PVP-360 kDa or K29/32) by using SpeedMixer™, followed by probe-sonication and evaluated for particle size and polydispersity index (PDI). Transmission electron microscopy (TEM) was also used to assess the particle size before and after DMN casting. AmB-NE embedded DMN arrays were found to be strong enough, revealed efficient skin insertion, and penetrated down to the fourth layer (depth ≈ 508 μm) of Parafilm M® (validated skin model). Ex vivo skin deposition experiments in full-thickness neonatal porcine demonstrated that after 24 h, AmB-NE-DMN arrays were able to deposit 111.05 ± 48.4 µg/patch AmB into the skin. At the same time, transdermal porcine skin permeation studies showed significantly higher permeability of AmB (29.60 ± 8.23 μg/patch) from AmB-NE-DMN compared to MN-free AmB-NE patches (5.0 ± 6.15 μg/patch) over 24 h. Antifungal studies of optimized AmB-NE-DMN, AmB-loaded discs and drug-free DMN against Candida albicans, confirmed the synergistic activity of Campul-MCM C-8, used in the nanoemulsion formulation. This study establishes that nanoemulsion based dissolving microneedle may serve as an efficient system for intradermal as well as transdermal drug delivery.

Graphical abstract
Political ideas of the network society: why digitalization research needs critical conceptual analysis
Authors: August Vincent
Published: December 2021

In this article, I argue for an interpretive approach to digitalization research that analyzes the concepts, narratives, and belief systems in digitalization debates. I illustrate this methodological proposal by assessing the spread of network ideas. Many political actors and digitalization researchers follow network ideas, e.g. by claiming that the rise of a network society must lead to network governance. In contrast to this narrative, I argue that there are multiple visions of the digital society, each of which follows a specific pattern of epistemology, social imaginary, and political proposals. These competing self-interpretations must be investigated by digitalization research in order to map and evaluate different pathways into a digital society. For doing so, critical conceptual analysis draws on political theory, critical conceptual history, and the sociology of knowledge. It offers two major benefits for digitalization research. Firstly, it provides a systematic overview of competing governance rationalities in the digital society, enabling a critical evaluation of their potentials and proposals. Secondly, it enhances the methodological rigor of digitalization research by reviewing the narratives researchers themselves tell. I substantiate these claims by analyzing and historicizing the above network narrative. Tracing it back to cybernetics, I show that it has been used multiple times in efforts to reshape the way we think about society and politics, including our concepts of subjectivity, power, and governance.
Pattern of Contracture and Recovery Following Ischaemia of the Upper Limb
Authors: SUNDARARAJ G. D. , MANI K.
Published: December 2021

196 cases of Volkmann’s Ischaemic Contracture of the upper limb with well-established ischaemia are presented. In all cases tight external circumferential splintage was the primary factor. 59.2% of these patients had been initially treated by “bone setters”. 54.6% had fractures of the forearm; supracondylar fracture of the humerus was seen in 10.7% and 17.9% had no evidence of bone or joint injury.

Different patterns of ischaemic contractures are recognised and the severity of the contracture is found to be related to the extent of paralysis. Sensory recovery occurs in a proximodistal direction even following total ischaemia and degeneration of the nerve. Motor recovery, however, does not seem to take place. Sensory recovery in the forearm proceeds rapidly in the first six months; thereafter it is less significant. However, the sensory recovery in the hand is significant only after more than twelve months. Since sensory recovery occurs even after total ischaemic degeneration of the nerve it is postulated that such nerves recover and regenerate in course of time.
Free Vascularised Bone Grafts in Reconstruction of the Upper Extremity
Authors: HIRAYAMA T. , SUEMATSU N. , INOUE K. , BAITOH C. , TAKEMITSU Y.
Published: December 2021

Free vascularised bone grafting was performed on six patients with large segmental bone defects following trauma, osteo-cutaneous defects and large bony defects following tumour resection. A free vascularised fibular graft was performed in five patients and a free iliac osteo-cutaneous flap was performed in one patient. In all patients, bony fusion was achieved by two to three months, without infection or recurrence of bone tumour. The donor site deficit was minimal.
The Relationship of the Double Crush to Carpal Tunnel Syndrome (An Analysis of 1,000 Cases of Carpal Tunnel Syndrome)
Authors: HURST LAWRENCE C. , WEISSBERG DAVID , CARROLL ROBERT E.
Published: December 2021

In this series of 1,000 cases of carpal tunnel syndrome (888 patients) there is a statistically significant incidence of bilaterality in patients with cervical arthritis. There is also a statistically significant increase in the incidence of diabetes mellitus over the general population. These findings lend further support to Upton’s Double Crush hypothesis. Further, the double crush syndrome predisposes to bilateral carpal tunnel syndrome and may be an important prognostic factor. It may also be an explanation for some of the failures following carpal tunnel surgery and lead surgeons to look for other associated systemic diseases or mechanical blocks, when attempting to alleviate recalcitrant symptoms.
An Experimental Study of Instability During Supination and Pronation of the Fractured Scaphoid
Authors: FALKENBERG PER
Published: December 2021

Rotatory instability of scaphoid fractures was studied by a method not used previously. On two fresh specimens the scaphoid bone was fractured by osteotomy, and the fracture was fixed by a Hoffmann apparatus extending from the distal radius to the 1st, 2nd and 3rd metacarpals. This permits free rotation in the forearm. The scaphoid fragments were marked by Kirschner wires. No movement occurred between the fragments when supination/pronation was kept within the normal range of movement.
Nerve Tumours in the Upper Limb a Clinical Review
Authors: HOLDSWORTH B. J.
Published: December 2021

Tumours arising from the peripheral nerves in the upper limb are rare. This paper reviews eighteen such cases and the clinical outcome. Problems of pre-operative diagnosis are emphasized.
Lymphangiosarcoma of the Hand Arising in a Pre-Existing Non-Irradiated Lymphangioma
Authors: MOSS A. L. H. , IBRAHIM NASSIF B. N.
Published: December 2021

Lymphangioma is an uncommon lesion which is widely believed not to undergo malignant change. Lymphangiosarcoma is even rarer and most of the cases reported in the literature were encountered in the setting of chronic lymphoedema, although occasional cases have been reported in irradiated lymphangiomata. This brief communication describes a case of multifocal lymphangiosarcoma arising in a non-irradiated, long standing lymphangioma of the hand. To our knowledge no similar case has been reported previously in the English literature, which is briefly reviewed.
Skin Hook: The Brown-Burr Modification of the Gillies Single Hook Skin Retractor
Authors: LUTHRA P. K. , BROWN H. G.
Published: December 2021

An extremely useful modification of the skin hook retractor has been designed, constructed and used successfully at the Newcastle Plastic Surgery unit.
The Relationship between Cold Intolerance and Cutaneous Blood Flow in Digital Replantation Patients
Authors: FREEDLANDER E.
Published: December 2021

Twenty-one patients with replanted digits were examined. An assessment of cold symptoms relating to their replants was made and the pulp two-point discrimination measured. Cutaneous blood flow was then monitored using a laser Doppler flowmeter. Recordings were taken at room temperature and following cooling. In all cases but one flow decreased with lowering of temperature in both replanted and normal digits. In eleven cases (52%) replant flow fell to noticeably lower levels compared to normal digits, but in the remainder this difference was not apparent. The presence or absence of cold intolerance did not correlate with flow levels or with two-point discrimination measurements.
Ischaemic Contracture of the Intrinsic Muscles of the Hands a Hazard of Physical Restraint
Authors: McLARDY-SMITH P. , BURGE P. D. , WATSON N. A.
Published: December 2021

A case is described of bilateral ischaemic contracture of the intrinsic muscles of the hands, presenting in a mentally-disturbed patient one year after a reported period of immobilisation in a physical restraint device.

Involvement of the deep thenar muscles and the interossei on the radial side of the hand can be explained by consideration of the anatomy of the deep palmar arch. Division of the tendons of the contracted interosseous muscles proximal to the metacarpophalangeal joints and release of the left first web improved hand function. Those who supervise the use of physical restraint devices should be aware of the risk of intrinsic muscle ischaemia and of the need for prompt diagnosis and treatment.
Trapezius Transfer for Paralysis of the Deltoid
Authors: KAREV AVNER
Published: December 2021

A case of selective paralysis of shoulder muscles with its reconstructive procedure, is presented.

The deltoid, infra- and supraspinatus paralysed, leaving one of the steering group of muscles around the shoulder—the subscapularis—intact, made the transfer of the trapezius to deltoid feasible, utilizing a modification of Saha's technique. An excellent result with full range of motion of the paralysed shoulder has been achieved.
Assessment of Thumb to Index Pulp to Pulp Pinch Grip Strengths
Authors: HOOK W. E. , STANLEY J. K.
Published: December 2021

In this study of fifty men and women with normal hand function, the strength of thumb to index finger pulp to pulp pinch grip was assessed with the remaining fingers either flexed or extended. When the pinch grip was performed with the remaining fingers flexed the value was up to 92% higher than when the remaining fingers were extended.

In future studies where thumb to index finger pinch grip is used as an objective test of function then the position of the remaining fingers must be defined to aid interpretation of the results.
A Comparison of Conservative Treatment and Silicone Replacement Arthroplasty in Kienböck’s Disease
Authors: EVANS G. , BURKE F. D. , BARTON N. J.
Published: December 2021

Two forms of treatment of Kienböck’s disease were compared in a total of thirty-seven wrists. Sixteen had been treated conservatively and were followed-up for an average of twenty years. Twenty-one had undergone silicone replacement arthroplasty an average of five years prior to review. Clinical results of conservative treatment showed four (25%) good, six (37.5%) fair and six (37.5%) with a poor result. Radiological deterioration was seen in only a quarter of cases. After silicone replacement there were nine (43%) good and seven (33%) fair. Five (24%) cases had a very poor result associated with dislocation of the prosthesis but design improvements have made this less frequent. Radiological abnormalities were noted in more than half of cases treated by silicone replacement arthroplasty. These included carpal collapse, scapho-lunate diastasis and generalised degenerative changes in the carpus. There were two cases with cyst formation in the capitate which closely resembled previous reports of silicone synovitis.
Lateral Approach to the Hook of Hamate for its Fracture
Authors: MIZUSEKI TAKAYA , IKUTA YOSHIKAZU , MURAKAMI TSUNEJI , WATARI SADAO
Published: December 2021

We have recently experienced one case of the fracture of the hook of the hamate that was diagnosed only by the CT scan. As a surgical approach, lateral approach to the hook of the hamate for its fracture was utilized. We found that this approach was safe, easy and quick.
Sarcoidosis Presenting with Pathological Fracture of a Metacarpal
Authors: LUNN P. G. , McGLONE R. , VARIAN J. P. W.
Published: December 2021

We describe a patient who presented with pathological fracture of the fifth metacarpal which on further investigation, was found to be due to Sarcoidosis. There is no previous record of the condition presenting in this way, with a pathological fracture.
Percutaneous Accessory Collateral Ligament Release in the of Treatment Proximal Interphalangeal Joint Flexion Contracture
Authors: STANLEY J. K. , JONES W. A. , LYNCH M. C.
Published: December 2021

A percutaneous release or capsulo-ligamentous proximal interphalangeal joint contracture is described, the indications are outlined and the advantage over open releases are discussed. The results of a small pilot study are reported which we feel are comparable to the results of open techniques.

The procedure in itself, however, merely allows operative correction to be achieved. Its maintenance depends upon a stringent post-operative rehabilitation regime.
Anatomical Variations of the Extensor Pollicis Brevis
Authors: DAWSON S. , BARTON N.
Published: December 2021

Sixteen arms in eight cadavers were dissected. The extensor pollicis brevis followed the description given in standard anatomy texts in only three out of the sixteen arms. Four out of the eight cadavers showed asymmetry of the extensor pollicis brevis between their two sides.
Joint Reconstruction Following Trauma: Comparison of Microsurgical Transfer and Conventional Methods: A Report of 61 Cases
Authors: FOUCHER G. , HOANG P. , CITRON N. , MERLE M. , DURY M.
Published: December 2021

Joint reconstruction at the metacarpophalangeal or proximal interphalangeal levels remains a difficult problem in hand surgery. The authors reviewed sixty-one joints reconstructed acutely or electively allowing to compare Swanson spacer (30 joints), interpositional arthroplasty (4), non vascularized joint transfer (5) and vascularized joint transfer (21). Among these, two different techniques have been used: island compound transfer from a finger bank (10) and free vascularized transfer from the second toe (10) or from a non replantable finger (1). It is not worth while comparing different techniques applied to different indications. The only point which can be stressed is the better average range of movement of metacarpophalangeal reconstruction compared to that obtained at the proximal interphalangeal level.
Functional Assessment After Pollicisation
Authors: ROPER B. A. , TURNBULL T. J.
Published: December 2021

Nine children with congenital aplasia or hypoplasia of the thumb were treated by pollicisation of the index finger. Functional assessment was performed on average five years after surgery. It demonstrated normal sensation and a power grip, pinch grip and adductor grip of the thumb of 63%, 56% and 63% respectively of the unoperated hand. Efficient use of the hand increased after surgery and continued to improve for some years. The results indicate that pollicisation benefits hand function and should be performed early.
One in Four Flexor Digitorum Superficialis Lasso for Correction of the Claw Deformity.
Authors: SHAH ATUL
Published: December 2021

In continuation of the author’s work on ‘lasso’ principle, flexor digitorum superficialis split in to four tails and looped around A1 pulley has been described in this article to correct the ulnar claw and to correct the total claw hand when used along with opponensplasty as a one stage technique. This operation has the advantage of retaining superficialis tendons of the other fingers for better power grip and the avoiding swan neck deformity.
A Review of Total Elbow Arthroplasty and an Early Assessment of the Liverpool Elbow Prosthesis
Authors: SOURMELIS S. G. , BURKE F. D. , VARIAN J. P. W.
Published: December 2021

The elbow joint is frequently affected by rheumatoid arthritis causing pain and disability which limits the use of the upper limb. Excisional or interpositional arthroplasties of the elbow have failed to provide satisfactory results. The design of a total elbow prosthesis in the early 1970’s followed the principles and evolution of joint replacement in the lower limb.

In this study twenty-two Liverpool elbow prostheses (non-constrained) in nineteen patients were reviewed with an average follow-up of 26.5 months. Postoperatively the arc of flexion-extension improved with no change in pronation-supination range. Pain was significantly improved postoperatively. Rheumatoid patients were very pleased, but patients with secondary osteoarthritis were less satisfied. Two prostheses became loose and three had deep infection and were removed. Five patients had postoperative symptoms of ulnar neuritis and in three the symptoms gradually resolved. Early results of total elbow arthroplasty are promising in carefully selected patients.
Primary Flexible Implant Arthroplasty of the Metacarpophalangeal Joints During Digital Replantation.
Authors: KAY S. , WATSON J. S.
Published: December 2021

Primary silicone rubber arthroplasty in a total of four metacarpophalangeal joints during digital replantation or revascularisation in two patients is reported. The results appear preferable to present alternatives and allow good function without prejudicing further management.
Osteosynthesis for the Unstable Fracture of the Hand
Authors: THAKORE. H. K. D.
Published: December 2021

Unstable, displaced, fractures of the hand present a challenge to surgeons all over the world. Retention of the reduction using a cast, splint or even K wire fixation is difficult during the period of bone healing: also a relatively prolonged period of immobilisation after such treatment leads to stiffness of the metacarpal and finger joints. The picture gets more complicated if the hand suffers more than one fracture. The unique ability of the hand to grasp and grip objects of different size and shape depends on the intact functional anatomy of the hand articulations. Thus accurate and stable reduction of metacarpal and phalangeal fractures is essential for early active mobility with a view to early’return to work even before the recovery is complete, especially in the case of an industrial worker. We recommend osteosynthesis as a method of choice for treating such displaced, unstable fractures of the band as shown by the present retrospective study of fifty patients. We suggest a simple practical method of assessing the results of treatment for severe fractures of the hand.
Kienböck’s Disease — Late Results by Non-Surgical Treatment
Authors: KRISTENSEN S. S. , THOMASSEN E. , CHRISTENSEN F.
Published: December 2021

Two groups of patients with Kienböck’s disease were followed. Twenty-three wrists had been immobilised with plaster and twenty-six had no treatment. At follow up there was a marked improvement in both groups.

Eighty-three percent of the wrists in the new treated group were pain free, or reported pain only on heavy work, and in the nontreated group this was valid for 77%.

Examining X-rays at follow up we did not find a single wrist in which the lunate was normal or less deformed than at the time of diagnosis. In all forty-nine wrists the lunate was deformed and in 67% osteoarthrosis in the radiocarpal joint was evident. It is concluded, that Kienböck’s disease has a naturally benign course, the remaining symptoms at follow-up might be caused by osteoarthrosis and nothing seems to be gained by rigorous immobilisation. If pain persists efficient treatment must be based on surgical methods.
Trans-Triquetral Mid-Carpal Dislocation
Authors: NUNN D.
Published: December 2021

A fracture of the Triquetrum with a dislocation of the carpus, being an unusual configuration, is reported.
Scaphoid-Trapezium-Trapezoid Subluxation
Authors: KUUR EJNAR , BOE ANNE MARIE
Published: December 2021

A case of scaphoid-trapezium-trapezoid subluxation (STTS) is presented. This injury has only been described three times before. More interest in injuries to the ligaments of the wrist will probably show a greater frequency of (STTS). In cases of pain on the radial border of the wrist due to trauma and with normal routine radiographs, one would recommend supplementary radiographs with the wrists kept in maximal ulnar deviation. The treatment of (STTS) is discussed.
The Value of a Next Day Hand Injury Review Clinic
Authors: FINLAYSON B. J. , CROSS A. B. , SHALLEY M. J. , CHERRY R. J.
Published: December 2021

A daily hand injury review clinic takes place at East Birmingham Hospital. The purpose of this study is to determine whether this clinic is beneficial in reducing the morbidity of neglected hand injuries, and to compare the running of the clinic with the original criteria laid down at its inception as a ‘once only’ screening clinic.

We conclude that such a clinic is highly beneficial, and recommend that it should be standard practice in other hospitals.
Post Mastectomy Pain after Brachial Plexus Palsy: Metastases or Radiation Neuritis?
Authors: HOANG P. , FORD D. J. , BURKE F. D.
Published: December 2021

Three patients have been reported who developed metastatic tumour within the neural tissue of the brachial plexus three years, four years and fourteen years respectively after treatment of breast carcinoma by simple mastectomy and postoperative radiotherapy.

A fourth patient who developed bilateral upper limb paralysis after radiotherapy for a lymphoma is also reported.

At exploration of the brachial plexus extensive fibrosis was present in all cases with metastases only diagnosed through biopsy of neural tissue.

The clinical features and the role of surgery are discussed in the light of our experience and a review of available literature.
Closed Rupture of Extensor Digitorum Communis Tendon Following Excision of Distal Ulna
Authors: PRING D. J. , WILLIAMS D. J.
Published: December 2021

Two cases of closed rupture of the extensor communis tendons are presented following excision of the distal ulna after fracture of radius and ulna. This complication has not been previously reported. A mechanism of injury is described.
Cubital Canal Syndrome Due to Subanconeus Muscle
Authors: SUCHER E. , HERNESS D.
Published: December 2021

A forty-nine-year-old patient, suffering from right cubital canal syndrome, was admitted for surgery. The diagnosis was established clinically and by subsequent electromyography.

The factor producing pressure on the ulnar nerve was the subanconeus muscle, an auxiliary extension of the medial portion of the triceps muscle, arising from the medial border of the olecranon and adjacent triceps tendon and inserting into the dorsal aspect of the medial epicondyle.

Complete excision of this muscle is sufficient, leading to immediate improvement in most cases.
Oestrogen and Progesterone Hormone Receptors in Dupuytren’s Disease
Authors: HANKIN F. M. , ECKENRODE J. , LOUIS D. S.
Published: December 2021

Dupuytren’s disease is associated with alcoholism and chronic liver disease, conditions frequently associated with deranged steroid hormone metabolism. The possible influence of endogenous sex steroid hormones on the development of Dupuytren’s disease has therefore been investigated.

An analysis of diseased palmar fascia for oestrogen and progesterone receptors was undertaken in fifteen patients. Hormone specific receptors were not found in the palmar fascia of our patients with Dupuytren’s disease, thus suggesting that other mechanisms or factors contribute to the pathogenesis of this fibrotic process.
A Seven-Year-Old Girl with Orf of the Hand
Authors: WALDRAM M. A.
Published: December 2021

A seven-year-old child presented with orf of the hand. There was a clear history of contact with sheep. The lesion was incised and drained and healed spontaneously within five weeks. The features of orf infection are described as a reminder of a diagnosis to be remembered in the urban accident and emergency department or hand clinic.
Synovial Sarcoma of the Hand—A Literature Study
Authors: DREYFUSS U. Y. , BOOME R. S. , KRANOLD DOROTHEA H.
Published: December 2021

Ninety cases of synovial sarcoma of the hand, including eight case reports have been described during the last fifty years, (1934–1984). 8.5% of all synovial sarcomata involve the hand, and affect predominantly individuals under the age of thirty. The five-year survival of these cases was 18% and the ten-year survival 9%.
The Present Role of the Groin Flap in Hand Trauma in the Light of a Long-Term Review
Authors: FREEDLANDER E. , DICKSON W. A. , McGROUTHER D. A.
Published: December 2021

A series of patients with groin flaps to the hand and forearm have been reviewed. The current role of this flap in managing hand trauma is discussed.
The Incidence and Pattern of Hand Fractures in Children
Authors: WORLOCK P. H. , STOWER M. J.
Published: December 2021

The incidence and pattern of hand fractures occurring in children living in Nottingham has been reviewed. The hand is the second commonest site of fracture in children. The incidence is low in infants, but rises steeply after the age of eight, especially in boys. The most common site is the proximal phalanx. The little finger/fifth metacarpal is the most vulnerable area, especially around the metacarpophalangeal joint. Greenstick fractures. are more common in metacarpals, while epiphyseal injuries predominate in the phalanges. Over 45% of fractures occurred either at sport or in a fight. Aetiological factors are discussed in relation to the fracture patterns described.
The Role of Carpal Instability in Scaphoid Nonunion: Casual or Causal?
Authors: MONSIVAIS J. J. , NITZ P. A. , SCULLY T. J.
Published: December 2021

We studied twenty consecutive scaphoid nonunions in twenty patients between the ages of eighteen and thirty-eight years. There were nineteen males and one female. The mean age was 25.2 years. Factors evaluated were fracture displacement, delay in treatment, and carpal instability. Fracture displacement and carpal instability were documented in patients by abnormal x-rays showing fragment displacement, abnormal scapholunate and radiolunate angles, etc., or by fluoroscopically controlled arthrography. We concluded that intercarpal ligamentous instability is consistently present and, therefore, the critical factor in wrists with ununited scaphoid fractures. Thirteen patients have been treated surgically; ligamentous disruption was confirmed at surgical exploration. In twelve patients, treatment of the nonunion included intercarpal ligamentous reconstruction. A satisfactory outcome was achieved in all twelve of these patients. One patient’s treatment did not include ligament reconstruction. Although the scaphoid fracture united after a Russe bone graft, he remains symptomatic with persistent intercarpal instability. The remaining seven patients are being evaluated or awaiting surgery. Since ligamentous injury is so common in nonunion, we believe it is causal and that surgical care of nonunion involves ligamentous repair or other stabilization procedure. Prevention of nonunion involves early attention to the therapy of carpal instability when associated with scaphoid fracture.
Fracture of the Body of the Hamate Bone Associated with Compartment Syndrome and Dorsal Decompression of the Carpal Tunnel
Authors: ALI M. A.
Published: December 2021

Fracture of the body of the hamate is rare. A case is reported where a crushing injury produced disruption of the carpus and a compartment syndrome of wrist and forearm. The median nerve escaped compression by the dorsal decompression produced by the injury. The fracture was fixed with wires and a good recovery followed.
Entrapment of the Ulnar Nerve in a Greenstick Fracture of the Ulna
Authors: PROSSER A. J. , HOOPER G.
Published: December 2021

This report describes entrapment of the ulnar nerve in a greenstick fracture of the ulna, with complete recovery of function after freeing the nerve from bone.
Haemorrhagic, Traumatic Tenosynovitis
Authors: DACRUZ D. J. , HARRIS A. M. , JONES J.
Published: December 2021

A case of haemorrhagic traumatic tenosynovitis is described for the first time.
Disappointing Outcomes in Staged Flexor Tendon Grafting for Isolated Profundus Loss
Authors: SULLIVAN D. J.
Published: December 2021

Staged flexor tendon grafting was conducted in sixteen young adults for isolated loss of the flexor digitorum profundus. Though thirteen of sixteen achieved a subjectively pleasing result, only seven of the sixteen cases achieved satisfactory results. Five major complications occurred in four patients. The overall results were no better than the results obtained for single stage flexor tendon grafting through an intact superficialis. This study establishes no advantage of staged flexor tendon grafts, over unstaged grafts for isolated profundus loss.
Operative Correction of Posttraumatic and Congenital Swanneck Deformity—A New Technique
Authors: KARTHAUS R. P. , van der WERF G. J. I. M.
Published: December 2021

Volar plate reconstruction by using a part of the slip of the superficialis tendon is a new technique in the treatment of posttraumatic and congenital swanneck deformity.

This small series represents two patients with a posttraumatic swanneck deformity due to volar plate rupture and one patient with a congenital swanneck deformity in six fingers. The results of the operation with a two years follow-up show seven fingers with a normal flexion-extension range without hyperextension. Only one finger has an extension lag of five degrees. All fingers have a normal grip strength and normal fine movements without pain.

There were no complications.
Ulnar Variance Determination
Authors: KRISTENSEN S. S. , THOMASSEN E. , CHRISTENSEN F.
Published: December 2021

Surgical procedures concerning the distal articular surfaces of the radius and ulna, demand an accurate method of measurement of ulnar variance. A new method, which is a modification of the method described by Palmer (1982), is introduced.

100 randomly selected healthy persons were submitted to X-ray of the wrist and the ulnar variance was determined independently by three observers using both methods.

By “weighted kappa” statistics the results, expressed in intra- and interobserver agreement, showed a significantly higher reliability in favour of the Modified method.
Hand Assessment Charts
Authors: ROBINS ROBERT H. C.
Published: December 2021

This paper reports the recommendations of a sub-committee of the British Orthopaedic Association on the design of assessment charts for routine use in accident and emergency departments and in hand clinics. The legal implications of these charts and their potential contribution to training are emphasised.
Solitary Loose Body within the Flexor Tendon Sheath of the Little Finger
Authors: ALI M. A.
Published: December 2021

An unusual case of fibrocartilaginous loose body within the synovial flexor tendon sheath is presented.
Use of a Previously Repaired Tendon for Tendon Transfer
Authors: CHIU HAW-YEN
Published: December 2021

A patient in whom a previously repaired flexor digitorum superficialis tendon was used for transfer to correct a claw deformity is described. I have found this to be possible under optimal conditions of tendon repair, thus providing the hand surgeon with another choice of donor material.
Median Nerve as Free Tendon Graft
Authors: VASTAMÄKI M.
Published: December 2021

Four patients are described, all of whom bad tendon injuries in which the median nerve was used as a free tendon graft. Three cases involved the repair of a flexor tendon injury, and one the repair of an extensor tendon. In all cases, reconstruction of the median nerve was performed with a free sural nerve graft. The difficulty was that the palmaris longus tendon was missing in all cases. The importance of preoperative clinical testing for the presence of the palmaris longus tendon is emphasized.
Restoration of Elbow Flexion by Complete Latissimus Dorsi Muscle Transposition
Authors: HIRAYAMA T. , TAKEMITSU Y. , ATSUTA Y. , OZAWA K.
Published: December 2021

Flexor-plasty of the elbow has been performed using either a tubed complete latissimus dorsi muscle or musculocutaneous transposition in eight patients, six of whom had brachial plexus palsy and two traumatic loss of the anterior brachial musculature and overlying soft tissue. The range of follow-up was from one to eight years.

When the postoperative results were evaluated according to the criteria of Segal (1959), the results were excellent in four cases and good in three, with one failure. The indications, operative technique and results are discussed.
Vascularized Bone Graft Pedicled on the Volar Carpal Artery for Non-Union of the Scaphoid.
Authors: KUHLMANN J. N. , MIMOUN M. , BOABIGHI A. , BAUX S.
Published: December 2021

A bone graft, taken from the medial part of the radial epiphysis can be pedicled on the radial branch of the volar carpal arch, freed back to its origin. The graft can be transferred into the proximal row of the carpus to fill up a loss of bony substance or to provide vascularised bone.

This permits the treatment of chronic pseud-arthrosis of the scaphoid where a Matti-Russe operation has failed. In the first three cases operated upon, favourable results have been obtained.
Lipofibroma of the Median Nerve: A Report of Two Cases
Authors: LANGA V. , POSNER M. A. , STEINER G. E.
Published: December 2021

Two cases of lipofibroma of the median nerve are described. The literature is reviewed and the clinical and treatment aspects of this unusual condition are discussed.
Haemangioma of the Median Nerve Associated with Raynaud’s Phenomenon
Authors: PROSSER A. J. , BURKE F. D.
Published: December 2021

Raynaud’s phenomenon was a presenting feature of a cavernous haemangioma of the median nerve. The role of excision by interfascicular microdissection is discussed against the background of a 25 year follow-up.
Pathology of the Flexor Tendon Sheath in the Spontaneous Carpal Tunnel Syndrome
Authors: NEAL N. C. , McMANNERS J. , STIRLING G. A.
Published: December 2021

The histological features of the flexor tendon sheath in the spontaneous carpal tunnel syndrome were studied. The main differences between our findings and previous studies were twofold. Firstly a striking absence of inflammation in our material and secondly the diversity of the pathological changes encountered — alterations in the connective tissue especially the collagen; proliferation with thickening of the tissues of the tendon sheath; fibrosis; amyloid deposition; oedema; vascular lesions including thickening of vessels walls, intimal hyperplasia, and thrombosis; and a foreign body giant cell reaction. Although the lesions described here may not be significant in every case in which they are encountered, they do appear to support the view that pressure in the carpal tunnel and ischaemia are the important factors in a majority of cases of the spontaneous carpal tunnel syndrome.
Ulnar Nerve Laceration — a Complication of Carpal Tunnel Decompression: Case Report and Review of the Literature
Authors: FAVERO K. J. , GROPPER P. T.
Published: December 2021

Complications of peripheral nerve injury arising from the surgical treatment of carpal tunnel syndrome are not uncommon. No documented report of the association of ulnar nerve injury with carpal tunnel decompression has been found. This case-study describes partial laceration of the ulnar nerve as a complication of carpal tunnel surgery and reviews the literature on this subject.