2,031 results match your criteria Hand Clinics [Journal]


Local Anesthesia Without Tourniquet in Hand and Forearm Surgery: My Story of Using and Promoting it.

Authors:
Jin Bo Tang

Hand Clin 2019 Feb;35(1):xv-xx

Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China. Electronic address:

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February 2019

How the Wide Awake Tourniquet-Free Approach Is Changing Hand Surgery in Most Countries of the World.

Hand Clin 2019 Feb;35(1):xiii-xiv

Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong 226001, Jiangsu, China. Electronic address:

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February 2019
2 Reads

Extending Applications of Local Anesthesia Without Tourniquet to Flap Harvest and Transfer in the Hand.

Hand Clin 2019 Feb;35(1):97-102

Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong 226001, Jiangsu, China.

The authors' experience demonstrates that wide-awake flap surgery in the hand is safe. The authors used this approach in 4 commonly used flaps in the hand in 27 patients: the extended Segmuller flap, the homo-digital reverse digital artery flap, the dorsal metacarpal artery perforator flap, and the Atasoy advancement flap. Wide-awake flap surgery works very well and safely achieved excellent anesthetic and vasoconstrictive effects in the authors' cases. Read More

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February 2019
6 Reads

Wide Awake Surgery as an Opportunity to Enhance Clinical Research.

Hand Clin 2019 Feb;35(1):93-96

Department of Orthopedic Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address:

Wide Awake surgery under Local Anesthesia with No Tourniquet (WALANT) has revolutionized clinical hand surgery, improving clinical outcomes and reducing postoperative pain and morbidity. It can also be used to deepen scientific knowledge, because the unsedated patient, with sensation intact and without the adverse effects of tourniquet neurapraxia or paralysis, can follow commands and actively move the limb after tendon and nerve surgery. These movements can be correlated with fingertip force, tendon tension, nerve conduction and amplitude, and muscle sarcomere length measurements to develop new insights into the effectiveness of many different tendon and nerve procedures in the hand. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260941PMC
February 2019
7 Reads

Wide-Awake Wrist and Small Joints Arthroscopy of the Hand.

Hand Clin 2019 Feb;35(1):85-92

Upper Limb Unit, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, Lancashire WN6 9EP, UK.

The minimally invasive nature of wrist and small joint arthroscopy renders it particularly suitable for the application of the wide-awake local anesthesia no tourniquet (WALANT) technique. The application of WALANT wrist and small joint arthroscopy has given surgeons the ability to visualize both static and dynamic movements of a joint, to show the pathology and discuss with the patient, and to visualize a patient's repaired structures. This reinforces confidence in surgeons and encourages patients to comply with postoperative rehabilitation. Read More

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February 2019
11 Reads

Wide-Awake Hand Surgery in Two Centers in China: Experience in Nantong and Tianjin with 12,000 patients.

Hand Clin 2019 Feb;35(1):7-12

Department of Hand Surgery, Tianjin Hospital, 406 Jiefang Nan Road, Hexi District, Tianjin 300211, China.

This article summarizes the application of local anesthesia no tourniquet in 2 hand surgery centers in China, Nantong and Tianjin, where more than 12,000 patients were operated on with the new approach. This approach achieves excellent anesthetic and vasoconstrictive effects. In Nantong, surgeons performed fracture fixation, soft tissue tumor excision, and flap transfer in the hand with this approach. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.011DOI Listing
February 2019
10 Reads

Wide Awake Tendon Transfers in Leprosy Patients in India.

Hand Clin 2019 Feb;35(1):67-84

Division of Plastic Surgery, Dalhousie University, Dalhousie Medicine New Brunswick, Suite C204, 600 Main Street, Saint John, New Brunswick E2K 1J5, Canada.

Dr Akbar Khan began using the wide awake local anesthesia no tourniquet (WALANT) technique for leprosy tendon transfers in the summer of 2015 at the Damien Foundation Hospital in Nellore, India. This article summarizes his first 18 months of experience and describes 5 of his operations. He found that WALANT provides effective anesthesia with good visibility for leprosy tendon transfers. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.09.001DOI Listing
February 2019
10 Reads

Lessons Learned in the Authors' First Years of Wide-Awake Hand Surgery at the W Hospital in Korea.

Hand Clin 2019 Feb;35(1):59-66

W Institute for Hand & Reconstructive Microsurgery, W General Hospital, 1632 Dalgubeol-daero, Dalseo-Gu, Daegu 42642, Korea.

Wide-awake local anesthesia no tourniquet (WALANT) is a promising development for surgeons and patients through improved operation outcomes in hand and wrist surgery. The authors have mostly used WALANT for flexor and extensor tendon repair, tenolysis, and tendon transfer. Its application at W Hospital in korea has bolstered surgeon confidence in tendon repair integrity, gliding ability, and transfer tension via direct observation and patient feedback. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.006DOI Listing
February 2019
1 Read

Wide Awake Hand Surgery Under Local Anesthesia No Tourniquet in South America.

Hand Clin 2019 Feb;35(1):51-58

Departament of Surgery and Orthopedics, Botucatu Medical School, São Paulo State University, UNESP, Av. Professor Mario Rubens Montenegro s/n, Botucatu, São Paulo 18 618-687, Brazil.

The authors report the introduction and development of wide awake hand surgery under local anesthesia no tourniquet (WALANT) in South America, specifically in Brazil, where thousands of cases have already been performed with this technique. This was largely stimulated by Dr Lalonde's first visit to Brazil in 2012. The authors began with smaller procedures such as trigger fingers and carpal tunnels, which were easily implemented. Read More

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February 2019
8 Reads

Practice in Wide-Awake Hand Surgery: Differences Between United Kingdom and Cyprus.

Hand Clin 2019 Feb;35(1):43-50

Manchester Hand Centre, Salford Royal NHS Foundation Trust, Manchester, UK; Orthopaedic Department, Salford Royal Hospital, Stott Lane, Salford M6 8HD, UK.

The implementation of the wide-awake local anesthetic no tourniquet (WALANT) approach to surgical procedures in Cyprus has led to significant cost savings. In the United Kingdom, the implementation of WALANT has led to shorter waiting times for hand surgical procedures, cost savings for the National Health Service, and high patient satisfaction rates. In both countries, patient education is a prerequisite for WALANT surgery. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.007DOI Listing
February 2019
9 Reads

Wide Awake Secondary Tendon Reconstruction.

Hand Clin 2019 Feb;35(1):35-41

Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, 770 Welch Road, Suite 400, Palo Alto, CA 94304, USA.

The wide awake anesthesia technique is a useful tool in secondary tendon reconstruction. With active participation of the patient, the tendon repair can be adjusted appropriately to prevent repairs that are too tight or too loose. Areas of tendon scarring or triggering can be identified and released. Read More

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February 2019
9 Reads

Impact of Wide-Awake Local Anesthesia No Tourniquet on Departmental Settings, Cost, Patient and Surgeon Satisfaction, and Beyond.

Hand Clin 2019 Feb;35(1):29-34

Chirurgie Lindenpark, Surgical Day Case Center, Lindenstrasse 23, Kloten 8302, Switzerland.

This article reviews the impact of wide-awake hand surgery without tourniquet on departmental settings and savings on patients' medical cost, and efficiency of fellowship training and practice of junior hand surgeons in 3 units in 3 countries. The medical cost of the commonly performed procedures is decreased remarkably with this approach in the 3 units. Hand surgery fellowship training and practice of junior surgeons are benefited from this approach in 2 units in Turkey and Switzerland. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.012DOI Listing
February 2019
11 Reads

The Canadian Model for Instituting Wide-Awake Hand Surgery in Our Hospitals.

Hand Clin 2019 Feb;35(1):21-27

Department of Plastic and Reconstructive Surgery, Dalhousie University, Suite C204, 600 Main Street, Saint John, New Brunswick E2K1J5, Canada.

Clinic-based hand surgery performed under local anesthetic has been steadily increasingly performed in Canada for 50 years. The drive for its development stems from the Canadian health care system's finite funding structure and resources. Benefits have extended far beyond cost and garbage reduction. Read More

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February 2019
5 Reads

The Current and Possible Future Role of Wide-Awake Local Anesthesia No Tourniquet Hand Surgery in Military Health Care Delivery.

Hand Clin 2019 Feb;35(1):13-19

Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address:

Wide-awake hand surgery is versatile and can be performed in a variety of settings for various pathologies. The benefits associated with wide-awake local anesthesia no tourniquet hand surgery can be extremely beneficial in the military health care system. Military medicine focuses on supporting soldiers in areas of combat, providing humanitarian care to local nationals, and to delivering health care to active duty soldiers and veterans in the domestic setting. Read More

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February 2019
9 Reads

Latest Advances in Wide Awake Hand Surgery.

Authors:
Donald H Lalonde

Hand Clin 2019 Feb;35(1):1-6

Division of Plastic Surgery, Dalhousie University, Dalhousie Medicine New Brunswick, Suite C204, 600 Main Street, Saint John, New Brunswick E2K 1J5, Canada. Electronic address:

Injection of tumescent local anesthesia should no longer be painful. WALANT anesthesia, strong sutures, a slightly bulky repair, intraoperative testing of active movement, and judicious venting of the A2 and A4 pulleys improve results in flexor tendon repair. WALANT K wire finger fracture reduction permits intraoperative testing of K wire stability with active movement to facilitate early protected movement at 3 to 5 days after surgery. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.002DOI Listing
February 2019
7 Reads

Upper Extremity Spasticity.

Hand Clin 2018 11;34(4):xiii

Division of Plastic Surgery, Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 232, Indianapolis, IN 46202, USA. Electronic address:

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November 2018

The Future of Upper Extremity Spasticity Management.

Authors:
Mitchel Seruya

Hand Clin 2018 Nov 20;34(4):593-599. Epub 2018 Aug 20.

Division of Plastic and Maxillofacial Surgery, USC Keck School of Medicine, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS#96, Los Angeles, CA 90027, USA. Electronic address:

Surgical management of upper limb spasticity has traditionally tackled the downstream effects at the muscle, tendon, and joint levels. Because this approach does not address the underlying pathologic condition within the nerve, surgical outcomes have been marked by unsatisfactory relapse over time. Future management may focus on reestablishing a normal neuronal impulse pathway to the dysfunctional musculotendinous unit. Read More

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November 2018
11 Reads

Outcomes After Surgical Treatment of Spastic Upper Extremity Conditions.

Hand Clin 2018 Nov 20;34(4):583-591. Epub 2018 Aug 20.

Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN 55455, USA. Electronic address:

Surgical interventions for the spastic upper extremity aim to correct the common deformities of elbow flexion, forearm pronation, wrist flexion and ulnar deviation, and thumb-in-palm deformity. One goal is achieving optimal function and improved limb positioning. Aesthetics of the limb have a profound impact on self-esteem and satisfaction. Read More

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November 2018
5 Reads

Rehabilitation Strategies Following Surgical Treatment of Upper Extremity Spasticity.

Hand Clin 2018 Nov 20;34(4):567-582. Epub 2018 Aug 20.

Occupational Therapy, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 142, Chicago, IL 60611-2605, USA. Electronic address:

Upper motor neuron injuries that occur in cases such as cerebral palsy, cerebrovascular accidents, and traumatic brain injury often have resulting upper extremity deformity and dysfunction. Multiple surgical options are available to improve upper extremity positioning, and, in some cases, motor control. Postoperative therapeutic management is imperative to assist the patient/caregiver in maximizing potential functional gains. Read More

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November 2018
3 Reads

Management of Spinal Cord Injury-Induced Upper Extremity Spasticity.

Hand Clin 2018 Nov 20;34(4):555-565. Epub 2018 Aug 20.

Department of Hand Surgery, Swiss Paraplegic Centre, Guido A. Zäch Str. 1, Nottwil CH-6207, Switzerland; Institute of Clinical Sciences, Center for Advanced Reconstruction of Extremities, University of Gothenburg, Gothenburg, Sweden. Electronic address:

Spasticity affects more than 80% of patients with spinal cord injury. Neural mechanisms and musculotendinous alterations lead to typical upper extremity features including shoulder adduction/internal rotation, forearm pronation, and elbow, wrist, and finger flexion. Long-standing spasticity may lead to soft tissue and joint contractures and further impairment of upper extremity function. Read More

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November 2018
2 Reads

Neurosurgical Management of Spastic Conditions of the Upper Extremity.

Hand Clin 2018 Nov 18;34(4):547-554. Epub 2018 Aug 18.

Section of Pediatric Neurosurgery, Department of Neurosurgery, Goodman Campbell Brain and Spine, Riley Hospital for Children, Indiana University School of Medicine, 705 Riley Hospital Drive, Suite #1134, Indianapolis, IN 46202, USA. Electronic address:

Spasticity is a hypertonic segmental reflex pathway caused by a central nervous system injury. Spasticity of the upper extremity causes loss of function, joint contracture, pain, and poor cosmesis. Treatment aims to reduce or change the pathophysiology underlying the hyperactive reflex from dorsal sensory rootlets through the intrinsic machinery of the spinal cord to the neuromuscular junction. Read More

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November 2018
1 Read

Selective Neurectomy for the Spastic Upper Extremity.

Hand Clin 2018 Nov;34(4):537-545

Institut de la Main, Clinique Bizet, 21 rue Georges Bizet, Paris 75116, France. Electronic address:

Surgery is one element of the rehabilitative care of the spastic upper limb. Different surgical techniques have been advocated to address each of the common deformities and underlying causes, including muscle spasticity, joint contracture, and paralysis. Partial neurectomy of motor nerves has been shown to reduce spasticity in the target muscles. Read More

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November 2018
2 Reads

Technical Pearls of Tendon Transfers for Upper Extremity Spasticity.

Hand Clin 2018 Nov;34(4):529-536

Pediatric Hand and Upper Extremity Center, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 2017, Cincinnati, OH 45229, USA; University of Cincinnati School of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA. Electronic address:

Tendon transfers are an important surgical option when treating patients with muscular imbalance due to upper extremity spasticity. A successful surgical outcome requires a thorough preoperative clinical evaluation, an understanding of tendon transfer biomechanics, appropriate donor and recipient muscle selection, technical execution, and postoperative rehabilitation. This article reviews the principles, biomechanics, and techniques for commonly performed tendon transfers in patients with upper extremity spasticity. Read More

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November 2018
4 Reads

Management of Joint Contractures in the Spastic Upper Extremity.

Hand Clin 2018 Nov;34(4):517-528

Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 5th Floor, New York, NY 10021, USA; Department of Hand and Upper Extremity, Hospital for Special Surgery, 523 East 72nd Street, 4th Floor, New York, NY 10021, USA. Electronic address:

Upper extremity contractures in the spastic patient may result from muscle spasticity, secondary muscle contracture, or joint contracture. Knowledge of the underlying cause is critical in planning successful treatment. Initial management consists of physical therapy and splinting. Read More

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November 2018
4 Reads

Surgical Management of Spasticity of the Shoulder.

Authors:
Dan A Zlotolow

Hand Clin 2018 Nov 18;34(4):511-516. Epub 2018 Aug 18.

Department of Orthopaedics, The Hospital for Special Surgery, 535 East 70th Street, New York City, NY 10021, USA; Shriners Hospital for Children Philadelphia, 3551 North Broad Street, Philadelphia, PA 19140, USA. Electronic address:

Although spastic conditions often involve the shoulder, it is rare for surgical intervention to be required. In cases in which chemodenervation and therapy are insufficient to optimize the patient's function or minimize their care requirements, surgical options, such as tendon and joint releases, can be considered. Tendon transfers are rarely indicated. Read More

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November 2018
25 Reads

Surgical Management of Spasticity of the Elbow.

Hand Clin 2018 Nov 20;34(4):503-510. Epub 2018 Aug 20.

Department of Orthopaedic Surgery, Nicklaus Children's Hospital, 3100 Southwest 62nd Avenue, Miami, FL 33155, USA.

A spastic limb refers to one with increased tone. This commonly results from an upper motor neuron injury, which, in turn, leads to disinhibition of reflex arcs. At the level of the elbow, affected individuals typically exhibit a flexion posture secondary to spastic contracture of the biceps, brachialis, and brachioradialis muscles. Read More

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November 2018
3 Reads

Surgical Management of Spasticity of the Forearm and Wrist.

Hand Clin 2018 Nov;34(4):487-502

Division of Plastic Surgery, Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 232, Indianapolis, IN 46202, USA. Electronic address:

Upper extremity spasticity may result from a variety of types of brain injury, including cerebral palsy, stroke, or traumatic brain injury. These conditions lead to a predictable pattern of forearm and wrist deformities caused by opposing spasticity and flaccid paralysis. Upper extremity spasticity affects all ages and sociodemographics and is a complex clinical problem with a variety of treatment options depending on the patient, the underlying disease process, and postoperative expectations. Read More

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November 2018
2 Reads

Surgical Management of Spasticity of the Thumb and Fingers.

Hand Clin 2018 Nov;34(4):473-485

Department of Surgery, Section of Plastic Surgery, Michigan Medicine, 2131 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.

Spasticity of the hand profoundly limits an individual's independent ability to accomplish self-care and activities of daily living. Surgical procedures should be tailored to patients' needs and functional ability, and even patients with severe cognitive injuries and poor upper extremity function may benefit from surgery to improve appearance and hygiene. Careful preoperative examination and planning are needed, and consideration is given to the potential unintended detrimental effect of a surgical procedure on hand function. Read More

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November 2018
5 Reads

Considerations in the Management of Upper Extremity Spasticity.

Hand Clin 2018 Nov 18;34(4):465-471. Epub 2018 Aug 18.

Division of Plastic Surgery, Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 232, Indianapolis, IN 46202, USA. Electronic address:

Spasticity is a movement disorder characterized by a velocity-dependent increase in muscle tone and a hyperexcitable stretch reflex. Common causes of spasticity include cerebral palsy, spinal cord injury, and stroke. Surgical treatment plans for spasticity must be highly individualized and based on the characteristics of patients and the spasticity in order to maximize functional gains. Read More

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November 2018
7 Reads

Nonsurgical Treatment Options for Upper Limb Spasticity.

Hand Clin 2018 Nov 18;34(4):455-464. Epub 2018 Aug 18.

Shirley Ryan AbilityLab, Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, 355 East Erie Street, Chicago, IL 60601, USA.

There are many nonsurgical treatment options for patients with upper limb spasticity. This article presents an algorithmic approach to management, encompassing evidence-based rehabilitation therapies, medications, and promising new orthotic and robotic innovations. Read More

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November 2018
3 Reads

Assessment of the Spastic Upper Limb with Computational Motion Analysis.

Hand Clin 2018 Nov 18;34(4):445-454. Epub 2018 Aug 18.

Orthopaedic Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, 225 East Chicago Avenue, Box 69, Chicago, IL 60611, USA.

This article presents the current status of integrating 3-dimensional motion analysis and electromyography to assess upper extremity function clinically. The authors used their approach to establish a normative database for 5 Shriners Hospital Upper Extremity Evaluation tasks, which provides ranges of motion at the point of task achievement. Also, the inter-joint correlations are provided to understand the movement coordination required for each task. Read More

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November 2018
2 Reads

Common Etiologies of Upper Extremity Spasticity.

Hand Clin 2018 11 18;34(4):437-443. Epub 2018 Aug 18.

Division of Plastic Surgery, Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 232, Indianapolis, IN 46202, USA. Electronic address:

Spasticity is a motor disorder that manifests as a component of the upper motor neuron syndrome. It is associated with paralysis and can cause significant disability. The most common causes leading to spasticity include stroke, traumatic brain injury, multiple sclerosis, spinal cord injury, and cerebral palsy. Read More

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November 2018
3 Reads

Errata.

Authors:

Hand Clin 2018 08;34(3):xiii

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http://dx.doi.org/10.1016/j.hcl.2018.05.001DOI Listing
August 2018
4 Reads

Dupuytren Disease.

Hand Clin 2018 08;34(3):xi

Michigan Medicine, University of Michigan Medical School, 2130 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0340, USA. Electronic address:

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August 2018
2 Reads

Bringing It All Together: A Practical Approach to the Treatment of Dupuytren Disease.

Hand Clin 2018 Aug;34(3):427-436

Department of Surgery, Michigan Medicine, University of Michigan Medical School, 2130 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.

As minimally invasive options for treatment of Dupuytren contractures become increasingly widespread, it is important that the evidence is carefully evaluated and patients are informed of the risks and benefits of the options available. The authors advocate a shared decision-making process, using evidence-based medicine, to guide patients in their treatment choices. In this article, the authors present their thoughtful approach to selecting the appropriate Dupuytren treatment of patients, along with detailed, practical technical tips to avoid complications during the execution of these interventions; both collagenase injection and limited fasciectomy techniques are described in detail. Read More

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August 2018
1 Read

Advances in Minimally Invasive Treatment of Dupuytren Disease.

Hand Clin 2018 Aug;34(3):417-426

Hand and Wrist Surgery, Xpert Clinic, Rotterdam, The Netherlands; Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.

A comparison is provided between minimally invasive techniques and limited fasciectomy (LF) in the treatment of Dupuytren disease. A technique called percutaneous needle aponeurotomy and lipofilling is described. In a randomized controlled trial, there is no significant difference between this technique and LF after 1 year in contracture correction and recurrent contractures. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.03.010DOI Listing
August 2018
3 Reads

Treatment of Recurrent Dupuytren Disease.

Hand Clin 2018 Aug;34(3):403-415

Indiana Hand to Shoulder Center, 8501 Harcourt Road, Indianapolis, IN 46260, USA.

Treatment of recurrent Dupuytren disease is challenging. Multiple options exist, each having relative benefits and weaknesses. Choice for optimal treatment is made on a case-by-case basis, with shared decision making with the patient. Read More

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August 2018
5 Reads

The Role of Hand Therapy in Dupuytren Disease.

Hand Clin 2018 Aug;34(3):395-401

Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping University, Linköping 581 85, Sweden; Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, Norrköping 60174, Sweden. Electronic address:

The role of hand therapy in the treatment of Dupuytren disease varies depending on the patient and the procedure. There is limited evidence for hand therapy as a preventive treatment of Dupuytren disease. Before corrective treatment, the hand therapist can contribute with assessments to promote evaluation of outcome. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.03.008DOI Listing
August 2018
8 Reads

Complications of Treatment for Dupuytren Disease.

Hand Clin 2018 08 8;34(3):387-394. Epub 2018 Jun 8.

Hand Surgery Service, Department of Orthopaedics, Yawkey Center, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:

Dupuytren contracture is a progressive disease involving collagen within the palmar fascia. When the contracture progresses to meet specific parameters, intervention is considered and includes collagenase injection, percutaneous or open fasciotomy, or palmar fasciectomy. Complications after treatment include contracture recurrence, digital nerve injury or postoperative neurapraxia, flexor tendon injury/rupture, delayed wound healing or skin necrosis, dysvascular digit/arterial injury, hematoma, and infection. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.03.007DOI Listing
August 2018
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Comparative Outcomes of Dupuytren Disease Treatment.

Authors:
Paul Binhammer

Hand Clin 2018 08;34(3):377-386

Division of Plastic and Reconstructive Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, M1 500, Toronto, Ontario M4N 3M5, Canada. Electronic address:

Despite more than a hundred years of publications on Dupuytren disease, there has been a lack of consensus on definitions and outcomes until recently. Staging and classifications systems have an important historical context; however, more recently, outcomes rely on patient-reported outcomes, angular correction, and definitions of recurrence. This article reviews commonly used assessments, classifications, and staging systems for Dupuytren disease. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183003
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http://dx.doi.org/10.1016/j.hcl.2018.03.006DOI Listing
August 2018
5 Reads

Alternative and Adjunctive Treatments for Dupuytren Disease.

Hand Clin 2018 08 8;34(3):367-375. Epub 2018 Jun 8.

Department of Orthopedic Surgery-Hand Unit, University Hospitals Leuven, University of Leuven, Herestraat 49, Leuven B-3000, Belgium.

Clinicians struggle with limited efficacy and durability of standard treatments when treating patients with Dupuytren disease diathesis. Alternative treatments such as low-dose radiation therapy in early phase of disease, supplemental pharmacotherapy with anti-inflammatory and/or anti-mitotic drugs, as well as other pharmacologic targets, and more aggressive surgery such as dermofasciectomy all have been reported with variable success or with serious side effects that hamper their standard use. This article gives an overview of the available literature. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.03.005DOI Listing
August 2018
13 Reads

Fasciectomy for Dupuytren Contracture.

Hand Clin 2018 08;34(3):351-366

AToMS-Academic Team of Musculoskeletal Surgery, Undercroft, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.

This article discusses limited fasciectomy for Dupuytren contracture, reviews the literature to list common complications, addresses the observations that need to be made after surgery, and systematically reviews the literature for 2 clinical questions: (1) regarding leaving wounds open and (2) the use of postoperative splintage. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.04.002DOI Listing
August 2018
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Development of Collagenase Treatment for Dupuytren Disease.

Hand Clin 2018 08;34(3):345-349

Department of Orthopaedics, T-18 Health Science Center, Stony Brook University Medical Center, Room 080, Stony Brook, NY 11794, USA.

Proof-of-principle, basic-science studies, using a rat-tail tendon model and surgically removed Dupuytren cords, began collagenase Clostridium histolyticum (CCH) development. Clinical studies in humans were then conducted, where the primary endpoint was reduction in contracture to within 0° to 5° of extension. Phase 2 studies, which confirmed the optimal dose of collagenase as 0. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.03.004DOI Listing
August 2018
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Needle Aponeurotomy for Dupuytren Disease.

Hand Clin 2018 08;34(3):331-344

Division of Plastic Surgery, University of Alberta, 14310 111 Avenue Northwest, Edmonton, Alberta T5M 3Z7, Canada. Electronic address:

Needle aponeurotomy is an effective, minimally invasive treatment for metacarpophalangeal and interphalangeal joint contractures caused by Dupuytren disease. Multiple joints and digits can be safely treated in 1 session. Needle aponeurotomy is more cost-effective and has a significantly lower complication rate compared with open fasciectomy and collagenase injections. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183003
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http://dx.doi.org/10.1016/j.hcl.2018.03.003DOI Listing
August 2018
8 Reads

Normal and Pathologic Anatomy of Dupuytren Disease.

Hand Clin 2018 08;34(3):315-329

Department of Orthopedic Surgery and Division of Plastic and Reconstructive Surgery, Virginia Commonwealth University, Richmond, VA 23298, USA; Virginia Hand Center, 2819 N. Parham Road, Suite 100, Richmond, VA 23294, USA. Electronic address:

Dupuytren disease causes nodules and thickened fascial cords in the hands of affected individuals. In this article, the author explains normal fascial anatomy of the hand and describes how it relates to the pathologic anatomy found in Dupuytren disease. Anatomic findings in diseased cords are described, with particular reference to dangers encountered in treatment of this condition. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.04.001DOI Listing
August 2018
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Risk Factors, Disease Associations, and Dupuytren Diathesis.

Authors:
Sandip Hindocha

Hand Clin 2018 08;34(3):307-314

Plastic Surgery & Laser Centre, Bedford Hospital NHS Trust, Reception J, Kempston Road, Bedford MK429DJ, UK. Electronic address:

Dupuytren disease (DD) is a benign, fibroproliferative disease of unknown cause. The disease predominantly affects the palms of the hands, causing permanent digital contracture of affected digits. DD is a late-onset disease and is often progressive, irreversible, and bilateral. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.03.002DOI Listing
August 2018
2 Reads

The Basic Science of Dupuytren Disease.

Hand Clin 2018 08 8;34(3):301-305. Epub 2018 Jun 8.

Department of Plastic Surgery, University of Texas Southwestern Medical Center, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX 75216, USA.

Dupuytren disease is a fibroproliferative condition affecting the hands of millions of patients worldwide. The hypothesis of pathogenesis involves genetic factors and internal factors. Recent genome-wide association studies have provided much needed evidence for the long-held belief of a strong genetic component to the pathogenesis of Dupuytren disease. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.03.001DOI Listing
August 2018
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Current Concepts in the Management of Proximal Interphalangeal Joint Disorders.

Authors:
Kevin C Chung

Hand Clin 2018 05;34(2):xiii

Michigan Medicine, University of Michigan Medical School, 2130 Taubman Center, SPC 5340, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. Electronic address:

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http://dx.doi.org/10.1016/j.hcl.2018.01.002DOI Listing
May 2018
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Therapy Concepts for the Proximal Interphalangeal Joint.

Hand Clin 2018 05;34(2):289-299

Department of Orthopedic Surgery, Robert A. Chase Hand & Upper Limb Center, Stanford University, 450 Broadway Street, Pavilion C, Redwood City, CA 94063, USA. Electronic address:

The principles of hand therapy for proximal interphalangeal joint disorders include protecting injured structures, minimizing patient discomfort, and optimizing patient recovery. Comprehension of hand anatomy, the nature of the injury being treated, and the phases of healing are critical when designing a safe and effective hand therapy program. Hand therapists use a combination of orthoses, guided exercises, and modalities to improve edema, sensitivity, range of motion, and function. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.01.001DOI Listing
May 2018
19 Reads

Complications of Proximal Interphalangeal Joint Injuries: Prevention and Treatment.

Hand Clin 2018 05;34(2):267-288

Section of Plastic Surgery, University of Michigan, 2130 Taubman Center, SPC 5340, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5340, USA. Electronic address:

Proximal interphalangeal joint injuries are one of the most common injuries of the hand. The severity of injury can vary from a minor sprain to a complex intra-articular fracture. Because of the complex anatomy of the joint, complications may occur even after an appropriate treatment. Read More

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http://dx.doi.org/10.1016/j.hcl.2017.12.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891829PMC
May 2018
2 Reads