2,044 results match your criteria Hand Clinics [Journal]


Revascularization and Replantation in the Hand.

Hand Clin 2019 May 18;35(2):xi. Epub 2019 Feb 18.

Hand & Arm Center, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Yawkey Building 2100, Boston, MA 02114, USA. Electronic address:

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http://dx.doi.org/10.1016/j.hcl.2019.01.005DOI Listing
May 2019
3 Reads

Secondary Surgery Following Replantation and Revascularization.

Hand Clin 2019 May 25;35(2):231-240. Epub 2019 Feb 25.

Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Wang Building, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:

Secondary surgery following digital replantation and revascularization is common and is often performed to improve range of motion, tendon gliding, sensibility, and/or contour. In this article, the authors present the most common secondary procedures performed after digital replantation or revascularization and discuss current techniques. The importance of patient selection and postoperative compliance with ongoing hand therapy is paramount to achieving good outcomes. Read More

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http://dx.doi.org/10.1016/j.hcl.2019.01.004DOI Listing
May 2019
4 Reads

Postoperative Management and Rehabilitation of the Replanted or Revascularized Digit.

Hand Clin 2019 May 18;35(2):221-229. Epub 2019 Feb 18.

Orthopaedics, Division of Plastic Surgery, University of Washington, Harborview Medical Center, Seattle Children's Hospital, 325 9th Avenue, Box 359796, Seattle, WA 98104, USA.

Postoperative care of amputated digits begins before replantation. Detailed informed consent should be obtained and completion amputation discussed if revascularization is not ultimately successful. Complications and failure of the replanted digit should also be addressed. Read More

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http://dx.doi.org/10.1016/j.hcl.2019.01.003DOI Listing
May 2019
1 Read

Outcomes Following Replantation/Revascularization in the Hand.

Hand Clin 2019 May;35(2):207-219

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

The variability in reported outcomes and outcome measures used in digit replantation makes it difficult to compare results among studies. This article reviews the principles of measuring functional and patient-reported outcomes after replantation, and describes the recommended instruments to use and ways to report results. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.12.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446589PMC
May 2019
1 Read

Revascularization and Replantation in the Hand: Ectopic Banking and Replantation.

Hand Clin 2019 May 25;35(2):199-206. Epub 2019 Feb 25.

The Curtis National Hand Center, MedStar Union Memorial Hospital, 3333 North Calvert Street, Johnston Professional Building, 2nd Floor, Baltimore, MD 21218, USA. Electronic address:

Traumatic amputation of the upper extremity remains a challenging problem for reconstructive hand surgeons. Temporary ectopic banking of amputated parts for subsequent replantation is an innovative and valuable surgical technique for patients who would otherwise be poor candidates for replantation. The applications of ectopic banking have evolved and expanded to include various clinical scenarios. Read More

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http://dx.doi.org/10.1016/j.hcl.2019.01.002DOI Listing
May 2019
1 Read

Flap Coverage of Dysvascular Digits Including Venous Flow-Through Flaps.

Hand Clin 2019 May 18;35(2):185-197. Epub 2019 Feb 18.

Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital, 36, Digital-road, Gwangmyeong, Gyeonggi-do 14241, South Korea.

A dysvascular digit is defined as a threatened circulatory condition of a digit caused owing to multiple reasons, such as medical illness or trauma. A dysvascular digit always needs surgical manipulation of the vessel in trauma cases. The revascularization of the digit is a priority in such conditions, after which reconstruction of the defect is performed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712193000
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http://dx.doi.org/10.1016/j.hcl.2019.01.001DOI Listing
May 2019
2 Reads
1.071 Impact Factor

Recent Topics on Fingertip Replantations Under Digital Block.

Hand Clin 2019 May;35(2):179-184

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, 1-3-7, Hongo, Bunkyo-ku, Tokyo 113-0011, Japan.

The authors describe 3 cases with successful fingertip replantations using supermicrosurgical arteriole (terminal branch of digital artery) anastomoses, arteriole graft obtained from the same fingertip defect, reverse arteriole flow to subdermal venule, and delayed venular drainage for venous congestion. Among these 16 consecutive distal phalangeal replantations, 7 fingers showed postoperative venous congestion (43.8% of the total fingers) and 5 were reoperated on with delayed venous drainage under digital block. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.12.007DOI Listing
May 2019
1 Read

Pediatric Replantation and Revascularization.

Authors:
Amir H Taghinia

Hand Clin 2019 May 18;35(2):155-178. Epub 2019 Feb 18.

Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Enders 1, Boston, MA 02115, USA. Electronic address:

Replantation and revascularization in the pediatric extremity has unique challenges that provide a fertile field of research and clinical experience. Children regenerate peripheral nerves rapidly, resulting in good sensory and motor function. They adapt well to functional deficits and mismatch errors of reinnervation. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.12.006DOI Listing

Hand, Wrist, Forearm, and Arm Replantation.

Authors:
Matthew L Iorio

Hand Clin 2019 May;35(2):143-154

Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Colorado, Anschutz Medical Center, 12631 East 17th Avenue, C309 (Room 6414), Aurora, CO 80045, USA; Department of Orthopedics, University of Colorado, Anschutz Medical Center, 12631 East 17th Avenue, C309 (Room 6414), Aurora, CO 80045, USA. Electronic address:

Level of injury plays a significant role in decisions to perform replantation, with improved function, nerve regeneration, and decreased rate of reperfusion injury for injuries at the distal forearm or wrist compared with proximal injuries. The principles of a functional and sensate outcome dictate replantable parts, whereas patient comorbidity, expectations, and safety dictate patient candidacy. Vascular grafts are an expected part of the operation, and the contralateral arm or a lower extremity should be prepped into the surgical field. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.12.005DOI Listing

Efficiency in Replantation/Revascularization Surgery.

Hand Clin 2019 May 25;35(2):131-141. Epub 2019 Feb 25.

Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, WAC 435, Boston, MA 02114, USA.

Digital replantation and revascularization have evolved significantly since the first published reports in the 1960s. Advances in techniques and instruments have made these once formidable procedures a routine part of hand surgery training. Despite this, the frequency of successful outcomes for replantation may be on the decline in the United States. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.12.004DOI Listing
May 2019
2 Reads

Indications for Replantation and Revascularization in the Hand.

Hand Clin 2019 May 23;35(2):119-130. Epub 2019 Feb 23.

Northwestern University School of Medicine, NMH/Galter Room 19-250, 675 North Saint Clair, Chicago, IL 60611, USA.

The indications for upper extremity replantation are fluid, and it has long been appreciated that they change with time. Traditional strong indications for replantation include hand, thumb, or multiple digit amputation in adults, and almost any amputation in a child. Patients often desire replantation of single nonthumb digits based on aesthetic preference and personal/cultural values. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.12.003DOI Listing

Revascularization and Replantation in the Hand: Presurgical Preparation and Patient Transfer.

Hand Clin 2019 May 23;35(2):109-117. Epub 2019 Feb 23.

Department of Plastic Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Medical Center North, D-4219, Nashville, TN 37232, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, 1211 Medical Center Drive, Medical Center North, D-4219, Nashville, TN 37232, USA; Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 1211 Medical Center Drive, Medical Center North, D-4219, Nashville, TN 37232, USA. Electronic address:

Replantation of a digit or hand is most successful when performed at a specialized, high-volume center. However, most patients with amputations initially present to local hospitals. Therefore, patients amenable to replantation frequently require expedited transfer to a tertiary center. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.12.002DOI Listing

A Decade of Progress Toward Establishing Regional Hand Trauma Centers in the United States.

Hand Clin 2019 May 18;35(2):103-108. Epub 2019 Feb 18.

University of Pennsylvania, 3737 Market Street, 6th Floor, Philadelphia, PA 19104, USA. Electronic address:

Although upper extremity amputations have become less common in the workplace because of improvements in safety and equipment, the American health system's ability to provide emergent microvascular care for these injuries remains highly fragmented, inconsistent, overburdened, and at times unavailable. Over the past decade, hand surgeons have worked to improve this disparity within health systems. This article discusses the need for emergent microsurgical treatment, barriers encountered in improving access to care, and a description of current and future efforts of developing a sustainable network of highly specialized regional hand trauma centers. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.12.001DOI Listing
May 2019
1 Read
1.071 Impact Factor

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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http://dx.doi.org/10.1016/j.hcl.2018.10.002DOI Listing
February 2019
4 Reads

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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http://dx.doi.org/10.1016/j.hcl.2018.10.001DOI Listing
February 2019
3 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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http://dx.doi.org/10.1016/j.hcl.2018.08.009DOI Listing
February 2019
7 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
12 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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http://dx.doi.org/10.1016/j.hcl.2018.08.010DOI Listing
February 2019
18 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
16 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
13 Reads
1.071 Impact Factor

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
7 Reads

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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https://linkinghub.elsevier.com/retrieve/pii/S07490712183010
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http://dx.doi.org/10.1016/j.hcl.2018.08.005DOI Listing
February 2019
15 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
10 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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http://dx.doi.org/10.1016/j.hcl.2018.08.004DOI Listing
February 2019
14 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
17 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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https://linkinghub.elsevier.com/retrieve/pii/S07490712183009
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http://dx.doi.org/10.1016/j.hcl.2018.08.001DOI Listing
February 2019
12 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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http://dx.doi.org/10.1016/j.hcl.2018.08.008DOI Listing
February 2019
13 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
13 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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http://dx.doi.org/10.1016/j.hcl.2018.07.003DOI Listing
November 2018
2 Reads

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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http://dx.doi.org/10.1016/j.hcl.2018.07.002DOI Listing
November 2018
16 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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http://dx.doi.org/10.1016/j.hcl.2018.06.014DOI Listing
November 2018
13 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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http://dx.doi.org/10.1016/j.hcl.2018.06.013DOI Listing
November 2018
5 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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http://dx.doi.org/10.1016/j.hcl.2018.07.001DOI Listing
November 2018
4 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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http://dx.doi.org/10.1016/j.hcl.2018.06.012DOI Listing
November 2018
4 Reads

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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http://dx.doi.org/10.1016/j.hcl.2018.06.010DOI Listing
November 2018
3 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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http://dx.doi.org/10.1016/j.hcl.2018.06.009DOI Listing
November 2018
6 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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http://dx.doi.org/10.1016/j.hcl.2018.06.011DOI Listing
November 2018
5 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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http://dx.doi.org/10.1016/j.hcl.2018.06.008DOI Listing
November 2018
32 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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http://dx.doi.org/10.1016/j.hcl.2018.06.007DOI Listing
November 2018
4 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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http://dx.doi.org/10.1016/j.hcl.2018.06.006DOI Listing
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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http://dx.doi.org/10.1016/j.hcl.2018.06.005DOI Listing
November 2018
6 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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http://dx.doi.org/10.1016/j.hcl.2018.06.004DOI Listing
November 2018
9 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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http://dx.doi.org/10.1016/j.hcl.2018.06.003DOI Listing
November 2018
4 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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http://dx.doi.org/10.1016/j.hcl.2018.06.002DOI Listing
November 2018
3 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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http://dx.doi.org/10.1016/j.hcl.2018.06.001DOI Listing
November 2018
5 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
5 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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http://dx.doi.org/10.1016/j.hcl.2018.04.004DOI Listing
August 2018
3 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
2 Reads

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
5 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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https://linkinghub.elsevier.com/retrieve/pii/S07490712183003
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http://dx.doi.org/10.1016/j.hcl.2018.03.009DOI Listing
August 2018
11 Reads