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FP Essent 2019 Jul;482:23-26

Uniformed Services University Department of Family Medicine, 4301 Jones Bridge Road A1038, Bethesda, MD 20814-4799.

Family physicians commonly treat athletes with simple fractures and other musculoskeletal injuries that require temporary immobilization. Certain fractures (eg, intraarticular, multiple, open, associated with dislocations or tendon injury) typically are managed by orthopedic subspecialists. During the healing process, a custom-molded or prefabricated orthopedic support, known as an orthosis, may be used to support the injured area and prevent reinjury. Read More

BMJ Case Rep 2019 Mar 31;12(3). Epub 2019 Mar 31.

Orthopaedics and Traumatology, North District Hospital, Hong Kong, Hong Kong.

A 56-year-old man, right-hand-dominant office worker, complained of pain and swelling at the base of his right thumb after using his hand to press onto the front passenger seat during an emergency brake. X-ray showed a dorsal dislocation of the first carpometacarpal joint of his right hand. Closed reduction of the joint was performed. Read More

Osteoarthritis Cartilage 2014 Apr 13;22(4):601-2. Epub 2014 Feb 13.

Coastal Orthopaedics/Coastal Hand Therapy, Norwalk, CT, USA.

Osteoarthritis Cartilage 2014 Apr 13;22(4):603-4. Epub 2014 Feb 13.

Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.

Eur J Phys Rehabil Med 2014 Feb 4;50(1):49-57. Epub 2013 Nov 4.

Orthopedics and Hand Surgery The Catholic University School of Medicine, Rome, Italy -

Background: Rupture of ulnar collateral ligament of the thumb (UCL) represents a frequent injury of the hand. Surgical repair is considered the gold standard but postoperative immobilization causes partial stiffness in a percentage of cases.

Aim: The aim of this paper was to assess the effectiveness of a postoperative functional hand-based splint for the thumb which allows immediate postoperative motion. Read More

Osteoarthritis Cartilage 2013 May 28;21(5):668-75. Epub 2013 Feb 28.

Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA.

Objective: In patients with trapeziometacarpal arthrosis, we tested the hypothesis that there is no difference in arm-specific disability 5-15 weeks after prescription of a pre-fabricated neoprene or a custom-made thermoplast hand-based thumb spica splint with the metacarpophalangeal joint included and the first interphalangeal joint free.

Method: One hundred nineteen patients with a diagnosis of trapeziometacarpal arthrosis were prospectively randomized to wear either a neoprene or a thermoplast hand-based thumb spica splint. At enrollment, patients completed a set of validated questionnaires. Read More

Cochrane Database Syst Rev 2009 Jul 8(3):CD005616. Epub 2009 Jul 8.

Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, Netherlands, 9713 AV.

Background: De Quervain's tenosynovitis is a disorder characterised by pain on the radial (thumb) side of the wrist and functional disability of the hand. It can be treated by corticosteroid injection, splinting and surgery.

Objectives: To summarise evidence on the efficacy and safety of corticosteroid injections for de Quervain's tenosynovitis. Read More

J Hand Surg Am 2008 Jan;33(1):40-8

Columbia University College of Physicians & Surgeons, New York, NY 10032, USA.

Purpose: Conservative, nonsurgical therapies for basal joint osteoarthritis, such as thumb spica splinting and intra-articular corticosteroid injections, remain the mainstays for symptomatic treatment. This study compares intra-articular hylan, corticosteroid, and placebo injections with regard to pain relief, strength, symptom improvement, and metrics of manual function in a randomized, controlled, double-blinded study.

Methods: Sixty patients with basal joint arthritis were randomized to receive 2 intra-articular hylan injections 1 week apart, 1 placebo injection followed by 1 corticosteroid injection 1 week later, or 2 placebo injections 1 week apart. Read More

J Am Acad Orthop Surg 2007 Dec;15(12):757-64

Department of Orthopaedic Surgery and Sports Medicine, Temple University Hospital, Philadelphia, PA 19140, USA.

De quervain disease, or stenosing tenosynovitis of the first dorsal compartment of the wrist, is a common wrist pathology. Pain results from resisted gliding of the abductor pollicis longus and the extensor pollicis brevis tendons in the fibro-osseus canal. de Quervain tenosynovitis of the wrist is more common in women than men. Read More

Am J Emerg Med 2005 Oct;23(6):777-81

Department of Emergency Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA.

There are a significant number of hand and upper extremity injuries treated in US emergency departments (EDs) each year. Many of these involve the thumb and wrist. These injuries encompass the range from fractures, strains, and sprains to more specific injuries such as gamekeeper thumb and de Quervain tenosynovitis. Read More

J Hand Surg Am 2004 Mar;29(2):247-51

Department of Orthopaedic Surgery, Washington University at Barnes-Jewish Hospital, One Barnes Hospital Plaza, St Louis, MO 63110, USA.

Purpose: There have been few prospective studies evaluating the results of nonsurgical treatment of a well-defined patient cohort with symptomatic basal joint osteoarthritis of the thumb. This prospective study uses a validated outcome instrument to examine the effectiveness of a single steroid injection and 3 weeks of splinting in patients with osteoarthritis in Eaton stages 1 to 4 with a minimum of 18 months of follow-up evaluation.

Methods: Thirty consecutive patients (30 thumbs) were studied prospectively to evaluate the efficacy of a single injection of corticosteroid into the trapeziometacarpal joint, followed by immobilization in a thumb spica splint for 3 weeks. Read More

Arch Orthop Trauma Surg 2003 Jul 29;123(6):305-7. Epub 2003 May 29.

Department of Orthopaedic Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, 814-0180 Fukuoka, Japan.

Introduction: A transscaphoid and transtriquetral perilunate fracture dislocation is fairly rare among the known cases of perilunate fracture dislocations, and the details of the initial treatment and outcome of this injury have never been reported.

Materials And Methods: A 21-year-old, right-handed man presented with fractures at the proximal third of the scaphoid and at the mid-body of the triquetrum with an associated dorsal perilunate dislocation after a fall onto his outstretched hand. Under general anesthesia, closed reduction was attempted with 3 kg of traction applied by means of finger traps. Read More

J Hand Surg Am 2002 Mar;27(2):322-4

Department of Orthopaedics, Ankara Güven Hospital, Turkey.

de Quervain's disease of pregnancy and lactation is usually self-limited and responds well to nonsurgical treatment. We conducted a randomized prospective study on 19 wrists of 18 patients with de Quervain's disease who were either pregnant or breast-feeding. One group had a cortisone injection into the tendon sheath and the other group used thumb spica splints. Read More

Phys Sportsmed 1998 Jun;26(6):57-69

Department of Surgery, University of Wisconsin Hospital, Madison, WI, 53792, USA.

Three common finger injuries-proximal interphalangeal (PIP) injuries, mallet finger, and skier's thumb-present unique diagnostic and treatment challenges. Careful history-taking and physical examination are, of course, essential for diagnosing these injuries, but appropriate x-rays are often pivotal. For PIP joint dislocations and fracture-dislocations, extension block splinting is often appropriate, but surgery may be required for an unstable injury. Read More

Orthop Clin North Am 1996 Apr;27(2):305-15

Department of Orthopaedic Surgery, University of Louisville School of Medicine, Kentucky, USA.

The radial nerve is frequently more involved in entrapment syndromes than the ulnar and median nerves. Common sites of compression are the juncture of the middle and distal third of the arm (especially with fractures of the humerus), just distal to the elbow (radial tunnel), and proximal to the wrist between the brachioradialis and extensor carpi radialis longus. Often in entrapment syndromes involving the radial nerve, the true diagnosis is not evident and is arrived at only by exclusion, which sometimes delays initiation of effective treatment. Read More

Orthopedics 1995 Dec;18(12):1161-5

Department of Orthopedic Surgery, Mt Sinai Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

Thirty-nine patients diagnosed with 40 acute complete ruptures of the ulnar collateral ligament of the thumb metacarpophalangeal joint were treated primarily with thumb spica splint immobilization. Duration of splinting ranged from 8 to 12 weeks. Thirty-four of these injuries (85%) followed for 1 to 5 years (average 2. Read More