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Am Fam Physician 2022 Jun;105(6):631-639

Fairfax Family Medicine Residency Program and University of Virginia, Fairfax, VA, USA.

Finger fractures and dislocations are commonly seen in the primary care setting. Patients typically present with a deformity, swelling, and bruising with loss of function. Anteroposterior, lateral, and oblique radiography should be performed to identify fractures and distinguish uncomplicated injuries from those requiring referral. Read More

J Orthop Case Rep 2021 Jun;11(6):63-67

Department of Orthopaedic Surgery, Zucker School of Medicine at Hofstra/Northwell, Plainview, New York, United States.

Introduction: Perilunate dislocations are rare high-energy injuries, and the diagnosis is not infrequently missed at initial presentation. The combination of fractures resulting in a trans-styloid, trans-scaphoid, and trans-triquetral perilunate fracture dislocation is extremely rare. Early recognition and diagnosis of these injuries is prudent to restore patient function and prevent morbidity. Read More

J Hand Surg Glob Online 2021 Jul 29;3(4):210-214. Epub 2021 Apr 29.

Baton Rouge Orthopaedic Clinic, Baton Rouge, LA.

Proximal forearm median nerve compressive neuropathy, termed as pronator syndrome, is difficult to diagnose and often overlooked. Its symptoms include vague proximal volar forearm pain that may be associated with paresthesia and numbness in the median nerve distribution. Weakness is typically not present. Read More

Plast Reconstr Surg Glob Open 2021 Nov 22;9(11):e3923. Epub 2021 Nov 22.

Plastic and Reconstructive Surgery Section, Department of Surgery, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.

Background: Central slip and volar plate injuries rarely occur in the same finger, with only two cases previously reported in published literature. In these two patients, both teenagers, two highly distinct protocols were used. Here, we report a third case involving a 51-year-old gentleman who closed a door on his left third finger. Read More

Med J Islam Repub Iran 2021 24;35:53. Epub 2021 Apr 24.

Department of Orthotics & Prosthetics, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran.

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy presenting with sharp pain, parenthesis, dysfunction of the hand in coordination and gripping. Splinting is the most common conservative intervention to improve pain and enological symptom of this Syndrome (CTS). With regard to the importance of these interventions and controversies about different designs of splints, the aim of this study was to compare the therapeutic effects of volar wrist cock-up orthosis and dorsal lock wrist hand orthosis on pain, sensory and motor latency in carpal tunnel syndrome. Read More

Clin Orthop Surg 2021 Mar 15;13(1):105-109. Epub 2021 Feb 15.

Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul, Korea.

Background: Triangular fibrocartilage complex (TFCC) injury is common in distal radius fractures. The purpose of this study was to compare the conservative and surgical treatments of TFCC injury of the wrist associated with distal radius fractures.

Methods: A retrospective study was conducted on 39 patients who received treatment for TFCC injury with distal radius fractures. Read More

Eur J Orthop Surg Traumatol 2021 Oct 1;31(7):1493-1499. Epub 2021 Mar 1.

Department of Orthopaedics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.

Background: The treatment strategy for bony mallet fingers remains controversial. The outcomes of conservative treatment were investigated in this study. In addition, the time to bone union, and gap between the bone fragment and distal phalanx are discussed. Read More

BMJ Case Rep 2020 Dec 17;13(12). Epub 2020 Dec 17.

Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Volar plate injuries are typically caused by hyperextension of the proximal interphalangeal joint. These injuries are usually seen in sports where the ball comes in direct contact with the hands. Forceful dorsiflexion of the finger caused by the speeding ball leads to volar plate avulsion. Read More

Int J Occup Med Environ Health 2020 Oct 15;33(6):771-780. Epub 2020 Sep 15.

University Medical Centre Maribor, Maribor, Slovenia (Institute of Physical and Rehabilitation Medicine).

Objectives: There is no consensus on whether conservative treatment with night splints is indicated also in moderate and severe stages of carpal tunnel syndrome (CTS). The goal of this study was to compare the efficacy of night-time splinting at different stages of CTS.

Material And Methods: Forty-five patients with electrodiagnostic (EDX) features of CTS included in the study were divided into 2 groups based on nerve conduction studies. Read More

Arch Orthop Trauma Surg 2020 Aug 25;140(8):1133-1141. Epub 2020 May 25.

St Andrews Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, CM1 7ET, UK.

Introduction: Fracture-dislocation and pilon injuries of the proximal interphalangeal joints (PIPJ) continue to pose significant management challenges. Stable fracture configurations can be treated with extension block splinting or pinning. Unstable fractures usually require open or closed reduction and fixation either directly/internally onto the fracture using Kirschner wires, cerclage wires, screws or miniplates or indirectly/externally by ligamentotaxis using external fixators which can be dynamic or static. Read More

Hand Surg Rehabil 2020 09 15;39(4):256-260. Epub 2020 Feb 15.

Service d'orthopédie-traumatologie, Hôpital Aristide-Le-Dantec, 30, avenue Pasteur, B.P. 3001, Dakar, Senegal. Electronic address:

In Senegal, patients are seen an average of 16 months after their injury in a specialized hand and upper limb surgery department. Because of this lengthy delay, these patients have severe functional sequelae, such as wrist flexion contracture, averaging 45 degrees in our case series (range, 35 to 90 degrees). After reviewing the literature, we did not find any splint that was well suited to these patients. Read More

J Wrist Surg 2019 Dec 27;8(6):452-455. Epub 2019 May 27.

Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

 The effect of postoperative dressing and splinting after distal radius fracture (DRF) open reduction internal fixation (ORIF) is not well understood. A prospective cohort analysis was performed to assess differences in functional and radiographic outcomes with the use of plaster splinting or soft dressing following DRF ORIF.  All patients undergoing DRF ORIF with locking volar plates were consecutively enrolled. Read More

Arq Neuropsiquiatr 2019 23;77(9):638-645. Epub 2019 Sep 23.

University of Health Sciences, Sisli Hamidiye Etfal Research and Training Hospital, Department of Neurosurgery, Istanbul, Turkey.

Carpal tunnel syndrome (CTS) is the most common mononeuropathy caused by entrapment of the median nerve at the wrist. Common treatment options for CTS include oral analgesics, splinting, hand therapy, local injections with steroids or surgery. OBJECTIVE The aim of the present study was to assess the short-term clinical and electrophysiological outcomes of local corticosteroid injection (LCI) in patients with symptomatic CTS. Read More

Orthop Res Rev 2019 6;11:61-67. Epub 2019 May 6.

Physical Medicine and Rehabilitation Department, Tehran University of Medical Sciences (TUMS), School of Medicine, Tehran, Iran.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper limb. Local injection of different substances has been increasingly used as an acceptable conservative treatment in non-severe cases. This study aimed to evaluate the efficacy and safety of local ozone injection in the management of non-severe CTS. Read More

Ann Plast Surg 2019 05;82(5):520-522

Purpose: Volar plate injuries of the proximal interphalangeal joint (PIPJ) of a finger are common, often occurring in sporting or workplace incidents. Treatment of a stable dorsal dislocation entails a conservative approach, directed at preventing hyperextension and allowing the ligament to heal in position that does not negatively impact on healing. Current treatment regimens include dorsal block splinting (DBS) in 30° of flexion, which maintains the PIPJ in flexion in order to prevent any strain on the healing tissue while attempting to restore anatomical position. Read More

J Hand Surg Asian Pac Vol 2019 Mar;24(1):50-54

1 Birmingham Hand Centre, Queen Elizabeth Hospital, Birmingham, UK.

Background: To evaluate the treatment of severe dorsal fracture dislocation (DFD) injuries of the proximal interphalangeal joint (PIPJ) by open reduction, bone grafting and fixation with mini-hook plates.

Methods: Fourteen patients with extensive dorsal fracture dislocation of the PIPJ were operatively treated to reconstruct the fractured middle phalanx volar lip using a fabricated hook plate in conjunction with elevation and bone grafting of depressed articular fragments where present.

Results: Restoration of PIPJ articular anatomy and congruence by hook plate fixation permitted full-range mobilization of the joint during fracture healing, with an average arc of motion of 81° and an average loss of extension of 12. Read More

Handchir Mikrochir Plast Chir 2019 Feb 13;51(1):49-53. Epub 2019 Feb 13.

Klinika za djecje bolesti Zagreb Pediatric Surgery.

Introduction: Fractures of the phalanges in children can often be underappreciated by the physician of first contact. Therefore it is necessary to point out which of these fractures, because of the risk of possible future complications, need special mention.

Materials And Methods: A retrospective review of 512 fractures of the phalanges in children and adolescents during an one year period. Read More

J Wrist Surg 2018 Nov 7;7(5):409-414. Epub 2018 Aug 7.

Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.

 No consensus exists regarding postoperative splinting position following volar plate fixation of distal radius fractures.  The purpose of this study was to determine whether immobilization in supination would result in superior outcomes compared with no restriction of forearm range of motion.  All patients >18 years of age with distal radius fractures indicated for volar plate fixation were eligible. Read More

Case Rep Orthop 2018 24;2018:8195376. Epub 2018 Jun 24.

Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.

In this study, we performed osteosynthesis for a distal radius fracture using a minimally invasive approach for a patient with skin disorder of the forearm and obtained favorable results. This case report may provide new findings confirming the usefulness of this surgical approach for distal radius fractures. Blister formation on the right forearm was observed in a 53-year-old female who was diagnosed with a distal fracture of the right radius and underwent splinting in a local hospital, and she was referred to our hospital 2 days after the injury. Read More

Hand (N Y) 2020 01 15;15(1):125-130. Epub 2018 Jul 15.

Mayo Clinic, Rochester, MN, USA.

Distal radius fractures are common, and the trend in fixation has included the use of locked volar plating. The duration of splinting required after surgery and the effect splinting has upon outcome of the wrist are not clear. Our aim was to compare outcome of patients treated with early versus late motion protocol after volar plating. Read More

J Family Med Prim Care 2018 Jan-Feb;7(1):242-245

Department of Physiotherapy, KMPIP, Shree Krishna Hospital, Anand, Gujarat, India.

Splinting is a great domain of occupational therapy profession. Making a splint for the patient would depend on the need or requirement of the problems and deformities. Swan neck deformity is an uncommon condition, and it can be seen in rheumatoid arthritis, cerebral palsy, and after trauma. Read More

Hand Clin 2018 05;34(2):229-235

Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address:

Proximal interphalangeal joint (PIPJ) flexion contracture is a challenging and often frustrating problem. Treatment of PIPJ contracture begins with conservative measures. With good compliance and prolonged use, favorable results can be achieved using these modalities. Read More

Hand Clin 2018 05;34(2):139-148

Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Hospitals, 5841 South Maryland Avenue, Room P-211, MC 3079, Chicago, IL 60637, USA. Electronic address:

Proximal interphalangeal (PIP) joint dislocation a common injury. Usually, concentric stable reduction can be achieved with closed reduction. Occasionally, PIP joint dislocations are irreducible and open reduction is necessary. Read More

J Wrist Surg 2017 Nov 30;6(4):262-275. Epub 2017 Aug 30.

Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

 Palmar midcarpal instability (PMCI) is an uncommon form of nondissociative carpal instability. However, it is an important cause of chronic ulnar wrist pain. Diagnosis can be difficult and high index of suspicion is mandatory. Read More

Plast Surg (Oakv) 2017 Aug 15;25(3):151-156. Epub 2017 Sep 15.

Department of Hand Surgery, INSELSPITAL Bern, University of Bern, Bern, Switzerland.

Introduction: The management of volar plate avulsion fractures in the context of a stable joint and a bony fragment of less than 30% has traditionally been conservative. This study was performed to assess volar plate healing with high-resolution ultrasound in order to provide early full mobilization.

Material And Methods: Between January 2012 and December 2013, 78 patients with volar plate injuries of the proximal interphalangeal (PIP) joints (42 distortions and 36 dislocations) were treated conservatively in our department for volar plate avulsion fracture associated with stable joint and bony fragment inferior to 30% of the intra-articular surface assessed both by radiography and ultrasound. Read More

Handchir Mikrochir Plast Chir 2017 Oct 5;49(5):297-303. Epub 2017 Sep 5.

Kantonsspital Winterthur, Klinik für Hand- und Plastische Chirurgie.

Volar plate disruption of the proximal interphalangeal joint (PIP) is a common hand injury following finger hyperextension. At our institution, patients presenting with disruptions of the palmar plate (Eaton and Littler types I and II) before 2011 were treated with extension block splinting (group A). Since 2011, all patients with Eaton and Littler types I and II have received buddy taping (group B). Read More

Hand (N Y) 2017 Mar 1:1558944717697430. Epub 2017 Mar 1.

1 Division of Plastic Surgery, Department of Surgery, Western University, London, Ontario, Canada.

Background: Isolated stiffness in a single finger can affect the function of adjacent digits and decrease overall hand function due to the quadriga phenomenon. This study objectively quantifies the dysfunctional impact of each individual stiff finger upon the remaining digits.

Methods: Twenty-five individuals (10 men and 15 women) with a mean age of 31 years (range, 18-58 years) without any upper limb pathology, neuropathy, or systemic illness were recruited. Read More

J Pediatr Orthop 2017 Jul/Aug;37(5):e317-e320

*Harvard Combined Orthopaedic Residency Program †Department of Orthopaedic Surgery, Boston Children's Hospital ‡Harvard Medical School, Boston, MA.

Background: We hypothesize that surgery for moderate-to-severe camptodactyly (>50 degrees) results in modest gains in range of motion and improved digital position.

Methods: A retrospective analysis of patients undergoing surgery for camptodactyly at a tertiary children's hospital between 2000 and 2014 was performed. Surgery was indicated for patients with persistent, functionally limiting flexion contractures despite observation, therapy, and splinting. Read More

Arch Phys Med Rehabil 2017 05 14;98(5):947-956. Epub 2017 Feb 14.

Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Yang Ming University, Taipei, Taiwan. Electronic address:

Objective: To compare the effectiveness of local steroid injection plus splinting with that of local steroid injection alone using clinical and electrophysiological parameters in patients with carpal tunnel syndrome (CTS).

Design: Randomized controlled study with 12 weeks of follow-up.

Setting: Tertiary care center. Read More