As the, injury of flexor tendons has been rarely reported rarely after volar plate fixation in the distal radius fractures. Author experienced one case with delayed rupture of flexor pollicis longus and flexor digitorum profundus of index finger caused by anterior protrusion of volar plate. We also experienced another case with delayed rupture of flexor pollicis longus and wear on flexor digitorum profundus of index finger caused by volar plate placed distally to watershed line. Proper placement of volar plate and distal shape of the plate are important to prevent multiple tendon injury.
Fingers ; Radius ; Radius Fractures ; Rupture ; Tendon Injuries ; Tendons ; Palmar Plate

A contrast media is essential for the diagnostic accuracy of vascular structure or soft tissue imaging study. The incidence of extravasation of contrast media is very low (0.03% to 0.17%), but higher (0.25% to 0.9%) when using mechanical infuser. We report a case of 64-year-old female patient suffered from acute compartment syndrome, such as pain, skin discoloration in forearm and limitation of finger movement associated with extravasation of contrast media during the coronary angio-computed tomography.
Compartment Syndromes ; Contrast Media ; Extravasation of Diagnostic and Therapeutic Materials ; Female ; Fingers ; Forearm ; Humans ; Incidence ; Middle Aged ; Skin ; Upper Extremity

PURPOSE: To discuss the diagnosis and treatment of nonidiopathic carpal tunnel syndrome (CTS) caused by variable local lesions. MATERIALS AND METHODS: Fifteen patients who underwent surgery for CTS caused by local lesions were studied. The average age was 53.3 years. There were 5 men and 10 women. Plain radiographs including carpal tunnel view and ultrasonography were routinely performed, and magnetic resonance imaging and computed tomography were taken in selected cases. Carpal tunnel release were done by a single surgeon. RESULTS: Lesions causing CTS included calcification in five cases, ganglion in two, malunion after distal radius fracture in one, osteophyte of carpal bone in one, tuberculosis tenosynovitis in one, synovitis by foreign body in one, acute lunate dislocation in one, lipoma in two, median artery in one. Following surgery, all cases showed alleviation of symptoms. CONCLUSION: Prior to surgical decompression of CTS, it is important to assess any lesion around median nerve and carpal tunnel through physical examination, radiographs including carpal tunnel view and ultrasonography.
Arteries ; Carpal Bones ; Carpal Tunnel Syndrome ; Decompression, Surgical ; Dislocations ; Female ; Foreign Bodies ; Ganglion Cysts ; Humans ; Lipoma ; Magnetic Resonance Imaging ; Male ; Median Nerve ; Osteophyte ; Physical Examination ; Radius Fractures ; Synovitis ; Tenosynovitis ; Tuberculosis

PURPOSE: To evaluate the clinical and radiological outcomes of plate fixation for olecranon fractures which was difficult to be fixed firmly with tension band wiring alone. MATERIALS AND METHODS: From 1995 through 2008, 20 patients who underwent plate fixation of an olecranon fracture were included in this retrospective study. According to the Mayo classification, there were 3 type IIA fracture, 7 type IIB, and 10 type IIIB fractures. Clinical evaluation was done based on radiographic union of olecranon and measurements of range of motion at last follow-up. Disability of the arm, shoulder and hand (DASH) score and Mayo Elbow Performance score was used for evaluation of functional recovery. RESULTS: Union was achieved in 18 (90%) at an average of 5.6 months. The mean arc of elbow motion was 123degrees and the mean rotation arc was 81degrees. According to the MEPS, sixteen of twenty patients had a good or excellent outcome. The mean DASH score was 16.3. Most common complication was hardware irritation in 3 patients. CONCLUSION: Plate fixation is an effective treatment option for severe olecranon fracture pattern like comminuted fractures, Monteggia equivalent with unstable elbows and nonunions.
Arm ; Elbow ; Follow-Up Studies ; Fractures, Comminuted ; Hand ; Humans ; Olecranon Process ; Range of Motion, Articular ; Retrospective Studies ; Shoulder

PURPOSE: To report the causes of recurrent and persistent symptoms after carpal tunnel release and to evaluate the result of revision surgery. MATERIALS AND METHODS: wenty one patients who underwent surgery for recurrent or persistent carpal tunnel syndrome after carpal tunnel release were studied. The mean age was 59 years. There were 2 men and 19 women. The mean time interval between first operation and revision surgery was 29.8 months, and mean follow up period was 10.6 months. The operations were done by single surgeon. RESULTS: The most common cause of failed carpal tunnel release was scar adhesion, which was observed in nine cases. Other causes included incomplete release of transverse carpal ligament in six, scar adhesion with incomplete release in three, iatrogenic median nerve injury in two, and unrecognized calcification in one. Following revision surgery, 15 cases (71%) showed alleviation of symptoms. CONCLUSION: In cases of recurrent or persistent carpal tunnel syndrome following carpal tunnel release, evaluation of the causes is essential in performing revision surgery.
Carpal Tunnel Syndrome ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Ligaments ; Male ; Median Nerve

PURPOSE: The purpose of this study was to evaluate surgical outcomes of thumb carpometacarpal osteoarthritis treated either by volar ligament reconstruction or trapeziectomy with suspensionplasty. MATERIALS AND METHODS: From July 2004 to January 2011, we treated 43 patients with thumb carpometacarpal joint arthritis by volar ligament reconstruction in stages I and II, and by trapeziectomy with suspensionplasty in stages III and IV. Out of the 43, we evaluated 19 patients (9 treated by volar ligament reconstruction, 10 treated by trapeziectomy with suspensionplasty) at an average of 36.8 months (range: 8 to 65 months) after surgery. Outcome measures included pain visual analogue scale (VAS), ranges of motion, and grip and pinch strengths. RESULTS: The mean VAS was 1.2 in the volar ligament reconstruction group and 2.0 in the trapeziectomy with suspensionplasty group at final follow-up. The ligament reconstruction group had significantly better thumb radial abduction and opposition ranges of motion, and key grip strength. No further radiographic arthritic changes were noted in the ligament reconstruction group at a mean follow-up of 39 months. CONCLUSION: The authors obtained satisfactory pain control in patients with thumb carpometacarpal osteoarthritis by volar ligament reconstruction for stages I-II and trapeziectomy with suspensionplasty for stages III-IV.
Arthritis ; Carpometacarpal Joints ; Follow-Up Studies ; Hand Strength ; Humans ; Ligaments ; Osteoarthritis ; Outcome Assessment (Health Care) ; Thumb

PURPOSE: The purpose of this study was to determine whether keeping the wound moist improves the results of composite grafting of amputated fingertip. MATERIALS AND METHODS: Between 1997 and 2010, 93 patients with traumatic amputation of 100 digits have undergone composite finger tip graft. The hand was kept elevated and a topical antibiotics was frequently applied to avoid desiccation. Their ages ranged from 10 months to 73 years. We assessed the success rate based on age, amputation level, ischemic time and etiology. RESULTS: Of these 100 composite grafts, grafting had been successful in 65. Evaluation by age revealed that grafting had been successful in 13 of 18 fingers among patients less than 6 years old, in four of five fingers among those 6 to 15 years old and in 48 of 77 fingers among those 16 years of age and older. Assessment by level of amputation showed that grafting had been successful in 37 of 56 fingers amputated in zone I, in 12 of 19 fingers amputated in zone II and in 16 of 25 fingers amputated in zone III. No statistically significant differences in graft survival were found in relation to age, amputation level, ischemic time or type of amputation. CONCLUSION: Our results demonstrate that composite finger tip graft in adult is feasible and a very high rate of survival is obtained. We believe that moist-exposed dressings should improve the success rate associated with fingertip composite grafting.
Adult ; Amputation ; Amputation, Traumatic ; Anti-Bacterial Agents ; Bandages ; Desiccation ; Fingers ; Graft Survival ; Hand ; Humans ; Replantation ; Transplants

PURPOSE: The purpose of this study was to evaluate clinical and radiological results after osteosynthesis of distal phalangeal nonunion with bone defect by using matchstick-shaped bone graft. MATERIALS AND METHODS: Fifteen distal phalangeal nonunions were treated with osteosynthesis using matchstick-shaped bone graft from September, 2009 to October, 2010. The mean age of patients was 36.1 years (range: 15 to 56 years). This study included 4 women and 10 men. The mean duration of follow-up was 16.8 months (range: 12 to 20 months). We evaluated radiographs, and measured postoperative visual analogue scale (VAS) score and pinch power. RESULTS: Union was achieved in all cases at a mean of postoperative 5.5 weeks (range: 4 to 6 weeks). The mean VAS score improved from 7.25 (range: 5 to 9) to 1.0 (range: 0 to 2) postoperatively. The mean postoperative pinch power was 7.75 lbs (range: 4 to 13 lbs) compared to opposite pinch power of 9.63 lbs (range: 5 to 15 lbs). There was no scar problem, pinch pain and other complication. CONCLUSION: Steosynthesis of distal phalageal nonunion with bone defect by using matchstick-shaped bone graft is technically feasible and simple in that it does not need volar incision and debridement. It is considered as an effective treatment option in distal phalangeal nonunion with bone defect.
Bone Transplantation ; Cicatrix ; Debridement ; Female ; Follow-Up Studies ; Humans ; Male ; Transplants

Congenital pseudarthrosis of the clavicle is a rare condition, which rarely produces functional disabilities except for cosmetic problems. Surgical treatment involves autogenous iliac bone grafts and internal fixation. Few studies have reported long-term results of surgical treatment or morphological changes of the clavicle. We report a patient with a congenital pseudarthrosis of the clavicle, who demonstrated a near normal radiographic appearance of the clavicle and an excellent result 22 years after the operation performed at 4 years of age.
Clavicle ; Cosmetics ; Follow-Up Studies ; Humans ; Pseudarthrosis ; Transplants

Ganglions are the most common mass occurred in the wrist and hand. Ganglion usually arises from the dorsal aspect of the radiocarpal joint that may lead to the wrist pain. We report a patient with a ganglion of the triangular fibrocartilage complex. Using arthroscopic technique, ganglion located in triangular fibrocartilage complex was successfully excised.
Arthroscopes ; Ganglion Cysts ; Hand ; Humans ; Joints ; Triangular Fibrocartilage ; Wrist