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Wrist Ganglion: Current Review of Literature for Pathogenesis and Treatment.

Journal of the Korean Society for Surgery of the Hand.2016;21(4):173-180. doi:10.12790/jkssh.2016.21.4.173

Ganglion cysts are benign soft tissue tumors most commonly encountered in hand and wrist. Sixty to seventy percent of these are found in the dorsal aspect of the wrist. They are more common in the twenties to forties and in female. Its origin and pathogenesis remain unproved and there are several theories for genesis of ganglion. Non-surgical treatment is unreliable with a high recurrence rates. Open surgical excision is still golden standard treatment for wrist ganglion. Recently Arthroscopic excision has been tried to reduce unsightly scar and some complications, but still has some limitations. We reviewed the current literature available on wrist ganglion.
Cicatrix ; Female ; Ganglion Cysts* ; Hand ; Humans ; Recurrence ; Wrist*

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Open Reduction Through the Modified Volar Approach in Complex Dorsal Dislocations of the Metacarpophalangeal Joint.

Soo Joong CHOI ; Bong Cheol KWON ; Yong Beom LEE ; Won Hyoung SHIN

Journal of the Korean Society for Surgery of the Hand.2011;16(3):149-153.

PURPOSE: To describe the surgical treatment of the complex dorsal metacarpophalangeal dislocations and its results, emphasizing on the modified volar approach with A1 pulley release. MATERIALS AND METHODS: We experienced 6 cases of dorsal dislocation of the metacarpophalangeal joint. We performed open reduction with the modified volar approach described by Eaton and Dray. Postoperatively posteroanterior and lateral radiographs of the index finger metacarpophalangeal joint and metacarpophalangeal joint range of motion was followed. RESULTS: One case with a large osteochondral fracture was operated with volar and doral approach both. Overall end results were good without any significant restriction of motion and stability of the fingers. CONCLUSION: Modified volar approach with A1 pulley release is an excellent method for complex dorsal metacarpophalangeal dislocations without osteochondral fracture.
Benzodiazepines ; Dislocations ; Fingers ; Metacarpophalangeal Joint ; Range of Motion, Articular

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Free Flaps for Reconstruction of Soft Tissue Defects Following Crushing Injury to Fingers.

Baek Kyu KIM ; Chanyeong HEO ; Seok Chan EUN ; Rongmin BAEK ; Nam Kyung HYUNG

Journal of the Korean Society for Surgery of the Hand.2011;16(3):142-148.

PURPOSE: The crushing injury is one of the most severe type injuries in the finger. For the reconstruction of fingers with crushed and devitalized tissue, various surgical methods have been attempted to cover the soft tissue defects. We performed free flaps for finger reconstruction and investigated the results. MATERIALS AND METHODS: Between March 2010 and July 2011, we retrospectively reviewed 14 patients who had soft tissue defects of fingers after severe crushing injuries. There were 8 pulp losses, 4 dorsal skin losses with bony exposure, 1 nail complex loss, and 1 total loss of distal phalanx. In all cases, soft tissue defects in fingers were reconstructed with a free flap. RESULTS: All flaps survived successfully. We could reserve the functional length without additional necrosis and amputation. Reconstructed fingers were returned to normal activity in a short time and the atrophy or deformity was not observed. CONCLUSION: Free flap transfer for the reconstruction of the finger defect after crushing injury is useful for the functional recovery and cosmesis.
Amputation ; Atrophy ; Congenital Abnormalities ; Fingers ; Free Tissue Flaps ; Humans ; Nails ; Necrosis ; Retrospective Studies ; Skin

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Clinical and Radiologic Outcomes of AO Type C1, 2 Distal Radius Fractures Treated with Percutaneous Pinning or Volar Locking Plating.

Yoon Suk HYUN ; Kyung Won SONG ; Hyun Jin PARK ; Hyun Tai PARK

Journal of the Korean Society for Surgery of the Hand.2011;16(3):134-141.

PURPOSE: To compare clinical and radiological results between closed reduction followed by percutaneous K-wire fixation and volar locking compression plate fixation in the treatment of AO type-C1, 2 fractures of the distal radius. MATERIALS AND METHODS: The subjects of this study were 61 patients who had a AO type-C1,2 fracture of the distal radius treated from March 2006 to January 2010, and were followed up for over 12 months. Clinical evaluations included disabilities of arm, shoulder and hand score (DASH) score, patient-rated wrist evaluation questionnaires (PRWE) score, the Grip strength, and the range of joint motion at the last follow-up, and radiological assessment included the presence of bony union, the dorsal tilt angle of the radius, the inclination of the radius, and the radial shortening. RESULTS: The range of joint motion, the grip strength, DASH and PRWE demonstrated no significant difference between the two groups. Radiological results revealed that the patients treated with percutaneous K-wire fixation showed greater radial shortening than those treated with locking compression plate fixation. CONCLUSION: Although clinical results are similar between volar locking plating and percutaneous pinning in the treatment of AO C1, 2 distal radius fractures, volar locking plating is more effective in preventing radial shortening during fracture healing.
Arm ; Follow-Up Studies ; Fracture Healing ; Hand ; Hand Strength ; Humans ; Joints ; Surveys and Questionnaires ; Radius ; Radius Fractures ; Shoulder ; Wrist

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Trans-scaphoid Perilunate Fracture Dislocations: Screw Fixation of the Scaphoid and Lunotriquetral Ligament Repair Using a Dorsal Approach.

Chang Ho YI ; Jin Rok OH

Journal of the Korean Society for Surgery of the Hand.2011;16(3):127-133.

PURPOSE: To evaluate clinical and radiological results after screw fixation of the scaphoid and lunotriquetral ligament repair using a dorsal approach in the treatement of trans-scaphoid perilunate fracture dislocations. MATERIALS AND METHODS: From May 2003 to August 2007, 11 patients who underwent operative management of a trans-scaphoid perilunate fracture dislocation were included in this study. Average follow up period was 58 months. In all patients, screw fixation of the scaphoid and lunotriquetral ligament repair with a suture anchor after open reduction was performed. Clinical evaluation was done by measuring range of motion and grip power and disabilities of arm, shoulder and hand (DASH) score evaluation for functional recovery at the last follow up. Union of scaphoid, change in lunotriquetral distance, and development of any instability and arthritis of wrist joint were radiographically assessed. RESULTS: In clinical outcomes, 89.3% recovery of grip power and 87.5% recovery of range of motion compared to healthy side were observed at the last follow-up. Average range of motions of extension, flexion, ulnar deviation, radial deviation, supination and pronation were 51.8degrees, 58.4degrees, 21.2degrees, 16.2degrees, 74.3degrees, 75.1degrees respectively. Average DASH score was 13.2. Bony union of scaphoid was achieved in all cases at the average of postoperative 19.3 weeks. Lunotriquetral distance after the operation and at the last follow up were 1.9 mm and 2.0 mm, respectively. There were no radiographic evidence of instability or arthritis. CONCLUSION: Dorsal approach allows reduction of carpal bone, scaphoid fixation and lunotriquetral ligament repair in the treatment of trans-scaphoid perilunate fracture dislocations, providing satisfactory clinical and radiological results.
Arm ; Arthritis ; Carpal Bones ; Dislocations ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Ligaments ; Pronation ; Range of Motion, Articular ; Shoulder ; Supination ; Suture Anchors ; Wrist Joint

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Giant Wart as a Cutaneous Horn on the Dorsum of the Hand.

Hong Man CHO ; Kyujung LEE ; Woongbae MIN ; Yong Suk CHOI

Journal of the Korean Society for Surgery of the Hand.2016;21(2):100-104. doi:10.12790/jkssh.2016.21.2.100.

A 81-year-old female presented with a giant cutaneous horn (1.5×2×4 cm sized) over the right hand, rapid growth recent 6 months. Cutaneous horn was excised and split thickness skin graft of the defect was done under regional anesthesia. Histopathology showed overlying a wart. In the current study, we report the case of a patient with giant wart as a giant cutaneous horn in a dorsal side of hand.
Aged, 80 and over ; Anesthesia, Conduction ; Animals ; Female ; Hand* ; Horns* ; Humans ; Skin ; Transplants ; Warts*

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Postaxial Polydactyly of the Hands and Feet in Monozygotic Twins.

So Min HWANG ; Beom PARK ; Min Kyu HWANG ; Hyung Do KIM ; Min Wook KIM ; Jong Seo LEE

Journal of the Korean Society for Surgery of the Hand.2016;21(2):93-99. doi:10.12790/jkssh.2016.21.2.93

Polydactyly is the most common congenital difference of the hand and foot presenting as a range of defects from minor soft tissue duplications to major bony abnormalities. Although polydactyly of the hand is reported to occur among approximately 1 in 1,000 live births, the co-occurrence of hand polydactyly on hands and polydactyly on feet is as rare as one out of 100,000 persons. We report a case of hand and foot polydactyly in twins. One of the twins had polydactyly on both hands and feet, the other had polydactyly on the right hand and both feet. Postaxial polydactyly in monozygotic twins appears on both hands and feet in a different form shows that polydactyly is caused by multiple factors. It has been reported that the mother's infection and drug in addition to hereditary factors are the causes for polydactyly, but since they are unknown yet, it is necessary to conduct a study of them.
Foot* ; Hand* ; Humans ; Live Birth ; Polydactyly* ; Twins ; Twins, Monozygotic*

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Trigger Finger of a Distal A2 Pulley.

Jin Woo JIN ; Byoung Youl KANG ; Dong Hee KIM

Journal of the Korean Society for Surgery of the Hand.2016;21(2):89-92. doi:10.12790/jkssh.2016.21.2.89

Trigger finger commonly occurs in A1 pulley. However, there have been occasional reports of proximal or distal A2 pulley and A3 pulley at other sites. Especially, trigger finger that occurs in A2 pulley is usually due to thickening of flexor tendon. Flexor tendon plasty surgery or A2 pulley partial release are well known treatments of A2 pulley trigger finger. We conducted pulley lengthening of the A2 pulley to a 62-year-old man who has trigger finger occurring in distal portion of the A2 pulley, and we report about this with good results obtained.
Fingers* ; Humans ; Middle Aged ; Tendons

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Flexor Pollicis Longus Reconstruction in Patient with the Linburg-Comstock Syndrome.

Sung Jong WOO ; Sang Won MOON

Journal of the Korean Society for Surgery of the Hand.2016;21(2):84-88. doi:10.12790/jkssh.2016.21.2.84

Linburg-Comstock phenomenon is defined simultaneous flexion of thumb and other fingers. The coupling of the flexor pollicis longus and flexor digitorum profundus tendons is the main pathognomonic feature of this lesion. Typically, pain is noted at the distal level of the forearm at the site of the abnormal connection. We describe a case of flexor pollicis longus tendon rupture who undergoes a carpal tunnel release, and report the Linburg-Comstock syndrome after the flexor tendon reconstruction.
Fingers ; Forearm ; Humans ; Rupture ; Tendons ; Thumb

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Fingertip Reconstruction with Perionychial Flaps.

Kwan Chul TARK ; Hee Young LEE ; Ryun LEE ; Ji Hyun KIM ; Dong Chul KIM

Journal of the Korean Society for Surgery of the Hand.2016;21(2):77-83. doi:10.12790/jkssh.2016.21.2.77

PURPOSE: Out of nail components, nail plate, nail fold, paronychium, hyponychium, nail bed, and matrices are referred to as the perionychium. The authors report the outcomes of perionychial flap for reconstruction of fingertip injuries with nail bed injuries. METHODS: We performed 8 cases of perionychial flap for fingertip injuries with nail bed injuries between January 2012 and December 2015, and analyzed the outcomes of the reconstruction surgery. The patients evaluated the aesthetic results on a four-point scale, and we measured and evaluated the ratio of axis length of the nail plate compared with collateral side of normal nail plate. RESULTS: The mean follow up period was 8.4 months, and range of motion of distal interphalangeal joints and sensation of the reconstructed pulp were normal in all patients. After reconstructive surgery the nail plates regrew up to 80% in average compared to the normal side, and the satisfactory score were good to excellent as 3.8 point in average. CONCLUSION: The reconstruction of fingertip injuries with nail bed injuries using perionychial flap including paronychium and hyponychium is safe and easy procedure and aesthetic outcomes were excellent. The authors consider the perionychial flap as a useful technique for fingertip reconstruction.
Follow-Up Studies ; Humans ; Joints ; Range of Motion, Articular ; Sensation

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