Hand and Wrist

Latest journal articles about hand and wrist from Journal of Hand Surgery, Journal of Hand Therapy, Hand Clinics, Hand, The Bone & Joint Journal, Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Acta Orthopaedica, Orthopedic Clinics of North, America, Journal of Orthopaedic Surgery and Research, Orthopedics

Related Articles Recurrent carpal tunnel syndrome. Hand Clin. 2013 Aug;29(3):427-34 Authors: Mosier BA, Hughes TB Abstract Carpal tunnel release is a common procedure with a high rate of alleviating the patient's symptoms. The incidence of recurrent or persistent carpal tunnel syndrome is rare, although likely underestimated. Complaints of worsening numbness, tingling, or weakness should alert the physician to possible nerve injury and need for early exploration. The overall results of revision carpal tunnel procedures are less successful than primary surgery; however, surgery should be performed when indicated, as it may alleviate or improve symptoms. PMID: 23895723 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895723?dopt=Abstract

Related Articles Symptoms and disability after major peripheral nerve injury. Hand Clin. 2013 Aug;29(3):421-5 Authors: Ring D Abstract Laceration and irrecoverable stretch, crush, or avulsion of a major peripheral nerve in the upper extremity causes substantial impairment in an adult patient. Hand care professionals who treat these patients encounter a wide range of coping strategies leading to varied courses of recovery and strikingly different final outcomes. There is evidence that the cognitive, emotional, and behavioral aspects of recovery (not to mention the circumstantial aspects such as worker compensation and litigation) are as important as the physical aspects. Awareness of the factors that facilitate or hinder these aspects of recovery might improve the quality and effectiveness of our care. PMID: 23895722 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895722?dopt=Abstract

Related Articles Management of neuromas of the upper extremity. Hand Clin. 2013 Aug;29(3):409-20 Authors: Brogan DM, Kakar S Abstract Neuromas primarily arise from iatrogenic injury, trauma, or chronic irritation. Given the disabling symptoms of neuromas, an array of treatment strategies exist, with varied results. Successful treatment relies on accurate identification of the offending nerve, containment of the regenerating fascicles, and cessation of mechanical or other noxious stimuli over the regenerating nerve end. The choice of treatment depends in part on the nerve affected, whether it involves critical or noncritical sensation, and its location. PMID: 23895721 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895721?dopt=Abstract

Related Articles Management of Chronic Pain Following Nerve Injuries/CRPS Type II. Hand Clin. 2013 Aug;29(3):401-8 Authors: Carroll I, Curtin CM Abstract Chronic pain affects quality of life and adversely affects functional outcomes. Chronic postoperative pain is a frustrating problem for the surgeon because it ruins a technically perfect procedure, and the surgeon may be unsure of treatment strategies. There is much information on chronic pain and its treatment, but it is often published outside of surgery and diffusion of this information across disciplines is slow. This article synthesizes some of this literature and provides a systematic presentation of the evidence on pain associated with peripheral nerve injury. It highlights the use of perioperative and early intervention to decrease this debilitating problem. PMID: 23895720 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895720?dopt=Abstract

Related Articles Tendon versus nerve transfers in elbow, wrist, and hand reconstruction: a literature review. Hand Clin. 2013 Aug;29(3):393-400 Authors: Meals CG, Meals RA Abstract Upper extremity reconstruction forces the surgeon to chose between several available procedures, among them tendon and nerve transfer. Few guidelines exist to assist the surgeon in this regard, and the authors, therefore, undertook a retrospective review of case series describing tendon and nerve transfer. The authors discovered a scarcity of robust reporting, particularly in regard to tendon transfer, making an objective comparison between the two techniques difficult. Tendon transfers are popular and familiar. Nerve transfers promise distinct advantages; however, excellent evidence of their superiority is lacking. PMID: 23895719 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895719?dopt=Abstract

Related Articles Evidence and techniques in rehabilitation following nerve injuries. Hand Clin. 2013 Aug;29(3):383-92 Authors: Novak CB, von der Heyde RL Abstract Following upper extremity peripheral nerve injury and surgery, rehabilitation is essential to optimize sensorimotor function and outcome. This review presents the evidence and related literature regarding a few key topics related to rehabilitation following peripheral nerve injury and surgery. PMID: 23895718 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895718?dopt=Abstract

Related Articles Major peripheral nerve injuries. Hand Clin. 2013 Aug;29(3):371-82 Authors: Isaacs J Abstract Major peripheral nerve injuries in the upper extremities can result in significant morbidity. Understanding the pathophysiology of these injuries aids in the assessment and planning of appropriate treatment. With limited nerve mobilization, tension-free repairs can often be performed using sutures, fibrin glue, or nerve connectors. Acellular allograft and autograft reconstruction are better for bridging any gaps greater than a few millimeters. Adherence to proper principles of nerve repair improves the chances of achieving a favorable result, although in general these injuries portend a guarded prognosis. PMID: 23895717 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895717?dopt=Abstract

Related Articles Timing and appropriate use of electrodiagnostic studies. Hand Clin. 2013 Aug;29(3):363-70 Authors: Bergquist ER, Hammert WC Abstract Electrodiagnostic studies are powerful tools used to objectively examine the physiologic status of a nerve. These consist of nerve conduction studies, which directly examine motor and sensory function of the nerve, and electromyography, which examines spontaneous and voluntary motor unit action potentials in the muscle. Together these studies enable characterization, localization, and duration of nerve pathology. Appropriate timing and use of electrodiagnostic studies assist medical providers in treating nerve pathology. PMID: 23895716 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895716?dopt=Abstract

Related Articles How to measure outcomes of peripheral nerve surgery. Hand Clin. 2013 Aug;29(3):349-61 Authors: Wang Y, Sunitha M, Chung KC Abstract Evaluation of outcomes after peripheral nerve surgeries include several assessment methods that reflect different aspects of recovery, including reinnervation, tactile gnosis, integrated sensory and motor function, pain and discomfort, and neurophysiologic and patient-reported outcomes. This review lists measurements addressing these aspects as well as the advantages and disadvantages of each tool. Because of complexities of neurophysiology, assessment remains a difficult process, which requires researchers to focus on measurements best relevant to specific conditions and research questions. PMID: 23895715 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895715?dopt=Abstract

Related Articles Nerve allografts and conduits in peripheral nerve repair. Hand Clin. 2013 Aug;29(3):331-48 Authors: Lin MY, Manzano G, Gupta R Abstract Since the last update on nerve conduits and allograft in 2000, investigations have established the efficacy of these alternatives to autograft in the repair of small sensory neural gaps. However, limited insights into the biology of the regenerating nerve continue to preclude intelligent conduit design. Ongoing discoveries in neuroscience and biomaterial engineering hold promise for the eventual development of allograft and conduits with potential of surpassing nerve autografts in clinical efficacy. In this review, we summarize the history, recent advances, and emerging developments in nerve conduits and allograft. PMID: 23895714 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23895714?dopt=Abstract