By Martin I. Boyer, James Chang MD
100 Hand Cases offers a scientific write-up of a hundred average circumstances from globally well-known professionals who go over among cosmetic surgery and orthopedics, the 2 specialties devoted to education hand surgeons.
The circumstances during this publication percentage a concise process consisting of:
- A description of the problem
- Key anatomy
- Principles and scientific pearls
- Classic references concerning the case
Full-color pictures and radiographs are incorporated in each one case, in addition to a dialogue of the authors’ most well-liked therapy solution.
Presented in a hugely templated, high-yield layout, 100 Hand Cases is a perfect quickly reference for college students and trainees getting ready for clinics and the working room, in addition to busy surgeons wanting a short reminder on key information.
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Additional resources for 100 Hand Cases
Although an ulnar-shortening osteotomy is the preferred procedure, many patients do not want the risks and lengthy immobilization that is necessary. • Salvage operations such as those listed previously may be effective in relieving pain but have the added risk of contorting normal anatomy and destabilizing the wrist. Pitfalls include persistent pain, nonunion of the ulna, incongruity of the distal radioulnar joint, and progressive wrist destabilization. Specifically, the ulnar-shortening osteotomy technique needs to be precise.
The mainstays of treatment are oral nonsteroidal antiinflammatory drugs and intermittent splint immobilization and corticosteroid injections. These can decrease symptoms satisfactorily to allow surgical treatment to be deferred. Key Anatomy The proximal pole and waist of the scaphoid articulate with the radial styloid and the scaphoid fossa of the distal radius. The proximal pole of the lunate articulates with the lunate fossa of the distal radius and the seat of the ulna. Any or all of these joints can become arthritic, and symptoms vary depending on whether the wrist or the forearm is involved primarily.
Splinting might be useful in acute flares but do not provide long-term relief for the PIP joint. Surgical treatment of the osteoarthritic PIP joint consists of either arthrodesis (using K-wires with a tension-band wire construct, a dorsal plate, or a transarticular screw) or arthroplasty (with a linked silicone prosthesis or an unlinked metal and polyethylene prosthesis). The surgical approach to the PIP joint for arthrodesis is lateral or dorsal, whereas the surgical approach to the PIP joint for arthroplasty can be volar (by detachment of the volar plate) or dorsal (by splitting of the central slip and tendon longitudinally or by a V-Y flap of the extensor tendon based distally over the insertion of the central slip).
100 Hand Cases by Martin I. Boyer, James Chang MD