Corrective Osteotomy of Distal Radius Malunion Using a Rectangular-shaped Iliac Bone Graft and Volar Plating.

Distal radius fractures are one of the most common injuries seen by orthopedists at the emergency room and clinics. Severity and configuration may vary, and therapeutic options are broad, but regardless of the course of treatment, all cases can potentially lead to malunion. When malunion requires surgical correction, the surgery can be technically demanding. Here, we demonstrate an alternative technique to perform corrective osteotomies for extra-articular or minimally displaced articular distal radius malunion. We provide simplification of the procedure by eliminating one of the planes taken into consideration when performing an osteotomy. This technique includes the use of a tricortical iliac bone graft, which we feel, provides dependable structural support, preventing collapse. The technique allows the surgeon an easy means to access the osteotomy gap and apply the graft. Finally, we supplement this surgical technique by providing our outcomes. Our data suggest that the technique effectively restores radiographic wrist parameters and provides good union rates.

Carpal tunnel release using the radial sided approach compared with the two-incision approach.

We compared carpal tunnel release using a radial sided approach (RCTR) with a two-incision approach with regards to complications, grip strength, and functional outcomes. Retrospective chart review was done and data was collected pre-operatively, and post-operatively at six weeks and three months. A total of 32 and 26 patients were included in the two-incision and RCTR groups respectively. At six weeks, the RCTR group showed an increased grip strength (+32.24%) while the two-incision group was weaker (-6.75%). Both groups showed an increased strength at three months, RCTR at 98.4% while the two-incision group was significantly lower at 38.6% increase. Both techniques provided improvement in outcome scores, with no statistical difference. RCTR was associated with a significantly earlier return of grip strength and had better grip strength at six weeks and three months post-operatively. Both techniques provided symptom relief and good functional outcome.

Anatomic outcome of percutaneous release among patients with trigger finger.

PURPOSE: To investigate the adequacy and safety of percutaneous trigger finger release on symptomatic patients. METHODS: Two orthopedic non-hand surgeons performed percutaneous A1 pulley release on the thumb, index, middle, and ring fingers with the use of a 19-gauge needle in 25 fingers of 24 patients. Open inspection was then performed to determine the extent of release and any injury to the surrounding anatomic structures. RESULTS: Triggering was eliminated in all fingers. Of the 25 A1 pulleys, 19 were partially released; only 6 were completely released. Noted injury included only superficial abrasions in 15 tendons. None of the patients had injury to the digital artery or nerve. CONCLUSIONS: In the percutaneous release of trigger fingers, complete anatomic release of the A1 pulley is not always adequately achieved, even though clinically patients experience relief of triggering. It is a safe procedure for the thumb, index, middle, and ring fingers as long as the recommended technique is observed.