Hand Grip Strength Differences in Geriatric Subjects with and without Hand Diseases.

Objective: The aim of this study was to investigate the impact of untreated hand diseases on hand grip strength, a value that is commonly used as a diagnostic parameter for sarcopenia and frailty in geriatric populations. We hypothesized that individuals with untreated hand diseases would have lower grip strength than those without hand diseases. Methods: A total of 240 individuals aged at least 65 years were recruited and divided into two groups based on the presence or absence of typical hand diseases. Grip strength was compared between the two groups separately for men and women using a t-test, with each group consisting of 60 women or 60 men. Results: Both women and men in the hand disease group exhibited significantly lower grip strength than those in the control group. Conclusions: These findings suggest that untreated hand diseases have a negative impact on grip strength, and this may introduce bias in the screening or diagnosis of sarcopenia and frailty. It is essential to consider the presence of hand diseases when measuring hand grip strength in older adults.

Needle-in-needle Pinning Technique Using Disposable Hypodermic Needles for Fractures of Distal Phalanx With Dorsal Disruption.

Fingertip injuries are frequently encountered by the hand surgeon, and often present with a combination of the following: avulsed or broken nail plate, nail bed disruption, and/or distal phalangeal fracture. Recommended management of these injuries consists of reduction of the fracture followed by repair of soft tissues. To achieve an anatomic reduction and sufficient stability of the fracture, current management consists of temporary Kirschner-wire stabilization. Hypodermic needles can be substituted to secure temporary transosseous fixation. We describe a technique for stabilizing open distal phalangeal fracture using hypodermic needles which are readily available. Eight patients over 12 months have been treated with this technique which has proven to be successful. We would advocate that providers consider this technique when Kirschner-wires or other necessary instruments are unavailable.

Microsurgical reconstruction of congenital upper extremity deformities of malformations.

We present two rare microsurgical reconstructions. A case with phocomelia was treated with lengthening of soft tissues following vascularized fibula grafting with epiphysis, and a case with cleft hand was reconstructed with spare-part toe transfer.

Symptom Recurrence After Endoscopic Cubital Tunnel Release.

Purpose: To evaluate the recurrence of symptoms after an endoscopic cubital tunnel release using the technique of Hoffmann and Siemionow. Methods: We retrospectively reviewed 286 consecutive patients who underwent Hoffmann and Siemionow's technique of endoscopic cubital release by a single surgeon during an 8-year period. Inclusion criteria were adult patients without previous elbow surgery, pathology, or trauma, and patients with a minimum 3-months' postoperative follow-up. We evaluated symptom recurrence rate and assessed risk factors that would affect recurrence. Results: A total of 223 patients met inclusion criteria, 204 of whom (91.5%) had improvement at 3 months after surgery. Eleven patients (4.9%) had persistent symptoms and 8 (3.6%) had recurrent symptoms at a mean of 16 months (range, 3-93 months) after the primary surgery. Intraoperative ulnar nerve subluxation had a statistically significant relationship with symptom recurrence. Conclusions: Symptoms recurred at a rate of 3.6% after Hoffmann and Siemionow's endoscopic cubital tunnel release. This is comparable to other endoscopic or open techniques for cubital tunnel release. The procedure has the added advantage of less tissue dissection. Intraoperative ulnar nerve subluxation seems to be associated with symptom recurrence. Type of study/level of evidence: Therapeutic IV.

Inflammatory pseudotumor of the spleen: clinical impact in surgical treatment.

An inflammatory pseudotumor of the spleen is a rare benign tumor and designated as mass-like lesions with histologic features of nonspecific inflammation and mesenchymal repair although its etiopathogenesis still remains unknown. Here we describe the case of an inflammatory pseudotumor of the spleen in a 57-year-old woman, whose lesion was accidentally found and thought to be lymphoma at first. Generally splenic tumors are difficult to diagnose exactly before surgery, then the patient underwent splenectomy, followed by histopathological diagnosis of inflammatory pseudotumor of the spleen. The optimal management of the asymptomastic patient with such disease is still controversial. The clinical and pathological features of previously reported cases are also reviewed in this paper.