Acute compartment syndrome of forearm and hand.

The diagnosis and treatment of the acute compartment syndrome is of paramount importance. Unless the viscious cycle is intervened at an appropriately early time it will result in irreversible damage leading to disability. In this review article we are discussing the basic pathophysiological process through which the various aetiological factors causing increased compartmental pressure lead to the progressive death of muscles and nerves. We also discuss the various clinical features that aid in the diagnosis and the role of intracompartmental pressure measurements. Finally we hope to ascertain the basic principles and the surgical techniques for treating this condition effectively.

Modified Jones transfer for radial nerve palsy using a single incision: surgical technique.

Various modifications in the classic Jones transfer for radial nerve palsy have been described. All use multiple incisions producing multiple surgical scars over the forearm. To avoid this problem, we have devised a method in which the tendon transfer procedure can be carried out through a single incision. Sixteen patients with radial nerve palsy were operated on from 2003 to 2007. We used a single incision running along the radial border of the distal third of the forearm curving obliquely at the lower end of radius to end at the Lister tubercle. We used the flexor carpi radialis transfer in all patients. The cosmetic as well as functional results were excellent in all cases. The advantages of this method are better cosmesis with a single linear scar on the radial border of the forearm, easy rerouting of the extensor pollicis longus tendon without the need for a tendon tunneller, and less operating time.

A method of assessment of pollicisation.

The evaluation and comparison of results of pollicisation for different pre-operative conditions is difficult as no standard method exists. An assessment is proposed, based upon tip pinch, opposition, pulp pinch, grasp, mobility, sensitivity and cosmetic appearance which gives a numerical score.

Pollicisation of the index finger in congenital anomalies. A retrospective analysis.

Between 1977 and 1988, 30 pollicisations were performed on 22 children with hypoplasia or aplasia of the thumb. A review was undertaken to grade the results. 73% were graded good or excellent, 17% fair and ten % poor. 36% required secondary surgery to achieve a satisfactory result. Better results were obtained in Blauth III or IV deformities, with poorer outcomes in Blauth V or patients with associated radial hypoplasia. Good functional and cosmetic results were found in patients operated upon at an early age. The presence of previously unreported bony spikes was a significant cause of poor mobility and was amenable to secondary surgery.