Complex Dislocation of the Metacarpo-Phalangeal Joint of the Index Finger: A Comparison of the Surgical Approaches

1988 ◽  
Vol 13 (4) ◽  
pp. 466-468
Author(s):  
K. BARRY ◽  
H. McGEE ◽  
J. CURTIN
Keyword(s):  
Surgical Intervention ◽  
Index Finger ◽  
Volar Plate ◽  
Surgical Approaches ◽  
Normal Anatomy ◽  
Dorsal Approach ◽  
Palmar Approach ◽  
Longitudinal Division ◽  
Theoretical Risk ◽  
Late Instability

Complex dislocation of the index metacarpo-phalangeal joint almost always requires surgical intervention. Controversy exists as to the most suitable surgical approach to reduction: palmar or dorsal. We reviewed four cases and carried out dissections in eight cadaver hands to compare the surgical approaches. The interposed volar plate was found to be the most important obstacle to reduction. Both approaches were successful in obtaining reduction. The dorsal approach was simple and safe, hut necessitated longitudinal division of the volar plate and may carry a theoretical risk of late instability. The palmar approach allows restoration of normal anatomy but the radial neurovascular bundle is always vulnerable.

scholarly journals Dislocation of the metacarpophalangeal joint of the index finger requiring open reduction due to the presence of an intra-articular sesamoid bone

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110211
Author(s):  
Elizabeth S O’Neill ◽  
Mia M Qin ◽  
Kevin J Chen ◽  
Marek A Hansdorfer ◽  
Matthew E Doscher
Keyword(s):  
Open Reduction ◽  
Surgical Intervention ◽  
Index Finger ◽  
Metacarpophalangeal Joint ◽  
Volar Plate ◽  
Digital Nerve ◽  
Sesamoid Bone ◽  
Joint Dislocation ◽  
Patient Reported ◽  
Definitive Management

Complex dislocation of the metacarpophalangeal joint of the index finger is rare and often requires surgical intervention. Here, we present a case of an index finger metacarpophalangeal joint dislocation requiring open reduction due to obstruction by a displaced volar plate and the intra-articular entrapment of a sesamoid bone. Surgical approach was performed dorsally, allowing easy visualization of the volar plate and sesamoid bone as well as minimizing risk to the radial digital nerve to the index finger. Postoperatively, the patient reported good functional return despite the delay in definitive management.

FIXATION OF AN ULNODORSAL FRAGMENT WHEN TREATING AN INTRA-ARTICULAR FRACTURE IN THE DISTAL RADIUS

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 139-144 ◽  
Author(s):  
Kazuo Ikeda ◽  
Naoki Osamura ◽  
Kaoru Tada
Keyword(s):  
Distal Radius ◽  
Surgical Procedure ◽  
Plate Fixation ◽  
Volar Plate ◽  
Dorsal Approach ◽  
Articular Fracture ◽  
Low Profile ◽  
Volar Plate Fixation ◽  
Mini Plate

If fixation of an ulnodorsal fragment in an intra-articular fracture of the distal radius is not stable, it is sometimes caused by dorsal displacement after surgery. Hence, we recommend the volar plate fixation with an additional dorsal approach and fixation of irreducible ulnodorsal fragments using a low-profile dorsal mini plate. The details of the surgical procedure and indications are discussed in this article.

scholarly journals The proximal interphalangeal joint: arthritis and deformity

2019 ◽  
Vol 4 (6) ◽  
pp. 254-262 ◽  
Author(s):  
Daniel Herren
Keyword(s):  
Index Finger ◽  
Proximal Interphalangeal Joint ◽  
Surgical Approaches ◽  
Silicone Implants ◽  
Common Site ◽  
Joint Implant ◽  
Goal Revision ◽  
Pip Joint ◽  
Joint Arthritis ◽  
Saddle Joint

Finger joints are of the most common site of osteoarthritis and include the DIP, PIP and the thumb saddle joint. Joint arthroplasty provides the best functional outcome for painful destroyed PIP joints, including the index finger. Adequate bone stock and functional tendons are required for a successful PIP joint replacement Fixed swan-neck and boutonnière deformity are better served with PIP arthrodesis rather than arthroplasty. Silicone implants are the gold standard in terms of implant choice. Newer two-component joints may have potential to correct lateral deformities and improve lateral stability. Different surgical approaches are used for PIP joint implant arthroplasty according to the needs and the experience of the surgeon. Post-operative rehabilitation is as critical as the surgical procedure. Early protected motion is a treatment goal. Revision and exchange PIP arthroplasty may successfully be used to treat chronic pain, but will not correct deformity. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180042

Different surgical treatments for nasal septal perforation and their outcomes

2007 ◽  
Vol 121 (5) ◽  
pp. 419-426 ◽  
Author(s):  
A Y Goh ◽  
S S M Hussain
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Journal Club ◽  
Treatment Options ◽  
Surgical Approaches ◽  
Septal Perforation ◽  
Inclusion Criteria ◽  
Hand Search ◽  
Nasal Septal Perforation ◽  
The Subject

Objective: To critically evaluate the literature on surgical treatment options for nasal septal perforations and to analyse the outcomes of these treatment options.Design: A systematic review of studies of nasal septal perforation closure using surgical intervention, published from January 1975 to March 2006.Data sources: Forty-nine papers were identified from electronic databases (all Evidence Based Medicine reviews (Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effectiveness and Cochrane Controlled Trials Register), EMBASE, Ovid (Medline) and British Medical Journal publications) and from a hand search of the reference lists of retrieved papers. Textbooks pertinent to the subject were referred to for background reading. Twenty-three studies met the inclusion criteria.Main outcome measure: Effectiveness of the surgical intervention to completely close the perforation.Results: Five studies examined the sole use of intranasal mucosal flaps to close the perforation, i.e. inferior turbinate flaps, quadrangular cartilage flap and mucoperiosteal flap. Eighteen studies reported the use of a combination of intranasal mucosal flap and interposition graft. Graft materials included temporalis fascia, mastoid periosteum, nasal septal material, acellular human dermal graft, conchal cartilage and porcine small intestine mucosa. Studies utilising interposition grafts generally produced higher closure rates. The surgical approaches documented include closed endonasal, unilateral hemitransfixion, external rhinoplasty and midfacial degloving techniques. A range of surgical treatment methods was reported in the literature, but some papers were excluded from this review as they did not meet the inclusion criteria. It was difficult to infer the true effectiveness of each study as the subject numbers were small, patient selection criteria were often unspecified and the follow-up period was brief. However, factors leading to an increased chance of success were identified.Conclusion: The review found an extensive range of surgical treatment techniques, but reported results were rarely statistically significant. It is difficult to be categorical about the effectiveness of a surgical treatment method; nonetheless, each technique has its own advantages and drawbacks.

Neurosurgical Approaches to Intractable Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2000 ◽  
Vol 5 (11) ◽  
pp. 23-34 ◽  
Author(s):  
Steven Rasmussen ◽  
Benjamin Greenberg ◽  
Per Mindus ◽  
Gerhard Friehs ◽  
George Noren
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Neural Circuits ◽  
Surgical Intervention ◽  
Behavioral Therapy ◽  
Surgical Approaches ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Past ◽  
School Of Medicine ◽  
Brown University

AbstractAlthough significant progress has been made over the last decade in the treatment of obsessive-compulsive disorder (OCD), approximately 20% of OCD patients remain refractory to nonsurgical therapies, including pharmacologic and cognitive-behavioral therapy. Because a number of neural circuits involving the basal ganglia, thalamus, limbic system, and frontal lobes have been implicated in the pathophysiology of OCD, the need for an effective intervention in these patients has brought the focus on surgical approaches, including cingulotomy and capsulotomy procedures. Unlike free-hand surgical approaches used in the past, current neurosurgical interventions have been greatly enhanced by advances in technology, which allow lesioning to an accuracy of 1 mm. Today's neurosurgical approaches have shown significant benefit in as many as 60% of refractory patients, while preserving personality and cognitive functioning and limiting morbidity. A study of gamma knife capsulotomy conducted at Brown University School of Medicine showed that 40% of patients undergoing two lesioning procedures were much or very much improved 2 years postsurgery. The inherent obstacles to conducting placebo-controlled studies in these severely ill patients mean that further study is required to identify optimal candidates for surgical intervention.

scholarly journals Iatrogenic Supraclavicular Nerve Injuries in Surgical Treatment of Clavicle Fractures

2015 ◽  
Vol 22 (2) ◽  
pp. 50-54
Author(s):  
A. S Zolotov ◽  
M. S Feshchenko ◽  
O. I Pak
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Early Postoperative Period ◽  
Surgical Approaches ◽  
Nerve Injuries ◽  
Clavicle Fractures ◽  
Traumatic Damage

Incidence and pattern of disturbed sensitivity in the zone of surgical intervention was studied in 24 patients with clavicle fractures. Traumatic damage of supraclavicular nerve (not related to surgery) was observed only in 1 case. Disturbance of sensitivity in the zone of surgical intervention was noted in 21 (87.5%) patients. Mean area of anesthesia made up 44.5±29.3 cm2 (from 8.0 to 125.5 cm2). That complication developed at both horizontal and vertical surgical approaches. Intraoperatively supraclavicular nerves were visualized and preserved in 6 patients however disturbed sensitivity in early postoperative period was observed in 4 cases. Preventive isolation of supraclavicular nerves does not always ensure the preservation of sensitivity in early postoperative period.

Current Image-Guided Interventions in Pediatric Surgery

2020 ◽  
Vol 30 (02) ◽  
pp. 164-171
Author(s):  
Nathan S. Rubalcava ◽  
Marcus D. Jarboe
Keyword(s):  
Image Quality ◽  
Surgical Technique ◽  
Minimally Invasive ◽  
Pediatric Surgery ◽  
Image Guidance ◽  
Surgical Intervention ◽  
Surgical Approaches ◽  
Current Image ◽  
Image Guided ◽  
Invasive Management

AbstractTraditionally, surgical technique has not included imaging modalities. Image guidance had largely been left to radiology specialties. However, in recent years, tremendous advances in imaging have taken place with improvements in image quality, portability, and accessibility. With these advances, surgeons have begun to realize the benefits of fusing image guidance with traditional surgical approaches. Subsequently, many novel surgical approaches utilizing image guidance have been developed that allow for precise, safe, and minimally invasive management of conditions that previously required open surgical intervention.

Surgical approaches in juxtarenal and pararenal aortic aneurysms repair

2021 ◽  
pp. 021849232199738
Author(s):  
Eduard R Charchyan ◽  
Anna B Stepanenko ◽  
Andrey P Gens ◽  
Nail A Galeev ◽  
Yuri V Belov
Keyword(s):  
Operative Time ◽  
Surgical Intervention ◽  
Pain Syndrome ◽  
Reliable Data ◽  
Aortic Aneurysms ◽  
Retroperitoneal Approach ◽  
Surgical Approaches ◽  
Midline Laparotomy ◽  
Advantages And Disadvantages ◽  
Case Basis

Background In this study, surgical tactic features and juxtarenal and pararenal treatment immediate results were analyzed depending on the use of various surgical approaches. Methods Between 2015 and 2019, a total of 89 patients received surgical treatment, of which 52(58%) had juxtarenal aneurysms and 37 (42%) – pararenal aneurysms. During repairs, three types of surgical approaches were used: midline laparotomy, extended retroperitoneal approach and thoraco-phreno-retroperitoneal approach. The patients were divided into three groups accordingly. Results At the immediate postoperative period, mortality rate equaled 2 (2.2%). The reasons were pulmonary embolism and sepsis. Statistically reliable data were obtained, confirming the advantages of midline laparotomic approach over the lateral retroperitoneal ones, which consisted in a shorter operative time, less pronounced pain syndrome, lesser blood loss, fewer postoperative days. The disadvantages were that enteroparesis occurred more often when the midline laparotomy was used in comparison to extended retroperitoneal or thoraco-phrenoretroperitoneal approaches. Conclusion Thus, open repairs of juxtarenal and pararenal aortic aneurysms have some specific technical and strategical features which are associated with intraoperative renal ischemia. During open surgical intervention, it is important to first consider the possibility of repair with midline laparotomy. However, lateral retroperitoneal approaches can also be used on a case-by-case basis noting their advantages and disadvantages.

Pediatric Jaw Fractures: Indications for Open Reduction

1979 ◽  
Vol 87 (3) ◽  
pp. 318-322 ◽  
Author(s):  
Anthony S. Krausen ◽  
Martin Samuel
Keyword(s):  
Open Reduction ◽  
Surgical Intervention ◽  
Normal Anatomy ◽  
The Past ◽  
Fractures In Children ◽  
Dental Anatomy ◽  
Jaw Fractures ◽  
The One ◽  
And Function

Jaw fractures in children are generally managed without major surgical intervention. Closed reduction usually is sufficient to restore normal anatomy and function. The one inviolate principle is early treatment. During the past three years, four pediatric jaw fractures that required open reduction were treated. This mode of treatment was necessitated by the limitations imposed by pediatric dental anatomy and by the type of fractures encountered. In at least 24 months of follow-up, no dental problems have been seen.

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