Management of Skin Grafts and Flaps
CRITICAL POINTS ▪ Reconstructive surgery of the upper limb has been advanced by the continual addition and use of new flaps and the increasing use of functional free tissue transfer,…
A Functionally Based Neuromechanical Approach to Shoulder Rehabilitation
A Context for Change The pressure for health care reform has increased awareness that rehabilitation costs are too high. As a result, both payers and consumers are demanding high-quality, cost-effective…
Acute Care and Rehabilitation of the Hand After Cold Injury
CRITICAL POINTS ▪ Frostbite is a severe, freezing-temperature, cold-induced injury. ▪ Tissue injury occurs by two mechanisms: cellular injury due to ice crystal formation, and progressive tissue ischemia. ▪ Frostbite…
Diagnostic Imaging of the Shoulder and Elbow
CRITICAL POINTS Shoulder Ultrasound Applications ▪ Rotator cuff integrity assessment (especially post arthroplasty) ▪ Evaluation and fenestration of rotator cuff calcific tendinosis ▪ Evaluation of rotator cuff muscle atrophy ▪…
Clinical Examination of the Wrist
CRITICAL POINTS ▪ Successful clinical examination of the wrist requires a thorough knowledge of wrist anatomy, biomechanics, and pathology. ▪ The wrist examination includes a complete history, visual inspection, objective…
Therapeutic Management of Dupuytren’s Contracture
CRITICAL POINTS KEYS TO SUCCESSFUL POSTOPERATIVE MANAGEMENT FOR DUPUYTREN’S CONTRACTURE ▪ Proper preoperative evaluation of associated problems (carpal tunnel syndrome [CTS], triggers, abductor band) ▪ Early referral to therapy; proper…
Common Infections of the Hand
CRITICAL POINTS Acute Paronychia ▪ Indication: Infection involving the nail fold, most common overall hand infection (usually Staphylococcus aureus ). ▪ Diagnostic Pearls: Of all the fingertip areas, the hyponychium…
Staged/Delayed Tendon Reconstruction
CRITICAL POINTS ▪ Reconstructive surgeons should have multiple procedures at their disposal for delayed tendon reconstruction, including tenolysis, pulley reconstruction, immediate tendon grafting, and staged tendon reconstruction. ▪ Assessment of…
Sensibility Testing: History, Instrumentation, and Clinical Procedures
* I gratefully acknowledge Bill Buford, bioengineer, University of Texas at Galveston, formerly at the Paul W. Brand Research Laboratory, Gillis W. Long Hansen’s Disease Center, Carville, Louisiana, for his…
Staged Flexor Tendon Reconstruction
Part I: Staged Flexor Tendon Reconstruction JAMES M. HUNTER * Indications/Contraindications * Part I reproduced from Hunter JM: Staged flexor tendon reconstruction. In Strickland JW, editor: Master techniques in orthopaedic…
