Nerve Response to Injury and Repair
CRITICAL POINTS ▪ Peripheral nerve end-organs require innervation to stay viable. The loss of the trophic stimulus of the nerve axon dooms the end-organ to atrophy and eventual death. ▪…
Advances in Understanding of Tendon Healing and Repairs and Effect on Postoperative Management
Critical Points Biology ▪ Motion aids healing and reduces adhesions. ▪ There is no evidence that loading, in the absence of motion, is helpful, or that, once the tendon is…
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…
