Abstract:
:High clinical suspicion is of paramount importance in evaluating the hand or wrist for an evolving compartment syndrome. A detailed history coupled with a thorough physical examination form the basis for the diagnosis. The use of techniques to measure compartment pressures forms the objective foundation to assist in formulating the correct treatment plan. The particular technique used to measure the compartments is not critical as long as the information is evaluated in the context of the history and physical examination. No absolute threshold pressure exists over which a fasciotomy is indicated. The need for immediate fasciotomy once the diagnosis is made is clear, however. No one can be faulted for proceeding with a fasciotomy on clinical grounds alone, even when the appearance of findings typically associated with compartment syndrome at surgery (herniating muscle bellies, edema, etc.) are less than convincing. At their worst, the wounds from a fasciotomy present a cosmetic challenge. Great fault can be assigned, however, to the clinician who chooses to ignore an evolving compartment syndrome that unnecessarily places the patient at risk of permanent disability. Here, the cosmetic benefit of avoiding the fasciotomy is overwhelmed by the often-devastating dysfunction created by ischemic damage to the contents of the affected compartments. Once the damage is done, it is permanent. A thorough understanding of the pertinent anatomy is critical to safe, efficacious treatment. Handled promptly and judiciously, compartment syndrome of the hand and wrist can be managed effectively, decreasing the morbidity associated with this potentially devastating and debilitating process.
journal_name
Hand Clinjournal_title
Hand clinicsauthors
Ortiz JA Jr,Berger RAsubject
Has Abstractpub_date
1998-08-01 00:00:00pages
405-18issue
3eissn
0749-0712issn
1558-1969journal_volume
14pub_type
杂志文章,评审相关文献
HAND CLINICS文献大全abstract::Since the first description of an ulnar collateral ligament (UCL) tear at the elbow 60 years ago and the first description of surgical reconstruction 20 years ago, many advances have been made in management and surgery. UCL tears at the elbow remain a disease of the overhead athlete. Various imaging studies have been ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2007.11.011
更新日期:2008-02-01 00:00:00
abstract::Necrotizing fasciitis is a severe, fulminant infection most commonly encountered in patients with diabetes mellitus, alcohol abuse, and intravenous drug abuse. The infection can spread-unrecognized along fascial planes beneath seemingly normal skin. The relatively benign appearance of the extremity is misleading and o...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1998-11-01 00:00:00
abstract::The lumbrical muscles are unique in having their origin and insertion on tendons. The lumbricals assist in metacarpophalangeal joint flexion; they contribute to interphalangeal joint extension by acting as deflexors of the proximal interphalangeal joint. Anatomically, they are highly specialized in terms of their arch...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2011.09.002
更新日期:2012-02-01 00:00:00
abstract::Dupuytren disease is a fibroproliferative condition affecting the hands of millions of patients worldwide. The hypothesis of pathogenesis involves genetic factors and internal factors. Recent genome-wide association studies have provided much needed evidence for the long-held belief of a strong genetic component to th...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2018.03.001
更新日期:2018-08-01 00:00:00
abstract::The anatomy and function of the dorsal ligaments of the wrist have received increased attention over the past decade. The anatomy, variability, osseous attachments, and function of the dorsal radiocarpal (DRC) and the dorsal intercarpal (DIC) ligaments have been studied. More detailed anatomic and mechanical studies o...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:2001-02-01 00:00:00
abstract::The authors used gradual ligamentous distraction for closed reduction of nine irreducible dorsal fracture dislocations of the PIP joint. The volar fragment size was equal to or less than 40% in five and more than 50% in four. The average follow up was 18 months. The sequence of treatment required distraction, translat...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::Osteoarthritis should initially be treated conservatively with the use of oral medication, intra-articular steroid injections, hand therapy, and splinting. The reduction of pain and the resultant increase in function to the patient are the ultimate goals of this treatment. ...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract::Peripheral ulnar-sided tears of the triangular fibrocartilage complex (TFCC) are common injuries and are amenable to arthroscopic repair. This article describes an all-arthroscopic knotless technique for TFCC repair. This technique has the advantage of being all arthroscopic using 3 portals, has the ability to repair ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2011.05.008
更新日期:2011-08-01 00:00:00
abstract::Trauma to the upper extremity can present with an associated arterial injury. After patient stabilization, thorough assessment with physical examination and various imaging modalities allows accurate diagnosis of the specific arterial injury. After diagnosis, efficient treatment is necessary to allow limb salvage. Tre...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2017.09.009
更新日期:2018-02-01 00:00:00
abstract::To reduce ischemic time and yet achieve a high-quality repair, the replantation team should be well organized. The team should be conversant with microvascular techniques and employ efficient methods of tendon repair and bone fixation. Developments in instrumentation and technique in recent years have improved success...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:2001-08-01 00:00:00
abstract::Release of the transverse carpal ligament is commonly performed and highly successful in the treatment of carpal tunnel syndrome; however, complications do occur and may be broadly classified as errors in diagnosis and surgical technique. Complications range from incomplete division of the transverse carpal ligament t...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::This article provides an update on wound management with wound diagnosis and treatment discussed in terms of the normal cellular events of the wound healing process. The role of growth factors as cell regulators, the importance of wound fluids to wound metabolism, and the deleterious effects of some wound cleansers, d...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-08-01 00:00:00
abstract::Over the last 2 decades, arthroscopy has assumed a greater role in the treatment of disorders of the wrist. The arthroscopic treatment of radioscaphoid arthritis and ulnar hamate impaction provides the benefits of being minimally invasive, with less morbidity, earlier motion, less recovery time, early return to work, ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2005.08.008
更新日期:2005-11-01 00:00:00
abstract::The treatment of lunotriquetral interosseous (LTIO) ligament injuries is controversial. It is part of a spectrum of injuries involving the ulnar side of the wrist. Associated injuries may play a greater role in the outcome of treatment than does the LTIO injury. Arthroscopy is the most accurate diagnostic tool availab...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract::Vascular pathology in the upper extremity of a throwing athlete comprises a spectrum of serious disorders apt to threaten the patient's career and the viability of the involved parts. Such pathology includes digital vessel thrombosis, proximal thrombosis with distal embolization, vessel aneurysm, and vessel compressio...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:2000-08-01 00:00:00
abstract::The standard treatment for delayed union or nonunion of the scaphoid is operative management. Electrical stimulation has been employed in these clinical situations in patients unable or unwilling to undergo surgical intervention. Recent interest has also focused on the use of low-intensity ultrasound as an adjunct to ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:2001-11-01 00:00:00
abstract::Until the 1920s, TOS was believed to be a vascular condition caused by compression of the subclavian artery by a congenital anomaly, either a cervical rib or tight anterior scalen muscle. Today it is regarded primarily as a neurologic condition caused by neck trauma injuring and scarring the scalene muscles. ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0712(03)00079-9
更新日期:2004-02-01 00:00:00
abstract::Treatment of recurrent Dupuytren disease is challenging. Multiple options exist, each having relative benefits and weaknesses. Choice for optimal treatment is made on a case-by-case basis, with shared decision making with the patient. Percutaneous and enzymatic techniques are best reserved for patients with well-defin...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2018.03.009
更新日期:2018-08-01 00:00:00
abstract::From a research work on 40 upper limbs of nonembalmed specimens, several narrow passages for the brachial plexus and the axillosubclavian vessels are described, extending from the neck and mediastinum to the lower border of the pectoralis major. The effects of sustained forced positions are also discussed, and the rol...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-11-01 00:00:00
abstract::Since the use of fire became part of life, mankind has sought remedies to treat burns. The upper extremity, due to its frequency of exposure as the foremost organ in the everyday exploration of the environment and in manipulative and social interactions, is often involved. This article discusses the history of burn tr...
journal_title:Hand clinics
pub_type: 历史文章,杂志文章
doi:
更新日期:1990-05-01 00:00:00
abstract::Carpal instability is a complex array of maladaptive and posttraumatic conditions that lead to the inability of the wrist to maintain anatomic relationships under normal loads. Many different classification schemes have evolved to explain the mechanistic evolution and pathophysiology of carpal instability, including 2...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2015.04.011
更新日期:2015-08-01 00:00:00
abstract::This article reviews the history of total wrist arthroplasty as a treatment option for painful, nonfunctional wrists in disease states. Technologic advances in materials, wear properties, and manufacturing now account for increased implant longevity. They may also improve total wrist replacement design, survival, and ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2012.08.015
更新日期:2012-11-01 00:00:00
abstract::Metacarpal and phalangeal fractures are common athletic injuries that can significantly affect the athlete's career when they occur during the season and affect the athlete's training when they occur in the off season. This situation is particularly relevant if there are complications or if fixation is not stable enou...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2009.05.005
更新日期:2009-08-01 00:00:00
abstract::Many surgical techniques are available for the repair of peripheral nerve defects. Autologous nerve grafts are the gold standard for most clinical conditions. In selected cases, alternative types of reconstructions are performed to fill the nerve gap. Non-nervous autologous tissue-based conduits or synthetic ones are ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2017.04.005
更新日期:2017-08-01 00:00:00
abstract::Careful preoperative planning, fixator selection and design, surgical technique, and sustained follow-up care are essential for successful gradual correction of pediatric forearm deformities. The sequence of planning gradual deformity correction can be created by establishing a problem list and using this as the basis...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00
abstract::Resection of the distal ulna for post-traumatic arthritis can lead to an unstable forearm joint through loss of the normal articular contact through the distal radioulnar joint and loss of soft tissue constraint. The resulting convergence instability can lead to residual pain, weakness, and loss of function. Restabili...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2005.08.015
更新日期:2005-11-01 00:00:00
abstract::The authors' strategy for soft-tissue coverage of the hand is presented. The concept of replacing like with like and reconstruction with similar adjacent tissue enhances functional and aesthetic outcomes. In this viewpoint, the pedicle perforator flap is an ideal flap. A decision-making algorithm to select an ideal fl...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2017.04.001
更新日期:2017-08-01 00:00:00
abstract::Elbow arthroscopy is, to a degree, technically demanding. A complete knowledge of the regional anatomy of the elbow is essential. The technical expertise of the arthroscopist continues to improve, and sophistication of equipment continues to increase. These clear the way for new indications of elbow arthroscopy. It is...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::The hand is extremely susceptible to burn injuries, and hand burns can occur in up to 90% of all major burns. A thorough neurovascular examination of the hand should be performed in the acute setting. Escharotomies are required in patients with full-thickness or circumferential burns, when perfusion of the upper extre...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2016.12.001
更新日期:2017-05-01 00:00:00
abstract::The care of patients with spastic cerebral palsy requires the dedicated attention of a surgeon who is interested in the upper extremity, in association with therapists and other medical personnel who have a similar interest. The difficult problems of the upper extremity have often been overlooked by concerns related t...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-11-01 00:00:00