Problems in Hand Surgery: Solutions to Recover Function

Problems in Hand Surgery
Contents
Videos
Foreword
Preface
Acknowledgments
Contributors
Part I Problems with Nailbed Repairs
	1 Nonadherence of the Nail Plate
		1.1 Patient History Leading to the Specific Problem
		1.2 Anatomic Description of the Patient’s Current Status
		1.3 Recommended Solution to the Problem
		1.4 Technique
		1.5 Postoperative Photographs and Critical Evaluation of Results
		1.6 Teaching Points
		Bibliography
	2 Posttraumatic Split Nails
		2.1 Patient History Leading to the
		2.2 Anatomic Description of the Patient’s Current Status
		2.3 Recommended Solution to the
		2.4 Technique
		2.5 Postoperative Photographs and Critical Evaluation of Results
		2.6 Teaching Points
	3 Gentian Violet Treatment of Severe Chronic Paronychia
		3.1 Introduction
		3.2 Patient History Leading to the
		3.4 Recommended Solution to the
		3.6 Postoperative Photographs and
		3.7 Patient History Leading to the
		3.9 Recommended Solution to the
		3.11 Postoperative Photographs
		3.12 Teaching Points
Part II Problems with Trigger Release
	4 Bowstringing
		4.1 Patient History Leading to the
		4.2 Anatomic Description of the Patient’s Current Status
		4.3 Recommended Solution to the Problem
		4.4 Technique
		4.5 Postoperative Photographs and Critical Evaluation of Results
		4.6 Teaching Points
		Bibliography
Part III Problems with Dupuytren’s Disease
	5 Exposed Tendons
		5.1 Patient History Leading to the
		5.2 Anatomic Description of the Patient’s Current Status
		5.3 Recommended Solution to the Problem
		5.4 Technique
		5.5 Postoperative Photographs and Critical Evaluation of Results
		5.6 Teaching Points
		Bibliography
	6 Acute Vascular Compromise after Dupuytren’s Fasciectomy
		6.1 Patient History Leading to the
		6.2 Anatomic Description of the Patient’s Current Status
		6.3 Recommended Solution to the
		6.4 Technique
		6.5 Postoperative Photographs and Critical Evaluation of Results
		6.6 Teaching Points
	7 Secondary Contractures
		7.1 Patient History Leading to the
		Patient’s Current Status
		7.4 Technique
		7.5 Postoperative Photographs
		7.6 Teaching Points
	8 Complications of Dupuytren’s Contracture Treatment
		8.1 Patient History Leading to the
		8.2 Anatomic Description of the Patient’s Current Status
		8.3 Recommended Solution to the
		8.4 Technique
		8.5 Postoperative Photographs and Critical Evaluation of Results
		8.6 Teaching Points
Part IV Problems with Flexor Tendon Repairs
	9 Flexor Tendon Rupture
		9.1 Patient History Leading to the
		9.2 Anatomic Description of the Patient’s Current Status
		9.3 Recommended Solution to the Problem
		9.4 Technique
		9.5 Postoperative Photographs and Critical Evaluation of Results
		9.6 Teaching Points
		Bibliography
	10 Adhesions of the Flexor Tendon
		10.1 Patient History Leading to
		Patient’s Current Status
		10.4 Technique
		10.5 Critical Evaluation of Results
		10.6 Teaching Points
	11 Bowstringing of the Flexor Tendon
		11.1 Patient History Leading to
		Patient’s Current Status
		11.4 Technique
		11.5 Postoperative Photographs and Critical Evaluation of Results
		11.6 Teaching Points
	12 Ruptured Flexor Pollicis Longus Tendon
		12.1 Patient History Leading to
		Patient’s Current Status
		12.4 Technique
		12.5 Postoperative Photographs
		12.6 Teaching Points
Part V Problems with Extensor Tendon Repair
	13 Extensor Lag
		13.1 Patient History Leading to
		Patient’s Current Status
		13.4 Technique
		13.5 Postoperative Photographs
		13.6 Teaching Points
	15 Relative Motion Treatment of Chronic Boutonniere Deformity
		15.1 Patient History Leading to
		15.2 Anatomic Description of the Patient’s Current Status
		15.3 Recommended Solution to
		15.4 Technique
		15.5 Postoperative Photographs and Critical Evaluation of Results
		15.6 Teaching Points
	16 Management of Chronic Sagittal Band Rupture
		16.1 Patient History Leading to
		16.2 Anatomic Description of the Patient’s Current Status
		16.3 Recommended Solution to
		16.4 Technique
		16.5 Postoperative Photographs and Critical Evaluation of Results
		16.6 Teaching Points
		References
	17 Posttraumatic Swan Neck Deformity
		17.1 Patient History Leading to
		17.2 Anatomic Description of the Patient’s Current Status
		17.3 Technique
		17.4 Postoperative Photographs
		17.5 Teaching Points
Part VI Problems with Vasospasm
	18 Refractory Raynaud’s Phenomenon
		18.1 Patient History Leading to
		18.2 Anatomic Description of the Patient’s Current Status
		18.4 Technique
		18.5 Postoperative Photographs
		18.6 Teaching Points
Part VII Problems with Compression Neuropathy
	19 A Practical Approach to Recurrent Carpal Tunnel Syndrome
		19.1 Patient History Leading to
		19.2 Anatomic Description of the Patient’s Current Status
		19.3 Recommended Solution to
		19.4 Technique
		19.5 Postoperative Photographs and Critical Evaluation of Results
		19.6 Teaching Points
	20 Recurrent Carpal Tunnel Syndrome
		20.1 Patient History Leading to
		20.2 Anatomic Description of the Patient’s Current Status
		20.3 Recommended Solution to
		20.4 Technique
		20.5 Postoperative Photographs and Critical Evaluation of Results
		20.6 Teaching Points
	21 Failed Carpal Tunnel Release: Recognizing the Lacertus Syndrome
		21.1 Patient History Leading to
		21.2 Anatomic Description of the Patient's Current Status
		21.3 Recommended Solution to
		21.4 Technique
		21.5 Postoperative Photographs and Critical Evaluation of Results
		21.6 Teaching Points
	22 Cubital Tunnel Release at the Elbow
		22.1 Patient History Leading to
		Patient’s Current Status
		22.4 Technique
		22.5 Postoperative Photographs
		22.6 Teaching Points
		Bibliography
	23 Recurrent Cubital Tunnel
		23.1 Patient History Leading to
		Patient’s Current Status
		23.4 Technique
		23.6 Teaching Points
		Bibliography
	24 Recurrent Ulnar Neuropathy
		24.1 Patient History Leading to
		Patient’s Current Status
		24.4 Technique
		24.5 Postoperative Photographs
		24.6 Teaching Points
	25 Radial Tunnel Release in the Forearm
		25.1 Patient History Leading to
		25.2 Anatomic Description of the Patient’s Current Status
		25.3 Recommended Solution to
		25.4 Technique
		25.5 Postoperative Photographs and Critical Evaluation of Results
		25.6 Teaching Points
Part VIII Problems with Nerve Repair
	26 End Neuroma
		26.1 Patient History Leading to
		26.2 Anatomic Description of the Patient’s Current Status
		26.4 Technique
		26.5 Postoperative Photographs
		26.6 Teaching Points
	27 Pain following Nerve Repair
		27.1 History
		27.2 Anatomic Description of the Patient’s Current Status
		27.3 Recommended Solution to the Problem
		27.4 Technique for Nerve Harvest and Repair
		27.5 Postoperative Care and Critical Evaluation of Results
		27.6 Teaching Points
		Bibliography
Part IX Problems with Nerve Palsy
	28 Finger Contractures
		28.1 Patient History Leading to
		Patient’s Current Status
		28.4 Technique
		28.5 Postoperative Photographs
		28.6 Teaching Points
Part X Sarcoma
	29 Incomplete Resection of Sarcoma at the Hand
		29.1 Patient History Leading to
		29.2 Anatomic Description of the Patient’s Current Status
		29.3 Recommended Solution to
		29.4 Technique
		29.5 Postoperative Photographs and Critical Evaluation of Results
		29.6 Teaching Points
Part XI Problems with Soft Tissue Coverage
	30 Perfusion Problems
		30.1 Patient History Leading to
		30.2 Anatomic Description of the Patient’s Current Status
		30.3 Recommended Solution to the Problem
		30.4 Technique
		30.5 Postoperative Photographs and Critical Evaluation of Results
		30.6 Teaching Points
		Bibliography
	31 The Bulky Flap
		31.1 Patient History Leading to
		Patient’s Current Status
		31.4 Technique
		31.5 Postoperative Photographs
		31.6 Teaching Points
	32 Contracture after Acute Trauma Surgery of a Blast Burn
		32.1 Patient History Leading to
		32.2 Anatomic Description of the Patient’s Current Status
		32.3 Recommended Solution to
		32.4 Technique
		32.5 Postoperative Photographs and Critical Evaluation of Results
		32.6 Teaching Points
	33 Dorsal Hand Defect
		33.1 Patient History Leading to
		Patient’s Current Status
		33.4 Technique
		33.5 Postoperative Photographs and Critical Evaluation of Results
		33.6 Teaching Points
Part XII Problems with Nonarticular Phalanx Fractures
	34 Malrotation in Nonarticular Phalanx Fractures
		34.1 Patient History Leading to
		34.2 Anatomic Description of the Patient’s Current Status
		34.3 Recommended Solution to the Problem
		34.4 Technique
		34.5 Postoperative Photographs and Critical Evaluation of Results
		34.6 Teaching Points
		Bibliography
	35 Nonunion in Nonarticular Phalanx Fractures
		35.1 Patient History Leading to
		Patient’s Current Status
		35.4 Technique
		35.5 Postoperative Photographs
		35.6 Teaching Points
	36 Stiffness and Hardware Problems in NonarticularPhalanx Fractures
		36.1 Patient History Leading to the Specific Problem
		36.2 Anatomic Description of the Patient’s Current Status
		36.3 Recommended Solution to the Problem
		36.4 Technique
		36.5 Postoperative Photographs and Critical Evaluation of Results
		36.6 Teaching Points
		Bibliography
	37 Angulation in Nonarticular Phalanx Fractures
		37.1 Patient History Leading to
		Patient’s Current Status
		37.4 Technique
		37.5 Postoperative Photographs
		37.6 Teaching Points
Part XIII Problems with Articular Phalanx Fractures
	38 Angulation in Articular Phalanx Fractures
		38.1 Patient History Leading to
		Patient’s Current Status
		38.4 Technique
		38.5 Postoperative Photographs
		38.6 Teaching Points
	39 Posttraumatic Bone Loss in Articular Phalanx Fractures
		39.1 Patient History Leading to
		39.2 Anatomic Description of the Patient’s Current Status
		39.3 Recommended Solution to
		39.4 Technique
		39.5 Postoperative Photographs and Critical Evaluation of Results
		39.6 Teaching Points
	40 Fracture after Prior Kirschner’s Wire Fixation
		40.1 Patient History Leading to
		Patient’s Current Status
		40.4 Technique
		40.5 Postoperative Photographs
		40.6 Teaching Points
	41 Contractures in Articular Phalanx Fractures
		41.1 Patient History Leading to
		Patient’s Current Status
		41.4 Technique
		41.5 Postoperative Photographs
		41.6 Teaching Points
Part XIV Problems with Metacarpal Fractures
	42 Nonunion in Metacarpal Fractures
		42.1 Patient History Leading to
		Patient’s Current Status
		42.4 Technique
		42.5 Postoperative Results and
		42.6 Teaching Points
	43 Malunion in Metacarpal Fractures
		43.1 Patient History Leading to
		Patient’s Current Status
		43.4 Technique
		43.5 Postoperative Photographs
		43.6 Teaching Points
	44 Angulation in Metacarpal Fractures
		44.1 Patient History Leading to
		Patient’s Current Status
		44.4 Technique
		44.5 Postoperative Photographs
		44.6 Teaching Points
Part XV Problems with Basalar Joint Osteoarthritis
	45 Recurrent Pain in Basilar Joint Osteoarthritis
		45.1 Patient History Leading to
		Patient’s Current Status
		45.4 Technique
		45.5 Postoperative Photographs
		45.6 Teaching Points
	46 Painful Proximalization of the First Metacarpal after Trapeziectomy
		46.1 Patient History Leading to
		46.2 Anatomic Description of the Patient’s Current Status
		46.3 Recommended Solution to
		46.4 Technique
		46.5 Postoperative Photographs and Critical Evaluation of Results
		46.6 Teaching Points
	47 Metacarpal Phalangeal Hyperextension
		47.1 Patient History Leading to
		Patient’s Current Status
		47.4 Technique
		47.5 Postoperative Photographs
		47.6 Teaching Points
Part XVI Problems with Metacarpal Phalangeal Osteoarthritis after Implant Arthroplasty
	48 Intraoperative Instability During Metacarpophalangeal Joint Arthroplasty for Osteoarthritis
		48.1 Patient History Leading to
		48.2 Anatomic Description of the Patient’s Current Status
		48.3 Recommended Solution to the Problem
		48.4 Technique
		48.5 Postoperative Photographs and Critical Evaluation of Results
		48.6 Teaching Points
		Acknowledgments
		Bibliography
	49 Revision of Subsided Pyrocarbon Implants
		49.1 Patient History Leading to
		49.2 Anatomic Description of the Patient’s Current Status
		49.3 Recommended Solution to the Problem
		49.4 Technique
		49.5 Postoperative Photographs and Critical Evaluation of Results
		49.6 Teaching Points
		Bibliography
Part XVII Problems with Interphalangeal Osteoarthritis
	50 Failed Silicone Proximal Interphalangeal Joint Arthroplasty
		50.1 Patient History Leading to
		50.2 Anatomic Description of the Patient’s Current Status
		50.3 Recommended Solution to
		50.4 Technique
		50.5 Postoperative Photographs and Critical Evaluation of Results
		50.6 Teaching Points
	52 Contracture in Interphalangeal Osteoarthritis
		52.1 Patient History Leading to
		Patient’s Current Status
		52.4 Technique
		52.5 Postoperative Photographs
		52.6 Teaching Points
	53 Proximal Interphalangeal Posttraumatic Osteoarthritis
		53.1 Patient History Leading to
		53.2 Anatomic Description of the Patient’s Current Status
		53.3 Recommended Solution to
		53.4 Technique
		53.5 Postoperative Photographs and Critical Evaluation of Results
		53.6 Teaching Points
		Acknowledgments
Part XVIII Problems with Infection in the Thumbs, Fingers, and Wrist
	54 Inadequate Drainage of Infection in the Thumbs, Fingers, and Wrist
		54.1 Patient History Leading to
		54.2 Anatomic Description of the Patient’s Current Status
		54.4 Technique
		54.5 Postoperative Photographs
		54.6 Teaching Points
	55 Salvage of Osteomyelitis of the Distal Radius after Internal Fixation of an Open Fracture
		55.1 Patient History Leading to
		55.2 Anatomic Description of the Patient’s Current Status
		55.3 Recommended Solution to
		55.4 Technique
		55.5 Postoperative Photographs and Critical Evaluation of Results
		55.6 Teaching Points
	56 Infectious Destruction of the Wrist
		56.1 Patient History Leading to
		Patient’s Current Status
		56.4 Technique
		56.5 Postoperative Photographs
		56.6 Teaching Points
Part XIX Problems with Replantation
	58 Failed Replant: Ray Amputation
		58.1 Patient History Leading to
		58.2 Anatomic Description of the Patient’s Current Status
		58.3 Recommended Solution to
		58.4 Technique
		58.5 Postoperative Photographs and Critical Evaluation of Results
		58.6 Teaching Points
	59 Failed Digit Replant: Toe-to-Hand Transfer
		59.1 Patient History Leading to
		Patient’s Current Status
		59.4 Technique
		59.5 Postoperative Photographs and Critical Evaluation of Results
		59.6 Teaching Points
	60 Failed Thumb Replant: Great Toe-to-Thumb Transfer
		60.1 Patient History Leading to
		60.2 Anatomic Description of the Patient’s Current Status
		60.3 Recommended Solution to the Problem
		60.4 Technique
		60.5 Postoperative Photographs and Critical Evaluation of Results
		60.6 Teaching Points
		Bibliography
	61 Failed Replant: Failed Degloving Revascularization
		61.1 Patient History Leading to
		61.3 Technique
		61.4 Postoperative Photographs and Critical Evaluation of Results
		61.5 Teaching Points
	62 Attempted Replantation
		62.1 Patient History Leading to
		62.2 Anatomic Description of the Patient’s Current Status
		62.3 Recommended Solution to
		62.4 Technique
		62.5 Postoperative Photographs and Critical Evaluation of Results
		62.6 Teaching Points
	63 Nonunion following Digital Replant
		63.1 Patient History Leading to
		Patient’s Current Status
		63.5 Technique
		63.6 Postoperative Photographs and Critical Evaluation of Results
		63.7 Teaching Points
	64 Nonunion following Major Replant
		64.1 Patient History Leading to
		Patient’s Current Status
		64.4 Technique
		64.5 Postoperative Photographs and Critical Evaluation of Results
		64.6 Teaching Points
	65 Painful Finger after Bony Nonunion
		65.1 Patient History Leading to
		Patient’s Current Status
		65.4 Technique
		65.5 Postoperative Photographs and Critical Evaluation of Results
		65.6 Teaching Points
	66 Stiff Fingers and Elbow after Replantation
		66.1 Patient History Leading to the Specific Problem
		66.2 Anatomical Description of the Patient’s Current Status
		66.3 Recommended Solution to the Problem
		66.4 Technique
		66.5 Postoperative Photographs and Critical Evaluation of Results
		66.6 Teaching Points
		Bibliography
	67 Poor Grip or Weak Motion after Replantation
		67.1 Patient History Leading to
		Patient’s Current Status
		67.4 Technique
		67.5 Postoperative Photographs and Critical Evaluation of Results
		67.6 Teaching Points
Part XX Problems with Complex Regional Pain Syndromes
	68 Complex Regional Pain Syndrome
		68.1 Patient History Leading to
		68.2 Anatomic Description of the Patients Current Status
		68.3 Recommended Solution to the Problem
		68.4 Teaching Points
		Bibliography
Part XXI Problems with Scaphoid Fractures
	69 Nonunion of the Proximal Pole
		69.1 Introduction
		69.2 Patient History Leading to
		69.3 Anatomic Description of the Patient’s Current Status
		69.4 Recommended Solution to
		69.5 Technique
		69.6 Postoperative Photographs and Critical Evaluation of Results
		69.7 Teaching Points
	70 Scaphoid Nonunion with Avascular Necrosis
		70.1 Patient History Leading to
		Patient’s Current Status
		70.4 Technique
		70.5 Postoperative Photographs
		70.6 Teaching Points
	71 Scaphoid Revision Nonunion
		71.1 Patient History Leading to
		Patient’s Current Status
		71.4 Technique
		71.5 Postoperative Photographs
		71.6 Teaching Points
	72 Scaphoid Nonunion
		72.1 Patient History Leading to
		Patient’s Current Status
		72.4 Technique
		72.5 Postoperative Photographs
		72.6 Teaching Points
	73 Scaphoid Implant Malplacement
		73.1 Patient History Leading to
		73.2 Anatomic Description of the Patient’s Current Status
		73.3 Recommended Solution to
		73.4 Technique
		73.5 Postoperative Photographs and Critical Evaluation of Results
		73.6 Teaching Points
Part XXII Problems with Scapholunate Instability
	74 Failed Scapholunate Ligament Repair: Acute
		74.1 Patient History Leading to
		74.2 Anatomic Description of the Patient’s Current Status
		74.3 Recommended Solution to
		74.4 Technique
		74.5 Postoperative Photographs and Critical Evaluation of Results
		74.6 Teaching Points
	75 Failed Reconstruction with Tenodesis: Chronic
		75.1 Patient History Leading to
		Patient’s Current Status
		75.4 Technique
		75.5 Postoperative Photographs
		75.6 Teaching Points
Part XXIII Problems with the Lunotriquetral Joint
	76 Problems with the Lunotriquetral Joint after Ligament Repair
		76.1 Patient History Leading to
		76.2 Anatomic Description of the Patient’s Current Status
		76.3 Recommended Solution to the Problem
		76.4 Technique
		76.5 Postoperative Photographs and Critical Evaluation of Results
		76.6 Teaching Points
		Bibliography
	77 Problems with Lunotriquetral Fusion
		77.1 Patient History Leading to
		77.2 Anatomic Description of the Patient’s Current Status
		77.3 Recommended Solution to the Problem
		77.4 Technique
		77.5 Postoperative Photographs and Critical Evaluation of Results
		77.6 Teaching Points
		Bibliography
Part XXIV Problems after Partial Wrist Fusions
	78 Complications of Partial Wrist Fusion
		78.1 Patient History Leading to
		78.2 Anatomic Description of the Patient’s Current Status
		78.3 Recommended Solution to
		78.4 Technique
		78.5 Postoperative Photographs and Critical Evaluation of Results
		78.6 Teaching Points
	79 Dislocated Lunar Facet Fragments and Radioscapholunate Arthrodesis
		79.1 Patient History Leading to
		79.2 Anatomic Description of the Patient’s Current Status
		79.3 Recommended Solution to
		79.4 Technique
		79.5 Postoperative Photographs and Critical Evaluation of Results
		79.6 Teaching Points
Part XXV Total Wrist Arthroplasty
	80 Implant Migration after Total Wrist Arthroplasty
		80.1 Patient History Leading to
		80.2 Anatomic Description of the Patient’s Current Status
		80.3 Recommended Solution to
		80.4 Technique
		80.5 Postoperative Photographs and Critical Evaluation of Results
		80.6 Teaching Points
Part XXVI Problems with Triangular Fibrocartilage Complex Tears
	81 Pain after Triangular Fibrocartilage Complex Tears
		81.1 Patient History Leading to
		81.2 Anatomic Description of the Patient’s Current Status
		81.3 Recommended Solution to the Problem
		81.4 Technique
		81.5 Postoperative Photographs and Critical Evaluation of Results
		81.6 Teaching Points
		Bibliography
	82 Persistent Instability after Triangular Fibrocartilage Complex Tears
		82.1 Patient History Leading to
		82.2 Anatomic Description of the Patient’s Current Status
		82.3 Recommended Solution to the Problem
		82.4 Technique
		82.5 Postoperative Photographs and Critical Evaluation of Results
		82.6 Teaching Points
		Bibliography
Part XXVII Problems with Ulnar Impaction
	83 Arthroscopic Treatment of Ulnar Impaction
		83.1 Patient History Leading to
		83.2 Anatomic Description of the Patient’s Current Status
		83.3 Recommended Solution to
		83.4 Technique
		83.5 Postoperative Photographs and Critical Evaluation of Results
		83.6 Teaching Points
	84 Nonunion after Ulnar Shortening
		84.1 Patient History Leading to
		Patent’s Current Status
		84.4 Technique
		84.5 Postoperative Photographs and Critical Evaluation of Results
		84.6 Teaching Points
Part XXVIII Problems with Distal Radial Ulnar Joint
	85 Failed Bowers’ Arthroplasty: Ulnar Head Prosthesis
		85.1 Patient History Leading to
		Patient’s Current Status
		85.4 Technique
		85.5 Postoperative Photographs
		85.6 Teaching Points
	86 Dislocated Ulnar Head Prosthesis
		86.1 Patient History Leading to
		Patient’s Current Status
		86.4 Technique
		86.5 Postoperative Photographs
		86.6 Teaching Points
Part XXIX Problems with Distal Radius Fractures
	87 Distal Radius Fracture Malunion
		87.1 Patient History Leading to
		Patient’s Current Status
		87.4 Technique
		87.5 Postoperative Photographs
		87.6 Teaching Points
	88 Distal Radius Fracture Nonunion
		88.1 Patient History Leading to
		Patient’s Current Status
		88.4 Technique
		88.5 Postoperative Photographs
		88.6 Teaching Points
	89 Troublesome Lunate Facet
		89.1 Introduction
		89.2 Patient History Leading to
		89.3 Anatomic Description of the Patient’s Current Status
		89.4 Recommended Solution to the Problem
		89.5 Technique
		89.6 Teaching Points
		Bibliography
	90 Troublesome Lunate Facet: Treatment with Microvascular Techniques
		90.1 Patient History Leading to
		90.2 Anatomic Description of the Patient’s Current Status
		90.3 Recommended Solution to the Problem
		90.4 Technique
		90.5 Postoperative Photographs and Critical Evaluation of Results
		90.6 Teaching Points
		Bibliography
Index