Reanimation of palsied upper limbs usually follows an escalating pattern of nerve repair, nerve transfers, and musculotendinous transfers and culminates in free functioning muscle transfers. When there are no other musculotendinous options, we explored the possibility of transferring the rectus abdominus to the biceps by maintaining the nerve pedicle but dividing the vascular pedicle and anastomosing it to the brachial artery.
The COVID-19 pandemic created unprecedented challenges for the healthcare system. In order to meet capacity demands, hospitals around the world suspended surgeries deemed to be “elective.” In hand surgery, there are numerous pathologies treated on an elective basis, but a delay or absence of care may result in poorer outcomes. We present here an ethical framework for prioritizing elective surgery during a period of resource scarcity. Instead of using the term elective, we define procedures that can be safely delayed based on three considerations.
Thirty years ago, the first anatomic reconstruction of the palmar and dorsal radioulnar ligaments for chronic distal radioulnar joint (DRUJ) instability was proposed by Sanders. In this surgical technique, the midpoint of a free tendon autograft is firmly secured in a bony tunnel at the ulnar fovea. The 2 graft limbs anchored at the fovea traverse the DRUJ and are securely woven into the periarticular soft tissues radially, reproducing the ligamentous anatomy while not overconstraining the joint.
This study examined the effect of low-profile volar rim plates (VR), proximally placed standard variable-angle locking plates (pVA-LCP), and distally placed standard variable-angle locking plates (dVA-LCP) on the flexor pollicis longus (FPL) tendon in a cadaver model. We hypothesized that tendons from the VR and pVA-LCP groups would exhibit similar contact pressures, wear patterns, and post-fatigue testing mechanical properties, whereas dVA-LCP tendons would exhibit higher contact pressures, increased tendon wear patterns, and decreased mechanical properties.