Carpal Tunnel Repair and Fasciectomy for Carpal Tunnel Syndrome and Dupuytren’s Disease
Sudhir B. Rao, MD
Munson Healthcare Cadillac Hospital
Carpal Tunnel Syndrome (CTS) and Dupuytren’s disease (DD) are two common hand conditions that can significantly impact a patient’s quality of life and hand function. In cases where both conditions coexist, as demonstrated in this video, a combined surgical approach is adopted in suitable candidates. Combining carpal tunnel release and fasciectomy in a single surgical setting is safe, cost-effective, and efficient, reducing recovery time and healthcare costs while achieving functional outcomes comparable to staged interventions. This video demonstration is particularly valuable for practicing hand surgeons and surgical trainees, offering detailed insights into technical challenges such as neurovascular bundle protection, management of retrovascular cord components, and the precise balance between complete disease excision and preservation of vital structures. The demonstrated solutions, including the use of vessel loops for nerve protection, staged fascia removal, and careful hemostasis management, provide practical guidance for similar cases.
Excision of a Ganglion Cyst from Distal Middle Finger Near Nail Bed
Arya Rao1; Sudhir B. Rao, MD2
1Harvard/MIT MD-PhD Program
2Munson Healthcare Cadillac Hospital
Ganglion cysts (GCs) are common benign soft tissue tumors that when presenting near the nail bed of digits, are specifically termed digital mucous cysts (DMCs). The surgical excision of GCs near the nail bed requires precise technique and a thorough understanding of the anatomical relationships to prevent recurrence and minimize complications. This case report describes the surgical management of a GC located on the distal phalanx of the middle finger near the nail bed. The procedure demonstrates several key principles that are essential for successful outcomes, including the necessity of complete cyst excision to prevent recurrence, the importance of careful dissection near the germinal matrix to prevent permanent nail deformity, the value of a bloodless surgical field in maintaining precise visualization, and the significance of proper wound closure technique in ensuring optimal aesthetic and functional outcomes.
Contracture Release and Full-Thickness Skin Graft to Volar Index Finger with K-Wire Insertion
Ryan P. Boyle1; Jonah Poster2; Jonathan Friedstat, MD3
1Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine
2Icahn School of Medicine at Mount Sinai
3Shriners Hospitals for Children – Boston
The complications stemming from a poorly-healed burn wound can lead to functional deficits and overall aesthetically unfavorable results leading to psychological distress. Due to the inquisitive nature of infants and toddlers, and their nature to learn the world with their hands, their sensitive regions like the hands become likely targets for burns.
Superficial burns can be managed on an outpatient basis with spontaneous healing expected in 2 or 3 days with minimal scarring. Deep burns, particularly in pediatric populations, need considerable attention to avoid secondary contracture that leads to deformity.
Many treatment options exist, but in sensitive areas like the hands and face, full-thickness skin grafts are favored due to their superior healing and decreased likelihood of secondary contracture. This article aims to guide the surgeon in managing a pediatric burn wound with an arsenal of treatment options with the goal of achieving full mobility and functionality of the hand.
Arthrodesis of the Distal Interphalangeal (DIP) Joint of the Right Ring Finger for Arthritis
Lasya P. Rangavajjula, BS1; Amir R. Kachooei, MD, PhD2; Asif M. Ilyas, MD, MBA, FACS1,2
1Sidney Kimmel Medical College at Thomas Jefferson University
2Rothman Institute at Thomas Jefferson University
Osteoarthritis commonly impacts the finger distal interphalangeal (DIP) joints. The prevalence of DIP joint arthritis is high, with more than 60% of individuals older than 60 having DIP joint arthritis.
Operative treatment for arthritis of the DIP joint is indicated for pain, deformity, dysfunction, and instability in patients who are recalcitrant to conservative measures. Arthrodesis, or the fusion, of the DIP joint is a widely accepted surgical treatment for DIP joint arthritis.
Several surgical techniques have been historically described, with headless compression screw (HCS) fixation being a particularly common technique because of its advantages, including reliable compression, rigid fixation, lack of prominence, and no need for removal. This video demonstrates arthrodesis using HCS for arthritis in the right ring finger DIP joint.
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