Tag Archives: Rothman Institute

PUBLISHED: De Quervain’s Release (Cadaver)

 

De Quervain’s Release (Cadaver)

Asif M. Ilyas, MD, FACS
Rothman Institute at Thomas Jefferson University

Irene Kalbianr
Rothman Institute at Thomas Jefferson University

De Quervain’s release is a surgical procedure performed to curatively treat stenosing extensor tenosynovitis of the first extensor compartment of the wrist after nonoperative management fails. This procedure involves surgical release of the first dorsal compartment with care taken to fully release the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons from their respective sheaths, while protecting the radial sensory nerve, in order to decompress the extensor tendons. This video outlines the operative technique used by Dr. Asif Ilyas at the Rothman Institute for performing a De Quervain’s release on a cadaveric wrist.

 

PUBLISHED: Flexor Tendon Repair for a Zone 2 FDP Tendon Laceration

 

Flexor Tendon Repair for a Zone 2 FDP Tendon Laceration

Asif M. Ilyas, MD, FACS
Rothman Institute at Thomas Jefferson University

Chaim Miller
Sidney Kimmel Medical College at Thomas Jefferson University

In this case, Dr. Asif Ilyas at the Rothman Institute presents a zone 2 flexor tendon repair with a 4-0 Ethibond suture with a modified Kessler stitch that resulted in an 8-core strand repair. The procedure was done under wide awake local anesthesia no tourniquet (WALANT) protocol, which among other strengths allows the surgeon to test the repair and set postrehabilitation expectations for the patient.

 

PUBLISHED: Scaphoid Open Reduction and Internal Fixation Through Dorsal Approach

Scaphoid Open Reduction and Internal Fixation Through Dorsal Approach

M. Grant Liska, BS
University of Central Florida College of Medicine

Asif M. Ilyas, MD, MBA, FACS
Rothman Institute at Thomas Jefferson University

Dr. Asif Ilyas at the Rothman Institute presents the case of a proximal pole scaphoid fracture repaired with ORIF via a dorsal approach. After dissection through the joint capsule and exposure of the base of the scaphoid, a headless compression screw is placed anterograde in line with the thumb in all planes. This procedure provides increased stability and improved rate of the union in correlation with the accuracy of intraoperative reduction, leading to improved outcomes for surgical candidates over more conservative approaches.

PUBlished: Trigger Finger Release (Cadaver)

Trigger Finger Release (Cadaver)
Rothman Institute

Asif Ilyas, MD, FACS
Orthopaedic Surgeon

Vivian Xu

Stenosing flexor tenosynovitis of the digital flexor tendon sheath, also known as trigger finger, occurs when there is a size mismatch between the flexor tendon and the surrounding retinacular pulley system at the first annular (A1) pulley. When the flexor tendon thickens or becomes inflamed, its ability to properly glide through the flexor tendon sheath becomes impaired. Thus, the tendon catches as the finger is flexed and extended. Conservative management includes activity modification, splinting, short-term NSAIDs, corticosteroid injection, and other adjuvant therapies. In this video, Dr. Asif Ilyas at the Rothman Institute demonstrates a surgical approach to the treatment of trigger finger via the open A1 pulley release procedure on a cadaver.

PUBLISHED: Subcutaneous Ulnar Nerve Transposition

Subcutaneous Ulnar Nerve Transposition
Rothman Institute at Thomas Jefferson University

Jasmine Phun
Sidney Kimmel Medical College

Asif M. Ilyas, MD, MBA, FACS
Rothman Institute at Thomas Jefferson University

In this case, Dr. Ilyas at the Rothman Institute performs a subcutaneous anterior transposition on a patient with cubital tunnel syndrome. The patient’s ulnar nerve subluxed upon elbow flexion and extension upon physical examination, which was a primary indication for choosing this surgical approach over other techniques.

This procedure not only decompresses the affected nerve but also transposes the nerve anterior to the medial epicondyle so as to relieve strain on the nerve upon the full range of motion of the elbow.

PREPRINT RELEASE: Ulnar Nerve Transposition

Ulnar Nerve Transposition
Rothman Institute, Thomas Jefferson University
Asif Ilyas, MD, FACS
Professor of Orthopedic Surgery
Program Director of Hand Surgery

In this cadaveric case, Dr. Asif Ilyas demonstrates the ulnar nerve transposition method for treating cubital tunnel syndrome, showing both the subcutaneous and submuscular techniques.

PREPRINT RELEASE: Cubital Tunnel Release

Cubital Tunnel Release
Rothman Institute, Thomas Jefferson University
Asif Ilyas, MD, FACS
Professor of Orthopedic Surgery
Program Director of Hand Surgery

Cubital tunnel syndrome, the second most common compressive neuropathy, causes tingling and numbness in the ring and small fingers and can be treated with either a cubital tunnel release or an ulnar transposition. In this case, Dr. Asif Ilyas demonstrates the former on a cadaveric hand.

PREPRINT RELEASE: De Quervain’s Release

De Quervain’s Release
Rothman Institute, Thomas Jefferson University
Asif Ilyas, MD, FACS
Professor of Orthopedic Surgery
Program Director of Hand Surgery

Instead of conducting a De Quervain's release on a patient with stenosing extensor tenosynovitis, Dr. Asif Ilyas walks through the procedure on a cadaver, demonstrating the approach to the first dorsal extensor retinaculum and providing tips to release it without injuring the radial sensory nerve.

PREPRINT RELEASE: Trigger Finger Release

Trigger Finger Release
Rothman Institute, Thomas Jefferson University
Asif Ilyas, MD, FACS
Professor of Orthopedic Surgery
Program Director of Hand Surgery

When the flexor tendons of the hand thicken or become inflamed, stenosing flexor tenosynovitis of the hand (also known as trigger finger) develops. Dr. Asif Ilyas demonstrates on a cadaver how to perform the most standard trigger finger release, releasing the A1 pulley and then decompressing or releasing the flexor tendon.

PREPRINT RELEASE: Carpal Tunnel Release

Carpal Tunnel Release
Rothman Institute, Thomas Jefferson University
Asif Ilyas, MD, FACS
Professor of Orthopedic Surgery
Program Director of Hand Surgery

Dr. Asif Ilyas performs a carpal tunnel release, the most common hand surgery, on a cadaveric hand. This surgery is typically done for paresthesia in the hand due to median nerve compression when non-operative treatment, such as splinting and injections, fails or becomes recalcitrant.