Triceps tendon ruptures are rare injuries. Coexistence of ipsilateral ulnar collateral ligament injury is even rarer. Here, we describe an unusual combination injury to elbow of a 39-year-old male construction worker consisting of triceps tendon rupture, avulsion of elbow ulnar collateral ligament and flexor pronator muscle origin ipsilaterally. A simultaneous repair and reconstruction of all damaged structures was proposed with individualized postoperative rehabilitation. Return to pre-injury level of activities obtained with this treatment protocol. High degree of suspicion and careful examination were needed to prevent missed diagnosis and prolonged instability which may be inevitable after inappropriate treatment of such injury.
Background/Objectives: After the earthquakes in Turkey, many citizens were injured, and a long ongoing process requiring physiological and psychological treatments began. The aim of this study was to observe the pain and psychological changes in earthquake victims in light of the QoR-15 score. Methods: After approval by the local ethics committee (Decision No. 2023-194), earthquake victims with catheters in trauma and reconstructive surgery were retrospectively evaluated. Demographic and catheterization data were collected. Baseline, 24 h, 72 h QoR-15 (Quality of Recovery-15), and VAS (Visual Analog Scala) scores were compared for changes over time. Results: A total of 40 catheters were placed in 29 patients (after the exclusion of children, 36 catheters were evaluated in 26 (15 w/11 m) patients). The mean age of the patients was 35.57 ± 13.69 years, and the duration of catheterization was 8 (4.25–12.75) days. An infusion of 0.1% bupivacaine 0.5–1 mg/kg/24 h was started routinely. The QoR-15 scores of the patients at baseline, 24 h, and 72 h were 80.45 ± 17.76, 95.27 ± 15.16, and 101.06 ± 15.52, respectively (p < 0.001). The VAS scores of the patients at baseline, 24 h, and 72 h were 4.61 ± 1.41, 1.79 ± 1.36, and 0.76 ± 0.86, respectively (p < 0.001). Conclusions: In this study, a significant improvement in QoR-15 and VAS scores was achieved as a result of catheter insertion in earthquake victims. Considering that post-traumatic injuries require repeated surgeries and that pain aggravates the existing psychological state, it can be said that catheterization is beneficial.
Background and Objectives: The objective of this study is to examine the correlation between the active range of motion (ROM) of the affected upper extremity and functional capacity in children with Obstetric Brachial Plexus Palsy (OBPP) who have undergone the modified Hoffer tendon transfer technique. Materials and Methods: The study cohort comprised 52 children with OBPP, aged 4–14 years, who had undergone a shoulder tendon transfer. The ROM was quantified using a goniometer, while functionality was evaluated through the administration of the Brachial Plexus Outcome Measure (BPOM). Results: The study identified significant correlations between the shoulder ROM and the Brachial Plexus Outcome Measure (BPOM). Specifically, shoulder flexion (p = 0.017; r = 0.351) was positively associated with shoulder functionality, while shoulder internal rotation (p = 0.001; r = 0.481) was linked to appearance scores. A significant negative relationship was observed between elbow extension (p < 0.001; r = −0.512) and elbow and forearm activities. Conclusions: The study highlights the necessity of assessing both joint range of motion and body perception for effective treatment and follow-up, to improve the functionality and quality of life for children with OBPP.
Objectives: We aimed to compare clinical and functional results of treatment of scaphoid pseudoarthrosis between patients undergoing wide-awake local anesthesia no tourniquet (WALANT) versus axillary block anesthesia. Methods: The patients diagnosed with scaphoid non-union who underwent pseudoarthoris surgery were divided into WALANT group ( n = 12) and axial block group ( n = 11). Visual analog scores (VAS) were measured by calling the patients via phone on postoperative days 1, 2, 3, and 7. The VASs were also measured on the 14th day during patient check-ups. At the end of 12 months, Michigan Hand Questionnaire was used to assess clinical recovery. Bone union rate and surgery time were also investigated. Radiological and clinical examinations were compared between the groups. Results: Eleven patients (91.7%) in the WALANT group and 10 patients (90.9%) in the axillary block group achieved bone union ( P = .94). Although there was no significant difference in preoperative VAS score between the groups, the WALANT group had significantly lower VAS score of the first 3 days postoperatively. However, there was no significant difference in VAS score between the groups on the seventh and 14th day postoperatively. There was no significant difference between the groups regarding Michigan score, time to surgery, time to union and operation time. Conclusion: The scaphoid pseudoarthrosis surgery can be done safely with WALANT technique which has significant lower VAS score on the first 3 days postoperatively.
26 April 2026 in Journal of Hand Surgery (European Volume)
Introduction: This study retrospectively assessed the long-term outcomes of surgical treatment for House type 1 thumb-in-palm deformities in 25 patients with spastic hemiplegic cerebral palsy. Methods: The study included 25 patients (mean age: 12.8 years) who met the inclusion criteria. The surgical technique involved the release of spastic thumb adductors, enhancement of thumb abduction and extension and stabilization of the first metacarpophalangeal joint. Patients wore a below-elbow palmar splint with the first phalanx in abduction for 6 weeks, followed by static splinting between weeks 6 and 8, dynamic splinting and rehabilitation between weeks 8 and 16 and night splinting until month 6. The Manual Ability Classification System (MACS) scores and fine and gross grasping abilities were measured and compared with those on the contralateral side. Results: The mean follow-up period was 8.8 years. The MACS score decreased from 2.72 preoperatively to 1.56 in the long term. Marked improvements in grasping ability were observed: key-pinch improved by 19%, tip-to-pinch by 19.2%, triple-pinch by 19.5% and gross grasping by 37%. Conclusion: This study suggests that surgical treatment can improve long-term functional outcomes of thumb-in-palm deformities in patients with cerebral palsy. Level of evidence: III, Therapeutic.
Background/Objectives: After the earthquakes in Turkey, many citizens were injured, and a long process requiring physiological and psychological treatments started in the ongoing process. The aim of this study was to observe the pain and psychological changes in earthquake victims in light of the QoR-15 score. Methods: After approval by the local ethics committee (Decision No. 2023-194), earthquake victims with catheters in trauma and reconstructive surgery were retrospectively evaluated. Demographic and catheterization data were collected. Baseline, 24-hour, and 72-hour QoR-15 (Quality of Recovery-15) and VAS (Visual Analog Scala) scores were compared for changes over time. Results: A total of 40 catheters were placed in 29 patients (after the exclusion of children, 36 catheters were evaluated in 26 (15 w/11 m) patients). The mean age of the patients was 35.57 ± 13.69 years, and the duration of catheterization was 8 (4.25–12.75) days. Infusion of 0.1% bupivacaine 0.5–1 mg/kg/24 h was started routinely. The QoR-15 scores of the patients at baseline, 24-hour, and 72-hour were 80.45 ± 17.76, 95.27 ± 15.16, and 101.06 ± 15.52, respectively (p<0.001). The VAS scores of the patients at baseline, 24-hour, and 72-hour were 4.61 ± 1.41, 1.79 ± 1.36, and 0.76 ± 0.86, respectively (p<0.001). Conclusions: In this study, a significant improvement in QoR-15 and VAS scores was achieved as a result of catheter insertion in earthquake victims. Considering that post-traumatic injuries require repeated surgeries and that pain aggravates the existing psychological state, it can be said that catheterization is beneficial.