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Hand Surgery Complications articles offer brief but focused information about one specific complication of hand surgery treatment, be it nonsurgical or surgical. Articles discuss how and why the complication has occurred, its adverse effects, treatment, and--most importantly--precise strategies about preventing the complication.
Brachial Plexopathy Following Wrist Arthroscopy
The patient is a healthy 56-year-old right-handed woman with gradual onset of right wrist pain for 1 year. She works as a registered nurse. On physical examination, she has pain over the scaphotrapeziotrapezoid joint, and no pain provoked with trapeziometacarpal grind test. Radiographs confirm the presence of scaphotrapeziotrapezoid osteoarthritis. After a trial of orthosis fabrication, nonsteroidal anti-inflammatory medication, and 2 corticosteroid injections that provided temporary partial relief, the patient underwent right wrist arthroscopic distal scaphoid excision, as previously described.Nonunion Following Trapeziometacarpal Arthrodesis With Plate and Screw Fixation
A healthy 50-year-old right-handed man presented with a history of a work-related injury after which he developed posttraumatic trapeziometacarpal (TMC) arthritis affecting bilateral thumbs. Physical examination demonstrated tenderness to palpation at the base of both thumbs, positive grind test, and mild crepitus with axial rotation at the TMC joints. He also had weak key pinch. He failed to improve with initial conservative management. Because of his age and the demands of his job as a laborer, he underwent left thumb TMC arthrodesis with a Synthes modular hand 2.0-mm T-plate (Synthes/USA, Paoli, PA) and screws, with autogenous bone graft.Missed Pathologic Fracture From Multiple Myeloma
A 68-year-old right-hand-dominant man presented 6 weeks after having a fall, tripping briefly before catching himself. He initially presented with pain, in the proximal left fifth metacarpal and middle finger, mild edema and ecchymosis extending to the distal phalanx of the middle finger, and along the hypo-thenar eminence. There was no complaint of sensory loss and he described no other injuries resulting from this event. On physical examination he had restricted active and passive range of motion of the left wrist, and middle finger secondary to pain and edema.Posterior Interosseous Nerve Laceration Following Elbow Arthroscopy
A 17-year-old left-handed girl was referred to our institution with an inability to extend the fingers and thumb and weakness of wrist extension. This problem developed immediately after an elbow arthroscopy for loose body removal done 4 months earlier at an outside facility. She was otherwise healthy. Examination of the left upper extremity revealed 5/5 strength of the brachioradialis and the extensor carpi radialis longus muscles. The following muscles had 0/5 strength: extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum communis, extensor pollicis longus, extensor indicis proprius, abductor pollicis longus, extensor digiti minimi, and extensor pollicis brevis.Volar Carpal Subluxation Following Lunate Facet Fracture
A 27-year-old right-handed man presented with pain and limited motion in the left wrist and forearm after surgical treatment for an intra-articular volar marginal distal radius fracture with a lunate facet fragment and volar carpal subluxation (Fig. 1). He was treated at an outside hospital with volar plate fixation and pinning of the distal radioulnar joint (Fig. 2). The pin was removed 4 weeks after surgery and he was started on rehabilitative exercises.Failure of Open Reduction Internal Fixation of Acute Scaphoid Fractures
A 35-year-old right-handed woman, nonsmoker, presented to an outside hospital with a minimally displaced scaphoid waist fracture after falling on an outstretched right hand. She underwent percutaneous screw fixation but serial radiographs failed to demonstrate fracture healing and she was referred to our clinic 1 year after the initial operation.Radial Head Dislocation During Proximal Radial Shaft Osteotomy
The following case report describes a 48-year-old female patient with a longstanding both-bone forearm malunion, who underwent osteotomies of both the radius and ulna to improve symptoms of pain and lack of rotation at the wrist. The osteotomies were templated preoperatively. During surgery, after performing the planned radial shaft osteotomy, the authors recognized that the radial head was subluxated. The osteotomy was then revised from an opening wedge to a closing wedge with improvement of alignment and rotation.
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