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Atasoy E.,Care at Hand
Journal of Hand Surgery | Year: 2016

The reverse cross finger flap is usually performed on patients with deep dorsal digital skin, nailbed, and extensor tendon injuries that cannot be repaired and grafted. These patients will require additional dorsal digital flaps from the adjacent fingers. © 2016 American Society for Surgery of the Hand. All rights reserved.

Tomaino M.M.,Care at Hand
Journal of Hand Surgery | Year: 2011

Thumb metacarpal extension osteotomy provides effective treatment for the hypermobile trapeziometacarpal joint consistent with Eaton stage 1 disease. This procedure is a useful alternative to Eaton ligament reconstruction. Clinical outcomes are favorable and, should symptoms persist, the procedure does not jeopardize satisfactory execution of trapezial resection arthroplasty in the future. © 2011 American Society for Surgery of the Hand.

Ozyurekoglu T.,Care at Hand
Journal of Hand Surgery | Year: 2010

A 17-year-old boy who played baseball presented with swelling, pain, and crepitation in the right ring finger proximal interphalangeal joint after a remote trauma. Multiple osteochondral defects were identified on opposing articular surfaces. Cylindrical osteochondral grafts of 2.0, 2.5, and 5.0 mm were applied to the defects and congruency was restored. We confirmed vascularity of the grafts by magnetic resonance. The boy returned to full sports activities. No signs of arthritis were seen at 4-year follow-up radiographs. © 2010.

Atasoy E.,Care at Hand
Handchirurgie Mikrochirurgie Plastische Chirurgie | Year: 2013

Although hand surgeons may often see patients with arm and hand pain, numbness and tingling in their practice, the possibility of the presence of thoracic outlet compression syndrome (TOCS) is not often considered. In our practice almost half of newly referred patients have the complaint of upper extremity pain, numbness and tingling. In approximately 50% of these patients detailed history and physical examination are suggestive of TOCS. For this reason it is quite important to recognize the possibility of the existence of this condition. Very often in the past, and occasionally today, this condition has been considered a controversial subject by numerous physicians because of the absence of objective findings in many patients. For several years it has been very well known that the objective findings are present in about 10% of patients and the remaining 90% of patients have subjective complaints. For this reason it has been one of the most commonly underrated, overlooked, and misdiagnosed conditions. During the last 22 years our experience with combined surgical approach for this condition (transaxillary first rib resection with immediate transcervical anterior and middle scalenectomy) has been quite satisfactory. During these years over 850 of these procedures were performed. Between 1989 and 2002 (13 years) 532 patients from a wide geographic area had this combined approach procedure. We were able to locate 358 of these patients for follow-up and of those only 102 responded to our questionnaire. Of the 102 who responded, 95 reported improvement of their symptoms. From 2003 to the middle of 2012, 350 patients from a wide region had this combined procedure. We sent a questionnaire to these patients and had only 57 to respond. Of those who responded, there were 19 bilateral interventions performed a few months apart, with a total of 76 procedures performed. Results based on these 76 procedures revealed 95% improvement of their symptoms. This combined approach for TOCS is the most complete intervention with high rate of improvement and low rate of recurrences.

Atasoy E.,Care at Hand
Journal of Hand Surgery | Year: 2010

Because hand surgeons frequently see patients with arm and hand pain, numbness, and tingling, it is important for them to recognize the possibility of the presence of thoracic outlet compression syndrome (TOCS). Approximately 40% to 50% of patients with this condition have associated peripheral nerve compression symptoms. Only about 10% of patients with suspected TOCS might show some objective evidence during physical examination and other examination modalities. For this reason, TOCS is one of the most overlooked, misdiagnosed, and underrated conditions. During the past 20 years (19892009) our surgical experience with combined-approach surgery for TOCS, involving transaxillary first rib resection followed by immediate transcervical anterior and middle scalenectomy, has been gratifying. During this period, more than 750 patients had this combined procedure. Between the end of 1989 and 2002 (13 years), 532 patients (many of whom were from out of state) had this kind of intervention. At the end of 2002, we surveyed our patients for the outcome of their surgery. Unfortunately, we were able to locate only 358 patients, and only 102 patients returned a mailed questionnaire. About 95 patients reported improvement of their symptoms. Since the beginning of 2003, more than 230 patients have had the same procedure. It is our impression that the outcome of the surgery in this last group of patients is at least as good as (if not better than) the earlier reported outcome in the first group of patients. The combined surgical approach to TOCS with transaxillary first rib resection and transcervical scalenectomy is the most complete procedure for total decompression of the thoracic outlet, with a much better rate of improvement of symptoms and a lower rate of recurrences. The surgical techniques of these two procedures are described. © 2010 Published by Elsevier Inc. on behalf of the American Society for Surgery of the Hand.

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