Dupuytren Disease from Past to Present: A Review of the Historical and Evolving Landscape of Its Management.

Dupuytren disease (DD) has been described since the 17th century, but its true aetiology remains a mystery. The treatment of DD largely involves addressing the end stage of a complex fibroproliferative pathway, specifically, the cords. In recent years, there has been a shift to less radical approaches, with an increased adoption of percutaneous needle aponeurotomy (PNA) or collagenase.

Health Policy Implications of Digital Replantation.

There have been dwindling numbers of replantations in the United States. Despite the advocacy for centralization in hand trauma, the fundamental landscape and attitudes of surgeons toward replantation have remained lackluster. There is growing and substantial evidence to demonstrate the superior outcomes of replantation in comparison to revision amputation in most scenarios.

Middle-phalanx-base radiographic morphology and its clinical implications.

The aim of this study was to establish normative values for the teardrop angle at the base of the middle phalanx. Our results showed a consistent mean teardrop angle in the range of 50°-51°, with no statistically significant difference observed between digits. III.

Survival outcomes of malignant peripheral nerve sheath tumors (MPNSTs) with and without neurofibromatosis type I (NF1): a meta-analysis.

Introduction: Malignant peripheral nerve sheath tumors (MPNSTs) are malignancies that demonstrate nerve sheath differentiation in the peripheral nervous system. They can occur sporadically or be associated with neurofibromatosis type 1 (NF1), an autosomal dominant neurocutaneous disorder, with up to 13% of patients developing MPNSTs in their lifetimes. Previous studies have suggested conflicting findings regarding the prognosis of NF1 for patients with MPNSTs.

Comparison of proximal and distal involvement of upper extremity metastatic lesions: an analysis of 55 cases.

We analysed the differences in clinical presentation between proximal (above elbow) and distal (below elbow) upper limb metastases in a retrospective review of patients presenting to our centre from 2011 to 2019. There were 55 cases, 64% involving the humerus and 62% occurring in men. The median age at the time of diagnosis was 64 years.

Surgical Technique: Lateral Plate Osteosynthesis of Proximal Phalanx Fractures.

Dorsal plate fixation of proximal phalanx (PP) fractures is a conventional approach but interferes with the extensor mechanism and results in stiffness. Biomechanical studies have shown that laterally placed plates on the proximal phalanges are equally stable and rigid. This technique obviates the issue of tendon adhesion and may result in better postoperative range of motion and lower secondary procedures such as removal of implant and tenolysis.

Palmar Dislocations of the 5 Carpometacarpal Joint: Case Report of a Rare Injury and Review of Published Cases.

Isolated palmar dislocation of the 5 carpometacarpal joint (CMCJ) is a rare injury that can be easily missed and requires a high index of suspicion to detect. We report a case of an initially missed isolated ulnopalmar dislocation of the 5 CMCJ and a summary of other published case reports comparing methods of fixation and outcomes. We conclude that a delay in diagnosis will significantly reduce the chances of successfully managing this injury via closed reduction.

Sarcoma of the Lower Limb: Reconstructive Surgeon's Perspective.

Management of sarcomas in the lower extremities have evolved from amputations to limb-preserving surgeries with evidence to support that they have equal overall survival, albeit with better functional outcome. The challenge of reconstruction lies in providing a durable, functional, and aesthetically pleasing limb. However, limb-preserving intention should not delay interventions that provide a survival benefit such as chemotherapy and radiotherapy.