Linked e-resources
Details
Table of Contents
Management of Complications in Common Hand and Wrist Procedures: FESSH Instructional Course Book 2021
Title Page
Copyright
Contents
Preface
Contributors
Section 1 Tendon Surgery
1 Management of Complications of Flexor Tendon Surgery
1.1 Management of Flexor Tendon Adhesions
1.1.1 Definition/Problem: Current Understanding of the Biology of Adhesion Formation
1.1.2 Treatment
1.1.3 Rehabilitation
1.1.4 Tips and Tricks
1.1.5 Conclusions
1.2 Bowstringing
1.2.1 Definition/Problem
1.2.2 Treatment
1.2.3 Rehabilitation
1.2.4 Tips and Tricks
1.2.5 Conclusion
1.3 Rupture
1.3.1 The Problem
1.3.2 Management of Patient with Rupture Presenting Early after Tendon Repair
1.3.3 Rehabilitation
1.3.4 Tips and Tricks
1.3.5 Conclusion
1.4 Infection after Flexor Tendon Repair
1.4.1 The Problem
1.4.2 Management
1.4.3 Rehabilitation
1.4.4 Tips and Tricks
1.5 Take-Home Message
2 Management of Complications of Extensor Tendon Surgery
2.1 Introduction
2.2 Complications after Extensor Tendon Lesion Zone 1 and Zone 2
2.3 Complications after Extensor Tendon Lesion Zone 3 and Zone 4
2.4 Complications after Extensor Tendon Lesion Zone 5 and Zone 6
2.4.1 Tethering of the Tendons: Tenolysis
2.4.2 Tethering of the Nerves
2.4.3 Punch Injury: Risk of Infection
2.4.4 Sagittal Band Lesion
2.5 Complications after Extensor Tendon Lesion Zone 7-Zone 9
2.5.1 Zone 7
2.5.2 Zone 9
2.6 Complication of the Thumb Extensor Tendons
2.7 Take-Home Message
3 Treatment of Complications after Surgical Management of Tenosynovitis
3.1 Introduction
3.2 Nerve Injury
3.2.1 A1 Pulley Release
3.2.2 First Extensor Compartment Release
3.3 Bowstringing and Subluxation
3.3.1 A1 Pulley Release
3.3.2 First Extensor Compartment Release
3.4 Infection.
3.5 Recurrence of the Triggering
3.5.1 A1 Pulley Release
3.5.2 First Extensor Compartment Release
3.6 Percutaneous Trigger FingerRelease
3.7 Discussion
3.8 Take-Home Message
Section 2 Nerve Surgery
4 Management of Complications in Sensory Nerve Surgery
4.1 No Recovery or Incomplete Sensory Recovery
4.1.1 Definition
4.1.2 Treatment
4.1.3 Rehabilitation
4.2 Neuropathy
4.3 Hyperalgesia/Hyperesthesia
4.4 Cold Intolerance
4.5 Painful Neuropathies
4.5.1 Definition
4.5.2 Diagnosis
4.5.3 Principles of Treatment
4.6 Rehabilitation-Sensory Desensitization
4.7 Take-Home Message
5 Management of Complications of Surgery of the Median, Ulnar, and Radial Nerves in the Forearm
5.1 Introduction
5.2 Optimizing the Nerve Repair
5.3 Normal Recovery
5.3.1 Timing of Normal Recovery
5.4 Problems with Recovery
5.4.1 Neuropathic Pain
5.4.2 Scar
5.4.3 Neuroma Formation
5.4.4 Surgical Management of Symptomatic Neuromas
5.5 Sensory Recovery
5.5.1 Sensory Nerve Transfer
5.6 Motor Recovery
5.6.1 Motor Nerve Transfer
5.6.2 Tendon Transfers for Paralysis Reconstruction
5.7 Distal Entrapment Following Proximal Repair
5.8 Follow-Up after Nerve Repair and Clinical Decision-Making
5.9 Management of Nerve Specific Problems
5.9.1 Median Nerve
5.9.2 Ulnar Nerve
5.9.3 Radial Nerve
5.9.4 Combined Nerve Injury
5.10 Failed Salvage Surgery
5.11 Take-Home Message
6 Management of Complications of Nerve Decompression Surgery
6.1 Part A: Complications of Carpal Tunnel Release
6.1.1 Introduction
6.1.2 Intraoperative Complications
6.1.3 Postoperative Complications
6.2 Part B: Complications and Failure of Cubital Tunnel Surgery
6.2.1 Introduction
6.2.2 Surgery for Ulnar Neuropathy: Different Procedures and Potential Complications.
6.2.3 Persistence or Recurrence of CuTS despite Previous Surgery
6.2.4 Prevention and Management of Complications
Tips and Tricks
6.2.5 Conclusions
Section 3 Bone Surgery: Fracture
7 Management of Finger Fracture Complications
7.1 Finger Stiffness
7.1.1 Evaluation of the Stiff Finger
7.1.2 Treatment of the Stiff Finger
7.2 Malunion
7.2.1 Treatment of Malunions
7.3 Nonunion
7.3.1 Treatment of Nonunions
7.4 Take-Home Message
8 Management of Complications in Carpal Fractures (Malunion, Nonunion)
8.1 Introduction
8.2 Uncommon Carpal Fractures
8.3 Scaphoid Fractures
8.3.1 (Patho-)Physiology of Fracture Healing in the Scaphoid
8.3.2 Complications in Fracture Healing
8.3.3 Surgical Interventions for Complication in the Healing Process
8.3.4 Types of Bone Grafts
8.3.5 Other Options for Proximal Pole Replacement
8.3.6 Treatment Algorithm for Scaphoid Nonunion
8.4 Osteosynthesis Devices
8.5 The Role of Arthroscopic Techniques
8.6 Take-Home Messages
9 Management of Complications of Scaphoid Fracture Fixation
9.1 Introduction
9.2 Hardware Complications
9.2.1 Tips and Tricks
9.3 Scaphoid Nonunion
9.3.1 Risk Factors
9.3.2 Treatment
9.3.3 Tips and Tricks
9.4 Recalcitrant Scaphoid Nonunion
9.4.1 Tips and Tricks
9.5 Scaphoid Malunion
9.5.1 Tips and Tricks
9.6 Miscellaneous Complications
9.6.1 Nerve/Tendon Lesions/Infection
9.7 Take-Home Message
10 Management of Complications in Lunate Facet Fracture Fixation
10.1 Definition and Problem
10.2 Anatomy of the Fracture
10.3 Treatment: Management of Volar Rim Fractures
10.3.1 Surgical Approach
10.3.2 Fixation Techniques
10.4 Arthroscopy
10.5 Lunate Facet Fractures: The Tip of the Iceberg
10.6 Rehabilitation
10.7 Salvage
10.8 Tips and Tricks
10.9 Take-Home Message.
11 Management of Complications Following Open Reduction and Plate Fixation of Distal Radius Fractures
11.1 Complications Related to the Surgical Approach
11.1.1 Neuromas due to the Volar Approach
11.1.2 Posterior Interosseous Nerve and Tendon Problems due to the Dorsal Approach
11.2 Complications Related to the Quality of Reduction
11.2.1 Posterior Anterior View
11.2.2 Lateral View
11.3 Complications due to Plate and Screw Position
11.3.1 Volar Plating
11.4 Complications due to Infections
11.5 Take-Home Message
12 Management of Distal Radius Malunion
12.1 Part A: Planning: From Educated Guess toward Computer-Assisted Correction Osteotomies
Pitfalls and Complications
12.1.1 Introduction
12.1.2 Diagnostics
12.1.3 Treatment
12.1.4 Navigation and Fixation
12.1.5 Take-Home Message
12.2 Part B: Practical Guideline: Malunion of Distal Radius
12.2.1 Timing: Early versus Late
12.2.2 How to Do It
12.2.3 How to Deal with the Gap?
12.2.4 Ulna Shortening Osteotomy
12.2.5 Outcome
12.2.6 Complications
12.2.7 Rehabilitation
12.2.8 Tips and Tricks
12.2.9 Take-Home Message
Section 4 Bone Surgery: Arthritis
13 Treatment of Complications after Surgery for Finger Joint Arthritis
13.1 Introduction
13.2 Complications in PIP and DIP Arthroplasty: Review of the Literature
13.3 Indication for Revision Surgery of Finger Arthroplasty
13.3.1 Implant Fracture or Loosening
13.3.2 Implant Malalignment
13.3.3 Other Causes of Revision
13.4 Solutions for Failed Finger Arthroplasty
13.4.1 Soft Tissue Revisions
13.5 Implant-Related Revisions
13.5.1 Silicone Implants
13.5.2 Two-Component Implants
13.6 Joint Fusion for Failed Implant Arthroplasty
13.7 Complications of PIP and DIP Fusion
13.8 Indication for Revision Surgery for Failed Finger Joint Fusion.
13.9 Solutions for Failed Finger Joint Fusion
13.10 Take-Home Message
14 Management of Complications of Thumb CMC Surgery: Trapeziectomy, Arthrodesis, and Total Joint Arthroplasty
14.1 Introduction
14.2 Injury to Sensory Nerve Branches
14.3 Trapeziectomy with and without Ligamentoplasty
14.3.1 Incomplete Trapeziectomy
14.3.2 Scaphotrapezoid Arthritis
14.3.3 Problematic Subsidence of the Thumb Metacarpal
14.4 Trapeziometacarpal Arthrodesis
14.4.1 Nonunion
14.4.2 Hardware-Related Problems
14.4.3 Malpositioning and Reduced Mobility
14.4.4 STT Arthritis
14.5 Thumb Carpometacarpal Joint Arthroplasty
14.5.1 Total Joint Arthroplasty
14.5.2 Pyrocarbon Interposition Arthroplasty
14.6 Arthroscopy
14.7 Take-Home Message
15 Treatment of Complications of Midcarpal Joints Arthritis
15.1 Introduction
15.2 Complications
15.2.1 Infection
15.2.2 Hardware-Associated Problems
15.2.3 Malalignment
15.2.4 Nonunion
15.2.5 Secondary OA
15.2.6 Prosthesis/Spacer
15.2.7 Pain/CRPS
15.3 Stiffness
15.3.1 Causes of Stiffness
15.3.2 Treatment of Stiffness
15.4 Take-Home Message
16 Management of Complications after Salvage Procedures of the Radiocarpal and Distal Radioulnar Joint
16.1 Radiocarpal and Total Wrist Arthrodesis
16.1.1 Definition of the Problem
16.1.2 Treatment of Complications: Nonunion and Hardware Problems
16.1.3 Rehabilitation
16.1.4 Tips and Tricks
16.2 Total and Interpositional Wrist Replacement
16.2.1 Definition of the Problem
16.2.2 Treatment of Complications
16.2.3 Rehabilitation
16.2.4 Tips and Tricks
16.3 The Distal Radioulnar Joint
16.3.1 Definition of the Problem
16.3.2 Treatment of Complications
16.3.3 Tips and Tricks
16.4 Take-Home Message
Section 5 Ligament Surgery.
17 Management of Complications of Ligament Repair of Thumb and Finger Joints.
Title Page
Copyright
Contents
Preface
Contributors
Section 1 Tendon Surgery
1 Management of Complications of Flexor Tendon Surgery
1.1 Management of Flexor Tendon Adhesions
1.1.1 Definition/Problem: Current Understanding of the Biology of Adhesion Formation
1.1.2 Treatment
1.1.3 Rehabilitation
1.1.4 Tips and Tricks
1.1.5 Conclusions
1.2 Bowstringing
1.2.1 Definition/Problem
1.2.2 Treatment
1.2.3 Rehabilitation
1.2.4 Tips and Tricks
1.2.5 Conclusion
1.3 Rupture
1.3.1 The Problem
1.3.2 Management of Patient with Rupture Presenting Early after Tendon Repair
1.3.3 Rehabilitation
1.3.4 Tips and Tricks
1.3.5 Conclusion
1.4 Infection after Flexor Tendon Repair
1.4.1 The Problem
1.4.2 Management
1.4.3 Rehabilitation
1.4.4 Tips and Tricks
1.5 Take-Home Message
2 Management of Complications of Extensor Tendon Surgery
2.1 Introduction
2.2 Complications after Extensor Tendon Lesion Zone 1 and Zone 2
2.3 Complications after Extensor Tendon Lesion Zone 3 and Zone 4
2.4 Complications after Extensor Tendon Lesion Zone 5 and Zone 6
2.4.1 Tethering of the Tendons: Tenolysis
2.4.2 Tethering of the Nerves
2.4.3 Punch Injury: Risk of Infection
2.4.4 Sagittal Band Lesion
2.5 Complications after Extensor Tendon Lesion Zone 7-Zone 9
2.5.1 Zone 7
2.5.2 Zone 9
2.6 Complication of the Thumb Extensor Tendons
2.7 Take-Home Message
3 Treatment of Complications after Surgical Management of Tenosynovitis
3.1 Introduction
3.2 Nerve Injury
3.2.1 A1 Pulley Release
3.2.2 First Extensor Compartment Release
3.3 Bowstringing and Subluxation
3.3.1 A1 Pulley Release
3.3.2 First Extensor Compartment Release
3.4 Infection.
3.5 Recurrence of the Triggering
3.5.1 A1 Pulley Release
3.5.2 First Extensor Compartment Release
3.6 Percutaneous Trigger FingerRelease
3.7 Discussion
3.8 Take-Home Message
Section 2 Nerve Surgery
4 Management of Complications in Sensory Nerve Surgery
4.1 No Recovery or Incomplete Sensory Recovery
4.1.1 Definition
4.1.2 Treatment
4.1.3 Rehabilitation
4.2 Neuropathy
4.3 Hyperalgesia/Hyperesthesia
4.4 Cold Intolerance
4.5 Painful Neuropathies
4.5.1 Definition
4.5.2 Diagnosis
4.5.3 Principles of Treatment
4.6 Rehabilitation-Sensory Desensitization
4.7 Take-Home Message
5 Management of Complications of Surgery of the Median, Ulnar, and Radial Nerves in the Forearm
5.1 Introduction
5.2 Optimizing the Nerve Repair
5.3 Normal Recovery
5.3.1 Timing of Normal Recovery
5.4 Problems with Recovery
5.4.1 Neuropathic Pain
5.4.2 Scar
5.4.3 Neuroma Formation
5.4.4 Surgical Management of Symptomatic Neuromas
5.5 Sensory Recovery
5.5.1 Sensory Nerve Transfer
5.6 Motor Recovery
5.6.1 Motor Nerve Transfer
5.6.2 Tendon Transfers for Paralysis Reconstruction
5.7 Distal Entrapment Following Proximal Repair
5.8 Follow-Up after Nerve Repair and Clinical Decision-Making
5.9 Management of Nerve Specific Problems
5.9.1 Median Nerve
5.9.2 Ulnar Nerve
5.9.3 Radial Nerve
5.9.4 Combined Nerve Injury
5.10 Failed Salvage Surgery
5.11 Take-Home Message
6 Management of Complications of Nerve Decompression Surgery
6.1 Part A: Complications of Carpal Tunnel Release
6.1.1 Introduction
6.1.2 Intraoperative Complications
6.1.3 Postoperative Complications
6.2 Part B: Complications and Failure of Cubital Tunnel Surgery
6.2.1 Introduction
6.2.2 Surgery for Ulnar Neuropathy: Different Procedures and Potential Complications.
6.2.3 Persistence or Recurrence of CuTS despite Previous Surgery
6.2.4 Prevention and Management of Complications
Tips and Tricks
6.2.5 Conclusions
Section 3 Bone Surgery: Fracture
7 Management of Finger Fracture Complications
7.1 Finger Stiffness
7.1.1 Evaluation of the Stiff Finger
7.1.2 Treatment of the Stiff Finger
7.2 Malunion
7.2.1 Treatment of Malunions
7.3 Nonunion
7.3.1 Treatment of Nonunions
7.4 Take-Home Message
8 Management of Complications in Carpal Fractures (Malunion, Nonunion)
8.1 Introduction
8.2 Uncommon Carpal Fractures
8.3 Scaphoid Fractures
8.3.1 (Patho-)Physiology of Fracture Healing in the Scaphoid
8.3.2 Complications in Fracture Healing
8.3.3 Surgical Interventions for Complication in the Healing Process
8.3.4 Types of Bone Grafts
8.3.5 Other Options for Proximal Pole Replacement
8.3.6 Treatment Algorithm for Scaphoid Nonunion
8.4 Osteosynthesis Devices
8.5 The Role of Arthroscopic Techniques
8.6 Take-Home Messages
9 Management of Complications of Scaphoid Fracture Fixation
9.1 Introduction
9.2 Hardware Complications
9.2.1 Tips and Tricks
9.3 Scaphoid Nonunion
9.3.1 Risk Factors
9.3.2 Treatment
9.3.3 Tips and Tricks
9.4 Recalcitrant Scaphoid Nonunion
9.4.1 Tips and Tricks
9.5 Scaphoid Malunion
9.5.1 Tips and Tricks
9.6 Miscellaneous Complications
9.6.1 Nerve/Tendon Lesions/Infection
9.7 Take-Home Message
10 Management of Complications in Lunate Facet Fracture Fixation
10.1 Definition and Problem
10.2 Anatomy of the Fracture
10.3 Treatment: Management of Volar Rim Fractures
10.3.1 Surgical Approach
10.3.2 Fixation Techniques
10.4 Arthroscopy
10.5 Lunate Facet Fractures: The Tip of the Iceberg
10.6 Rehabilitation
10.7 Salvage
10.8 Tips and Tricks
10.9 Take-Home Message.
11 Management of Complications Following Open Reduction and Plate Fixation of Distal Radius Fractures
11.1 Complications Related to the Surgical Approach
11.1.1 Neuromas due to the Volar Approach
11.1.2 Posterior Interosseous Nerve and Tendon Problems due to the Dorsal Approach
11.2 Complications Related to the Quality of Reduction
11.2.1 Posterior Anterior View
11.2.2 Lateral View
11.3 Complications due to Plate and Screw Position
11.3.1 Volar Plating
11.4 Complications due to Infections
11.5 Take-Home Message
12 Management of Distal Radius Malunion
12.1 Part A: Planning: From Educated Guess toward Computer-Assisted Correction Osteotomies
Pitfalls and Complications
12.1.1 Introduction
12.1.2 Diagnostics
12.1.3 Treatment
12.1.4 Navigation and Fixation
12.1.5 Take-Home Message
12.2 Part B: Practical Guideline: Malunion of Distal Radius
12.2.1 Timing: Early versus Late
12.2.2 How to Do It
12.2.3 How to Deal with the Gap?
12.2.4 Ulna Shortening Osteotomy
12.2.5 Outcome
12.2.6 Complications
12.2.7 Rehabilitation
12.2.8 Tips and Tricks
12.2.9 Take-Home Message
Section 4 Bone Surgery: Arthritis
13 Treatment of Complications after Surgery for Finger Joint Arthritis
13.1 Introduction
13.2 Complications in PIP and DIP Arthroplasty: Review of the Literature
13.3 Indication for Revision Surgery of Finger Arthroplasty
13.3.1 Implant Fracture or Loosening
13.3.2 Implant Malalignment
13.3.3 Other Causes of Revision
13.4 Solutions for Failed Finger Arthroplasty
13.4.1 Soft Tissue Revisions
13.5 Implant-Related Revisions
13.5.1 Silicone Implants
13.5.2 Two-Component Implants
13.6 Joint Fusion for Failed Implant Arthroplasty
13.7 Complications of PIP and DIP Fusion
13.8 Indication for Revision Surgery for Failed Finger Joint Fusion.
13.9 Solutions for Failed Finger Joint Fusion
13.10 Take-Home Message
14 Management of Complications of Thumb CMC Surgery: Trapeziectomy, Arthrodesis, and Total Joint Arthroplasty
14.1 Introduction
14.2 Injury to Sensory Nerve Branches
14.3 Trapeziectomy with and without Ligamentoplasty
14.3.1 Incomplete Trapeziectomy
14.3.2 Scaphotrapezoid Arthritis
14.3.3 Problematic Subsidence of the Thumb Metacarpal
14.4 Trapeziometacarpal Arthrodesis
14.4.1 Nonunion
14.4.2 Hardware-Related Problems
14.4.3 Malpositioning and Reduced Mobility
14.4.4 STT Arthritis
14.5 Thumb Carpometacarpal Joint Arthroplasty
14.5.1 Total Joint Arthroplasty
14.5.2 Pyrocarbon Interposition Arthroplasty
14.6 Arthroscopy
14.7 Take-Home Message
15 Treatment of Complications of Midcarpal Joints Arthritis
15.1 Introduction
15.2 Complications
15.2.1 Infection
15.2.2 Hardware-Associated Problems
15.2.3 Malalignment
15.2.4 Nonunion
15.2.5 Secondary OA
15.2.6 Prosthesis/Spacer
15.2.7 Pain/CRPS
15.3 Stiffness
15.3.1 Causes of Stiffness
15.3.2 Treatment of Stiffness
15.4 Take-Home Message
16 Management of Complications after Salvage Procedures of the Radiocarpal and Distal Radioulnar Joint
16.1 Radiocarpal and Total Wrist Arthrodesis
16.1.1 Definition of the Problem
16.1.2 Treatment of Complications: Nonunion and Hardware Problems
16.1.3 Rehabilitation
16.1.4 Tips and Tricks
16.2 Total and Interpositional Wrist Replacement
16.2.1 Definition of the Problem
16.2.2 Treatment of Complications
16.2.3 Rehabilitation
16.2.4 Tips and Tricks
16.3 The Distal Radioulnar Joint
16.3.1 Definition of the Problem
16.3.2 Treatment of Complications
16.3.3 Tips and Tricks
16.4 Take-Home Message
Section 5 Ligament Surgery.
17 Management of Complications of Ligament Repair of Thumb and Finger Joints.