The painful hand
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| Format: | Buch |
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| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
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| Schriftenreihe: | Hand clinics
12,4 |
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| Online-Zugang: | Inhaltsverzeichnis |
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| 245 | 1 | 0 | |a The painful hand |c Roger A. Daley ..., guest ed. |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 1996 | |
| 300 | |a X S., S. 633 - 830 |b Ill. | ||
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| 490 | 1 | |a Hand clinics |v 12,4 | |
| 650 | 2 | |a Main - Chirurgie | |
| 650 | 2 | |a Traumatismes de la main | |
| 650 | 4 | |a Hand | |
| 650 | 4 | |a Hand Injuries | |
| 650 | 4 | |a Hand |x Surgery | |
| 650 | 4 | |a Hand |x Wounds and injuries | |
| 650 | 4 | |a Hand |x surgery | |
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Datensatz im Suchindex
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|---|---|
| adam_text | THE PAINFUL HAND
CONTENTS
Preface xiii
Roger A. Daley and John S. Gould
The Pharmacologic Approach to the Painful Hand 633
Carol Czop, Thomas L. Smith, Richard Rauck, and L. Andrew Koman
The management of reflex sympathetic dystrophy with oral, topical, and
parenteral medications is complex. This article outlines the pharmacologic
options available to treat dystrophic pain, provides an overview of mecha
nisms of action, and defines relative indications for administration.
Carpal Tunnel Syndrome 643
Herbert P. von Schroeder and Michael J. Botte
Carpal tunnel syndrome has an incidence of 99 per 100,000 people and a
prevalence ranging from 1% to 10%. Both open and endoscopic methods
of decompression remain popular, and 80% to 90% of patients obtain good
or excellent results from either method. For patients with severe weakness
of the thenar muscles, the Camitz palmaris longus transfer has been effec¬
tive.
Ulnar Tunnel Syndrome 657
Michael S. Bednar
Patients with ulnar tunnel syndrome present with pain and ulnar motor
or sensory symptoms, depending upon the site of compression within
Guyon s canal. Ganglia, anomalous muscles, and fractures are the most
common causes. Decompression consists of releasing all three zones of the
tunnel and removing the pathologic anatomy.
Cubital Tunnel Syndrome and the Painful Upper Extremity 665
A. Marc Tetro and David R. Pichora
Cubital tunnel syndrome is the second most common compressive neurop¬
athy. With increasing prevalence of entrapment neuropathies, the presen¬
tation of ulnar nerve compression with a painful upper extremity appears
HAND CLINICS VOLUME 12 • NUMBER 4 • NOVEMBER 1996 vii
to be more common. Though our knowledge and understanding of this
disease is increasing, the principles of management remain. Reaching the
timely and appropriate diagnosis and instituting an appropriate treatment
regimen help to restore and preserve normal function. Though there
are many ways to reach these means, the avoidance of complications is
paramount to achieve a reliable and pain free outcome. Preventing injury
to the medial antebrachial cutaneous nerve, complete release of all sites of
compression, and avoidance of creating new compressive sites are the
keys to this end.
Radial Tunnel Syndrome 679
Michael Barnum, Robert D. Mastey, Arnold Peter C. Weiss, and
Edward Akelman
Radial nerve compression in the upper extremity is an unusual and highly
variable diagnosis. Intermittent compression of the posterior interosseous
nerve in the anatomic region known as the radial tunnel is responsible for
a constellation of signs and symptoms known as radial tunnel syndrome.
Diagnostic and treatment measures are discussed at length. Surgical expo¬
sures are also reviewed, with the authors presenting their own preferences.
High Median Nerve Entrapments: An Obscure Cause of
Upper Extremity Pain 691
A. Marc Tetro and David R. Pichora
High median nerve entrapment is an uncommon but important cause of
median nerve compression. With carpal runnel syndrome occasionally
being overdiagnosed or misdiagnosed, the proximal entrapment syn¬
dromes are increasingly being found to be a cause of the painful upper
extremity. The appropriate identification of this elusive diagnosis, along
with the proper treatment, will help many patients and decrease unneces¬
sary surgery.
Thoracic Outlet Syndrome 705
Scott D. Oates and Roger A. Daley
Thoracic outlet syndrome is a term ascribed to a complex clinical entity
encompassing complicated neurovascular signs, symptoms and pathology
of the upper extremity. Controversies exist concerning its causes, diagno¬
sis, and treatment despite years of intense study of hundreds of patients.
Although there is no universal agreement on the diagnostic and treatment
modalities to be applied to each patient, general guidelines have emerged
that can aid hand surgeons in recognizing and evaluating these potentially
difficult patients. A review of the anatomy, causes, clinical presentations,
diagnostic tests, and treatment options available for thoracic outlet syn¬
drome is presented, followed by an illustrative case.
Cervical Root Entrapment 719
Howard S. An
The clinical syndromes of neck pain with referred pain, radiculopathy,
and myelopathy due to degenerative disorders of the cervical spine are
reviewed in this article. Careful history and physical examination is the
key to making the initial diagnosis. Cervical spine pathology should be
considered a common cause of symptoms when evaluating any patient
who has pain in the upper extremity.
Recurrent Carpal Tunnel Syndrome 731
Michael J. Botte, Herbert P. von Schroeder, Reid A. Abrams, and
Harris Gellman
Recurrent carpal tunnel syndrome has been shown to occur in up to 19%
of patients. Common causes include incomplete release of the transverse
Viii CONTENTS
carpal ligament, fibrous proliferation, and recurrent tenosynovitis. The
prognosis for repeat CTS is fair (poorer than initial release). For a painful
scar with adhesions to the median nerve, numerous reconstructive proce¬
dures can be considered, including epineurolysis, local muscle grafts, fat
grafts, and vein wrapping procedures.
Management of Neuromas in the Hand 745
Rahul K. Nath and Susan E. Mackinnon
Injury to a peripheral nerve in the hand can result in loss of motor and
sensory function. In addition, incomplete or abnormal regeneration can
cause painful sequelae. The approach to neuromas in the hand requires
familiarity with the basic aspects of nerve regeneration as well as the
neurophysiology of pain mechanisms.
The Painful Hand 757
L. Andrew Koman, Thomas L. Smith, Beth Paterson Smith, and
Zhongyu Li
Reflex sympathetic dystrophy can be associated with the failure of extrem¬
ity physiology to recover in an orderly and predicable pattern after
trauma. The diagnosis of dystrophic pain may be based on objective,
clinical, anatomic, and physiologic criteria. Because early recognition and
treatment of reflex sympathetic dystrophy is the single most important
predictor of functional recovery and pain relief, objective techniques to
diagnose reflex sympathetic dystrophy are very important. This article
provides an approach to a diagnosis that uses quantitative techniques and
instruments.
Treatment of Chronic Pain by Wrapping Intact Nerves
with Pedicle and Free Flaps 765
Neil F. Jones
Chronic pain due to scarred or devascularized but intact peripheral nerves
may be potentially improved by neurolysis of the nerve, followed by the
circumferential wrapping of the nerve with either the fascia, subcutane¬
ous fat tissue, or muscle of either a pedicled or free flap. This procedure
may cushion the nerve from external pressure on the overlying skin,
insulate the nerve from traction forces of adjacent tendons, allow longitu¬
dinal gliding of the nerve, and potentially promote revascularization of
the scarred nerve.
The Treatment of Epineural Scarring with Allograft Vein Wrapping 773
Victoria R. Masear and Sharon Colgin
Painful scarring around peripheral nerves is a difficult treatment dilemma.
Many previously recommended treatment options have resulted in recur¬
rence of pain. The authors describe the technique of allograft vein wrap¬
ping with preserved human umbilical vein. To date, 119 vein wrappings
of peripheral nerves have been performed. Good or excellent results were
obtained in 79% of the patients. The most common complication has been
deep infection (in two patients) and a draining sinus tract (in seven
patients). The majority of patients have had significant relief from their
chronic pain, and the authors have found the results, at an average follow
up of 25 months, to be very encouraging.
Managing Chronic Neuropathic Pain with Implanted
Anesthetic Reservoirs 781
Jose J. Monsivais and Diane B. Monsivais
An implantable pump set to deliver Marcaine at a specified rate can be a
helpful addition to a chronic pain management program when other
modalities have not been successful.
CONTENTS ix
Botulinum Toxin in Painful Syndromes 787
Jose J. Monsivais and Diane B. Monsivais
Botulinum toxin is an effective treatment for painful symptoms arising
from dystonic scalene muscles.
Neural Blockade for Upper Extremity Pain 791
Rex A. Fouch, Stephen E. Abram, and Quinn H. Hogan
Pain perception involves complex interactions between afferent inputs
from nociceptors or abnormal peripheral foci in injured nerves, autonomic
neurons, dorsal horn modulatory interneurons, and descending inhibitory
pathways. Although local anesthetic blockade of pathways thought to be
involved in the generation of a patient s pain may have diagnostic or
therapeutic benefit, responses to such interventions are often unpredictable
and may be misleading. It is important to have a sound understanding of
the anatomic pathways involved, and of the pathophysiologic mechanisms
that may be at work. Therapeutic effects of neural blockade for painful
disorders are greatest if treatment is begun early in the course of the
pathologic process.
Rehabilitation of the Painful Upper Extremity 801
Barbara L. Haines
Therapy for the painful upper extremity is a challenge. This article focuses
on various assessment tools and techniques that are reflective of the
painful status. The author reviews several research articles that discuss
validating treatment options and outlines rehabilitation for the painful
upper extremity as it relates to peripheral nerve irritation and compres¬
sion.
Index 817
Subscription Information Inside back cover
X CONTENTS
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| language | English |
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| physical | X S., S. 633 - 830 Ill. |
| publishDate | 1996 |
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| publisher | Saunders |
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| series | Hand clinics |
| series2 | Hand clinics |
| spellingShingle | The painful hand Hand clinics Main - Chirurgie Traumatismes de la main Hand Hand Injuries Hand Surgery Hand Wounds and injuries Hand surgery Handkrankheit (DE-588)4023276-1 gnd Chronischer Schmerz (DE-588)4113226-9 gnd |
| subject_GND | (DE-588)4023276-1 (DE-588)4113226-9 (DE-588)4143413-4 |
| title | The painful hand |
| title_auth | The painful hand |
| title_exact_search | The painful hand |
| title_full | The painful hand Roger A. Daley ..., guest ed. |
| title_fullStr | The painful hand Roger A. Daley ..., guest ed. |
| title_full_unstemmed | The painful hand Roger A. Daley ..., guest ed. |
| title_short | The painful hand |
| title_sort | the painful hand |
| topic | Main - Chirurgie Traumatismes de la main Hand Hand Injuries Hand Surgery Hand Wounds and injuries Hand surgery Handkrankheit (DE-588)4023276-1 gnd Chronischer Schmerz (DE-588)4113226-9 gnd |
| topic_facet | Main - Chirurgie Traumatismes de la main Hand Hand Injuries Hand Surgery Hand Wounds and injuries Hand surgery Handkrankheit Chronischer Schmerz Aufsatzsammlung |
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