Hand and Microsurgery 

About: Hand and Microsurgery is an academic journal published by SAGEYA Publishing Company. The journal publishes majorly in the area(s): Medicine & Population. It has an ISSN identifier of 2458-7834. It is also open access. Over the lifetime, 118 publications have been published receiving 136 citations.

Hand grip strength: Age and gender stratified normative data in Anatolian population

Abstract: Objective: The purpose of this study is twofold; first we aimed to provide age and gender specific normative hand grip strength (HGS) data in Anatolian adult population and secondly we aimed to determine the effects of gender and hand dominance on HGS. Patients and Methods: The study included 1359 adult healthy subjects, aged 18-90 years. A calibrated hydraulic hand dynamometer was used for the HGS measurements in accordance with current standardized instructions. The HGSs on sides, age, gender, and dexterity were recorded and statistically analyzed. Results: The subjects were 712 males and 647 females with a mean age of 41.8±15.9 years and 46.9±16.1 years, respectively. Left hand dominance was determined in 67 subjects. Male subjects were stronger than female subjects in each age stratified group (p: 0.001). HGS showed a significant decline as the age of the subjects increased (r=-0.463, p=0.0001 dominant hand, r=-0.472, p=0.0001 non-dominant hand). The dominant hand was stronger than the non-dominant hand (p=0.0001). The mean difference between the dominant and non-dominant hand was 8.5% (SD: 13.1, median 7.6%). The mean strength ratio between the dominant and non-dominant hand was 1.07±0.12 for males and 1.09±0.13 for females. Conclusions: This study is the largest study to present normative values of HGS in an Anatolian population. These findings can be used as a reference for future studies in an Anatolian population. HGS was seen to be higher in males and to decrease proportionally with age. The dominant hand is on average 8% stronger than the non-dominant hand in both genders and all age groups.

Outcome and predictors in simple decompression of ulnar nerve entrapment at the elbow

Abstract: Objectives: Simple decompression is an accepted surgical treatment of ulnar nerve entrapment at the elbow (UNE) Our purpose was to evaluate the outcome and potential predictors for the outcome after simple decompression in UNE Methods: All surgically treated UNE cases (from 2004-2008) at our department were studied retrospectively Out of 285 primary surgeries, 242 primary simple ulnar nerve decompressions were included Medical records, including electrophysiologic protocols, were reviewed and postoperative outcome was graded: 1) cured/improved and 2) unchanged/worsened symptoms, based on surgeon-evaluated outcome Results: Of the 242 simple decompressions (122 males and 120 females; median age 505 years), 101 cases were students, retired, un-employed, or on a long-term sick-leave and 112 had manual, blue-collar type of careers 189 cases were cured or improved, while 53 cases had no change in, or even worsened, symptoms Gender, presence of smoking, or associated diseases did not affect outcome, while a tendency was observed for higher age, a manual occupation and constant symptoms Out of 196 cases electrophysiologically examined, 155 cases showed signs of ulnar nerve affection (56 reduced conduction velocity; 19 conduction block; 80 axonal degeneration; latter two groups significantly worse outcome) Conclusion: Patients with a preoperatively electrophysiologically diagnosed nerve conduction block or axonal degeneration have higher risk of not being cured or improved after simple decompression in UNE Older patients, those with a manual profession, and constant symptoms of UNE tend to be less improved after surgery

The rise of wide awake hand surgery - Contribution from Turkey -

Abstract: Objectives: Recently, many surgeons started to prefer wide awake local anesthesia no tourniquet (WALANT) approach to provide an almost bloodless field for the vast majority of hand surgery procedures We aimed to present our two-year experience with WALANT technique Methods: A wide variety of 682 hand surgery operations in 626 patients were performed with WALANT technique For infiltrative local anesthesia, the mixture of 1% lidocaine, 1:100000 epinephrine and 84% bicarbonate was prepared The need for intraoperative sedation and intraoperative patient cooperation were evaluated Patients' fingers were observed in case of postoperative circulatory compromise A simple cost-effectivity analysis for the anesthesia types was performed Results: Mean age of the patients was 437 None of the patients needed intraoperative sedation, and patients obeyed to orders of surgeon throughout the procedure The postoperative circulatory compromise was observed in two fingers; one finger resolved spontaneously and the other rescued with phentolamine WALANT technique was more cost-effective than Bier block or general anesthesia Conclusion: The WALANT technique seems like a great innovation to perform a wide variety of hand surgery cases Increased patient comfort without a tourniquet, cost-effectivity, no preoperative tests, no risks of general anesthesia, no need to stay in the hospital overnight, and intraoperative active motion assessment facility are important advantages

Giant lipomas of the hand

Abstract: Objective: Lipomas are the most common type of soft-tissue tumor found in the body. Very few of the benign tumors of the hand are classified as lipomas. Also, giant lipomas of the hand are extremely rare. The goal of this study was to present the cases of patients suffering from giant lipomas of the hand. Methods: 5 patients (3 females and 2 males) with giant lipomas of the hand were treated in our clinic between January 2012 and April 2014. Patients with lipomatous tumors of the hand having diameters equal or greater than 5 centimeters were included in our study. Both preoperatively and postoperatively, physical examination and magnetic resonance imaging (MRI) were used for diagnosis and determination of any residual mass. In the first month, the patients’ satisfaction rates were evaluated. Results: All 5 patients were operated upon. The mean age was 60.6 years. Postoperatively (1st month), no residual masses were found. The satisfaction rates of all patients in the 1st month were 100%. Conclusion: Giant lipomas of the hand are very rare and may cause compressions and other complications. Thus, they require a careful preoperative evaluation in order to make a proper differential diagnosis.

Posterior interosseous nerve palsy caused by a parosteal lipoma seated over the proximal radius; a case report and review of the literature -

Abstract: Several different pathologies may play a role in the etiology of posterior interosseous nerve (PIN) palsy such as trauma, radial tunnel syndrome, tumors, vasculitis, septic arthritis, and rheumatoid synovitis. The most common atraumatic factor is the compression of the nerve through its anatomic path. Parosteal lipoma around the proximal radius is the leading solid tumor seen among the neoplastic lesions. Although it is common, there are only case reports or few case series reported in the current literature and a comprehensive review is missing. Herein a rare case of PIN palsy due to parosteal lipoma of the proximal radius is presented together with a thorough literature review. A 48-year-old woman was presented with elbow pain and wrist drop that lasted for ten months. Electrodiagnostic and imaging findings lead to a diagnosis of PIN palsy due to parosteal lipoma seated over the proximal radius. Total surgical excision was performed, and the patient had been followed up for one year. Removal of the lipoma failed to recover the patient’s symptoms. We reviewed all the reported cases and discussed, epidemiology, clinical findings, imaging studies, electrodiagnostic studies, pathology, treatment and prognosis of PIN palsy due to parosteal lipoma.