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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 390 - 390
1 Sep 2012
Karuppaiah K Nanda R Stothard J
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Aims

The objective of our study is to identify the causes for recurrence and to evaluate the results of our technique.

Material and Methods

We retrospectively analysed 18 patients (12 females; 6 males) who had both clinical and electrophysiological confirmation (7 focal entrapments; 11 severe entrapments) of recurrent carpal tunnel syndrome. In all the patients, after releasing the nerve a vascularised fat pad flap was mobilised from hypothenar region and sutured to the lateral cut end of flexor retinaculum. All the patients were assessed post-operatively for relief of pain, recovery of sensory and motor dysfunction.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 535 - 535
1 Sep 2012
Karuppaiah K Nanda R Stothard J Balasubramaniam S
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Introduction

The role of in-situ decompression in patients with severe ulnar nerve compression is still controversial. The authors present a prospective study on the results of in-situ decompression in this selected group of patients treated through a mini open incision (4cms) and complete decompression by appropriate patient positioning.

Material/Methods

Thirty patients (20 Male/10 Female) with severe degree of nerve compression, confirmed clinically by Dellon's classification and by abnormal Nerve Conduction Study, underwent simple in-situ decompression under general anaesthesia as a day-case procedure. Through a 4cms incision and by moving the elbow the nerve is fully visualised and decompressed.

Outcome was measured prospectively at three months and one year using Modified Bishop's score, grip strengths and two point discrimination (2PD).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 391 - 391
1 Sep 2012
Karuppaiah K Miranda S
Full Access

Introduction

Surgical treatment is justified in patients with fifth metacarpal shaft fractures with angulation exceeding 30 degrees, as these patients are prone to have shortening, restriction of movements, decreased efficiency of the flexor tendons and poor cosmetic results1,2. The authors describe a new technique where these patients can be treated in the clinic non-surgically.

Material and Methods

Twenty-three patients with angulated fractures were prospectively enrolled for the study from Jan 2009 to Dec 2009. After appropriately instructing the patient, an ulnar nerve block was performed at the wrist. Once the nerve block had taken effect, the fracture was manipulated and an ulna gutter 3-point moulded splint was applied in the plaster room. The reduction was then confirmed with an x-ray. The patients were seen at 3 weeks for splint removal and for long-term follow-up at least 6 months later.