Monday 3 February 2014

Wide Awake Dupuytren's Fasciectomy

Through Wide Awake Fasciectomy the patho-anatomy can be addressed as shown in the diagram, further information at The Dupuytren's UK Wide Awake Microsite


Friday 27 December 2013

Wide Awake Fasciectomy For Dupuytren's Contracture

Through the OSWA approach, a pathanatomical and logical approach can be utilized.  In this case the young gentleman presented to our OSWA service requesting amputation of his ring and little fingers- he had previous surgery under GA years before.  At OSWA surgery we fully corrected the ring finger deformity by removal of the diseased fascia and there was also a partial correction of the little finger on account of the natatory cord which was removed.

Tuesday 26 November 2013

Extensor Carpi Ulnar injuries and the three Rs for soft tissue injuries

The ECU is a guider on the back of the wrist near the little finger.  It is particularly vulnerable in racquet sports when the wrist deviates towards the little finger (ulnar deviation).  The tendon can be painful or damaged.  My general approach for sporting tendon problems are the three R's: rest; rehabilitate; and reinstitute activity in a stepwise fashion and with protection of the injured structure and attention to sporting technique.  www.mskbismil.co.uk

World Wide Awake Hand Surgery

Worldwide Dr Prof Don Lalonde from Canada must be credited with the promotion of wide awake hand surgery.  Please read the abstract to one of his latest publications here.  He summarises the potential wide awake advantage as follows: "Patients spend less time and money and get to speak to their surgeon and receive education during the surgery itself. Improvements in operations such as flexor tendon repair have happened, because surgeons can see movement during the case and make adjustments before the skin is closed. Surgeons can perform more cases in the same amount of time with fewer personnel. The cost of the surgery is decreased, as all expenses surrounding the provision of sedation are removed."
#movingsensatehand #oswa #handsurgery

Wednesday 20 November 2013

Wide Awake Hand Surgery And The Diagnostic Nerve Decompression

Please see this recently published case report.  Nerve conduction studies have a significant false negative and significant false positive rate (around the 5% range).  Each year we have seen cases where a nerve conduction study result has confounded the diagnosis in a hand surgery patient.  With wide awake hand surgery during which the operation is performed with a #movingsensatehand the concept of a diagnostic decompression arises.  www.onestopwideawake.co.uk

Tuesday 22 October 2013

One Stop Wide Awake Hand Surgery London Mucoid (Mucous) Cyst

Mucoid cysts are ganglion variants which usually arise from the end joint of a digit.  They contain jelly-like ganglion fluid and communicate with the joint.  At OSWA surgery we remove the lesion and clean the joint.  Reasons to opt for surgery include discharging of the fluid, pain and if the lump is causing deformity of the nail...