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

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