Faculty Bibliography

Mirror hand is one of the rarest congenital differences of the upper extremity. Typically, there is absence of the radius, duplication of the ulna, and 7 digits in mirrored symmetry about the middle finger. We report a case of a rarer subset of hand duplication in which there is a normal radius and ulna and a hand with 8 digits. The patient underwent surgery to excise the radial 3 digits and to reconstruct the remaining radial digit to function as an opposable, 2 phalanx thumb. Wrist extension was augmented by transferring the digital extensors from the excised fingers to the radial wrist extensors

Carpometacarpal dislocations of the ulnar four joints are rare injuries that are usually associated with high-energy trauma. Given the small number of cases reported, there exists some controversy regarding their optimal management. The case of a 27-year-old man who sustained a dorsal dislocation (without associated fractures) of the ulnar four carpometacarpal joints as a result of a fall from a height is presented. The literature regarding these hand injuries is reviewed, and the need for anatomic reduction and stabilization is discussed

Delayed rupture of a flexor tendon in the hand due to the presence of a retained foreign body is rare. We present the case of a late flexor pollicis longus rupture 30 years after traumatic implantation of a glass fragment. The foreign body had migrated distally a distance of 4.5 cm from the site of the original injury and eroded into the flexor tendon sheath. Thumb function was restored with a flexor digitorum superficialis tendon transfer from the ring finger with excellent results

There remains some controversy and confusion regarding arthroscopic surgery of the knee in the elderly population, particularly for patients with osteoarthritis. A retrospective review was undertaken of 105 knees in patients 60 years or older who had arthroscopy during a 4-year period. The surgical outcomes were evaluated using a postoperative knee scoring system at a mean followup period of 11.7 months. Good and excellent results were obtained in 65% of knees. The most significant predictors of good outcome were preoperative mechanical symptoms, such as those resulting from loose bodies or flap tears of the meniscus, and only mild articular degeneration seen at arthroscopy. A review of the literature reflects similar success rates. Although the results are equivocal by orthopaedic standards, in selected patients arthroscopic surgery can offer significant relief of acute symptoms and defer more extensive surgical procedures with minimal risk