Search

The coronavirus disease 2019 (COVID-19) pandemic is rapidly evolving. Tan Tock Seng Hospital and the National Centre for Infectious Disease see the majority of confirmed and suspected cases in Singapore. This article describes the impact of COVID-19 on the practice of hand and reconstructive microsurgery (HRM) in our institution. It details our department's response as the situation escalated and the impact on the HRM elective and emergency workload, including the use of personal protective equipment on the surgical practice of HRM, as well as the effects of the condition on social and academic life., (Copyright © 2020 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

Purpose: Studies on grip endurance are scant even though it is an important topic with practical implications. This study compares the effect of wrist position, in the flexion-extension plane, on grip endurance and grip strength., Methods: Grip strength and grip endurance were quantified bilaterally at 6 different wrist positions (unrestrained, 45°, 30°, and 15° extension, 0° and 30° flexion) in 38 healthy right-handed individuals., Results: Our results show that wrist orthosis significantly reduced grip strength across all positions and the maximum grip strength in the position with an orthosis occurred at 15° and 30° extension for the dominant hand and 15°, 30°, and 45° extension for the nondominant hand. Hand dominance and sex did not significantly affect grip endurance. Using a wrist orthosis did not significantly reduce grip endurance at 45° and 30° extension., Conclusions: At a position of 30° of wrist extension, maximal grip strength is achieved without significantly compromising grip endurance. This has clinical implications for decisions regarding the optimal position for orthosis and radiocarpal joint arthrodesis., Clinical Relevance: This study would aid both surgeons and therapists in facilitating discussion with patients regarding the various therapeutic options in managing wrist pathologies., (Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

Extensor tendon subluxation over the metacarpal head, leading to metacarpophalangeal joint ulnar deviation, is a hand deformity seen in patients with systemic lupus erythematosus. Apart from soft tissue procedures, metacarpal shortening osteotomy is a previously described surgical treatment for this deformity. We present a patient whose fixed deformity was spontaneously corrected after a displaced distal radius fracture. At 1 year, the correction was maintained. We discuss the biomechanical basis behind the phenomenon., (Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)