Journal of Hand, Upper Limb, and Microsurgery

The Future of Hand Surgery in Indonesia: Embracing Progress Amidst Challenges and Winning the Opportunities

2024-06-02T08:12:46+07:00

As a president of Indonesian Society of Hand,
Upper Limb, and Microsurgery (INASHUM), I
believe that INASHUM have a promising future
to be known internationally. I hereby would
emphasize that a profound exploration into our
scope regarding to our new brand of the society,
the innovative surgical techniques, systemic
healthcare challenges, and imperative
educational initiatives will define our future

My Journey with WALANT

2024-06-02T08:24:11+07:00

I first listened to Dr Don Lalonde (Fig 1) during an
ASSH conference in the US in 2013. I was very
impressed with the clarity of his speech and the
topic. I invited him to Malaysia for the 2014
APFSSH meeting hosted by Malaysia and this was
the second time I heard about WALANT.

The surgical management of a symptomatic aberrant superficial palmar branch of the radial artery

2024-03-01T10:46:11+07:00

The radial artery is known to have anatomical variants but these only very rarely present symptomatically. Here we present a case report of an abnormal superficial branch of the radial artery lying superficial to the thenar muscles and causing thenar eminence pain. Our patient is a 26 year old female presenting with thenar pain and swelling with no prior history of trauma. Thenar pain was elicited with repetitive movements and prevented by occluding the radial artery, however after release of the artery the pain then returned. We present ultrasound imaging confirming the presence of this rare anatomical variant at the location of the patient’s pain as well as the first description and intraoperative photographs in the literature to delineate a surgical technique to excise the aberrant blood vessel, resulting in successful resolution of symptoms.

Management of Neglected Simple Elbow Dislocation

2024-04-01T10:18:45+07:00

Elbow dislocation is ranking second only to shoulder dislocations among adults. Neglecting and timely intervention can lead to a complex condition characterized by structural changes and functional impairments, underscoring the need for comprehensive management strategies to mitigate disability and prevent arthritic changes. Neglected elbow dislocations are relatively common in developing countries due to initial treatment by local bonesetters, contributing to delayed presentation and inadequate management. Surgical interventions, including open reduction and fixation, have shown promising outcomes in restoring joint stability and function, particularly in chronic cases. We would like to present a 59-year-old female with chronic simple elbow dislocation managed with double (medial and lateral) approach without violation of the triceps and ligament reconstruction followed by ulnohumeral transfixing wire for temporary immobilization could produce satisfactory result and reproducible outcome.

SURGICAL FASCIECTOMY WITH HONEYCOMB INCISION FOR DUPUYTREN’S CONTRACTURE: A REPORT OF TWO CASES

2024-04-05T00:26:30+07:00

Introduction Dupuytren's disease is a fibroproliferative disease involving the hand's palmar fascia and induces varying degrees of nodule and cord formation. High prevalence is reported in some diseases, such as hypertension, alcoholism, diabetes, hyperlipidemia, ischemic heart disease, chronic obstructive pulmonary disease (COPD), pulmonary tuberculosis, epilepsy, and rheumatoid arthritis (RA).

Case Presentation There were 2 cases presented within the same patient. A 69-year-old man complained that he couldn't bend or straighten his little fingers on both hands for the past eight years. there was a flexion deformity on the right metacarpophalangeal (MCP) joint of the small finger with visible thickening of the flexor tendon. Palpable cord was found on volar metacarpal 4 and volar phalanx 1 up to metacarpal 5. There were also limited active range of motion (AROM) at the level of MCP, proximal, and distal interphalangeal (PIP & DIP) joints in the ring and little finger due to stiffness. We performed fasciectomy and cord release following honeycomb incision to the affected hands. Cord was excised and histological evaluation confirmed the diagnosis. Post operative outcome was good with no residual deformity and satisfactory function.

Discussion The most common treatment modality for Dupuytren contracture is open partial fasciectomy. Numerous surgical skin incisions have been described, but had to avoid straight longitudinal incisions due to being prone to secondary skin contractures. For this purpose, the most common designs are the zigzag incision, the V-Y incision, and Z-plasties. Such procedures had been reported to produce good outcome for the patient and relief of symptoms.

Conclusion We repost a series of 2 cases of Dupuytren’s disease managed by open fasciectomy and cord release after a honeycomb incision. Good outcomes were achieved based on the corrected deformity and return to normal function.