Viol, 70, Nn. 3 / ansrnacs (Reprint requests to Dr. P,C. Altner, Univ. of Health Sei ‘The Chicago Med. Sch, V.A. Med. Cte, North Chicago, 60068) Bauman, T. D, etal. The acute carpal tunnel syndrome. ‘Clin. Orthop. 136: 131, 1981 ‘Acute median nerve compression is unusual, but has been reported following burns hemorrhage, hang fractures and Alslocations, and during infections and pregnancy. The au- ‘thors report 3 patients with acute median nerve compression, 4 following Colles fractures, and | fellowing compression plating of & nonunion ulvar facture ‘Al patients ad normal wo-point discrimination shortly after treatment of the fracture, but all developed marked ‘wrist and hand swelling subsequently. In 3 of the 4 patients, ‘wrists were immobilized in a neutral postion. Intracarpal pressure measurements by wick catheter technique were performed on one patient before carpal tunnel release, in the Immediate postoperative period, and 2 months later. Pres sures were initially quite high, but were reduced by carpal tunnel release, and 2 months following surgery they were similar to those recorded in 5 normal control patients Sin to 12 hours after the onset of symptoms, anesthesi was present in the median nerve dstibution. Despite rele of pain by spliting the east, ao change in nerve sensitivity ‘wat noted in 4 of the 5 patients. Carpal tunnel release was performed 36 10 96 hours after initial trauma in 4 patent, Fight to 14 month follow-up examinations reveal improved sensation but pertistent dysesthesis and subjective numb: ress in 3 of the patients. The patient who did not require carpal tunnel relate has normal two-point dierimination land no complaints of numbness or dysextesia. Stephen H, Miller (Reprint requests to Dr. R. H. Gelberman, Div. of Orthop. land Rehabil, Univ. of California Med. Ctr, 225 Dickinson St, San Diego, Calif 92103) Belsole, R.J. De Quervain's tenotynovits: Diagnostic and ‘operative complications. Onupeds 4: 899, 1981 [R review of 19 patients with 36 complications related to the diagnosis and treatment of de Quervain’s tenosynovitis is reported. Complications include incorrect diagnosis, in adequate operative decompression, an unsightly surgical ‘Sear, tendon subluxation, and nerve injury. Proper therape tie directives are suggested, Operative treatment should be approached cautiously. Improper surgical techniques may tause symptoms that are more disabling than the initial condition, James E. White (Reprint requests to De. R. J. Belole, Ast. Prof of Surg. Sect. of Hand Surg, Univ. of South Florida, Coll. of Med. 12901 N. 30th St. Tampa, Fla. 33612) Blair, W. F, Greene, E.R.,and Omer,G.E, Je. Amethod forthe ealeulation of blood flow in human digital arter- fes,J- Hand Surg. 6: 9, 1981. A specially designed 20 MHe pulsed Doppler provides high evolution and high sensitivity needed in calculating flow in digital arteries, This instrument provides transcuta neous measurements of average blood velocity and flow ‘ream diameter and velocity profiles in small vessels. The instrument provides accurate and reproducible data that can be used in calculations to quantitate blood flow in human digital arteries, J. Kenneth Chong, 41 (Reprint requests to De. W. F. Blair, Dept. of Orthop., Univ ‘of lowa Hosp. and Clin. lowa City, Towa 52242) Blair, W. F, and Marcus, N.A. Extrusion ofthe proximal Interphalangeal joint--Case report. J. Hand Surg 6: 145, 181 This report describes a fracture of the condyles of the proximal phalanx and a simultaneous fracture through the DPhysis of the middle phalanx ofthe right lite finger in a+ year-old boy. Such an injury has not been previously de {eribed. The proximal interphalangeal joint was exirided dorsally and entrapped between the dortal apparatus and proximal phalanx. “Treatment consisted of reduction by means of distraction ofthe middle and proximal phalanges with manipulation of the Tragments back into place. A Kewire fixation was re tnroved 4 weeks postoperatively. J. Kenneth Chong. (Reprint requests to De. W. F. Blair, Asst. Prof, Dept. of Onthop., Univ. of Towa Hasp. and Glin, lowa Gity, lowa, 52242) Bowers, W. H. The proximal interphalangeal joint volar plate: IE A clinical study of hyperextension injury. J Hand Surg 6.77, 1981 Bacing his observations on 12 patients, 50 eases from the Tterature, and from vascular injection studies of the volar plate, the author concludes that virtually all pure hyperex- Tension injuries cause a rupture of the volar plate at the distal end, The initial force ruptures the central distal margin ‘of the volar plate from ite periosteal continuation onto the floor of the’ flexor canal of the middle phalanx. These injuries, while being painful, ae stable laterally and volaly. ‘They do quite well with minimal splinting or even without ‘A continuing force may disrupt the cortical lateral-volar complex where the volar plate, accesory collateral ligament, land proper collateral ligament join in attaching tothe lateral ‘olar tubercles of the middle phalanx. ‘When not auociated with a marginal metaphyseal av sion fracture, a rupture ofthe volar plate atthe distal end is not easily dingnoted, and is likely 10 result in a chronic hyperextension deformity because the relatively avascular injured tiesue is insufficiently immobilized UJ. Kenneth Chong (Reprint requests to Dr, W. H. Bowers, Chief, Hand Sect, Divs of Orthop. Surg., 290 Burnett Womack Bldg., 229H, Univ. of North Carolina Sch, of Med, Chapel Hill, NC 27514) all, W. H., and Strickland, J. W. Functional hand re- ‘construction in the whistling-face syndrome. Hand Sug 6: 148, 1981, ‘Twenty-eight cases of whistling-fae syndrome (Freeman Sheldon syndrome or cranial-carpotarsal dysplasia) have bbeen reported inthe literature and ths isa new report that documents the surgical reconstruction of the hands. Corrective surgery consisted of Z-lengthening of al flexor superfiialis tendons, deepening ofthe first web space, release ‘ofthe first doreal interosteous and adductor pollicis muscles, skin grafts to the Mexor surface of the Fingers, and skeletal suppor J. Kenneth Chong, (Reprint requests to Dr. J. W. Strickland, 8402 Harcourt Re Suite 217, Indianapolis, Ind, 46260)