"Operative complications can have a major impact on patients and surgeons. While most textbooks list them, few provide in-depth discussion on prevention, repercussions, and methods to resolve them. Management of Complications in Common Hand and Wrist Procedures: FESSH Instructional Course Book 2021, edited by renowned hand surgeons Brigitte van der Heijden, Jan-Ragnar Haugstvedt, and Henk Coert, features contributions from an impressive group of international hand surgery experts. This book provides in-depth, illustrated coverage on the prevention and management of complications that can occur during common hand and wrist approaches. It also provides insights on how meticulously performed hand therapy can help alleviate postsurgical problems, on the complex regional pain syndrome (CRPS), and on critical social issues"--.

• Management of Complications in Common Hand and Wrist Procedures: FESSH Instructional Course Book 2021
• Title Page
• Copyright
• Contents
• Preface
• Contributors
• Section 1 Tendon Surgery
  • 1 Management of Complications of Flexor Tendon Surgery
    • 1.1 Management of Flexor Tendon Adhesions
      • 1.1.1 Definition/Problem: Current Understanding of the Biology of Adhesion Formation
      • 1.1.2 Treatment
      • 1.1.3 Rehabilitation
      • 1.1.4 Tips and Tricks
      • 1.1.5 Conclusions
    • 1.2 Bowstringing
      • 1.2.1 Definition/Problem
      • 1.2.2 Treatment
      • 1.2.3 Rehabilitation
      • 1.2.4 Tips and Tricks
      • 1.2.5 Conclusion
    • 1.3 Rupture
      • 1.3.1 The Problem
      • 1.3.2 Management of Patient with Rupture Presenting Early after Tendon Repair
      • 1.3.3 Rehabilitation
      • 1.3.4 Tips and Tricks
      • 1.3.5 Conclusion
    • 1.4 Infection after Flexor Tendon Repair
      • 1.4.1 The Problem
      • 1.4.2 Management
      • 1.4.3 Rehabilitation
      • 1.4.4 Tips and Tricks
    • 1.5 Take-Home Message
  • 2 Management of Complications of Extensor Tendon Surgery
    • 2.1 Introduction
    • 2.2 Complications after Extensor Tendon Lesion Zone 1 and Zone 2
    • 2.3 Complications after Extensor Tendon Lesion Zone 3 and Zone 4
    • 2.4 Complications after Extensor Tendon Lesion Zone 5 and Zone 6
      • 2.4.1 Tethering of the Tendons: Tenolysis
      • 2.4.2 Tethering of the Nerves
      • 2.4.3 Punch Injury: Risk of Infection
      • 2.4.4 Sagittal Band Lesion
    • 2.5 Complications after Extensor Tendon Lesion Zone 7–Zone 9
      • 2.5.1 Zone 7
      • 2.5.2 Zone 9
    • 2.6 Complication of the Thumb Extensor Tendons
    • 2.7 Take-Home Message
  • 3 Treatment of Complications after Surgical Management of Tenosynovitis
    • 3.1 Introduction
    • 3.2 Nerve Injury
      • 3.2.1 A1 Pulley Release
      • 3.2.2 First Extensor Compartment Release
    • 3.3 Bowstringing and Subluxation
      • 3.3.1 A1 Pulley Release
      • 3.3.2 First Extensor Compartment Release
    • 3.4 Infection
    • 3.5 Recurrence of the Triggering
      • 3.5.1 A1 Pulley Release
      • 3.5.2 First Extensor Compartment Release
    • 3.6 Percutaneous Trigger FingerRelease
    • 3.7 Discussion
    • 3.8 Take-Home Message
• Section 2 Nerve Surgery
  • 4 Management of Complications in Sensory Nerve Surgery
    • 4.1 No Recovery or Incomplete Sensory Recovery
      • 4.1.1 Definition
      • 4.1.2 Treatment
      • 4.1.3 Rehabilitation
    • 4.2 Neuropathy
    • 4.3 Hyperalgesia/Hyperesthesia
    • 4.4 Cold Intolerance
    • 4.5 Painful Neuropathies
      • 4.5.1 Definition
      • 4.5.2 Diagnosis
      • 4.5.3 Principles of Treatment
    • 4.6 Rehabilitation—Sensory Desensitization
    • 4.7 Take-Home Message
  • 5 Management of Complications of Surgery of the Median, Ulnar, and Radial Nerves in the Forearm
    • 5.1 Introduction
    • 5.2 Optimizing the Nerve Repair
    • 5.3 Normal Recovery
      • 5.3.1 Timing of Normal Recovery
    • 5.4 Problems with Recovery
      • 5.4.1 Neuropathic Pain
      • 5.4.2 Scar
      • 5.4.3 Neuroma Formation
      • 5.4.4 Surgical Management of Symptomatic Neuromas
    • 5.5 Sensory Recovery
      • 5.5.1 Sensory Nerve Transfer
    • 5.6 Motor Recovery
      • 5.6.1 Motor Nerve Transfer
      • 5.6.2 Tendon Transfers for Paralysis Reconstruction
    • 5.7 Distal Entrapment Following Proximal Repair
    • 5.8 Follow-Up after Nerve Repair and Clinical Decision-Making
    • 5.9 Management of Nerve Specific Problems
      • 5.9.1 Median Nerve
      • 5.9.2 Ulnar Nerve
      • 5.9.3 Radial Nerve
      • 5.9.4 Combined Nerve Injury
    • 5.10 Failed Salvage Surgery
    • 5.11 Take-Home Message
  • 6 Management of Complications of Nerve Decompression Surgery
    • 6.1 Part A: Complications of Carpal Tunnel Release
      • 6.1.1 Introduction
      • 6.1.2 Intraoperative Complications
      • 6.1.3 Postoperative Complications
    • 6.2 Part B: Complications and Failure of Cubital Tunnel Surgery
      • 6.2.1 Introduction
      • 6.2.2 Surgery for Ulnar Neuropathy: Different Procedures and Potential Complications
      • 6.2.3 Persistence or Recurrence of CuTS despite Previous Surgery
      • 6.2.4 Prevention and Management of Complications; Tips and Tricks
      • 6.2.5 Conclusions
• Section 3 Bone Surgery: Fracture
  • 7 Management of Finger Fracture Complications
    • 7.1 Finger Stiffness
      • 7.1.1 Evaluation of the Stiff Finger
      • 7.1.2 Treatment of the Stiff Finger
    • 7.2 Malunion
      • 7.2.1 Treatment of Malunions
    • 7.3 Nonunion
      • 7.3.1 Treatment of Nonunions
    • 7.4 Take-Home Message
  • 8 Management of Complications in Carpal Fractures (Malunion, Nonunion)
    • 8.1 Introduction
    • 8.2 Uncommon Carpal Fractures
    • 8.3 Scaphoid Fractures
      • 8.3.1 (Patho-)Physiology of Fracture Healing in the Scaphoid
      • 8.3.2 Complications in Fracture Healing
      • 8.3.3 Surgical Interventions for Complication in the Healing Process
      • 8.3.4 Types of Bone Grafts
      • 8.3.5 Other Options for Proximal Pole Replacement
      • 8.3.6 Treatment Algorithm for Scaphoid Nonunion
    • 8.4 Osteosynthesis Devices
    • 8.5 The Role of Arthroscopic Techniques
    • 8.6 Take-Home Messages
  • 9 Management of Complications of Scaphoid Fracture Fixation
    • 9.1 Introduction
    • 9.2 Hardware Complications
      • 9.2.1 Tips and Tricks
    • 9.3 Scaphoid Nonunion
      • 9.3.1 Risk Factors
      • 9.3.2 Treatment
      • 9.3.3 Tips and Tricks
    • 9.4 Recalcitrant Scaphoid Nonunion
      • 9.4.1 Tips and Tricks
    • 9.5 Scaphoid Malunion
      • 9.5.1 Tips and Tricks
    • 9.6 Miscellaneous Complications
      • 9.6.1 Nerve/Tendon Lesions/Infection
    • 9.7 Take-Home Message
  • 10 Management of Complications in Lunate Facet Fracture Fixation
    • 10.1 Definition and Problem
    • 10.2 Anatomy of the Fracture
    • 10.3 Treatment: Management of Volar Rim Fractures
      • 10.3.1 Surgical Approach
      • 10.3.2 Fixation Techniques
    • 10.4 Arthroscopy
    • 10.5 Lunate Facet Fractures: The Tip of the Iceberg
    • 10.6 Rehabilitation
    • 10.7 Salvage
    • 10.8 Tips and Tricks
    • 10.9 Take-Home Message
  • 11 Management of Complications Following Open Reduction and Plate Fixation of Distal Radius Fractures
    • 11.1 Complications Related to the Surgical Approach
      • 11.1.1 Neuromas due to the Volar Approach
      • 11.1.2 Posterior Interosseous Nerve and Tendon Problems due to the Dorsal Approach
    • 11.2 Complications Related to the Quality of Reduction
      • 11.2.1 Posterior Anterior View
      • 11.2.2 Lateral View
    • 11.3 Complications due to Plate and Screw Position
      • 11.3.1 Volar Plating
    • 11.4 Complications due to Infections
    • 11.5 Take-Home Message
  • 12 Management of Distal Radius Malunion
    • 12.1 Part A: Planning: From Educated Guess toward Computer-Assisted Correction Osteotomies; Pitfalls and Complications
      • 12.1.1 Introduction
      • 12.1.2 Diagnostics
      • 12.1.3 Treatment
      • 12.1.4 Navigation and Fixation
      • 12.1.5 Take-Home Message
    • 12.2 Part B: Practical Guideline: Malunion of Distal Radius
      • 12.2.1 Timing: Early versus Late
      • 12.2.2 How to Do It
      • 12.2.3 How to Deal with the Gap?
      • 12.2.4 Ulna Shortening Osteotomy
      • 12.2.5 Outcome
      • 12.2.6 Complications
      • 12.2.7 Rehabilitation
      • 12.2.8 Tips and Tricks
      • 12.2.9 Take-Home Message
• Section 4 Bone Surgery: Arthritis
  • 13 Treatment of Complications after Surgery for Finger Joint Arthritis
    • 13.1 Introduction
    • 13.2 Complications in PIP and DIP Arthroplasty: Review of the Literature
    • 13.3 Indication for Revision Surgery of Finger Arthroplasty
      • 13.3.1 Implant Fracture or Loosening
      • 13.3.2 Implant Malalignment
      • 13.3.3 Other Causes of Revision
    • 13.4 Solutions for Failed Finger Arthroplasty
      • 13.4.1 Soft Tissue Revisions
    • 13.5 Implant-Related Revisions
      • 13.5.1 Silicone Implants
      • 13.5.2 Two-Component Implants
    • 13.6 Joint Fusion for Failed Implant Arthroplasty
    • 13.7 Complications of PIP and DIP Fusion
    • 13.8 Indication for Revision Surgery for Failed Finger Joint Fusion
    • 13.9 Solutions for Failed Finger Joint Fusion
    • 13.10 Take-Home Message
  • 14 Management of Complications of Thumb CMC Surgery: Trapeziectomy, Arthrodesis, and Total Joint Arthroplasty
    • 14.1 Introduction
    • 14.2 Injury to Sensory Nerve Branches
    • 14.3 Trapeziectomy with and without Ligamentoplasty
      • 14.3.1 Incomplete Trapeziectomy
      • 14.3.2 Scaphotrapezoid Arthritis
      • 14.3.3 Problematic Subsidence of the Thumb Metacarpal
    • 14.4 Trapeziometacarpal Arthrodesis
      • 14.4.1 Nonunion
      • 14.4.2 Hardware-Related Problems
      • 14.4.3 Malpositioning and Reduced Mobility
      • 14.4.4 STT Arthritis
    • 14.5 Thumb Carpometacarpal Joint Arthroplasty
      • 14.5.1 Total Joint Arthroplasty
      • 14.5.2 Pyrocarbon Interposition Arthroplasty
    • 14.6 Arthroscopy
    • 14.7 Take-Home Message
  • 15 Treatment of Complications of Midcarpal Joints Arthritis
    • 15.1 Introduction
    • 15.2 Complications
      • 15.2.1 Infection
      • 15.2.2 Hardware-Associated Problems
      • 15.2.3 Malalignment
      • 15.2.4 Nonunion
      • 15.2.5 Secondary OA
      • 15.2.6 Prosthesis/Spacer
      • 15.2.7 Pain/CRPS
    • 15.3 Stiffness
      • 15.3.1 Causes of Stiffness
      • 15.3.2 Treatment of Stiffness
    • 15.4 Take-Home Message
  • 16 Management of Complications after Salvage Procedures of the Radiocarpal and Distal Radioulnar Joint
    • 16.1 Radiocarpal and Total Wrist Arthrodesis
      • 16.1.1 Definition of the Problem
      • 16.1.2 Treatment of Complications: Nonunion and Hardware Problems
      • 16.1.3 Rehabilitation
      • 16.1.4 Tips and Tricks
    • 16.2 Total and Interpositional Wrist Replacement
      • 16.2.1 Definition of the Problem
      • 16.2.2 Treatment of Complications
      • 16.2.3 Rehabilitation
      • 16.2.4 Tips and Tricks
    • 16.3 The Distal Radioulnar Joint
      • 16.3.1 Definition of the Problem
      • 16.3.2 Treatment of Complications
      • 16.3.3 Tips and Tricks
    • 16.4 Take-Home Message
• Section 5 Ligament Surgery
  • 17 Management of Complications of Ligament Repair of Thumb and Finger Joints
    • 17.1 Introduction
    • 17.2 Indications for Surgery
      • 17.2.1 Short-Term Complications and Their Treatment
      • 17.2.2 Mid-Term Complications and Their Treatment
      • 17.2.3 Long-Term Complications and Their Treatment
    • 17.3 Operative Technique
      • 17.3.1 Preferred Method of Secondary Ligament Reconstruction of the Radial/Ulnar Collateral Ligament of the Thumb MCP Joint
    • 17.4 Foreign Body Material
    • 17.5 Joint Specific Issues
    • 17.6 Take-Home Message
    • 17.7 Diagnostic Pearls
    • 17.8 Technical Tips
  • 18 Treatment of Complications after Scapholunate Ligament Repair
    • 18.1 Complication versus Mistake
    • 18.2 Treatment of Complications after Scapholunate Ligament Repair
      • 18.2.1 Loss of Scapholunate Reduction
      • 18.2.2 Loss of Carpal Reduction
      • 18.2.3 Stiffness
      • 18.2.4 Tendon Complications
      • 18.2.5 Bony Problems
      • 18.2.6 Nerve Complications
      • 18.2.7 Infection
    • 18.3 Take-Home Message
  • 19 Management of Complications Following Surgery to the Triangular Fibrocartilage Complex
    • 19.1 Introduction
      • 19.1.1 Definition and Causes of Complications Following TFCC Repair and Reconstruction
    • 19.2 Clinical Assessment
      • 19.2.1 History and Examination
      • 19.2.2 Investigations
      • 19.2.3 Arthroscopy
    • 19.3 General Overview of Complications Following TFCC Repair and Reconstruction
      • 19.3.1 Complications Following Repair of Superficial Tears
      • 19.3.2 Complications Following Repair of Foveal Fibers
    • 19.4 Addressing Bony Morphology
      • 19.4.1 Acute- on Chronic- with Positive Ulnar Variance
    • 19.5 Avoiding Problems with TFCC Tears: Challenging Scenarios
      • 19.5.1 Missed TFCC Tear with Distal Radius Fixation
      • 19.5.2 The Chronic TFCC Tear with DRUJ Instability
      • 19.5.3 The Chronic TFCC Tear with DRUJ Arthritis
    • 19.6 Algorithm
    • 19.7 Take-Home Message
• Section 6 Soft-Tissue Surgery
  • 20 Complications Following Treatment of Dupuytren’s Disease and Their Management
    • 20.1 Introduction
    • 20.2 General Overview of Complications of Fasciectomy
      • 20.2.1 Specific Complications of Limited Fasciectomy (LF)
      • 20.2.2 Specific Complications of Segmental Fasciectomy (SF)
      • 20.2.3 Specific Complications of Dermofasciectomy (DF)
    • 20.3 General Complications of Fasciotomy
      • 20.3.1 Specific Complications of Percutaneous Needle Fasciotomy (PNF)
      • 20.3.2 Specific Complications of Open Fasciotomy (OF)
    • 20.4 Complications of Treatment with Collagenase (CCH)
    • 20.5 Complications after Treatment with Radiotherapy (RTX)
    • 20.6 Complications of Local Treatment
    • 20.7 Complications of Systemic Treatment
    • 20.8 Take-Home Message
  • 21 Management of Complications in the Treatment of Fingertip Injuries
    • 21.1 Introduction
    • 21.2 Nail Deformities
    • 21.3 Painful Neuroma
    • 21.4 Infection
    • 21.5 Cold Intolerance and Fingertip Hypotrophy
    • 21.6 Authors’ Own Experience and Preferred Technique
      • 21.6.1 Nail Deformities
      • 21.6.2 Painful Neuroma
      • 21.6.3 Infection
      • 21.6.4 Fingertip Hypotrophy
    • 21.7 Take-Home Message
• Section 7 Rehabilitation: How to Prevent and Manage Complications by Hand Therapy
  • 22 Flexor Tendon Repair in Zone 2: Prevention and Management of Complications by Hand Therapy
    • 22.1 Wound Healing—A Paradigm Shift
    • 22.2 Complications
      • 22.2.1 Adhesions versus Ruptures
      • 22.2.2 Bowstringing
    • 22.3 Prevention of Complications
      • 22.3.1 Early Active Motion
    • 22.4 Effective Exercising—Tips and Tricks to Improve Outcomes
      • 22.4.1 Move from the DIP and Not from the PIP
      • 22.4.2 Make Sure the “Right” Tendon Is Moving
      • 22.4.3 Postoperative Exercise—Keep It Simple, Functional, and Relatable
      • 22.4.4 Patient-Centered versus Protocol-Driven Care
    • 22.5 Take-Home Message
  • 23 Peripheral Nerve Surgery: Prevention and Management of Complications by Hand Therapy
    • 23.1 Introduction
    • 23.2 Complications
      • 23.2.1 Edema
      • 23.2.2 Pain
      • 23.2.3 Muscle Strength Loss
      • 23.2.4 Contractures and Shortening (E.g., Muscle Tightness)
      • 23.2.5 Sensory Loss
      • 23.2.6 Autonomic Nerve Function Loss
      • 23.2.7 Psychological Stress
    • 23.3 Future
    • 23.4 Take-Home Message
  • 24 Bone and Joint Surgery: Prevention and Management of Complications by Hand Therapy
    • 24.1 Part A: Hand Therapy: Prevention and Management of Complications in Bone and Joint Fractures
      • 24.1.1 General Principles
      • 24.1.2 Complications
      • 24.1.3 Conclusions
      • 24.1.4 Take-Home Message
    • 24.2 Part B: Rehabilitation after Joint Arthroplasties in the Hand
      • 24.2.1 General principles
      • 24.2.2 Complications
      • 24.2.3 Conclusions
      • 24.2.4 Take-Home Message
• Section 8 CRPS
  • 25 Debunking Complex Regional Pain Syndrome/Sudeck/Reflex Sympathetic Dystrophy
    • 25.1 Introduction
    • 25.2 The Weakness of the CRPS Concept
    • 25.3 The Series
      • 25.3.1 Flare Reaction
      • 25.3.2 Causalgia
      • 25.3.3 Dystonic-Psychogenic Hand
      • 25.3.4 Misdiagnosis–Bad Doctoring
      • 25.3.5 Irritative Carpal Tunnel Syndrome (ICTS)
    • 25.4 Discussion
    • 25.5 Take-Home Message
• Section 9 Social Issues
  • 26 Managing Expectations/Factitious Disorders
    • 26.1 How to Set the Right Patient Expectations before Surgery
    • 26.2 Importance of Patient Expectations with Relationship to Outcome and Unhappiness/Litigation
    • 26.3 Role of the Therapist in Preoperative Counseling
    • 26.4 Factitious Disorders: Definition and Classification
      • 26.4.1 Self-Mutilation
      • 26.4.2 Factitious Edema
      • 26.4.3 Dystonic Posturing
      • 26.4.4 Diagnosis of FD
      • 26.4.5 Management of FD
    • 26.5 Take-Home Message
  • 27 Informed Consent/How to Prevent Medicolegal Issues
    • 27.1 Informed Consent
      • 27.1.1 Background
      • 27.1.2 Elements of Informed Consent
      • 27.1.3 Consent in Children
      • 27.1.4 Financial Consent
      • 27.1.5 Exceptions to Informed Consent
      • 27.1.6 Refusing Consent for Treatment
      • 27.1.7 Documentation
    • 27.2 How to Prevent Medicolegal Issues
      • 27.2.1 Nature of Malpractice Claims
      • 27.2.2 Preventing Medicolegal Issues
  • 28 Complications: What They Do to the Surgeon
    • 28.1 Introduction
    • 28.2 Complications and Errors
      • 28.2.1 What Is a Complication?
      • 28.2.2 The Chance of a Complication
      • 28.2.3 When Is a Complication a Non-negligent Error and When Is It Negligence?
    • 28.3 Avoiding Complications and Consequences
      • 28.3.1 The Competence of a Surgeon
      • 28.3.2 How Can a Surgeon Avoid Complications?
      • 28.3.3 Consent
    • 28.4 What to Do If a Complication Happens
      • 28.4.1 Admit to Yourself a Complication Has Happened
      • 28.4.2 Tell the Patient That a Complication Has Happened
      • 28.4.3 How to Deal with a Natural Complication
      • 28.4.4 How to Deal with an Error
    • 28.5 Effects of Complications on the Surgeon
      • 28.5.1 The Second Victim
      • 28.5.2 Emotional Toil
      • 28.5.3 Risk of Depression and Burnout
    • 28.6 Coping Strategies
      • 28.6.1 Emotional Strategies
      • 28.6.2 Risk Aversion
      • 28.6.3 Institutional Culture
      • 28.6.4 Recovery
      • 28.6.5 Resilience
      • 28.6.6 Summary
  • 29 Complications: What They Do to the Patient
    • 29.1 Introduction
    • 29.2 Trust
    • 29.3 Inconvenience
    • 29.4 Expense
    • 29.5 Functionality
• Index