OKOJ, Volume 13, No. 10

Chronic Hand Infections

Chronic infections of the hand can be debilitating if not adequately managed, with complications including stiffness and contracture and consequences not infrequently including amputation. Such infections are most often caused by fungi, , and atypical mycobacterial species. Early diagnosis and timely management are of paramount importance in avoiding the potential consequences of chronic hand infections. Treatment ranges from the use of topical antifungal agents and steroids to synovectomy or tenosynovectomy and surgical débridement and drainage for deep chronic mycobacterial infections. Most patients with successfully treated infections of the hand are left with substantial functional compromise and require extended rehabilitation.

    • Keywords:
    • chronic paronychia

    • onychomycosis

    • mycobacterial infections

    • fungal infections

    • aspergillosis

    • blastomycosis

    • sporotrichosis

    • coccidioidomycosis

    • cryptococcosis

    • histoplasmosis

    • candidiasis

    • chronic osteomyelitis

    • Subspecialty:
    • Hand and Wrist

Practical Applications of Patient-specific Instrumentation in Shoulder Surgery

Aseptic loosening of the glenoid component is the most common complication in anatomic total shoulder arthroplasty, and improper placement of the glenoid component is an important yet controllable cause of this complication. The literature shows that even experienced surgeons are often inaccurate when using radiographs, CT scans, and standard instrumentation for positioning of the glenoid component, particularly in shoulder joints with more severe pathology. The surgeon can more accurately place the glenoid component in the desired location using advanced techniques and tools, such as three-dimensional preoperative planning and templating, patient-specific instrumentation, and computer-assisted navigation. However, although these tools improve the accuracy of placement of the glenoid component, further work is needed to define its optimal position in cases of acquired and/or developmental bone loss. Before the advanced technologies named above can be more widely adopted, reductions are needed in their costs and in the intraoperative time required for their use.

    • Keywords:
    • patient-specific instrumentation

    • three-dimensional planning

    • computer-assisted navigation

    • glenoid

    • shoulder arthroplasty

    • Subspecialty:
    • Shoulder and Elbow