Background: There are different techniques for brachial plexus block, each with their advantages and disadvantages. The usual side-effects are: Incomplete block, especially ulnar nerve, and pneumothorax. We would like to report a modification of the technique which negates these side-effects.Methods: In an applied study, 50 cases (30 males, 20 females) that received a modified technique of interscalen block were studied. The mean age was 35 years. The site for local anesthetic injection was at the junction of the upper two-third and lower one-third of the line joining the midpoint of clavicle and chassaignac tubercle. Average time to production of block, period of sustained anesthesia, and any side-effects and patients' satisfaction were documented.Results: Ulnar nerve block was established in 50 cases. The block was functional within 15 minutes and 44 seconds. The analgesic effect on ulnar nerve was obtained in 96% of the cases, and continued for an average of 3 hours and 32 minutes. Excellent patients' satisfaction was observed in 70% of the cases. No pneumothorax was encountered.Conclusions: Modified interscalenblock is a suitable method of anesthesia for wrist and forearm surgeries with no risk for pneumothorax.

Introduction: Gasless transanal endoscopic microsurgery of rectum promises to offer a safe and effective option for the selective treatment of patients with rectal lesions. This study describes personal experience of using a modified hand-made device for transanal endoscopic surgery to facilitate surgical access to selected intrarectal lesions with an acceptable cost, safety and effectiveness.Materials and Methods: This descriptive cross-sectional study carried out from 2003 to 2005 at Ghaem Hospital of Mashhad University of Medical Sciences. This study was approved by the local committee of Medical Ethics. Nine patients including 4 men and 5 women with rectal polyp or tumors with low likelihood of malignancy enrolled in this study. Transanal endoscopic surgery was performed and pathological studies were done on tissue specimens. Data analyzed by SPSS.Results: The location of the mass in the rectum ranged from 5-20 cm from anal verge, and tumors ranged in size from 2 to 7 cm. Mean age of patients was 65 years. Curative local excision performed in 7 of 9 patients (77.8%). The complications included wound separation (n=1), massive postoperative bleeding (n=1) and temporary incontinence (n=2). There was no mortality, either recurrence within a follow-up period of 20 months. Mean of operative time recorded 55 minutes. Two patients underwent radical operation later, because of rectal polyposis and involved tomour margin.Conclusion: Transanal endoscopic surgery is a safe and effective option for the selective treatment of rectal lesions. The used device lowered the expenses and simplified the system, using a hand-made special rigid cylinder.

Background & Aims: Carpal tunnel surgery is mostly performed in the field of hand surgery. During the procedure the transverse carpal ligament is cut. This ligament has an important role in the strength of the hand. Objective evaluation of the hand strength can be used as a judgment of patient’s ability to return to the previous level of their hand function. The purpose of this study was to evaluate the effect of carpal tunnel surgery in the strength of the hand.Materials & Methods: In a prospective study, patients who had idiopathic carpal tunnel syndrome, were diagnosed by subjective, objective and electrophysiological findings and underwent carpal tunnel surgery. Their hand strengths were evaluated by power and pinch grip before and 6 months after carpal tunnel surgery. Paired T-test was used for statistical analysis. P-values less than 0.05 indicated statistically significant effects.Results: From an initial group of 103, 66 patients with the mean age of 48.98 and mean duration of symptoms almost 4.3 years were included in the study. The mean of the power grip strengths were 52.21 ±16.09 and 48.11 ± 13.98 before and 6 months after the surgery respectively. The mean of the pinch grip strengths were 14.16 ± 4.34 and 15.24 ± 3.3 before and 6 months after the surgery respectively. There were not statistically significant differences between the parameters before and 6 months after the surgery.Conclusion: Carpal tunnel surgery and cutting the transverse carpal tunnel ligament does not have negative effects on the hand strength. The patients have the ability to return to their normal level of hand function 6 months after the surgery.

Emerging technologies are changing hand surgery by improving surgical precision, minimizing tissue disruption, and expediting patient recovery. These advancements have the potential to revolutionize surgical procedures, patient outcomes, and rehabilitation processes. However, there are still challenges that need to be addressed before these technologies can be widely adopted. These challenges include the learning curve for surgeons, high costs, and ethical considerations. Future research should focus on addressing the limitations of these technologies, exploring their long-term effects, and evaluating their cost-effectiveness. To successfully implement them, a collaborative approach involving clinicians, researchers, engineers, and policymakers is necessary. This review provides an overview of current and future trends in emerging technologies for hand orthopedic surgery.