Hand Soft Tissue

Prevention: vitamin C 500mg daily for 50 days in distal radius fractures treated conservatively — contested — The Zollinger RCT and a 2017 meta-analysis support 500mg x 50 days, but a 2015 meta-analysis found no significant reduction in CRPS (RR 0.45, 95% CI 0.18-1.13) and graded the evidence low quality — medium confidence — source

Collagenase: may inject up to 1.6mg for multiple digits — incorrect dose — FDA label: 0.58 mg per palpable cord, up to 2 joints in the same hand per treatment visit (maximum 1.16 mg), not 1.6 mg — source

Dupuytren recurrence: 80% collagenase, 60% fasciotomy, 40% selected fasciectomy, 20% open fasciectomy — imprecise/overstated — 5-year series report lower rates: CORDLESS collagenase overall ~47% (MCP ~40%, PIP ~66%); van Rijssen RCT needle fasciotomy 85% vs limited fasciectomy 21% — medium confidence — source

In carpal tunnel syndrome NCV shows increased distal motor latency >4.2s — unit error — distal motor latency is measured in milliseconds; normal median DML is <=4.2 ms and >4.2 ms is abnormal — source

66% have recovery of motor function within 1 month in Parsonage-Turner syndrome — misleading/unsupported — secondary sources cite 66% early partial or any recovery at 1 month; validated functional recovery is 36% at 1 year, 75% at 2 years and 89% at 3 years — medium confidence — source

All four Kanavel signs positive gives >90% sensitivity for flexor tenosynovitis — conflates individual sign sensitivity with all four; misleading — individual Kanavel signs have 91-97% sensitivity but poor specificity (51-69%); all four are present in only a minority and are specific rather than >90% sensitive — source

The thumb-in-palm with ulnar deviation manoeuvre is Finkelstein's test — naming conflation — The thumb-in-palm then ulnar deviation manoeuvre is the **Eichhoff test**, commonly misnamed Finkelstein's test; the true Finkelstein test has the examiner grasp the thumb and ulnar-deviate the wrist and is more specific with fewer false positives — source

Breslow classification: I <0.75mm, II 0.76-1.5mm, III 1.6-4mm, IV >4mm — outdated — This is Breslow's original prognostic classification; current AJCC 8th edition T categories use 1/2/4mm thresholds (T1 <1.0mm, T2 >1.0-2.0mm, T3 >2.0-4.0mm, T4 >4.0mm), with T1 subdivided at 0.8mm and thickness rounded to the nearest 0.1mm — source

Subungual melanoma 5-year survival 40% — contested — Survival varies widely by study and stage; 5-year overall survival ~40% in an MD Anderson cohort but 5-year melanoma-specific survival 56-82% in other series, so a single 40% figure is potentially misleading — medium confidence — source

50% of congenital trigger thumbs resolve by 2 years and only <10% resolve if unresolved beyond 2 years — imprecise/optimistic — Published resolution rates vary widely: about 30-50% over several years, with some studies reporting 32-76% by 5 years; resolution is uncommon after age 2 and surgery is generally not advised before age 3. — medium confidence — source