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Journal of Hand Surgery

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https://www.readbyqxmd.com/read/29137829/effects-of-removal-and-reinsertion-of-headless-compression-screws
#1
Simon M Donald, Rui Niu, Christopher W Jones, Belinda J Smith, Elizabeth C Clarke, Richard D Lawson
PURPOSE: This study investigates the loss of compression when 3 commonly used headless compression screws are backed out (reversed), and assesses the ability to re-establish compression with screws of greater diameter. METHODS: Two investigators tested 3 screw designs (Acutrak 2, Synthes HCS, Medartis SpeedTip CCS) in 2 diameters and lengths. Each design had 10 test cycles in a polyurethane foam bone model with compression recorded using a washer load cell. A 28-mm screw of the narrower diameter was inserted until 2 mm recessed and then reversed 30°, 60°, 90°, 180°, 270°, 360°, and 720°...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132791/in%C3%A2-vitro-kinematic-assessment-of-a-hinged-elbow-orthosis-following-lateral-collateral-ligament-injury
#2
Ranita H Manocha, Graham J W King, James A Johnson
PURPOSE: Elbow lateral collateral ligament injuries (LCLI) are often managed with protected mobilization using a hinged elbow orthosis (HEO). The objective of this investigation was to determine the effectiveness of an HEO in stabilizing the elbow following LCLI. METHODS: Seven fresh-frozen cadaveric upper extremity specimens were studied using a custom simulator that enabled elbow motion via computer-controlled actuators and servomotors attached to relevant tendons...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132790/ulnar-thumb-pulp-reconstruction-using-the-anterograde-homodigital-neurovascular-island-flap
#3
REVIEW
Valeriy Shubinets, River M Elliott
The thumb ulnar pulp is a critical component of key pinch and precision manipulation. Injuries to this area should be reconstructed with robust, sensate tissue that restores bulk and contour. The existing reconstructive options, however, have substantial risks and drawbacks. We describe an anterograde homodigital neurovascular island flap that provides both sensate and durable coverage of the ulnar thumb pulp. The flap uses innervated glabrous tissue, limits donor site morbidity to the thumb and first web space, and does not require microvascular anastomoses or nerve coaptation...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132789/scaphoid-fracture-fixation-in-a-nonunion-model-a-biomechanical-study-comparing-3-types-of-fixation
#4
Avanthi Mandaleson, Stephen K Tham, Craig Lewis, David C Ackland, Eugene T Ek
PURPOSE: Union of a scaphoid fracture after fixation is influenced by various factors, one of which is fracture stability. This study aims to compare the biomechanical stability of 3 different types of scaphoid fracture fixation in a scaphoid nonunion model. METHODS: Thirty cadaveric scaphoid specimens were assigned to one of 3 different fixation groups: (1) single 3.0-mm compression screw, (2) two 2.2-mm screws, and (3) scaphoid plate. A 3-mm volar wedge osteotomy was created at the scaphoid waist to simulate a nonunion model...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132788/arthroscopic-partial-trapeziectomy-with-soft-tissue-interposition-for-symptomatic-trapeziometacarpal-arthritis-6-month-and-5-year-minimum-follow-up
#5
Anthony L Logli, Jonathan Twu, Brian J Bear, Jonathan R Lindquist, Theodore L Schoenfeldt, Kenneth J Korcek
PURPOSE: To determine if arthroscopic partial trapeziectomy (APT) and soft tissue interposition arthroplasty is an effective treatment for symptomatic trapeziometacarpal arthritis. METHODS: We retrospectively evaluated 30 consecutive patients with symptomatic isolated trapeziometacarpal arthritis, Eaton-Littler stages II and III. Treatment consisted of an APT with soft tissue interposition utilizing an acellular dermal matrix as the interposition material. At a minimum of 6 months and 5 years after surgery, Numeric Pain Rating Scale (NPRS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), grip strength, oppositional and appositional pinch strengths, arthroplasty space, and thumb range of motion (ROM) were evaluated...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132787/distal-biceps-brachii-tendon-transfer-for-re-establishing-extrinsic-finger-function-feasibility-study-in-cadavers
#6
Matthew D Welsch, Alexander D Mih, Brock D Reiter, Gregory A Merrell
PURPOSE: To determine the anatomic feasibility of transferring the biceps brachii tendon into either the extensor digitorum communis (EDC) or flexor digitorum profundus (FDP), determine the excursion imparted to EDC and FDP tendons after transfer, and compare the work capacity of the cadaver biceps to previously published data on the biceps as well as the recipient muscles by calculating the physiologic cross-sectional area (PCSA). METHODS: Four fresh-frozen cadaver shoulder-elbow-wrist specimens were used to measure tendon excursion that can be obtained with transfer of the distal biceps tendon into either the EDC or FDP...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132786/outcomes-following-acute-metacarpophalangeal-joint-arthroplasty-dislocation-an-analysis-of-37-cases
#7
Nathan Wanderman, Eric Wagner, Steven Moran, Marco Rizzo
PURPOSE: There remains a paucity of information regarding the treatment outcomes of dislocation after metacarpophalangeal (MCP) joint arthroplasty. The purpose of this study was to assess the outcomes of surgical and nonsurgical treatment modalities of MCP arthroplasty dislocations. METHODS: Of 816 MCP joint arthroplasties over a 14-year period, there were 37 (4%) acute MCP joint dislocations that required intervention by a health care professional. Implants involved included 28 nonconstrained implants including pyrocarbon (n = 17) and surface replacement arthroplasty (n = 11), and 9 silicone implants...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132785/nonrheumatoid-arthritis-of-the-hand
#8
REVIEW
Jonathan Lans, Jacques A Machol, Christian Deml, Neal C Chen, Jesse B Jupiter
Arthropathy of the hand is commonly encountered. Contributing factors such as aging, trauma, and systemic illness all may have a role in the evolution of this pathology. Besides rheumatoid arthritis, other diseases affect the small joints of the hand. A review of nonrheumatoid hand arthropathies is beneficial for clinicians to recognize these problems.
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29122426/anatomical-factors-contributing-to-radial-nerve-excursion-at-the-brachium-a-cadaveric-study
#9
Wayne A Chen, T David Luo, Michael D Wigton, Zhongyu Li
PURPOSE: The radial nerve appears to be more vulnerable to injury in the brachium than the median and ulnar nerves. The underlying mechanism for this increased vulnerability is not well explained. We hypothesize that the radial nerve has less excursion than the median and ulnar nerves because it is anatomically tethered by the lateral intermuscular septum (LIS) and that elbow positioning and LIS release will improve its excursion. METHODS: Eight paired fresh-frozen cadaveric upper extremity specimens were used...
November 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29122425/analgesic-consumption-following-outpatient-carpal-tunnel-release
#10
Blair Peters, Arash Izadpanah, Avinash Islur
PURPOSE: Few studies have examined the consumption of prescribed opioid medications after elective outpatient surgery. A better understanding of opioid consumption after elective upper-extremity surgery may lead to improved prescribing practices, decreased costs, and less leftover medication available for potential misuse. The goal of this study was to evaluate pain control and quantify the amount of leftover pain medication after outpatient carpal tunnel release. METHODS: We performed a prospective study of patients scheduled for outpatient carpal tunnel surgery...
November 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29122424/scaphoid-healing-necessary-for-unrestricted-activity-a-biomechanical-cadaver-model
#11
Michael S Guss, Joshua T Mitgang, Anthony Sapienza
PURPOSE: To determine if scaphoid fractures with bridging bone of 50% of their width treated with a centrally placed screw will restore biomechanical integrity equivalent to that of the intact scaphoid. METHODS: Twenty-four fresh cadaver scaphoids were used. Six were left intact to serve as the control group. Six were osteotomized 50% of their width and made up the osteotomy without screw group. Six were included in the 50% osteotomy plus compression screw group...
November 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29103850/length-changes-in-scapholunate-interosseous-ligament-with-resisted-wrist-radial-and-ulnar-inclination
#12
Jun Tan, Jing Chen, Shuai Mu, Jin Bo Tang, Marc Garcia-Elias
PURPOSE: To investigate the changes in length of the scapholunate interosseous ligament (SLIL) when the wrist is resisting horizontal lateral load and the forearm is in full pronation in vivo. METHODS: We obtained computed tomography scans of the wrists of 6 volunteers in 3 situations: 0° position (0° extension and 0° ulnar inclination) and full forearm pronation without force, and in the same position but with resisted ulnar and radial deviation. Nine zones of 3 subregions of the SLIL were measured and analyzed with computer modeling...
November 2, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29103849/the-effect-of-skin-pigmentation-on-determination-of-limb-ischemia
#13
Elizabeth M Polfer, Ryan M Zimmerman, Eshetu Tefera, Ryan D Katz, James P Higgins, Kenneth R Means
PURPOSE: Timely identification of tissue ischemia is critical, both in the traumatized limb and following free tissue transfer. The purpose of this study was to determine if skin pigmentation affects the ability to detect limb ischemia. METHODS: We conducted a study of healthy controls exposed to limb ischemia. The subjects were classified based on skin pigmentation using a defined skin type assessment tool, a visual color scale, and self-description of race. Participants were randomized by limb and tourniquet status; surgeons were blinded to both...
November 2, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29103848/the-posterior-bundle-s-effect-on-posteromedial-elbow-instability-after-a-transverse-coronoid-fracture-a-biomechanical-study
#14
Dave R Shukla, Elan Golan, Mitch C Weiser, Philip Nasser, Jack Choueka, Michael Hausman
PURPOSE: There has been increased interest in the role of the posterior bundle of the medial collateral ligament (pMUCL) in the elbow, particularly its effects on posteromedial rotatory stability. The ligament's effect in the context of an unfixable coronoid fracture has not been the focus of any study. The purposes of this biomechanical study were to evaluate the stabilizing effect of the pMUCL with a transverse coronoid fracture and to assess the effect of graft reconstruction of the ligament...
November 2, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29089162/tumor-like-conditions-of-the-hand-and-upper-extremity
#15
REVIEW
Courtney E Sherman, Peter M Murray
Tumor-like conditions of the hand and upper extremity typically present as masses and can be confused as more serious conditions. The differential diagnosis of these lesions can cross over with many more commonly recognized benign and malignant upper limb tumors, and it is, therefore, important for the hand surgeon to be familiar with tumor-like conditions. The diagnosis of these lesions often can be made on clinical grounds supported by a careful physical examination and plain film radiography. Advanced imaging and excisional biopsy may be needed in many circumstances to secure the diagnosis given their similarity with bone and soft tissue sarcomas...
October 28, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29107381/circumferential-adipofascial-graft-for-prevention-of-recurrence-of-posttraumatic-radioulnar-synostosis
#16
REVIEW
Michael Wigton, Megan Friend, Zhongyu Li
Radioulnar synostosis can cause substantial loss of function, and surgical treatment can be challenging. Recurrence of the contracture related to scar or reformation of the synostosis is problematic. Several techniques have been described for prevention of recurrence. We present a technique utilizing a free wrap around adipofascial graft for interposition and circumferential coverage of the ulna after resection of the heterotopic bone. We believe this technique has the advantages of technical simplicity, secure interposition, and reliable outcomes...
October 26, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29054355/the-effect-of-bisphosphonates-on-the-clinical-and-radiographic-outcomes-of-distal-radius-fractures-in-women
#17
Kristin E Shoji, Brandon E Earp, Tamara D Rozental
PURPOSE: To compare clinical and radiographic outcomes of distal radius fractures (DRF) treated with nonsurgical management in female postmenopausal patients receiving bisphosphonate (BP) therapy at the time of injury with those not receiving BP therapy. METHODS: We prospectively enrolled 33 female postmenopausal patients with 35 DRF between December 2010 and January 2014 at 2 Level I tertiary care centers. Eleven patients with 12 DRF were currently receiving BP at the time of injury (BP group) and were compared with 22 controls with 23 DRF (CONT group) who were not receiving BP at the time of injury...
October 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29054354/strategies-to-reduce-ischemia-reperfusion-injury-in-vascularized-composite-allotransplantation-of-the-limb
#18
REVIEW
Kavit R Amin, Jason K F Wong, James E Fildes
An important and often underinvestigated contributor to solid organ transplant rejection is ischemia reperfusion injury. This pathophysiological response releases damaging reactive oxygen species and cell stress signals that initiate inflammation, which has a critical role in priming the immune system for allorecognition. In time, this renders graft dysfunction and how this response is mediated in composite tissues remains unknown. Current protocols are drawn from solid organ transplantation with little scientific basis as to how this informs current hand transplantation practices...
October 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29054353/the-rate-of-radial-head-prosthesis-removal-or-revision-a-systematic-review-and-meta-analysis
#19
Amir R Kachooei, Aslan Baradaran, Mohammad H Ebrahimzadeh, C Niek van Dijk, Neal Chen
PURPOSE: We conducted a meta-analysis and systematic review with the primary objective to determine the overall incidence of radial head prosthesis removal or revision. Our secondary objectives addressed the incidence of removal or revision based on the type of prosthesis fixation (cemented, uncemented smooth stem, uncemented press-fit), material (metal, Vitallium, titanium, pyrocarbon), and design (short vs long stem and monopolar vs bipolar), and the reasons for prosthetic removal or revision...
October 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29054352/patient-related-risk-factors-for-infection-following-open-carpal-tunnel-release-an-analysis-of-over-450-000-medicare-patients
#20
Brian C Werner, Victor A Teran, D Nicole Deal
PURPOSE: To establish the rate of postoperative infection after open carpal tunnel release (CTR) on a national level using an administrative database and define relevant patient-related risk factors associated with its occurrence. METHODS: The PearlDiver patient records database was used to query the 100% Medicare Standard Analytic Files retrospectively from 2005 to 2012 for patients undergoing open CTR using Current Procedural Terminology code 64721. Postoperative infection within 90 days of surgery was assessed using both International Classification of Diseases, Ninth Revision codes for diagnoses of postoperative infection or pyogenic arthritis of the wrist and Current Procedural Terminology codes for procedures for these indications, including either open or arthroscopic irrigation and debridement...
October 18, 2017: Journal of Hand Surgery
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