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Journal of Hand Surgery

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https://www.readbyqxmd.com/read/27889093/removal-of-a-contraceptive-implant-from-the-brachial-neurovascular-sheath
#1
Christopher Belyea, Justin Ernat, Rey Gumboc
Subdermal implantable devices are commonly used for long-acting contraception in the United States and Europe. Although relatively safe in nature, their implantation and removal may be associated with potential complications, some of which may require surgical intervention. Complications may include infection, incorrect implantation, migration, or difficulty with removal. Proximal migration has been reported; however, there are no reports of devices that have migrated within the brachial neurovascular sheath...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#2
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27881244/negotiation-how-to-be-effective
#3
REVIEW
Arnold-Peter C Weiss
The art of successful negotiation is not as random or difficult as it might seem at first glance. Most negotiations end up with both sides receiving something of value as well as giving up something valuable in return. It has been said that the best negotiated outcomes occur when both parties walk away a bit disappointed or just a little bit happy. The goal of this short primer is to give some hints as to how to get a slightly better deal than the other party most of the time. There are several points to remember to be able to achieve such an outcome frequently...
November 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27863829/the-effect-of-carpal-tunnel-release-on-typing-performance
#4
Justin W Zumsteg, Matthew J C Crump, Gordon D Logan, Douglas R Weikert, Donald H Lee
PURPOSE: To describe the effect of carpal tunnel release (CTR) on typing performance. METHODS: We prospectively studied 27 patients undergoing open CTR. Patient demographics and clinical characteristics including nerve conduction studies, electromyography results, and duration of symptoms were collected. Before surgery and at 8 time points after surgery, ranging from 1 to 12 weeks, typing performance for an approximately 500-character paragraph was assessed via an on-line platform...
November 15, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27856100/comparison-of-postoperative-complications-associated-with-anesthetic-choice-for-surgery-of-the-hand
#5
Joshua W Hustedt, Andrew Chung, Daniel D Bohl, Neil Olmschied, Scott G Edwards
PURPOSE: There is a recent trend toward performing most hand surgery procedures under local and/or regional anesthesia without sedation. However, little evidence exists regarding the postoperative complications associated with local/regional anesthesia without sedation, especially compared with local/regional anesthesia with sedation or general anesthesia. METHODS: Patients who underwent hand procedures as part of the American College of Surgeons National Surgical Quality Improvement Program were identified...
November 14, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27856099/a-reconstructive-stabilization-technique-for-nontraumatic-or-chronic-traumatic-extensor-tendon-subluxation
#6
REVIEW
Jae Hoon Lee, Jong Hun Baek, Jung Seok Lee
Subluxation of the extensor tendon results from a disruption to the sagittal band at the metacarpophalangeal joint. When conservative treatment fails to correct the subluxation, surgical treatment may be necessary. Surgical techniques for chronic cases vary in graft source and graft pathway. We present a surgical technique to recentralize and stabilize the extensor tendon using a residual ruptured sagittal band. This technique is simple and effective without donor site morbidity and seems to provide potential biomechanical advantages by restoring nearly normal anatomy...
November 14, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27838209/distal-interphalangeal-joint-arthrodesis-complicated-by-postoperative-infection-a%C3%A2-rare-presentation-of-disseminated-herpes-simplex-virus
#7
Meredith N Osterman, Michael P Gaspar
Postoperative infection after elective arthrodesis of the interphalangeal joint is an uncommon complication often necessitating urgent debridement. We present the rare case of a female patient with a history of oral herpetic lesions, who underwent elective arthrodesis of the middle and index fingers for treatment of erosive osteoarthritis and subsequently developed a postoperative herpetic infection at the surgical site.
November 9, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27817941/trigger-finger-caused-by-extraskeletal-chondroma
#8
Karl Schwaiger, Florian Ensat, Daniel Neurreiter, Gottfried Wechselberger, Michaela Hladik
Chondroma is a relatively rare, but well-reported benign neoplasm. This lesion normally occurs attached to bone; however, they may be rarely found without association to bone and embedded in soft tissue. The authors describe the case of a 76-year-old man in whom flexor tendon triggering was associated with an extraskeletal chondroma between the annular ligament and the flexor tendon.
November 3, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27765455/evaluating-the-effect-of-comorbidities-on%C3%A2-the-success-risk-and-cost-of-digital%C3%A2-replantation
#9
Joshua W Hustedt, Andrew Chung, Daniel D Bohl, Neil Olmscheid, Scott Edwards
PURPOSE: The clinical decision to replant an amputated digit is driven primarily by surgical indication. However, the extent to which patient comorbidity should play into this decision is less well defined. This study was designed to determine the effect of patient comorbidities on the success, risk, and cost of digital replantation. METHODS: All amputation injuries and digital replantation procedures captured by the National Inpatient Sample during 2001 to 2012 were identified...
October 17, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27751780/multifocal-neuropathy-expanding-the-scope-of-double-crush-syndrome
#10
REVIEW
Brian H Cohen, Michael P Gaspar, Alan H Daniels, Edward Akelman, Patrick M Kane
Double crush syndrome (DCS), as it is classically defined, is a clinical condition composed of neurological dysfunction due to compressive pathology at multiple sites along a single peripheral nerve. The traditional definition of DCS is narrow in scope because many systemic pathologic processes, such as diabetes mellitus, drug-induced neuropathy, vascular disease and autoimmune neuronal damage, can have deleterious effects on nerve function. Multifocal neuropathy is a more appropriate term describing the multiple etiologies (including compressive lesions) that may synergistically contribute to nerve dysfunction and clinical symptoms...
October 14, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27751778/online-health-information-seeking-in-hand-and-upper-extremity-surgery
#11
Sezai Özkan, Jos J Mellema, Adam Nazzal, Sang-Gil Lee, David Ring
PURPOSE: Information gathering is a key component of shared decision making and has a measurable effect on treatment decisions. Access to health information might improve quality of care in hand surgery. Our purpose was to identify socio-demographic, condition-related, and psychosocial factors associated with online information-seeking behavior in patients with hand and upper-extremity conditions. METHODS: From June 2015 to February 2016, we enrolled 134 patients with an upper-extremity condition who presented to an outpatient hand surgery office at an urban level I trauma center in this cross-sectional study...
October 14, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27743752/endoscopic-repair-of-acute-and-chronic-retracted-distal-biceps-ruptures
#12
REVIEW
Deepak N Bhatia
Distal biceps tendon (DBT) ruptures are infrequent injuries that result in pain, weakness, and cosmetic deformity. Severe retraction of the ruptured DBT can occur at the time of injury, or in chronic neglected ruptures, and surgical exposure is performed using a single incision or a 2-incision technique. The technique presented here describes an endoscopic approach using 3 portals that provide access to the retracted DBT, biceps sheath, and radial tuberosity. Preoperative sonographic localization of the retracted DBT and neurovascular structures is used to guide portal placement...
October 12, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27743751/use-of-a-dermal-regeneration-template-wound-dressing-in-the-treatment-of-combat-related-upper-extremity-soft-tissue-injuries
#13
Ian L Valerio, Zachary Masters, Jonathan G Seavey, George C Balazs, Derek Ipsen, Scott M Tintle
PURPOSE: To assess the outcomes of treatment with a dermal regeneration template (DRT) in a cohort of combat casualties with severe upper extremity injuries. METHODS: Records of all active duty military patients treated with DRT at our institution between November 2009 and July 2013 were screened. Inclusion criteria were upper extremity open wounds sustained during combat, requiring split-thickness or full-thickness skin grafting for closure. The primary outcome measure was wound healing after the first attempt at definitive treatment (defined as the first application of split-thickness or full-thickness skin graft)...
October 12, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27707565/relationship-between-ulnar-variance-cortical-bone-density-and-load-to-failure-in-the-distal-radius-at-the-typical-site-of-fracture-initiation
#14
Danielle J Casagrande, Randal P Morris, Nikoletta L Carayannopoulos, William L Buford
PURPOSE: Increased ulnar variance has been shown to lead to diminished load borne by the distal radius. The purpose of this study was to determine the correlations among ulnar variance, bone mineral density, and load to failure at the distal radius. METHODS: Posteroanterior radiographs and computed tomographic scans were taken of 12 cadaveric forearms in neutral rotation. Ulnar variance was measured for each wrist by the method of perpendiculars. Measurements of cortical, trabecular, and combined bone density were made at the distal radius...
October 1, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27707564/a-systematic-review-and-meta-analysis-examining-the%C3%A2-differences-between-nonsurgical-management-and%C3%A2-percutaneous-fixation-of-minimally-and-nondisplaced-scaphoid-fractures
#15
Hassan Alnaeem, Salah Aldekhayel, Johnathan Kanevsky, Omar Fouda Neel
PURPOSE: The optimal management of undisplaced scaphoid fractures remains controversial. A systematic review was conducted to assess the outcomes of acute, undisplaced scaphoid fractures managed with cast immobilization versus percutaneous or miniopen screw fixation in terms of time to return to work (RTW), time to union, and morbidity. METHODS: PubMed MEDLINE, Ovid MEDLINE, EMBASE, SCOPUS, and Cochrane electronic databases were searched over the period 1974 to 2015...
October 1, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27671768/risk-factors-for-30-day-postoperative-complications-following-open-reduction-internal-fixation-of-proximal%C3%A2-ulna-fractures
#16
Nikunj N Trivedi, Matthew R Cohn, Samir K Trehan, Aaron Daluiski
PURPOSE: Fractures of the proximal ulna are common injuries in the elderly population. These fractures can be managed nonsurgically or with open reduction internal fixation (ORIF). Whereas nonsurgical management may lead to a relative loss of elbow extension and to nonunion, ORIF carries a risk of complications. Although complications specific to the orthopedic intervention have been reported, few studies have identified postoperative systemic complications in this higher-risk group. The purposes of this study were to determine the rate of systemic complications in patients undergoing surgical fixation of proximal ulna fractures and to determine risk factors for complications...
September 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27671767/scaphoid-fractures-nonunion-and%C3%A2-malunion
#17
Jessie Janowski, Caitlyn Coady, Louis W Catalano
The treatment of scaphoid nonunion and malunions has undergone a considerable transition since the 1960 modification of Matti's technique by Russe.(1) We present a review of articles with clear data on union rates and functional status to review the current methods of treatment for scaphoid nonunion and malunion.
September 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27671766/cost-of-immediate-surgery-versus-non-operative-treatment-for-trigger-finger-in-diabetic-patients
#18
Gaurav Aman Luther, Praveen Murthy, Philip E Blazar
PURPOSE: As health care costs continue to rise, providers must increasingly identify and implement cost-effective practice measures without sacrificing quality of care. Corticosteroid injections are an established treatment for trigger finger; however, numerous clinical trials have documented the limited efficacy of these injections in the diabetic population. Furthermore, the most cost-effective treatment strategy for diabetic trigger finger has not been determined. The purpose of this study was to perform a decision analysis to identify the least costly strategy for effective treatment of diabetic trigger finger using existing evidence in the literature...
September 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27663055/effects-on-the-distal-radioulnar-joint-of-ablation-of%C3%A2-triangular-fibrocartilage-complex-tears-with-radiofrequency-energy
#19
Michaela Huber, Markus Loibl, Christoph Eder, Richard Kujat, Michael Nerlich, Sebastian Gehmert
PURPOSE: This cadaver study investigated the temperature profile in the wrist joint and distal radioulnar joint (DRUJ) during radiofrequency energy (RFE) application for triangular fibrocartilage complex resection. METHODS: An arthroscopic partial resection of the triangular fibrocartilage complex using monopolar and bipolar RFE was simulated in 14 cadaver limbs. The temperature was recorded simultaneously in the DRUJ and at 6 other anatomic locations of the wrist during RFE application...
September 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27663054/radial-to-axillary-nerve-transfers-a%C3%A2-combined-case-series
#20
Mihir J Desai, Charles A Daly, John G Seiler, Walter H Wray, David S Ruch, Fraser J Leversedge
PURPOSE: Loss of active shoulder abduction after brachial plexus or isolated axillary nerve injury is associated with a severe functional deficit. The purpose of this 2-center study was to retrospectively evaluate restoration of shoulder abduction after transfer of a radial nerve branch to the axillary nerve for patients after brachial plexus or axillary nerve injury. METHODS: Patients who underwent transfer of a radial nerve branch to the anterior branch of the axillary nerve between 2004 and 2014 were reviewed...
September 20, 2016: Journal of Hand Surgery
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