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Journal of Hand Surgery

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https://www.readbyqxmd.com/read/28606437/the-effect-of-price-on-surgeons-choice-of-implants-a%C3%A2-randomized-controlled-survey
#1
Amy S Wasterlain, Eitan Melamed, Ricardo Bello, Raj Karia, John T Capo
PURPOSE: Surgical costs are under scrutiny and surgeons are being held increasingly responsible for cost containment. In some instances, implants are the largest component of total procedure cost, yet previous studies reveal that surgeons' knowledge of implant prices is poor. Our study aims to (1) understand drivers behind implant selection and (2) assess whether educating surgeons about implant costs affects implant selection. METHODS: We surveyed 226 orthopedic surgeons across 6 continents...
June 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28606436/a-comparative-outcome-study-of-hamstring-versus-tibialis-anterior-and-synthetic-grafts-for-deltoid-to-triceps-transfers
#2
Jennifer A Dunn, Khalid D Mohammed, Gordon P Beadel, Alastair G Rothwell, Jeremy W Simcock
PURPOSE: To assess elbow extension strength and complications after deltoid-triceps transfers using hamstring tendon graft compared with tibialis anterior and synthetic tendon grafts. METHODS: A retrospective review of deltoid-triceps transfers in patients with tetraplegia performed between 1983 and 2014. RESULTS: Seventy-five people (136 arms) had surgery performed, with the majority undergoing simultaneous bilateral surgery (n = 61; 81%)...
June 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28606435/cost-minimization-analysis-of-ganglion-cyst-excision
#3
Eric Quan Pang, Steven Zhang, Alex H S Harris, Robin N Kamal
PURPOSE: Cost minimization analysis can be employed to determine the least costly option when multiple treatments lead to equivalent outcomes. We present a cost minimization analysis from the payers' perspective, of the direct per patient cost of arthroscopic versus open ganglion cyst excision. We tested the null hypothesis that there is no difference in cost between the 2 procedures from the payer perspective. METHODS: We utilized data from a private payer administrative claims database comprising 16 million individuals from 2007 to 2015...
June 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28606434/the-relationships-between-surface-measurements-and%C3%A2-underlying-tendon-autograft-length-for-upper%C3%A2-extremity-reconstructive-surgery
#4
Michael T Milone, Mikael Starecki, Omri Ayalon, Michael W Aversano, Anthony Sapienza
PURPOSE: The availability of tendon grafts is an important consideration for successful upper extremity reconstructive surgery, including flexor or extensor tendon reconstructions, tendon transfers, and ligament reconstructions. Graft selection is based on availability, expendability, ease of harvest, and length. Given variations in patient height and extremity length, existing average values may provide suboptimal insight into actual tendon lengths available. The purpose of this study is, therefore, to pursue a method of estimating available donor tendon lengths based on easily measured anatomical surface landmarks...
June 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28606433/plate-osteosynthesis-of-proximal-ulna%C3%A2-fractures-a-biomechanical-micromotion-analysis
#5
Michael Hackl, Katharina Mayer, Mareike Weber, Manfred Staat, Roger van Riet, Klaus Josef Burkhart, Lars Peter Müller, Kilian Wegmann
PURPOSE: Double plating has been promoted, in recent years, as an alternative treatment method for proximal ulna fractures. This study aimed to compare the biomechanical properties of double-plate osteosynthesis with posterior plate fixation using a novel investigational design utilizing a 3-dimensional camera system to analyze fracture micromotion. METHODS: Fourteen fresh-frozen specimens were available for this study. Mayo type IIA fractures of the olecranon were created and internal fixation was performed with either an angular stable posterior plate or angular stable double plates...
June 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28601513/a-biomechanical-comparison-of-distal-fixation-for-bridge-plating-in-a-distal-radius-fracture-model
#6
Ram K Alluri, Sofia Bougioukli, Milan Stevanovic, Alidad Ghiassi
PURPOSE: To compare the biomechanical properties of second versus third metacarpal distal fixation when using a radiocarpal spanning distraction plate in an unstable distal radius fracture model. METHODS: Biomechanical evaluation of the radiocarpal spanning distraction plate comparing second versus third metacarpal distal fixation was performed using a standardized model of an unstable wrist fracture in 10 matched-pair cadaveric specimens. Each fixation construct underwent a controlled cyclic loading protocol in flexion and extension...
June 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28600107/remote-collection-of-patient-reported-outcomes-following-outpatient-hand-surgery-a-randomized-trial-of-telephone-mail-and-e-mail
#7
Justin Schwartzenberger, Angela Presson, Adam Lyle, Andrew O'Farrell, Andrew R Tyser
PURPOSE: Obtaining remote patient-reported outcomes (PRO) is limited by low patient response rates and resource-intensive collection methods. We hypothesized that an e-mail-delivered Web-based data collection tool would outperform the traditional methods of telephone and standard mail for collecting long-term Boston Carpal Tunnel Questionnaire (BCTQ) scores at a minimum of 1 year following carpal tunnel release (CTR). METHODS: We conducted a randomized trial of 969 patients who underwent CTR at a tertiary medical center within the past 5 years...
June 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28552442/evaluation-of-bone-atrophy-after-treatment-of-forearm-fracture-using-nonlinear-finite-element-analysis-a-comparative-study-of-locking-plates-and-conventional-plates
#8
Yusuke Matsuura, Tomoyuki Rokkaku, Takane Suzuki, Andrew Ryan Thoreson, Kai-Nan An, Kazuki Kuniyoshi
PURPOSE: Forearm diaphysis fractures are usually managed by open reduction internal fixation. Recently, locking plates have been used for treatment. In the long-term period after surgery, some patients present with bone atrophy adjacent to the plate. However, a comparison of locking and conventional plates as a cause of atrophy has not been reported. The aim of this study was to investigate long-term bone atrophy associated with use of locking and conventional plates for forearm fracture treatment...
May 26, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28550986/acute-deep-infections-of-the-upper-extremity-the-utility-of-obtaining-atypical-cultures-in-the-presence-of%C3%A2-purulence
#9
Nikolas H Kazmers, George W Fryhofer, Daniel Gittings, David J Bozentka, David R Steinberg, Benjamin L Gray
PURPOSE: In the setting of acute deep upper extremity infections, evidence is lacking to guide the decision whether to send atypical cultures (fungal and acid-fast-bacillus [AFB]) during surgical debridement, especially in the presence of purulent fluid that is commonly observed with typical bacterial infections. Our purpose was to determine the frequency of positive atypical cultures and the frequency with which they alter treatment, and identify factors associated with positive atypical cultures...
May 25, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28549895/needle-free-jet-lidocaine-administration-for-preinjection-anesthesia-in-trigger-finger-injection-a%C3%A2-randomized-controlled-trial
#10
Brandon E Earp, Spencer J Stanbury, Ariana N Mora, Philip E Blazar
PURPOSE: To evaluate the efficacy of needle-free jet lidocaine (J-tip) administration for pain reduction in trigger finger corticosteroid injection compared with simultaneous lidocaine injection with corticosteroid. METHODS: A prospective randomized clinical trial was performed in which patients received either 0.25 mL of 2% lidocaine administered by J-tip just prior to 0.5 mL of corticosteroid injection by needle or 0.5 mL of 1% lidocaine and 0.5 mL of corticosteroid administered simultaneously through a needle for the treatment of trigger finger...
May 24, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28549894/diagnosis-and-management-of-dermatofibrosarcoma-protuberans-in-a%C3%A2-3-year-old-patient
#11
Rajiv Iyengar, Elizabeth Kiwanuka, Shamlal Mangray, Antonio P Cruz, Julia Katarincic, Reena Bhatt
In this case report, we present a 3-year-old boy with a diagnosis of dermatofibrosarcoma protuberans (DFSP) on the dorsum of his right hand. Although rarely metastatic, DFSP is highly locally invasive and can cause considerable local morbidity. In the hand, DFSP is uncommon in the young pediatric patient. In our patient, the tumor extended down to the second and third metacarpal heads and was treated with a multistaged excision of his tumor to achieve negative margins under slow Mohs micrographic surgery.
May 24, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28549893/anesthetic-neurotoxicity-in-congenital-hand-surgery-an-overview-of-the-evidence-and-advice-for-counseling-parents
#12
REVIEW
Michael S Gart, Santhanam Suresh, Joshua M Adkinson
Millions of children undergo general anesthesia for surgical procedures each year, the implications of which are not fully understood. Animal models demonstrate neurotoxicity and long-term cognitive impairment following exposure to common general anesthetic agents. However, it is unclear if human brains are affected in a similar fashion and what-if any-the implications on cognitive development may be. Furthermore, it is not known if these effects are additive and if they can be avoided by delaying reconstruction...
May 24, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28549892/radial-head-arthroplasty-in-the-active-duty-military-service-member-with-minimum-2-year-follow-up
#13
John C Dunn, Nicholas A Kusnezov, Logan R Koehler, Emmanuel D Eisenstein, Kelly G Kilcoyne, Justin D Orr, Justin S Mitchell
PURPOSE: Radial head arthroplasty (RHA) is a viable treatment for complex radial head fracture. Whereas elbow stability and function is typically restored at short- to mid-term follow-up, the outcome in higher-demand populations is not well defined. We sought to characterize the functional and occupational outcomes following RHA in an active duty military population with intense upper extremity demands. METHODS: We retrospectively reviewed the records of all U.S...
May 24, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28533002/the-radial-aspect-of-the-distal-radial-metaphysis-diaphysis-as-a-source-of-cortical-bone-graft
#14
REVIEW
Steven Regal, Aakash Chauhan, Peter Tang
Cortical bone grafting is commonly required in the finger, hand, and carpus when managing bony trauma. A donor site that can provide a small or large amount of cortical bone graft that is easily accessible and within the same surgical field would be the ideal donor site. In high-energy injuries, a long cortical graft may be needed to reconstruct massive bony defects. In low-energy injuries such as scaphoid nonunions in which a wedge graft is needed, a reliable and easily accessible source of bone grafting would be beneficial...
May 19, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28526166/transhumeral-anterior-radial-nerve-transposition-to-simplify-anticipated-future-humeral-reconstruction
#15
REVIEW
David A Muzykewicz, Reid A Abrams
Anterior transhumeral radial nerve transposition has been described in the treatment of humeral shaft fracture to protect the nerve from implant irritation or callus entrapment. Transposing the radial nerve through a facilitating humeral defect also simplifies revision surgery should nonunion result. Here we describe a surgical technique for anterior transhumeral radial nerve transposition for complex humeral reconstruction when subsequent revision surgery is anticipated. Three cases are used for illustration: (1) revision of a total elbow arthroplasty with periprosthetic fracture; (2) revision of a total elbow arthroplasty after aseptic loosening from an allograft/prosthesis composite; and (3) septic humeral nonunion with substantial bone loss...
May 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28501341/chronic-boutonniere-deformity-cross-lateral-band-technique-using-palmaris-longus-autograft
#16
Serdar Duzgun, Alpay Duran, Ekrem Keskin, Ahmet K Yigit, Hasan Buyukdogan
PURPOSE: The purpose of this study was to evaluate the outcomes of treatment of chronic boutonniere deformity with a reconstruction technique using palmaris longus autograft. MATERIALS AND METHODS: Seven patients with chronic, posttraumatic, flexible boutonniere deformities referred to our clinic between January 2010 and September 2014 were included in the study. In all 7 patients, the lateral bands were deficient or damaged beyond repair. A novel reconstruction technique for chronic boutonniere deformity utilizing palmaris longus autograft was used...
May 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28501340/epitendinous-first-repair-of-zone-ii-flexor-digitorum-profundus-results-in-decreased-gliding-resistance
#17
Michael G Galvez, Garet C Comer, Arhana Chattopadhyay, Chao Long, Anthony W Behn, James Chang
PURPOSE: The importance of flexor tendon repair with both core and epitendinous suture placement has been well established. The objective of this study was to determine whether suture placement order affects gliding resistance and bunching in flexor digitorum profundus tendons in a human ex vivo model. METHODS: The flexor digitorum profundus tendons of the index, middle, ring, and little fingers of paired cadaver forearms were tested intact for excursion and mean gliding resistance in flexion and extension across the A2 pulley...
May 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28499510/effect-of-policy-change-on-the-use-of-long-distance-transport-and-follow-up-care-for-patients-with-traumatic-finger-amputations
#18
Michael T Nolte, Melissa J Shauver, Kevin C Chung, Aviram M Giladi
PURPOSE: In January 2006, the American College of Emergency Physicians released updated guidelines for air transfer. Digit amputation and near-amputation were no longer an indication for this costly service. We analyzed the effect of this update on the use of air transport and associated care outcomes for finger amputation patients and examined factors involved in providing follow-up care for these patients. METHODS: A retrospective chart review identified all patients treated for traumatic finger amputation between 1995 and 2012 at a major hand trauma referral center...
May 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28495027/medial-femoral-condyle-microvascular-bone-transfer-as-a-treatment-for-capitate-avascular-necrosis-surgical-technique-and-case-report
#19
Nikolas H Kazmers, Joshua C Rozell, Kevin M Rumball, Scott H Kozin, Dan A Zlotolow, L Scott Levin
Avascular necrosis (AVN) of the capitate is a rare clinical entity for which a variety of treatment options have been described, ranging from immobilization to microvascular bone transfer. Outcomes following medial femoral condyle corticocancellous free flap reconstruction have not been reported for this specific pathology. We present the case of a 16-year-old girl with posttraumatic capitate AVN who was treated with curettage and medial femoral condyle corticocancellous vascularized bone grafting. At 18 months after surgery, the patient remains pain-free and had resumed all activities including lifeguarding by 6 months after surgery...
May 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28479225/biomechanics-and-pinch-force-of-the-index-finger-under-simulated-proximal-interphalangeal-arthrodesis
#20
Paul Arauz, Karen DeChello, Alexander Dagum, Sue Ann Sisto, Imin Kao
PURPOSE: To analyze the effect of simulated proximal interphalangeal (PIP) joint arthrodesis on distal interphalangeal (DIP) joint free flexion-extension (FE) and maximal voluntary pinch forces. METHODS: Five healthy subjects were tested with the PIP joint unconstrained and constrained to selected angles to produce (1) free FE movements of the DIP joint at 2 selected angles of the metacarpophalangeal joint, and (2) maximal voluntary tip (thumb and index finger) and chuck (thumb, index, and middle fingers) pinch forces...
May 4, 2017: Journal of Hand Surgery
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