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Hand: Official Journal of the American Association for Hand Surgery

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https://www.readbyqxmd.com/read/29388487/direct-cost-comparison-of-open-carpal-tunnel-release-in-different-venues
#1
Logan W Carr, Brad Morrow, Brett Michelotti, Randy M Hauck
BACKGROUND: The increased efficiency and cost savings have led many surgeons to move their practice away from the traditional operating room (OR) or outpatient surgery center (OSC) and into the clinic setting. With the cost of health care continuing to rise, the venue with the lowest cost should be utilized. We performed a direct cost analysis of a single surgeon performing an open carpal tunnel release in the OR, OSC, and clinic. METHODS: Four treatment groups were prospectively studied: the hospital OR with monitored anesthesia care (OR-MAC), OSC with MAC (OSC-MAC), OSC with local anesthesia (OSC-local), and clinic with local anesthesia (clinic)...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29388486/distal-radius-allograft-reconstruction-utilizing-a-step-cut-technique-after-en-bloc-tumor-resection
#2
Timothy J Luchetti, Robert W Wysocki, Mark S Cohen
BACKGROUND: En bloc resection of the distal radius is a common treatment for advanced and recurrent giant cell tumors and less commonly for sarcoma. Various reconstructive options exist, including ulnar transposition, osteoarticular autograft and allograft, and allograft arthrodesis. We present a technique of reconstruction using a distal radius bulk allograft with a step-cut to allow for precise restoration of proper length and to promote bony union. METHODS: Preoperative templating is performed with affected and contralateral radiographs to assess the size of the expected bony defect, location of the step-cut, and the optimal size of the distal radius allograft required...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29388485/treatment-trends-complications-and-effects-of-comorbidities-on-distal-radius-fractures
#3
William P Mosenthal, Haroutioun H Boyajian, Sandra A Ham, Megan A Conti Mica
BACKGROUND: Distal radius fractures (DRFs) are the most common upper extremity fractures in adults. This study seeks to elucidate the impact age, fracture type, and patient comorbidities have on the current treatment of DRFs and risk of complications. We hypothesized that comorbidities rather than age would relate to the risk of complications in the treatment of DRFs. METHODS: A retrospective review of data was performed for patients treated between 2007 and 2014 using Truven Health MarketScan Research Databases...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29363359/touch-surgery-analysis-and-assessment-of-validity-of-a-hand-surgery-simulation-app
#4
Jacob Tulipan, Andrew Miller, Andrew G Park, Joseph T Labrum, Asif M Ilyas
BACKGROUND: Surgical educators are increasingly exploring surgical simulation and other nonclinical teaching adjuncts in the education of trainees. The simulators range from purpose-built machines to inexpensive smartphone or tablet-based applications (apps). This study evaluates a free surgery module from one such app, Touch Surgery, in an effort to evaluate its validity and usefulness in training for hand surgery procedures across varied levels of surgical experience. METHODS: Participants were divided into 3 cohorts: fellowship-trained hand surgeons, orthopedic surgery residents, and medical students...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29363358/analysis-of-national-institutes-of-health-funding-in-hand-surgery
#5
Jason Silvestre, Qing Z Ruan, Benjamin Chang
BACKGROUND: Federal research dollars help investigators develop biomedical therapies for human diseases. Currently, the state of funding in hand surgery is poorly understood. This study defines the portfolio of National Institutes of Health (NIH) grants awarded in hand surgery. METHODS: This was a cross-sectional study of hand surgeons in the US. Faculty members of accredited hand surgery fellowships and/or members of the American Society for Surgery of the Hand were queried in the NIH RePORT database for awards obtained during 2005-2015...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29363357/clinical-application-of-mathematical-long-bone-ratios-to-calculate-appropriate-donor-limb-lengths-in-bilateral-upper-limb-transplantation
#6
Justyn Lutfy, Alexis Pietak, Shaun D Mendenhall, Michael W Neumeister
BACKGROUND: Limited methods exist to aid in deciding the appropriate donor limb lengths in bilateral upper limb amputees qualifying for vascularized composite allotransplantation. We hypothesized mathematical equations could be created using long bone length ratios, and applied to radiographs, to approximate the patient's limb length prior to amputation. METHODS: A data set of 30 skeletons' unilateral upper limb long bones measured using osteometric board and calipers was used...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29357702/the-vascularity-and-osteogenesis-of-a-vascularized-flap-for-the-treatment-of-scaphoid-nonunion-the-pedicle-volar-distal-radial-periosteal-flap
#7
Cary Tanner, Toby Johnson, Alex Majors, Vincent R Hentz, Lisa Husak, Edward Walker Gallego, Brad Christ, Nathan Hoekzema
BACKGROUND: Vascularized periosteal flaps from the distal radius have been previously proposed. The purpose of this study was to investigate the vascularity and osteogenic potential of a vascularized volar distal radial periosteal flap for the treatment of scaphoid nonunion. METHODS: In 5 fresh frozen cadavers, a rectangular periosteal flap was elevated from the distal radius with the pedicle just proximal to the watershed line. Latex dye was injected into the radial artery proximally and the vascularity of the flap characterized by microscopic evaluation...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29357701/comparison-of-exposure-in-the-kaplan-versus-the-kocher-approach-in-the-treatment-of-radial-head-fractures
#8
Leslie Fink Barnes, Joseph Lombardi, Thomas R Gardner, Robert J Strauch, Melvin P Rosenwasser
BACKGROUND: The aim of this study was to compare the complete visible surface area of the radial head, neck, and coronoid in the Kaplan and Kocher approaches to the lateral elbow. The hypothesis was that the Kaplan approach would afford greater visibility due to the differential anatomy of the intermuscular planes. METHODS: Ten cadavers were dissected with the Kaplan and Kocher approaches, and the visible surface area was measured in situ using a 3-dimensional digitizer...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29343100/the-effect-of-an-orthopedic-hand-surgeon-s-attire-on-patient-confidence-and-trust
#9
Vince W Lands, Ajith Malige, Chinenye O Nwachuku, Kristofer S Matullo
BACKGROUND: Multiple studies have concluded that patients are more likely to understand and trust physicians who dress in more formal attire (shirt and tie) as opposed to casual attire (t-shirts and jeans). The white coat has repeatedly been reported as a major source of trust and confidence in a patient's eyes. METHODS: This study explores the effect an orthopedic hand surgeon's attire has on a patient's perception of their surgeon's clinical values. All patients 18 years of age and older who visited our orthopedic hand surgeon's suburban outpatient practice were asked to participate in our survey-based study...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29322875/biomechanical-analysis-of-capsular-repair-versus-arthrex-tfcc-ulnar-tunnel-repair-for-triangular-fibrocartilage-complex-tears
#10
Jayson C Johnson, Ferris M Pfeiffer, Jill E Jouret, David M Brogan
BACKGROUND: This study compares the effectiveness of a peripheral capsular repair with a knotless arthroscopic transosseous ulnar tunnel repair (TR) in restoring distal radioulnar joint (DRUJ) stability and stiffness in the setting of a massive triangular fibrocartilage complex (TFCC) tear. METHODS: Eight matched pairs of fresh-frozen cadaveric forearms were tested. Each forearm was tested in supination and pronation using 3-dimensional (3D) optical tracking devices prior to any intervention...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29322874/mrsa-incidence-and-antibiotic-trends-in-urban-hand-infections-a-10-year-longitudinal-study
#11
Justin M Kistler, Joseph J Thoder, Asif M Ilyas
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is the most reported pathogen in hand infections at urban medical centers throughout the country. Antibiotic sensitivity trends are not well known. The purposes of this study were to examine and determine the drug resistance trends for MRSA infections of the hand and to provide recommendations for empiric antibiotic treatment based on sensitivity profiles. METHODS: A 10-year longitudinal, retrospective chart review was performed on all culture-positive hand infections encountered at a single urban medical center from 2005 to 2014...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29322873/trends-and-complications-in-open-versus-endoscopic-carpal-tunnel-release-in-private-payer-and-medicare-patient-populations
#12
Sai K Devana, Andrew R Jensen, Kent T Yamaguchi, Anthony D'Oro, Zorica Buser, Jeffrey C Wang, Frank A Petrigliano, Casimir Dowd
PURPOSE: The purpose of this study was to report trends, complications, and costs associated with endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR). METHODS: Using Current Procedural Terminology (CPT) and International Classification of Diseases, Ninth Revision (ICD-9) codes, patients who had open versus endoscopic carpal tunnel release (CTR) were identified retrospectively in the PearlDiver database from both the Medicare and Humana (a private payer health insurance) populations from 2005 to 2014...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29319352/dual-antegrade-intramedullary-headless-screw-fixation-for-treatment-of-unstable-proximal-phalanx-fractures
#13
Michael P Gaspar, Shiv D Gandhi, Randall W Culp, Patrick M Kane
BACKGROUND: Although intramedullary headless screw (IMHS) fixation is a promising minimally invasive surgical treatment option for unstable proximal phalanx fractures, a single IMHS may provide inadequate fixation for certain fracture patterns. The purpose of this study was to evaluate the short-term clinical outcomes in a pilot series of patients with proximal phalanx fractures treated with dual antegrade IMHS fixation. METHODS: We performed a retrospective chart review of proximal phalanx fractures treated with dual antegrade IMHS fixation with a minimum 1 year of follow-up...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29319351/amniotic-constriction-bands-secondary-deformities-and-their-treatments
#14
Benjamin T Drury, Ghazi M Rayan
BACKGROUND: The purpose of this study was to report the surgical treatment experience of patients with amniotic constriction bands (ACB) over a 35-year interval and detail consequential limb deformities with emphasis on hands and upper extremities, along with the nature and frequency of their surgical treatment methods. METHODS: Fifty-one patients were identified; 26 were males and 25 females. The total number of deformities was listed. The total number of operations, individual procedures, and operations plus procedures that were done for each patient and their frequency were recorded...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29319350/biomechanical-evaluation-of-standard-versus-extended-proximal-fixation-olecranon-plates-for-fixation-of-olecranon-fractures
#15
Allison L Boden, Charles A Daly, Poonam P Dalwadi, Stephanie A Boden, William C Hutton, Raghuveer C Muppavarapu, Michael B Gottschalk
BACKGROUND: Small olecranon fractures present a significant challenge for fixation, which has resulted in development of plates with proximal extension. Olecranon-specific plates with proximal extensions are widely thought to offer superior fixation of small proximal fragments but have distinct disadvantages: larger dissection, increased hardware prominence, and the increased possibility of impingement. Previous biomechanical studies of olecranon fracture fixation have compared methods of fracture fixation, but to date there have been no studies defining olecranon plate fixation strength for standard versus extended olecranon plates...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29313380/an-on-top-plasty-reconstruction-for-complicated-radial-polydactyly
#16
Brian P Kelley, Carrie Kubiak, Kevin C Chung
BACKGROUND: The clinical presentation of radial polydactyly can vary greatly. Careful planning and appreciation of the anatomic subtleties provides alternative surgical options to improve patient outcomes. METHODS: We present a case of a well-formed accessory web space thumb and a hypoplastic primary thumb. RESULTS: Rather than excising the accessory digit, we performed a spare-part, on-top-plasty reconstruction to replace the diminutive distal phalanx of the primary thumb...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29310457/pediatric-ganglion-cysts-a-retrospective-review
#17
Joseph Meyerson, Yangshu L Pan, Maya Spaeth, Gregory Pearson
BACKGROUND: Ganglion cysts are the most common type of soft tissue tumors of the hand. In the pediatric population, monitoring may be appropriate unless cysts are painful, interfering with range of motion or parental concerns exist. Reported recurrence rates after surgical removal of pediatric ganglion cysts vary widely in the literature. Notably, recurrence rates are higher for children than adults, ranging from as low as 6% to as high as 35%. METHODS: A retrospective review was performed of a single pediatric hand surgeon's patients undergoing excision of primary and recurrent ganglion cysts from 2010 to 2015...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29308672/distal-radius-fractures-does-obesity-affect-fracture-pattern-treatment-and-functional-outcomes
#18
Michael D Montague, Jesse T Lewis, Obadah Moushmoush, Jaiyoung Ryu
BACKGROUND: Distal radius fractures (DRFs) are 16% of fractures treated by orthopedic surgeons. Obesity's influence on DRF complexity has not been studied. This study was undertaken to determine if body mass index (BMI) affects DRF pattern, treatment, and functional outcomes. METHODS: Part 1 was a retrospective review of patients who sustained a DRF after a fall from standing height with no prior reduction or treatment. Radiographs were classified as "simple" or "complex...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29303001/transbrachioradialis-approach-to-the-radial-tunnel-an-anatomic-study-of-5-potential-compression-sites
#19
Jason R Ummel, John G Coury, Zachary C Lum, Marc A Trzeciak
BACKGROUND: Recent anatomic studies have failed to demonstrate a single utilitarian approach to intraoperative identification and surgical release of all 5 potential sites of posterior interosseous nerve (PIN) compression in the radial tunnel. This study examines if a single incision brachioradialis-splitting approach without the use of additional anatomic windows is capable of adequately exposing the entire length of the radial tunnel, including all 5 sites of PIN compression to allow for adequate release...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29303000/patient-preferences-and-utilization-of-online-resources-for-patients-treated-in-hand-surgery-practices
#20
Allison J Rao, Christopher J Dy, Charles A Goldfarb, Mark S Cohen, Robert W Wysocki
BACKGROUND: The Internet is a widely used resource by patients however, objective data on details such as frequency of usage and specific sites visited is lacking. We surveyed patients from hand surgery practices to describe patient preferences and utilization patterns for online resources. METHODS: From October 2015 to June 2016, we enrolled patients presenting to 4 orthopedic hand surgeons at 2 academic institutions. Patients completed a survey, with questions related to their preference for learning about their diagnosis and Internet utilization both before and after the visit...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
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