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Hand: Official Journal of the American Association for Hand Surgery

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https://www.readbyqxmd.com/read/29216764/quantifying-the-center-of-elbow-rotation-implications-for-medial-collateral-ligament-reconstruction
#1
Kraig S Graham, Sara Golla, Sebastian V Gehrmann, Robert A Kaufmann
BACKGROUND: Medial collateral ligament (MCL) reconstruction of the elbow mandates precise characterization of where the centerline of elbow rotation projects onto the medial epicondyle (ME). A muscle-splitting approach allows the flexor-pronator muscles to remain attached to the ME and facilitates visualization of the MCL remnant, the sublime tubercle, and the ulnohumeral joint line. Knowledge of where the centerline of rotation intersects the ME relative to the ulnohumeral joint line may assist the surgeon during placement of the proximal drill hole...
December 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29199471/outcomes-of-triceps-rupture-in-the-us-military-minimum-2-year-follow-up
#2
John C Dunn, Nicholas Kusnezov, Austin Fares, Kelly Kilcoyne, E'stephan Garcia, Justin D Orr, Brian R Waterman
BACKGROUND: The objective of this study was to examine the subjective and objective midterm functional clinical outcomes of surgically repaired triceps injuries in a moderate- to high-demand population. METHODS: The US Military Health System was queried to identify all surgically treated triceps tendon ruptures between 2008 and 2013. Primary endpoints included rates of rerupture, perioperative complications, or significant persistent elbow dysfunction; Disability of the Arm, Shoulder and Hand (DASH) score, Mayo Elbow score, and ability to do push-ups were also extracted...
December 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29199470/risk-factors-for-30-day-complications-after-thumb-cmc-joint-arthroplasty-an-american-college-of-surgeons-national-surgery-quality-improvement-program-study
#3
Kalpit N Shah, Steven F Defroda, Bo Wang, Arnold-Peter C Weiss
BACKGROUND: The first carpometacarpal (CMC) joint is a common site of osteoarthritis, with arthroplasty being a common procedure to provide pain relief and improve function with low complications. However, little is known about risk factors that may predispose a patient for postoperative complications. METHODS: All CMC joint arthroplasty from 2005 to 2015 in the prospectively collected American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database were identified...
December 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29192506/extensive-hand-thermal-and-blast-injury-from-electronic-cigarette-explosion-a-case-report
#4
Ellen S Satteson, Nicholas J Walker, Christopher J Tuohy, Joseph A Molnar
BACKGROUND: As the use of electronic cigarettes rises, more reports of injuries related to device explosion are surfacing. METHODS: Presented here is the case of a 35-year-old man sustaining extensive thermal and blast injuries to his hand when the device exploded while he was holding it. He required multiple surgeries involving groin flap coverage, tendon transfer, and nerve grafting to optimize his postinjury function. RESULTS: While much of his hand function has been restored, he has continued deficits in range of motion and sensation as a result of the incident...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29185830/median-nerve-injury-after-removal-of-subdermal-implantable-contraceptive
#5
Joani M Christensen, Nicholas M Caggiano, Aviram M Giladi, Matthew L Iorio
BACKGROUND: Subdermal implantable contraceptives are highly effective, approved in over 60 countries, and used by millions of women. Due to simple insertion and removal protocols, these procedures are often performed in the outpatient clinic setting, and procedural complications are rare. However, given the location of the implant in the medial antebrachial interval, there is a risk of neurovascular injury, especially with malpositioned or deeply placed implants. METHODS: We present a case of proximal median nerve injury leading to severe neuropathy after attempted removal of a subdermal implantable contraceptive requiring neurolysis and tendon transfers...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29185813/the-trapezium-dislocation-case-presentation-review-of-the-literature-radiographic-analysis-proposed-classification-and-treatment
#6
Andrew P Harris, Avi D Goodman, Joseph A Gil, Neill Li, Jeremy Raducha, Arnold-Peter C Weiss
BACKGROUND: Trapezium dislocations are rare injuries. METHODS: A PubMed search of the term "trapezium dislocation" was conducted. Publications reporting a complete trapezium dislocation were included in the review. RESULTS: The PubMed search resulted in 168 results. Fourteen publications reporting on 16 complete trapezium dislocations met inclusion criteria. A case of delayed diagnosis of a trapezium dislocation is presented. The literature is reviewed for pertinent clinically relevant information with respect to trapezium dislocations...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29185810/investigation-into-the-optimal-number-of-intercostal-nerve-transfers-for-musculocutaneous-nerve-reinnervation-a-systematic-review
#7
Hyuma A Leland, Beina Azadgoli, Daniel J Gould, Mitchel Seruya
BACKGROUND: The purpose of this study was to systematically review outcomes following intercostal nerve (ICN) transfer for restoration of elbow flexion, with a focus on identifying the optimal number of nerve transfers. METHODS: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify studies describing ICN transfers to the musculocutaneous nerve (MCN) for traumatic brachial plexus injuries in patients 16 years or older...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29185351/irreducible-galeazzi-fracture-dislocations
#8
Nicholas J Yohe, Jadie De Tolla, Marc B Kaye, David M Edelstein, Jack Choueka
BACKGROUND: Fractures of the radial shaft with disruption of the distal radial ulnar joint (DRUJ) or Galeazzi fractures are treated with reduction of the radius followed by stability assessment of the DRUJ. In rare instances, the reduction of the DRUJ is blocked by interposed structures requiring open reduction of this joint. The purpose of this study is to review all cases of irreducible Galeazzi fracture-dislocations reported in the literature to offer guidelines in the diagnosis and management of this rare injury...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29185350/arthroscopic-resection-of-dorsal-wrist-ganglion-results-and-rate-of-recurrence-over-a-minimum-follow-up-of-4-years
#9
Carlos H Fernandes, Lia M Meirelles, Jorge Raduan Neto, Marcela Fernandes, João Baptista G Dos Santos, Flávio Faloppa
BACKGROUND: Dorsal wrist ganglia are the most common soft tissue tumor type of the upper limb. Surgical resection, open or arthroscopic, is one of the most frequent procedures performed by hand surgeons. This study sought to perform an objective evaluation of the outcomes of arthroscopic resection of dorsal wrist ganglia and their recurrence rates over 4 years. Patients treated with arthroscopic resection were expected to have favorable outcomes and low complication rates after 4 years of follow-up...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29183168/minimal-custom-pack-design-and-wide-awake-hand-surgery-reducing-waste-and-spending-in-the-orthopedic-operating-room
#10
Cassandra L Thiel, Rafaela Fiorin Carvalho, Lindsay Hess, Joelle Tighe, Vincent Laurence, Melissa M Bilec, Mark Baratz
BACKGROUND: The US health care sector has substantial financial and environmental footprints. As literature continues to study the differences between wide-awake hand surgery (WAHS) and the more traditional hand surgery with sedation & local anesthesia, we sought to explore the opportunities to enhance the sustainability of WAHS through analysis of the respective costs and waste generation of the 2 techniques. METHODS: We created a "minimal" custom pack of disposable surgical supplies expressly for small hand surgery procedures and then measured the waste from 178 small hand surgeries performed using either the "minimal pack" or the "standard pack," depending on physician pack choice...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29182026/extensor-carpi-ulnaris-tenodesis-versus-no-stabilization-after-wide-resection-of-distal-ulna-giant-cell-tumors
#11
Ioannis D Papanastassiou, Olga D Savvidou, George D Chloros, Panayiotis D Megaloikonomos, Vasileios A Kontogeorgakos, Panayiotis J Papagelopoulos
BACKGROUND: The necessity of stabilizing the residual ulnar stump after distal ulna tumor resection remains controversial. The authors retrospectively compared the outcome of patients who underwent wide resection of distal ulna giant cell tumors (GCTs) and reconstruction with tenodesis of the extensor carpi ulnaris (ECU) or without reconstruction. METHODS: Between 2007 and 2015, 9 patients (6 females, 3 males; mean age, 36.8 years; range, 24-65 years) who underwent distal ulna resection for GCT of bone were retrospectively reviewed...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29182019/pain-and-function-following-revision-cubital-tunnel-surgery
#12
Kristen M Davidge, Gregory C Ebersole, Susan E Mackinnon
BACKGROUND: The purpose of this study was to determine pain and functional outcomes following revision cubital tunnel surgery and to identify predictors of poor postoperative outcome. METHODS: A retrospective cohort study was conducted of all patients undergoing revision cubital tunnel surgery over a 5-year period at a high-volume peripheral nerve center. Intraoperative findings, demographic and injury factors, and outcomes were reviewed. Average pain, worst pain, and impact of pain on self-perceived quality of life were each measured using a 10-cm visual analog scale (VAS)...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29166787/analysis-of-expected-costs-of-carpal-tunnel-syndrome-treatment-strategies
#13
Michael T Milone, Adnan Karim, Christopher S Klifto, John T Capo
BACKGROUND: Over 500 000 carpal tunnel releases costing over $2 billion are performed each year in the United States. The study's purpose is to perform a cost-minimizing analysis to identify the least costly strategy for carpal tunnel syndrome treatment utilizing existing success rates based on previously reported literature. METHODS: We evaluate the expected cost of various treatment strategies based on the likelihood of further treatments: (1) a single steroid injection followed by surgical release; (2) up to 2 steroid injections before surgical release; (3) 3 steroid injections before surgery, and (4) immediate surgical release...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29166785/elevated-radiation-exposure-associated-with-above-surface-flat-detector-mini-c-arm-use
#14
Dennis P Martin, Talia Chapman, Christopher Williamson, Brian Tinsley, Asif M Ilyas, Mark L Wang
BACKGROUND: This study aims to test the hypothesis that: (1) radiation exposure is increased with the intended use of Flat Surface Image Intensifier (FSII) units above the operative surface compared with the traditional below-table configuration; (2) this differential increases in a dose-dependent manner; and (3) radiation exposure varies with body part and proximity to the radiation source. METHODS: A surgeon mannequin was seated at a radiolucent hand table, positioned for volar distal radius plating...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29121783/trends-in-upper-extremity-injuries-presenting-to-us-emergency-departments
#15
Eric Wenzinger, Angel Rivera-Barrios, Gil Gonzalez, Fernando Herrera
BACKGROUND: The purpose of this study was to identify the incidence of upper extremity injuries presenting to emergency departments (EDs) nationally. METHODS: The Nationwide Emergency Department Sample (NEDS) database was queried using International Classification of Diseases, Ninth Revision (ICD-9) codes specific for hand/wrist injuries to identify national estimates of ED visits. The incidence, mean age, gender, payer mix, hospital type, location (metropolitan vs nonmetropolitan), and geographic region were recorded...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29117740/regional-variations-of-medicare-physician-payments-for-hand-surgery-procedures-in-the-united-states
#16
David R Veltre, Mark Yakavonis, Emily J Curry, Antonio Cusano, Robert L Parisien, Josef K Eichinger, Scott F M Duncan, Andrew B Stein, Xinning Li
BACKGROUND: Medicare reimbursement is known to exhibit geographic variation for inpatient orthopedic procedures. This study determined whether US geographic variations also exist for commonly performed hand surgeries. METHODS: Using the Medicare Provider Utilization and Payment Data (2012-2013) from Centers for Medicare & Medicaid Services, we analyzed regional physician charges/payments for common outpatient hand surgeries. RESULTS: The most commonly performed procedures in the United States were open carpal tunnel release (n = 21 944), trigger finger release (n = 15 345), endoscopic carpal tunnel release (n = 7106), and basal joint arthroplasty/ligament reconstruction and tendon interposition (n = 2408)...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29103305/lower-trapezius-transfer-for-patients-with-brachial-plexus-injury
#17
Bruno E Crepaldi, José Queiroz L Neto, Marcelo R Rezende, Rames M Júnior, Daniele S Scarcella
BACKGROUND: Brachial plexus injury is a complex entity that often results in partial recovery. Most studies to date have focused on improving shoulder abduction. However, a recent technique has been outlined-one that transfers the lower trapezius to improve the external rotation of the shoulder. The primary objective of this study was to evaluate the gains in external rotation of the shoulder in patients who have undergone transfer of the lower trapezius; secondarily, we assessed the range of motion in the elbow and shoulder joints, as well as the muscle strength and quality of life...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29094605/distal-pole-resection-of-the-scaphoid-for-the-treatment-of-scaphotrapeziotrapezoid-osteoarthritis
#18
Merel J-L Berkhout, Yara Bachour, Daan Wessing, Marco J P F Ritt
BACKGROUND: Distal pole resection of the scaphoid is one of the surgical techniques applied for the treatment of painful scaphotrapeziotrapezoid osteoarthritis (STT-OA). METHODS: In this retrospective study, we evaluated midterm outcomes in a consecutive series of patients who underwent distal pole resection of the scaphoid: 13 patients (15 wrists) with a mean follow-up of 4.1 years. We examined objective functional and patient-reported outcome measures. In addition, we assessed the degree of dorsal intercalated segment instability (DISI) and postoperative complications...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29086650/metacarpal-lengthening-in-adults-with-brachymetacarpia
#19
Aaron Lam, Austin T Fragomen, S Robert Rozbruch
BACKGROUND: Metacarpal lengthening by distraction osteogenesis has been well documented in pediatric patients but limited in older patients. Fewer studies have assessed the success of the procedure through outcome measure scores. The purpose of this study is to assess the outcomes of distraction osteogenesis in skeletally mature adults with brachymetacarpia and patients' perspectives on their satisfaction through outcome measure scores. METHODS: Retrospective chart review of a consecutive series of metacarpal lengthenings for the treatment of brachymetacarpia was performed...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29078727/proximal-phalanx-fracture-management
#20
Tim T Lögters, Hannah H Lee, Sebastian Gehrmann, Joachim Windolf, Robert A Kaufmann
BACKGROUND: The goal of proximal phalangeal fracture management is to allow for fracture healing to occur in acceptable alignment while maintaining gliding motion of the extensor and flexor tendons. METHODS: We reviewed the most current literature on various treatment methods of proximal phalanx fractures, focusing on the indications and outcomes of nonoperative as well as operative interventions. RESULTS: Stable fractures can be successfully treated nonoperatively, whereas unstable injuries benefit from surgery...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
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