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Hand: Official Journal of the American Association for Hand Surgery

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https://www.readbyqxmd.com/read/30518263/improving-strength-and-quality-of-epitendinous-repairs
#1
Angel Farinas, Michael Stephanides, Steven Schneeberger, Alonda Pollins, Nancy Cardwell, Wesley P Thayer
BACKGROUND: Epitendinous sutures not only join the 2 severed tendon edges but also supply strength and support to the repair. Multiple techniques have been described, but none of them include another thread of suture. This could potentially increase the strength of the repair without affecting gliding. METHODS: Caprine tendons were harvested, transected, and sutured with 6-0 Prolene. Four groups were created: single thread running (SR), single thread locking (SL), double thread running (DR), and double thread locking (DL)...
December 5, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30501514/the-effect-of-age-on-fracture-healing-time-in-metacarpal-fractures
#2
Ronit Wollstein, Arie Trouw, Lois Carlson, Ilene Staff, Daniel J Mastella, Duffield Ashmead
BACKGROUND: Older patients are treated for fracture with increasing frequency. Although studies on animals suggest that older mice and rats heal fractures more slowly, the clinical implications remain unclear. A better understanding of differences in healing with age can help customize fracture treatment. Our purpose was to retrospectively evaluate metacarpal fractures for healing time looking specifically at age-related differences. METHODS: A retrospective review of patients treated for metacarpal fractures was conducted...
December 2, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30501506/carpal-tunnel-syndrome-retrospective-analysis-of-60-consecutive-cases-of-ambulatory-surgical-treatment-with-local-anesthesia
#3
Chia Y Chang, Murilo G Beduschi, Thierry A Pacheco, Clarissa C de M Chang
BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of ambulatory open surgical treatment for carpal tunnel syndrome with local anesthesia and without tourniquet ischemia, sedation by an anesthesiologist, or hospitalization. METHODS: A retrospective analysis of 60 consecutive cases performed during 1 year was conducted, excluding other compressive or noncompressive neuropathies. The criteria for treatment efficacy were improvements in symptoms and recurrence rates, and the safety criterion was the presence of complications...
December 2, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30499347/the-association-between-concomitant-ulnar-nerve-compression-at-the-elbow-and-carpal-tunnel-syndrome
#4
Brandon Shulman, Jonathan Bekisz, Christopher Lopez, Samantha Maliha, Siddharth Mahure, Jacques Hacquebord
BACKGROUND: Many patients treated for ulnar nerve compression at the elbow (UNE) are concomitantly treated for carpal tunnel syndrome (CTS). We sought to investigate the association between the conditions. METHODS: The Statewide Planning and Research Cooperative System (SPARCS) database was used to determine the number of patients with UNE concomitantly treated for CTS in New York State from 2003 to 2014. We then retrospectively reviewed each patient who received surgical treatment for UNE (n = 222 patients) or CTS (n = 1063 patients) at our tertiary care institution in 2014 and 2015 to assess concomitant treatment...
November 30, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30486676/comments-on-utilization-of-electrodiagnostic-testing-for-carpal-tunnel-syndrome-by-general-practitioners-prior-to-hand-surgery-consultation
#5
Domingo Ly-Pen, José-Luis Andréu
No abstract text is available yet for this article.
November 28, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30477346/comments-on-nonsurgical-treatment-of-de-quervain-tenosynovitis-a-prospective-randomized-trial
#6
Jad Abi-Rafeh, Roy Kazan, Stephanie Thibaudeau
No abstract text is available yet for this article.
November 27, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30463450/smoking-increases-postoperative-complications-after-distal-radius-fracture-fixation-a-review-of-417-patients-from-a-level-1-trauma-center
#7
Daniel E Hess, S Evan Carstensen, Spencer Moore, A Rashard Dacus
BACKGROUND: Unstable distal radius fractures that undergo surgical stabilization have varying complication rates in the literature. Smoking is known to affect bone healing and implant fixation rates but has never been definitively shown to affect postoperative outcomes of surgically managed distal radius fractures. METHODS: A retrospective review was performed of patients with surgically treated distal radius fractures at a Level 1 Trauma Center who had at least 6 weeks of follow-up over a 5-year period...
November 22, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30463441/antibiotic-use-in-hand-surgery-surgeon-decision-making-and-adherence-to-available-evidence
#8
John C Dunn, Kenneth R Means, Sameer Desale, Aviram M Giladi
BACKGROUND: There are no clearly defined guidelines from hand surgical societies regarding preoperative antibiotic prophylaxis. Many hand surgeons continue to routinely use preoperative prophylaxis with limited supporting evidence. This study aimed to determine for which scenarios surgeons give antibiotics, the reasons for administration, and whether these decisions are evidence-based. METHODS: An anonymous 25-question survey was e-mailed to the 921-member American Society for Surgery of the Hand listserv...
November 22, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30461326/intravenous-regional-anesthesia-using-a-forearm-tourniquet-a-safe-and-effective-technique-for-outpatient-hand-procedures
#9
Natalie Vaughn, Niraja Rajan, Michael Darowish
BACKGROUND: Bier block provides anesthesia of an entire extremity distal to the tourniquet without necessitating direct injection at the surgical site. This avoids obscuring anatomy with local anesthetic and anesthetizes a wide area, allowing for multiple procedures and incisions. We hypothesize that a low-volume Bier block with forearm tourniquet, rather than a traditional brachial tourniquet, is a safe, well-tolerated, and effective anesthesia technique. METHODS: All cases in which adult patients underwent hand procedures using Bier block anesthesia by a single surgeon over a 4-year period were reviewed...
November 21, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30461319/a-prospective-randomized-trial-comparing-open-and-endoscopic-carpal-tunnel-release-within-the-same-patient
#10
Brett M Michelotti, Kavita T Vakharia, Diane Romanowsky, Randy M Hauck
BACKGROUND: Surgical management of carpal tunnel syndrome includes performing an endoscopic (ECTR) or open (OCTR) carpal tunnel release. Several studies have shown less postoperative pain and improvement in grip and pinch strength with the endoscopic technique. The goal of this study was to prospectively examine outcomes, patient satisfaction, and complications after both ECTR and OCTR in the opposite hands of the same patient. METHODS: This was a prospective study in which patients with bilateral carpal tunnel syndrome underwent surgical release with both techniques, with initial operative approach randomized in the more symptomatic hand...
November 21, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30461316/interpreting-patient-reported-outcome-results-is-one-minimum-clinically-important-difference-really-enough
#11
Dylan L McCreary, Benjamin C Sandberg, Debra C Bohn, Harsh R Parikh, Brian P Cunningham
BACKGROUND: Patient-reported outcomes (PROs) are the gold standard for reporting clinical outcomes in research. A crucial component of interpreting PROs is the minimum clinically important difference (MCID). Patient-Rated Wrist Evaluation (PRWE) is a disease-specific PRO tool developed for use in distal radius fractures. The purpose of this study was to determine the influence of injury characteristics, treatment modality, and calculation methodology on the PRWE MCID in distal radius fractures...
November 21, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30428712/prevalence-of-a-septated-first-dorsal-compartment-among-patients-with-and-without-de-quervain-tenosynovitis-an-in-vivo-anatomical-study
#12
Bryan G Beutel, Matthew E Doscher, Charles P Melone
BACKGROUND: The reported prevalence of a subcompartment housing the extensor pollicis brevis (EPB) tendon within the first dorsal compartment varies widely in the literature, especially regarding the rates of occurrence between genders and among those with and without De Quervain. Based on direct intraoperative observation, we hypothesized that the prevalence of a septated compartment is far greater than previously reported, particularly in those with De Quervain disease. METHODS: A prospective analysis of consecutive patients who underwent first dorsal compartment release was carried out...
November 15, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30417703/to-tie-or-not-to-tie-a-systematic-review-of-postaxial-polydactyly-and-outcomes-of-suture-ligation-versus-surgical-excision
#13
Mustafa Chopan, Lohrasb Sayadi, Harvey Chim, Patrick J Buchanan
BACKGROUND: Ulnar polydactyly is frequently encountered in the newborn nursery and is commonly treated with bedside suture ligation. However, growing concern about the complications associated with suture ligation has led some practitioners to advocate for primary surgical excision instead. Thus, we set out to compare outcomes of suture ligation and surgical excision by systematic appraisal of the literature. METHODS: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was performed to identify studies published between 1950 and 2017 that described outcomes of suture ligation, surgical excision, or both...
November 12, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30417702/outcomes-of-distal-ulna-fractures-associated-with-operatively-treated-distal-radius-fractures
#14
Kevin F Lutsky, Ludovico Lucenti, Pedro K Beredjiklian
BACKGROUND: The purpose of this study was to report outcomes in patients with nonstyloid distal ulna fractures treated in conjunction with open reduction internal fixation (ORIF) of distal radius fractures. METHODS: A retrospective review of all patients who had undergone ORIF of a distal radius fracture over a 5-year period at a single institution was performed. Radiographic review was performed to identify patients with a concomitant fracture of the distal ulna...
November 12, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30417700/impact-of-handedness-on-disability-after-unilateral-upper-extremity-peripheral-nerve-disorder
#15
Benjamin A Philip, Vicki Kaskutas, Susan E Mackinnon
BACKGROUND: Impairment of the dominant hand should lead to greater disability than impairment of the nondominant hand, but few studies have tested this directly, especially in the domain of upper-extremity peripheral nerve disorder. The aim of this study was to identify the association between hand dominance and standardized measures of disability and health status after upper-extremity peripheral nerve disorder. METHODS: An existing database was reanalyzed to identify the relationship between affected-side (dominant vs nondominant) on individuals with unilateral upper-extremity peripheral nerve disorder (N = 400)...
November 12, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30417699/revision-total-wrist-arthroplasty-due-to-polyethylene-wear-metallosis-induced-carpal-tunnel-syndrome-distal-ulnar-impingement-and-fourth-carpometacarpal-joint-pain-case-report-and-pitfalls-to-avoid
#16
Fiesky A Nunez, Lauren Wright, Scott E Kilpatrick, William H Seitz
BACKGROUND: Total wrist arthroplasty (TWA) is indicated to alleviate pain secondary to arthritis while preserving wrist motion. Despite vigilant measures, TWAs are susceptible to complications. The current case illustrates an array of preventable complications which are addressed through operative technique in a revision setting. CASE PRESENTATION: The patient was a 72-year-old man who presented with chronic pain at the fourth carpometacarpal joint (CMCJ) and distal radioulnar joint with paresthesias in the median nerve distribution...
November 12, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30417697/a-prospective-evaluation-of-the-effect-of-supervised-hand-therapy-after-carpal-tunnel-surgery
#17
Joseph A Gil, Barrett Weiss, Justin Kleiner, Edward Akelman, Arnold-Peter C Weiss
BACKGROUND: The objective of this investigation is to examine the effect of postoperative therapy after routine carpal tunnel release. Our hypothesis was that supervised hand therapy does not improve outcomes after routine carpal tunnel release. METHODS: Patients with carpal tunnel syndrome were randomly assigned to one of 3 groups based on the last digit of their medical record numbers to one of 3 groups: standard 6-week postoperative rehabilitation (standard therapy), expedited one-session postoperative rehabilitation group (expedited therapy), and no postoperative rehabilitation group (no therapy)...
November 12, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30417694/the-use-of-telemedicine-decreases-unnecessary-hand-trauma-transfers
#18
Morgan Tripod, Mark Tait, John Bracey, Kevin Sexton, William Beck, Theresa O Wyrick
PURPOSE: The Arkansas Hand Trauma Telemedicine Program (AHTTP) is a novel telemedicine system that was developed in 2014 within a rural state to address the growing need of access to hand trauma care with one trauma center that cares for mangling hand injuries. The purpose is to compare transfers for hand injuries prior to and after the implementation of this system. METHODS: The hospital institutional database was queried for all transfers to a level 1 medical center in the state from 2012 to 2015, allowing the comparison of data prior to and after the institution of the AHTTP...
November 12, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30417693/long-term-patient-reported-outcomes-after-surgery-for-hypothenar-hammer-syndrome
#19
Leah Demetri, Jonathan Lans, Rachel Gottlieb, George S M Dyer, Kyle R Eberlin, Neal C Chen
BACKGROUND: This study aims to describe the long-term patient-reported outcomes after surgery for hypothenar hammer syndrome (HTHS) and to identify factors associated with inferior outcomes. METHODS: We retrospectively identified 27 patients who underwent surgical intervention for HTHS from 2002 to 2016. Fifteen patients (56%) completed outcome questionnaires: Quick Disabilities of the Arm, Shoulder, and Hand, Cold Intolerance Symptom Severity (CISS) survey, Patient-Reported Outcomes Measurement Information System Upper Extremity Computer Adaptive Test, and Patient-Reported Outcomes Measurement Information System Pain Interference Computer Adaptive Test...
November 12, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/30417692/bilateral-metacarpal-hands-reconstruction-with-6-toe-transfers
#20
Neil F Jones, David Graham, Katherine Au
BACKGROUND: Bilateral metacarpal hand injuries are extremely rare, but probably represent the most difficult reconstructive challenge in hand surgery. METHODS: We discuss the various options for metacarpal hand reconstruction, including the Krukenberg procedure, bionic prostheses, multiple toe-to-hand transfers, and possibly hand transplantation, and present the long-term functional outcomes, gait analysis, and psychological evaluation after a 4-stage reconstruction of bilateral metacarpal hands in a child using 6 toe-to-hand transfers-bilateral great toe transfers to reconstruct both thumbs and bilateral combined second-third monobloc transfers to reconstruct 2 fingers in each hand...
November 12, 2018: Hand: Official Journal of the American Association for Hand Surgery
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