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Hand: Official Journal of the American Association for Hand Surgery

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https://www.readbyqxmd.com/read/28825345/a-sonographically-guided-in-plane-distal-to-proximal-transligamentous-approach-to-carpal-tunnel-injections
#1
Brian M Jurbala, Troy A Burbank
BACKGROUND: Several sonographically guided injection methods have been described to treat carpal tunnel syndrome. In most cases, the medication diffuses through the carpal tunnel to the site of maximum compression of the nerve after being injected proximally. In this article, we describe a novel method of sonographically guided carpal tunnel injection that utilizes a distal-to-proximal, in-plane, and transligamentous approach. This novel method may provide ergonomic as well as safety advantages to both clinicians and patients, and should be considered by those performing carpal tunnel injections...
August 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28825344/performance-and-return-to-sport-after-forearm-fracture-open-reduction-and-internal-fixation-in-national-football-league-players
#2
Kyle R Sochacki, Robert A Jack, Takashi Hirase, Patrick C McCulloch, David M Lintner, Shari R Liberman, Joshua D Harris
BACKGROUND: Forearm fractures are one of the most common upper extremity injuries requiring surgery in professional football. Surgical fixation of forearm fractures may speed recovery and decrease games missed in football. METHODS: National Football League (NFL) players who underwent forearm fracture open reduction and internal fixation (ORIF) were identified. Matched controls (position, age, experience, performance) were identified. Control and case performance scores were calculated using a standardized scoring system...
August 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28825342/hand-surgery-resources-exceed-american-health-literacy
#3
Julia A Cook, Sarah E Sasor, Sunil S Tholpady, Arash Momeni, Michael W Chu
BACKGROUND: The National Institutes of Health, American Medical Association, and US National Library of Medicine recommend that educational material for patients be written at a sixth-grade reading level. The purpose of this study is to assess the complexity of hand surgery information on academic plastic and orthopedic surgery websites. METHODS: An online search was performed for all hand surgery patient education materials provided by institutions with plastic and orthopedic surgery training programs...
August 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28825339/reliability-and-validation-of-the-greek-version-of-the-boston-carpal-tunnel-questionnaire
#4
Anastasia Bougea, Thomas Zambelis, Panagiota Voskou, Paraskevi Zacharoula Katsika, Chara Tzavara, Panagiotis Kokotis, Nikolaos Karandreas
BACKGROUND: The Boston Carpal Tunnel Questionnaire (BCTQ) is an easy, brief, self-administered questionnaire developed by Levine et al for the assessment of severity of symptoms and functional status of patients with carpal tunnel syndrome. The aim of our study was to develop and validate the Greek version of BCTQ. METHODS: We conducted a cross-sectional study of 90 patients with idiopathic carpal tunnel syndrome. The original English version of BCTQ was adapted into Greek using forward and backward translation...
August 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28825335/the-pedicled-latissimus-dorsi-flap-provides-effective-coverage-for-large-and-complex-soft-tissue-injuries-around-the-elbow
#5
Jacques H Hacquebord, Douglas P Hanel, Jeffrey B Friedrich
BACKGROUND: The pedicled latissimus flap has been shown to provide effective coverage of wounds around the elbow with an average size of 100 to 147 cm(2) but with complication rates of 20% to 57%. We believe the pedicled latissimus dorsi flap is an effective and safe technique that provides reliable and durable coverage of considerably larger soft tissue defects around the elbow and proximal forearm. METHODS: A retrospective review was performed including all patients from Harborview Medical Center between 1998 and 2012 who underwent coverage with pedicled latissimus dorsi flap for defects around the elbow...
August 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28825334/night-splinting-for-idiopathic-trigger-digits
#6
Tessa Drijkoningen, Marijn van Berckel, St├ęphanie J E Becker, David C Ring, Chaitanya S Mudgal
BACKGROUND: This study assessed nighttime splinting for 6 weeks as treatment for recent onset idiopathic trigger fingers. METHODS: Patients over 18 years with a Quinnell grade 1 or 2, idiopathic trigger finger or thumb causing symptoms for less than 3 months were eligible for a custom-made hand-based orthoplast night orthotic. Improvement of symptoms and/or resolution of triggering were recorded. Patients also completed the short version of the Disabilities of the Arm, Shoulder and Hand and a numerical rating scale for pain at the initial visit, after 6 to 8 weeks, and after 3 months...
August 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28825332/the-incidence-of-arthroplasty-after-initial-arthroscopy-for-trapeziometacarpal-arthrosis
#7
Suzanne C Wilkens, Frederique L Vissers, Adam Nazzal, Neal Chen
BACKGROUND: It remains unclear how many patients undergo secondary surgery after initial arthroscopy for trapeziometacarpal (TMC) arthrosis. We studied the factors related to secondary TMC arthroplasty after TMC arthroscopy. We also examined secondary questions of: (1) what percentage of patients underwent secondary TMC arthroplasty; and (2) how much time elapsed from initial arthroscopy to arthroplasty. METHODS: In this retrospective study, we included all adult patients who were treated with arthroscopy of the TMC joint at 2 level I hospitals and affiliates...
August 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28825326/arthroscopic-wrist-debridement-and-radial-styloidectomy-for-advanced-scapholunate-advanced-collapse-wrist-long-term-follow-up
#8
Peter C Noback, Mani Seetharaman, Jonathan R Danoff, Michael Birman, Melvin P Rosenwasser
BACKGROUND: Symptomatic stage 2 or 3 scapholunate advanced collapse (SLAC) wrist is aggressively treated with salvage procedures, such as proximal row carpectomy or partial wrist fusion with resultant pain relief but limited motion. We hypothesize that arthroscopic synovectomy, radial styloidectomy, and neurectomy will preserve wrist motion, relieve pain, and delay or avoid salvage procedures. METHODS: We evaluated outcomes in 13 wrists through questionnaires and 11 of these through additional physical examination at a mean follow-up of 5...
August 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28691543/volar-locking-plate-fixations-for-displaced-distal-radius-fractures-an-evaluation-of-complications-and-radiographic-outcomes
#9
James Wilson, Jeremy J Viner, Kavan S Johal, Michael J Woodruff
BACKGROUND: A volar locking plate (VLP) is the most frequently used form of implant used for open reduction and internal fixation of distal radius fractures. They are known to have a complication rate of up to 27%. We hypothesized that plate design could influence complication rates. METHODS: We performed a review of patients undergoing VLP fixation for distal radius fracture. A total of 228 patients underwent fixation with the Distal Volar Radial Anatomical (DVR) plate; 388 patients underwent fixation with the VariAx plate...
July 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28691512/the-incidence-of-complex-regional-pain-syndrome-in-simultaneous-surgical-treatment-of-carpal-tunnel-syndrome-and-dupuytren-contracture
#10
Mitchell Buller, Steven Schulz, Morton Kasdan, Bradon J Wilhelmi
BACKGROUND: To determine the incidence of complex regional pain syndrome (CRPS) in the concurrent surgical treatment of Dupuytren contracture (DC) and carpal tunnel syndrome (CTS) through a thorough review of evidence available in the literature. METHODS: The indices of 260 hand surgery books and PubMed were searched for concomitant references to DC and CTS. Studies were eligible for inclusion if they evaluated the outcome of patients treated with simultaneous fasciectomy or fasciotomy for DC and carpal tunnel release using CRPS as a complication of treatment...
July 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28685589/surgeon-preference-influence-and-treatment-of-thumb-carpometacarpal-arthritis
#11
Zachary Deutch, Steven R Niedermeier, Hisham M Awan
BACKGROUND: The purpose of this study was to evaluate current surgical practice patterns, the factors that influence these patterns, and overall trends in the treatment of thumb carpometacarpal osteoarthritis. METHODS: An online survey containing 14 questions was sent to all active members of the American Society for Surgery of the Hand. Information on demographics and treatments was collected. Results were anonymously uploaded to an online spreadsheet. RESULTS: A total of 823 responses were recorded...
July 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28665145/suture-button-device-stabilization-following-ring-finger-ray-amputation-a-comparative-cadaver-study
#12
Emily N Morgan, Kenneth R Means, Adrian G Paez, Brent G Parks, Peter C Innis
BACKGROUND: The purpose of this study was to determine whether placing the suture-button device between the long and small finger metacarpals following ring finger ray amputation may better close the intermetacarpal gap and allow early range of motion without increasing the risk of malrotation than soft tissue repair alone. METHODS: We performed ray amputation of the ring finger of 14 cadaver specimens by performing an osteotomy of the base of the ring finger metacarpal and then excising the remainder of the digit...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28660786/cost-and-complications-of-percutaneous-fixation-of-hand-fractures-in-a-procedure-room-versus-the-operating-room
#13
Mark T Garon, Patrick Massey, Andreas Chen, Trevor Carroll, Bradley G Nelson, Anne M Hollister
BACKGROUND: The purpose of this study was to compare closed reduction and percutaneous pinning of metacarpal and phalanx fractures performed in the operating room (OR) versus the procedure room of the emergency department with primary outcomes being infection rate, radiographic union, and monetary cost. METHODS: From January 2006 to December 2010, all closed reduction and percutaneous pinnings of metacarpal and phalanx fractures (CPT codes: 26608; 26727) by a single board-certified hand surgeon (A...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28658595/flexor-digitorum-superficialis-tenodesis-for-traumatic-digit-amputation-at-the-level-of-the-proximal-phalanx
#14
Maureen A O'Shaughnessy, Sanjeev Kakar
BACKGROUND: Traumatic amputation of the digit requiring revision amputation at the level of the proximal phalanx provides the opportunity to improve flexor function via tenodesis of the remaining flexor digitorum superficialis (FDS) tendon. Salvage of the remaining FDS and performing flexor tenodesis to the proximal phalanx allows increased flexion at the metacarpophalangeal (MCP) joint. METHODS: This series reviews FDS tenodesis, outlining its surgical technique with clinical and functional outcomes...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28653544/operative-management-of-unstable-radial-head-fractures-in-a-young-active-population
#15
Nicholas Kusnezov, Emmanuel Eisenstein, John C Dunn, Austin Fares, Justin Mitchell, Kelly Kilcoyne, Brian R Waterman
BACKGROUND: Radial head and neck fractures are the most common elbow fracture in the general adult population; however, the optimal treatment for radial head fractures remains a topic of ongoing clinical controversy. The purpose of this study was to determine the rate of return to function, complications, and reoperation following operative management of unstable radial head fractures in a young, active patient population with intense upper extremity demands. METHODS: A military health care database was queried for all US military servicemembers undergoing open reduction with internal fixation (ORIF; Current Procedural Terminology [CPT] code: 24665) and radial head arthroplasty (RHA; CPT code: 24666) between 2010 and 2015...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28645243/extended-periarterial-sympathectomy-evaluation-of-long-term-outcomes
#16
Collier S Pace, Wyndell H Merritt
BACKGROUND: Periarterial sympathectomy is a proposed surgical treatment for patients with refractory Raynaud syndrome; however, there is debate regarding the indications and extent of dissection. Due to the segmental arterial sympathetic innervation, we favor an extended sympathectomy in concert with vein graft reconstruction of occluded vessels when necessary. The purpose of this study is to examine outcomes of extended periarterial sympathectomy in our patients. METHODS: A retrospective chart review was performed on 46 patients who underwent 58 periarterial sympathectomies (12 bilateral) since 1981...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28645218/wide-awake-anesthesia-in-the-in-office-procedure-room-lessons-learned
#17
Robert E Van Demark, Hillary A Becker, Matthew C Anderson, Vanessa J S Smith
BACKGROUND: Wide-awake local anesthesia and no tourniquet (WALANT) has become more popular in hand surgery. Without a tourniquet, there is no need for preoperative testing or sedation. The use of lidocaine with epinephrine has allowed a larger variety of cases to be done safely in an outpatient setting instead of the hospital. "Minor field sterility," which uses fewer drapes and tools to accomplish the same procedures, is a concept that is also gaining recognition. METHODS: Investigation of hand surgeons performing a majority of cases using WALANT and minor field sterility was the beginning of seeing its potential at our institution...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28645215/upper-extremity-trauma-resulting-from-agricultural-accidents-mechanism-and-severity-for-patients-with-and-without-upper-extremity-injury
#18
Louis C Grandizio, Benjamin Wagner, Jove Graham, Joel C Klena
BACKGROUND: Farming remains the most dangerous occupation in the United States and upper extremity (UE) injuries occur frequently in agricultural accidents. The purpose of this study is to describe the injury mechanisms, severity, and health care costs of UE injuries resulting from agricultural accidents and to compare patients with and without injuries to the UE. METHODS: We performed a 6-year retrospective review of our level I trauma center registry from January 2006 to May 2013, identifying all patients injured in an agricultural accident...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28643521/a-novel-all-inside-arthroscopic-technique-for-radial-sided-triangular-fibrocartilage-complex-tears-a-case-report-and-review-of-literature
#19
Michael T Edgerton, Robert C Kollmorgen
BACKGROUND: Triangular fibrocartilage complex (TFCC) injuries are a known cause of ulnar-sided wrist pain. Wrist arthroscopy is the gold standard for diagnosis of these lesions and is becoming a more frequent method of treatment. Isolated radial-sided tears are uncommon and treatment of these lesions is controversial. There are few reports on repair techniques. Here we report on a novel arthroscopic, all-inside technique for traumatic radial-sided TFCC tears that resulted in full range of motion, significant improvement in pain, and ultimately return to sport...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28643518/mini-c-arm-fluoroscopy-does-its-configuration-matter-for-radiation-exposure-to-the-surgeon
#20
Talia Chapman, Dennis P Martin, Christopher Williamson, Brian Tinsley, Mark L Wang, Asif M Ilyas
BACKGROUND: The risk of occupational radiation exposure to the surgeon associated with the use of a mini C-arm has yet to reach a wide consensus. Using a distal radius fracture surgery model, we tested the hypothesis that radiation exposure to the surgeon's critical body parts is independent of mini C-arm configuration. METHODS: An anthropomorphic mannequin (representing the upper body of a 60" male surgeon) was seated at a hand table as if operating on a volar-plated wrist Sawbone model...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
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