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Five-Year Results of a Randomized, Controlled Trial of Collagenase Treatment Compared With Needle Fasciotomy for Dupuytren Contracture
Over the past decade, collagenase treatment and needle fasciotomy (NF) have gained widespread popularity in the treatment of Dupuytren contracture. This prospective study was designed to compare the results of these treatments in terms of clinical and patient-reported outcomes.Scaphotrapeziotrapezoid Arthrodesis: Systematic Review
Scaphotrapeziotrapezoid (STT) arthrodesis surgery is used for various types of wrist pathologies. The objective of our study was to perform a systematic review of complications and outcomes after STT arthrodesis.Reconstruction of C5–C8 (T1 Hand) Brachial Plexus Paralysis in a Series of 52 Patients
A C5–C8 brachial plexus root injury, also known as a T1 hand, is associated with paralysis of shoulder abduction or external rotation and elbow flexion, accompanied by variable elbow, wrist, thumb, or finger extension deficits. We report the results of reconstruction for C5–C8 brachial plexus paralysis in 52 patients operated upon within 12 months of injury and having at least 24 months of follow-up.Outcome of Simple Decompression of Primary Cubital Tunnel Syndrome Based on Patient-Reported Outcome Measurements
To evaluate the patient-reported outcome measures of patients with primary cubital tunnel syndrome and to assess whether they are affected by preoperative symptom severity.Utilization of Diagnostic Testing for Carpal Tunnel Syndrome: A Survey of the American Society for Surgery of the Hand
In 2016, the American Academy of Orthopaedic Surgeons (AAOS) changed the clinical practice guidelines (CPGs) for the diagnosis of carpal tunnel syndrome, relaxing the recommendation for electrodiagnostic studies (EDS) prior to offering surgery. However, it is unknown how the updated guidelines changed the practice patterns of hand surgeons.Cost Drivers in Carpal Tunnel Release Surgery: An Analysis of 8,717 Patients in New York State
The annual high volume of carpal tunnel releases (CTRs) has a large financial impact on the health care system. Validating the cost drivers related to CTR in a large, diverse patient population may aid in developing cost reduction strategies to benefit health care systems.Long-Term Outcomes of Biceps Rerouting for Flexible Supination Contractures in Children With Brachial Plexus Birth Injuries
Forearm supination contractures occur in 7% of children with brachial plexus birth injuries (BPBI). Biceps rerouting is proposed when pronation has deteriorated but is passively correctable to at least 0° (neutral). The purpose of this investigation was to evaluate long-term outcomes of biceps rerouting for this indication, including magnitude and maintenance of correction, complications, and subsequent osteotomy.Trust and Distrust in Opioid Decision-Making: A Qualitative Assessment of Patient-Doctor Relationship
Surgeons often prescribe opioid analgesics for pain management after surgery. However, we understand little about how patients perceive opioid prescribing and make decisions to use opioids for postoperative pain management. In this study, we aimed to gain an understanding of patients’ decision-making process on postoperative opioid use.Assessment of Medical Cannabis in Patients With Osteoarthritis of the Thumb Basal Joint
With the increasingly widespread availability of cannabidiol-derived products, more patients with hand and wrist pain are seeking evidence for use of these products. We explored current utilization practices of medical cannabis for treatment of pain in patients with a diagnosis of thumb basal joint arthritis. Secondary aims were to determine patient and thumb arthritis disease characteristics of cannabis users and nonusers and to investigate patient perceptions of the efficacy of medical cannabis in various formulations for the treatment of thumb arthritis pain.Cross-Sectional Areas and Volumes Occupied by Implants in Simulated Scaphoid Fractures
This study determined the volume of bone replaced by an implant at the proximal and distal poles of simulated scaphoid fractures. We also measured the cross-sectional area of the implant relative to the cross-sectional area of the scaphoid at 2 different simulated fracture locations.Evaluation of the Induced Membrane for Neurotrophic Factors
Despite gaining popularity as a bridge for small and moderate nerve gaps, an acellular nerve allograft (ANA) lacks many of the neurotrophic characteristics of a nerve autograft. Pseudomembranes induced to form around temporary skeletal spacers are rich in growth factors. Induced membranes may have beneficial neurotrophic factors which could support ANA.Evaluation of a Comprehensive Telemedicine Pathway for Carpal Tunnel Syndrome: A Comparison of Virtual and In-Person Assessments
We evaluated a comprehensive telemedicine pathway for carpal tunnel syndrome (CTS). Our primary aim was to compare telemedicine and in-person administration of the six item CTS-6 instrument (CTS-6) in patients undergoing carpal tunnel release (CTR) and to determine whether surgical plans determined via telemedicine were altered by in-person assessments. We additionally aimed to assess agreement between telemedicine and in-person examinations.Minimal Clinically Important Difference for PROMIS Physical Function and Pain Interference in Patients Following Surgical Treatment of Distal Radius Fracture
We estimated the minimal clinically important difference (MCID) for the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference (PI) computer adaptive tests (CATs) following surgical treatment of distal radius fracture (DRF).Central Slip Reconstruction With a Distally Based Flexor Digitorum Superficialis Slip: A Biomechanical Study
The ideal method of central slip reconstruction is difficult to determine due to the multitude of techniques, nonstandardized outcome reporting, and small patient series in the literature. Although most boutonniere deformities may be treated with nonsurgical measures, chronic, subacute, or open injuries may require operative intervention. To aid surgeons in the choice of the ideal central slip reconstruction method, this biomechanical study compared the 3 most common methods performed at our institution: direct repair, lateral band centralization, and distally-based flexor digitorum superficialis (FDS) slip repair.Comparison of 2 Postoperative Therapy Regimens After Trapeziectomy Due to Osteoarthritis: A Randomized, Controlled Trial
The main aim of the present study was to evaluate whether early mobilization after trapeziectomy in the first carpometacarpal joint is noninferior to a postoperative regimen comprising the use of a rigid orthosis and mobilization after 6 weeks, with regards to patient-reported activity performance and the effect of surgery in patients with first carpometacarpal osteoarthritis.How Should We Use Patient-Reported Outcome Measures at the Point of Care in Hand Surgery?
Despite the importance of collecting patient-reported outcome measures (PROMs), there are few process guidelines for physicians on how to collect and communicate individualized PROMs in patients at the point of care. The purpose of this study was to develop process guidelines on how to routinely collect and communicate individualized PROMs at the point of care in hand surgery.The Intercalated Segment: Does the Triquetrum Move in Synchrony With the Lunate?
To quantify the relative motion between the lunate and triquetrum during functional wrist movements and to examine the impact of wrist laxity on triquetral motion.Efficacy of Hand Therapy After Volar Locking Plate Fixation of Distal Radius Fracture in Middle-Aged to Elderly Women: A Randomized Controlled Trial
This study aimed to evaluate the efficacy of hand therapy after volar locking plate fixation of distal radius fractures in middle-aged to elderly women.Evaluation of Risk Factors for Loss of Acceptable Alignment for Distal Radius Fractures That Are Nondisplaced or Minimally Displaced on Initial Presentation
Numerous studies have evaluated risk factors for loss of acceptable radiographic alignment, as described by the American Academy of Orthopaedic Surgeons Clinical Practice Guidelines (CPG), following closed reduction of distal radius fractures (DRFs). Less is known about DRFs that are well aligned on initial presentation and do not require closed reduction. We evaluated the rate of and risk factors for displacement of DRFs that are nondisplaced or minimally displaced on initial presentation.The Curtis Hand Injury Matrix Score: Determining the Need for Specialized Upper Extremity Care
Given the limited impact of transfer guidelines and the lack of comparative metrics for upper extremity trauma, we introduced the Curtis Hand Injury Matrix (CHIM) score to evaluate upper extremity injury acuity from the specialist perspective. Our goal was to evaluate the CHIM score as an indicator of complexity and specialist need by correlating the score with arrival mode, length of stay (LOS), discharge disposition, and procedure location.Systematic Review of Replant Salvage and Cost Utility Analysis of Inpatient Monitoring After Digit Replantation
Digit replantation is a high-stakes procedure that has been shown to be cost-effective, especially for multiple-digit replantation. However, it is associated with prolonged lengths of stay (LOS) for monitoring and attempts at salvage. The cost-effectiveness of prolonged inpatient stays presumes that this is necessary and inherent to the replantation. We hypothesized that prolonged monitoring of replanted digits, in the hope of possible salvage after primary failure, is cost-ineffective due to the low rates of vascular compromise and salvage after replantation.The Preoperative Cost of Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common condition, with well-defined diagnostic and treatment guidelines. Despite these guidelines, continued variation in care exists, with providers variably using diagnostic tests and nonsurgical treatment modalities prior to surgery. The purpose of this study was to evaluate the variation and cost associated with the diagnosis and nonsurgical treatment of patients prior to undergoing carpal tunnel release.The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery
Although multiple factors influencing return to work after a carpal tunnel release (CTR) have been identified, little is known about the influence of psychological patient factors on return to work. Therefore, this study aimed to identify the psychological factors that play a role in the return to work after a CTR surgery.The Value Added of Advanced Imaging in the Diagnosis and Treatment of Triangular Fibrocartilage Complex Pathology
Pathology of the triangular fibrocartilage complex is a prevalent cause of ulnar-sided wrist pain that presents a diagnostic challenge. We hypothesized that a history and physical examination (H&P) would be more cost-effective alone or with diagnostic injection than with magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) in the diagnosis and treatment of a symptomatic triangular fibrocartilage complex abnormality.Influence of Corticosteroid Injections on Postoperative Infections in Carpal Tunnel Release
Corticosteroid injections (CSIs) are commonly used in carpal tunnel syndrome; however, recent literature has demonstrated risk of postoperative infection associated with preoperative CSIs in other orthopedic fields. The aim of this study was to assess the relationship of CSIs and postoperative infection following carpal tunnel release (CTR).Racial and Gender Discrimination in Hand Surgery Letters of Recommendation
We sought to evaluate hand surgery applicants’ letters of recommendations to understand whether applicant and letter writer demographics contribute to racial and gender bias.Patterns of Upper Extremity Reconstruction for Patients With Tetraplegia Across the United States: A Retrospective Study
The rates of upper extremity reconstruction for patients with tetraplegia remain low. We performed a retrospective study to assess recent reconstruction rates and delineate factors associated with the occurrence of reconstruction.Comparative Analysis of 3 Techniques of Scapholunate Reconstruction for Dorsal Intercalated Segment Instability
The combination of scaphoid rotatory subluxation, dorsal intercalated segment instability, and dorsal scaphoid translation (DST) constitutes stage 5 scapholunate dissociation in the modified classification system of Garcia-Elias. The purpose of this study was to compare the static radiographic outcomes of reduction and association of the scaphoid and lunate (RASL), three-ligament tenodesis (TLT), and anatomic front and back (ANAFAB) reconstructions for stage 5 scaphoid and lunate malrotation and translation.Is the Dorsal Fiber-Splitting Approach to the Wrist Safe? A Kinematic Analysis and Introduction of the “Window” Approach
To compare the kinematic effects of the dorsal fiber-splitting approach for scapholunate ligament repair to a dorsal “window” approach that spares all ligaments.A Standard Set for Outcome Measurement in Patients With Hand and Wrist Conditions: Consensus by the International Consortium for Health Outcomes Measurement Hand and Wrist Working Group
To describe the principles, process, and results of creating the International Consortium for Health Outcomes Measurement (ICHOM) standard set for hand and wrist conditions.The Unsalvageable Radial Head in Patients Aged 30 Years and Younger
Concern exists regarding the use of radial head arthroplasty (RHA) in younger patients. This study assessed clinical, functional, and radiographic outcomes of RHA in patients aged 30 years and younger.Limited Fasciectomy Versus Collagenase Clostridium histolyticum for Dupuytren Contracture: A Propensity Score Matched Study of Single Digit Treatment With Minimum 5 Years of Telephone Follow-Up
The purpose of this study was to compare reintervention and perceived recurrence, with minimum 5 years of telephone follow-up, after limited fasciectomy or collagenase Clostridium histolyticum (CCH) in the treatment of Dupuytren contracture affecting a single digit.Variability in the Use of Disposable Surgical Supplies: A Surgeon Survey and Life Cycle Analysis
A substantial amount of waste is generated during surgery, yet few studies have investigated this problem. Therefore, we conducted a multicenter survey to investigate how the variation in the use of disposable supplies contributes to the environmental and financial burdens of health care.Quality Metrics in Hand Surgery: A Systematic Review
The enactment of the Patient Protection and Affordable Care Act in 2010 placed an emphasis on measuring the quality of care. However, the issue of how best to measure quality remains in question. Although some surgical specialties frequently rely on quality measures such as the mortality rate, measuring quality in hand surgery necessitates the use of metrics beyond this traditional scope. A review was performed of the potential quality metrics used in the hand surgery literature published after the Affordable Care Act was enacted, to identify current trends in quality measurement and guide efforts to improve the quality of care in hand surgery.Wound Healing Complications in Diabetic Patients Undergoing Carpal Tunnel and Trigger Finger Releases: A Retrospective Cohort Study
To evaluate the association of diabetes and perioperative hemoglobin A1C (HgA1C) value with postoperative wound healing complications following carpal tunnel release (CTR) and trigger finger release (TFR).Comparison of Complication Risk Following Trigger Digit Release Performed in the Office Versus the Operating Room: A Population-Based Assessment
Trigger digit release (TDR) performed in an office-based procedure room (PR) setting minimizes surgical costs compared with that performed in an operating room (OR); yet, it remains unclear whether the rates of major complications differ by setting. We hypothesized that surgical setting does not have an impact on the rate of major complications after TDR.The Impact of Dividing the Flexor Tendon Pulleys on Tendon Excursion and Work of Flexion in a Cadaveric Model
The A2 and A4 pulleys of the flexor tendon system have traditionally been considered critical components of efficient digital flexion. This dogma has recently been challenged. Using fresh human cadaveric hands and a model to measure force and excursion, we sought to clarify the clinical importance of releasing different pulleys.Geospatial Inefficiencies Associated With Digital Replantations at High-Volume Centers and Optimal Allocation Model for Centralization of Replantations
Digit replantation can improve dexterity, functionality, patient satisfaction, and pain following amputation, but rates continue to fall nationally. This study aimed to describe the effects of travel time and distance as barriers to high-volume hospitals, identify geospatial inefficiencies in the presentation of patients to replantation care, and provide an optimal allocation model in which cases are redistributed to select centers to reduce geospatial redundancies and optimize outcomes.Functional Recovery Following Trapeziectomy and Ligament Reconstruction and Tendon Interposition: A Prospective Longitudinal Study
Patients undergoing surgery for trapeziometacarpal (TMC) joint arthritis require preoperative counseling on the expectations of surgery. This study aims to document the objective and functional recovery over the initial 12 months following trapeziectomy and ligament reconstruction with tendon interposition (LRTI).Analysis of Gender Diversity Within Hand Surgery Fellowship Programs
To define and compare gender diversity among faculty and trainees within hand surgery fellowship programs.Does Patient Sex Affect Ultrasound Cutoff Values for Severity Grading of Carpal Tunnel Syndrome?
A growing body of evidence supports ultrasound (US) as an alternative first-line confirmatory test for carpal tunnel syndrome (CTS). Recent studies have demonstrated a correlation of US cross-sectional area with electrodiagnostic (EDX)-determined severity; however, it is unclear whether patient sex affects the cutoff values used for determining severity. The purpose of this study was to determine if patient sex affects US graded severity when using EDX as the reference standard.Assessing New Technologies in Surgery: Case Example of Acute Primary Repair of the Thumb Ulnar Collateral Ligament
Health technology assessment provides a means to assess the technical properties, safety, efficacy, cost-effectiveness, and ethical/legal/social impact of a novel technology. An important component of health technology assessment is the cost-effectiveness analysis (CEA), which can be performed using model-based CEA. This study used the CEA model to compare the cost-effectiveness of a novel ligament augmentation device with the standard technique for primary repair of complete ulnar collateral ligament (UCL) tears.Risk of Infection in Thumb Carpometacarpal Surgery After Corticosteroid Injection
The purpose of this study was to determine whether patients who had an intra-articular corticosteroid injection into the thumb carpometacarpal (CMC) joint for the treatment of arthritis within the 3 months before CMC joint arthroplasty or arthrodesis were at increased risk for wound complication/infection and/or repeat surgery for wound complication/infection in comparison with patients who did not receive an injection within 6 months or who received an injection between 3 and 6 months before surgery.The Epidemiology of Carpal Tunnel Revision Over a 1-Year Follow-Up Period
To establish the incidence of revision carpal tunnel surgery within a 1-year postoperative period using a national administrative database. This information has been unknown until this point because of the absence of laterality-specific coding with the International Classification of Diseases, Ninth Edition and earlier coding systems.Prospective Cohort Study to Investigate Factors Associated With Continued Immobilization of a Nondisplaced Scaphoid Waist Fracture
The decision to continue immobilization of a nondisplaced scaphoid waist fracture is often based on radiographic appearance (despite evidence that radiographs are unreliable and inaccurate for diagnosing scaphoid union 6–12 weeks after fracture) and fracture tenderness (even though it is influenced by cognitive biases on pain). This may result in unhelpful additional immobilization. We studied nondisplaced scaphoid waist fractures to determine the factors associated with (1) the surgeon’s decision to continue cast or splint immobilization at the first visit when cast removal was being considered; (2) greater pain on examination; and (3) the surgeon’s concern about radiographic consolidation.Disseminating Hand Surgery Research Using Social Media: The Relationship Between Altmetrics and Citations
Social media adds to the traditional methods of research dissemination. It allows researchers and publishers to immediately share content directly with interested end users on a global scale. Alternative metrics (altmetrics) are new bibliometrics that describe article-level activity on platforms such as Twitter, Wikipedia, and online news media. Altmetrics are strongly associated with citation counts in numerous medical disciplines. The aim of this study was to investigate the relationship of altmetrics to citation counts in the field of hand surgery.Early Outcomes of Endoscopic Versus Open Carpal Tunnel Release
To compare the short-term outcomes of endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR), including patient-reported outcomes, pain and satisfaction scores, return to work, and postoperative prescription pain medication use.The Effect of Adoption on Functioning and Psychosocial Well-Being in Patients With Congenital Upper-Extremity Differences
Adoption status has been investigated in numerous populations, identifying negative and positive effects on patient outcomes. This study compared parent-reported outcomes in adopted and nonadopted individuals with congenital upper-extremity (UE) anomalies to determine whether there was a measurable difference in parent perceptions of psychosocial health and functioning.Long-Term Hand Function Outcomes of the Surgical Management of Complete Brachial Plexus Birth Injury
Hand function outcomes of primary nerve reconstruction for total brachial plexus birth injury (BPBI) are confounded by nerve roots left in continuity, inclusion of secondary procedures, and no assessment of the ability to perform activities of daily living. The purpose of this study was to evaluate the long-term hand function outcomes in a cohort of patients with a complete BPBI who had no nerve root in continuity prior to primary nerve reconstruction targeting the lower trunk.Perioperative Laboratory Markers as Risk Factors for Surgical Site Infection After Elective Hand Surgery
The purpose of this study was to test the null hypothesis that there is no association between perioperative laboratory markers (serum albumin and hemoglobin A1c [HbA1c]) and incidence of surgical site infection (SSI) after soft tissue upper extremity surgery.Hand Trauma Network in the United States: ASSH Member Perspective Over the Last Decade
Upper extremity trauma is common, however the provision of emergency call for hand trauma can be challenging for hospital systems and hand surgeons. Over the past decade, the American Society for Surgery of the Hand (ASSH) has developed the Hand Trauma Network and an Emergency Hand Care Committee to refine care for hand trauma patients.A Prospective Randomized Comparison of Variable-Angle and Fixed-Angle Volar Locking Plating for Intra-Articular Distal Radius Fractures
To compare clinical and radiographic outcomes of using a variable-angle volar locking plate (VAVLP) with those of using a fixed-angle volar locking plate (FAVLP) for treating unstable intra-articular fractures of the distal radius.Experience Level Influences Users’ Interactions With and Expectations For Online Surgical Videos: A Mixed-Methods Study
Upper-extremity surgeons and trainees widely use online surgical videos, and the use of these videos can assist with procedural learning. The purpose of this study was to characterize online video use and understand the role videos play in the learning process of orthopedic residents and practicing surgeons. We hypothesized that the use of surgical videos and video content desired among orthopedic learners differs based on their experience level.Hook of Hamate Fractures in Major and Minor League Baseball Players
The purpose of this study was to describe an approach to surgical management of the hook of hamate fractures in professional baseball players.Total Elbow Arthroplasty: A Descriptive Analysis of 170 Patients From a United States Integrated Health Care System
Total elbow arthroplasty (TEA) can be used, with varying degrees of success, for the treatment of rheumatoid arthritis, osteoarthritis, and distal humerus fractures and their sequelae in elderly patients. Some of the largest studies of TEA have included data from more than 20 years ago and may not reflect the current practice of TEA. We sought to describe a modern cohort of patients who underwent TEA in a United States integrated health care system.Reliability of Radiographs and Computed Tomography in Diagnosing Scaphoid Union After Internal Fixation
To evaluate the reliability of radiographs (XR) alone versus the combination of XR and computed tomography (CT) in determining scaphoid union following open reduction internal fixation (ORIF) with a headless compression screw.Surgical Timing for Carpal Tunnel Syndrome: A Comparison of Health Care Delivery in the Veterans Administration and Private Sector
The U.S. Department of Veterans Affairs (VA) health care system monitors time from referral to specialist visit. We compared wait times for carpal tunnel release (CTR) at a VA hospital and its academic affiliate.Evaluation of PROMIS’ Ability to Detect Immediate Postoperative Symptom Improvement Following Carpal Tunnel Release
We sought to determine whether subjective clinical improvement immediately after carpal tunnel release (CTR) was captured by Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE), Physical Function (PF), Pain Interference (PI), and Depression.Risk Factors for Failed Nonsurgical Treatment Resulting in Surgery on Thumb Carpometacarpal Arthritis
The thumb carpometacarpal (CMC) joint is the second most common site of osteoarthritis in the hand, yet reported symptoms and ultimate treatment decisions are not simply a function of radiographic appearance. This study aimed to determine the patient- and/or disease-related factors associated with patients undergoing surgical treatment of thumb CMC arthritis.The Financial Implications of Telehealth Visits Within a Hand and Wrist Surgery Clinical Practice During the COVID-19 Pandemic
Telehealth use is likely to increase as a result of practice changes during the COVID-19 pandemic, although the overall picture surrounding the billing, coding, and continued insurance coverage of these visits remains uncertain. The purpose of this study was to identify potential financial implications of continued telehealth use in hand and wrist surgery clinical practice.Structural Versus Nonstructural Bone Grafting for the Treatment of Unstable Scaphoid Waist Nonunion Without Avascular Necrosis: A Randomized Clinical Trial
We evaluated the impact of structural versus nonstructural bone grafting on the time to union, scaphoid deformity correction, and clinical outcomes in adults with unstable scaphoid waist nonunion without avascular necrosis. We hypothesized that nonstructural grafting would provide earlier time to union, restoration of scaphoid anatomy, and equivalent clinical outcomes compared with structural grafting.Magnetic Resonance Imaging in Osteochondritis Dissecans of the Humeral Capitellum: Preoperative Assessment of Lesion Size and Lateral Wall Integrity
Magnetic resonance imaging (MRI) is a helpful tool in the evaluation of osteochondritis dissecans (OCD) of the humeral capitellum. The relationship between MRI appearance and clinically relevant intraoperative findings is incompletely understood. The goal of this study was to evaluate capitellar OCD lesions via preoperative MRI and to determine its accuracy in predicting lesion characteristics including lesion size and capitellar lateral wall integrity.Carpal Motion in Chronic Geissler IV Scapholunate Interosseous Ligament Wrists
This study evaluated the biomechanics of Geissler IV (G4) wrists in cadavers and compared them with intact specimens after multiple ligament sectioning to create scapholunate instability. It also evaluated carpal motion changes after sectioning of the lunotriquetral interosseous ligament (LTIL).Cost Comparison of Botulinum Toxin Injections Versus Surgical Treatment in Pediatric Patients With Cerebral Palsy: A Markov Model
The purpose of this study was to compare the cost-effectiveness of surgical release to botulinum toxin injections in the treatment of upper-extremity (UE) cerebral palsy (CP).Self-Perceived Hand Normality Before and After Surgical Treatment of Dupuytren Contracture
To describe patients’ self-reported hand normality before and after surgery for Dupuytren contracture and to determine whether this metric could be used as an adjunct to determine the success of surgery.Assessing the Relationship Between Bone Density and Loss of Reduction in Nonsurgical Distal Radius Fracture Treatment
Whether low bone mineral density affects loss of reduction for distal radius fractures (DRFs) managed without surgery is unknown. Our purpose was to understand how bone mineral density, based on second metacarpal cortical percentage (2MCP) measurement, affects DRF healing after nonsurgical treatment.Outcomes Associated With Scapholunate Ligament Injury Following Intra-Articular Distal Radius Fractures
The purpose of this study was to evaluate a series of intra-articular distal radius fractures (DRFs) to determine whether patients without radiographic evidence of scapholunate (SL) ligament injury have a difference in outcomes in comparison with patients with radiographic evidence of SL ligament injury and no ligament repair or reconstruction. Our hypothesis is that there are no significant differences in outcomes between patients after treatment of their intra-articular DRF.Rate of Bone Mineral Density Testing and Subsequent Fracture-Free Interval After Distal Forearm Fracture in the Medicare Population
Distal forearm fractures are prevalent among the Medicare population. Many patients who sustain these fractures have poor bone health and are at increased risk for subsequent fractures. We sought to determine the rate of bone mineral density (BMD) testing and subsequent fragility fracture-free interval after distal forearm fractures in the Medicare population.Technology, Social Media, and Telemedicine Utilization for Rural Hand and Upper-Extremity Patients
To define technology and social media use among rural upper-extremity patients. In addition, we aimed to assess how patients use social media in relation to health care and their willingness to participate in telemedicine programs.Comparative Accuracy of 1.5T MRI, 3T MRI, and Static Ultrasound in Diagnosis of Small Gaps in Repaired Flexor Tendons: A Cadaveric Study
We hypothesized that magnetic resonance imaging (MRI) would more accurately diagnose small gaps (<6 mm) after flexor tendon repair than static ultrasound (US) and that suture artifact would negatively impair accuracy.Impact of Insurance Type on Self-Reported Symptom Severity at the Preoperative Visit for Carpal Tunnel Release
Prior studies evaluated the impact of insurance type on access to hand care. However, there is limited literature quantifying whether patient symptoms are worse at the time of intervention. Our primary null hypothesis was that insurance type would not be associated with Patient-Reported Outcomes Measure Information System (PROMIS) Upper-Extremity (UE), Physical Function (PF), Pain Interference (PI), and Depression scores at the preoperative visit before carpal tunnel release (CTR).Results of Linked Convertible Total Elbow Arthroplasty for the Management of Distal Humeral Fractures in the Elderly
Total elbow arthroplasty (TEA) is increasingly used for the management of comminuted distal humeral fractures in elderly patients. There are limited data on the outcome of modern elbow arthroplasty designs in larger patient cohorts. The aim of the current study was to review the outcomes and complications using a cemented convertible TEA system in a linked configuration in patients with distal humeral fractures.Long-Term Outcome of Surgical Treatment for Kienböck Disease Using an Articular-Based Classification
The aim of this study was to report the outcomes of surgery using the Bain and Begg articular-based classification for the treatment of Kienböck disease.Variation in Use of Electrodiagnostic Testing: Analysis From the Michigan Collaborative Hand Initiative for Quality in Surgery
To evaluate factors that predict the use of electrodiagnostic testing (EDS) for patients undergoing carpal tunnel release (CTR).Use of Thermoplastic Rings Following Venting of Flexor Tendon Pulleys: A Biomechanical Analysis
Normal digital flexion relies on flexor tendon pulleys to convert linear muscular force to angular digital motion. However, there is a growing trend to vent them partially during flexor tendon repair. The objective of this study was to examine the effects of a thermoplastic ring, acting as an external pulley, on flexor tendon biomechanics and finger range of motion (ROM) after pulley venting.Improving Efficiency of Patient-Reported Outcome Collection: Application of Computerized Adaptive Testing to DASH and QuickDASH Outcome Scores
Patient-reported outcome measures assess health status and treatment outcomes in orthopedic care, but they may burden patients with lengthy questionnaires. Predictive models using machine learning, known as computerized adaptive testing (CAT), offer a potential solution. This study evaluates the ability of CAT to improve efficiency of the 30-item Disabilities of the Arm, Shoulder, and Hand (DASH) and 11-item QuickDASH questionnaires.Effectiveness of Distal Nerve Transfers for Claw Correction With Proximal Ulnar Nerve Lesions
To evaluate claw deformity correction following anterior interosseous nerve (AIN) end-to-end transfer to the deep motor branch of the ulnar nerve (DMBUN) in high ulnar nerve injuries.Factors Associated With Surgical Treatment of Nondisplaced or Minimally Displaced Scaphoid Waist Fractures
To determine whether there are identifiable factors associated with the surgical treatment of nondisplaced or minimally displaced scaphoid waist fractures.Relevance of Diagnosed Depression and Antidepressants to PROMIS Depression Scores Among Hand Surgical Patients
We aimed to test the utility of screening for depressive symptoms in the hand surgical office focusing on chances of heightened depressive symptoms in patients with no history of diagnosed depression and by quantifying ongoing depressive symptoms among patients diagnosed with depression accounting for antidepressant use. The clinical importance of this study was predicated on the documented negative association between depressive symptoms and hand surgical outcomes.Comparison of Nylon Suture Versus 2 Fibrin Glue Products for Delayed Nerve Coaptation in an Animal Model
To compare 2 different, commercially available fibrin glue products with nylon suture with regard to repair strength, muscle function, and axon regeneration after delayed nerve repair in an animal model.Reliability of Telephone Acquisition of the PROMIS Upper Extremity Computer Adaptive Test
Our primary purpose was to evaluate the reliability of telephone administration of the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Computer Adaptive Test (CAT) version 2.0 in a hand and upper extremity population, and secondarily to make comparisons with the abbreviated version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH).Evaluation of Dorsal Scaphoid Displacement Using Posterior Radioscaphoid Angle in Patients With Suspected Scapholunate Instability: A Preliminary Study
To assess the validity and reliability of the posterior radioscaphoid angle (PRSA), an indicator of dorsal displacement of the scaphoid, in distinguishing wrists with and without chronic scapholunate instability (SLI).The Influence of Self-Reported Hand–Arm Vibration Exposure on Functional Outcomes Following Carpal Tunnel Release
This study describes the impact of self-reported hand–arm vibration (HAV) exposure on patient-reported outcomes, health-related quality of life, and satisfaction after carpal tunnel release.The Association Between Electrodiagnostic Severity and Treatment Recommendations for Carpal Tunnel Syndrome
Our study aimed to evaluate the relationship between electrodiagnostic study (EDS) severity and utilization of treatments for carpal tunnel syndrome (CTS) as well as the duration of time between EDS and carpal tunnel release (CTR).Outcomes of Pediatric and Adolescent Carpal Tunnel Release
To investigate carpal tunnel syndrome (CTS) presentation and long-term outcomes of carpal tunnel release (CTR) in children and adolescents.Radiographic and Clinical Outcomes of the Shoulder in Long-Term Follow-Up of Brachial Plexus Birth Injury
The purpose of this study was to examine radiographic and functional outcomes of the shoulder in brachial plexus birth injury (BPBI) patients at long-term follow-up.Social Deprivation and Congenital Upper Extremity Differences—An Assessment Using PROMIS
Social deprivation, a measure of socioeconomic status, has been shown to negatively affect perceptions of orthopedic conditions and outcomes of treatment. The objective of this study was to assess whether social deprivation correlates with subjective assessment of function in pediatric patients with congenital hand differences.Distal Biceps Tendon Rupture Surgery: Changing Incidence in Finnish and Swedish Men Between 1997 and 2016
Distal biceps tendon rupture is a relatively rare injury usually occurring with excess external extension force applied to a flexed elbow. The aim of this study was to examine the incidence of distal biceps tendon rupture surgery in the Finnish and Swedish adult population between the years 1997 and 2016. A secondary aim was to investigate the distal biceps rupture incidence in the Swedish population in 2001 to 2016.Declining Trend in Medicare Physician Reimbursements for Hand Surgery From 2002 to 2018
To evaluate trends in Medicare physician reimbursements for 20 common hand procedures/surgeries from 2002 to 2018.A Multicenter Matched Cohort Study of Processed Nerve Allograft and Conduit in Digital Nerve Reconstruction
Biomaterials used to restore digital nerve continuity after injury associated with a defect may influence ultimate outcomes. An evaluation of matched cohorts undergoing digital nerve gap reconstruction was conducted to compare processed nerve allograft (PNA) and conduits. Based on scientific evidence and historical controls, we hypothesized that outcomes of PNA would be better than for conduit reconstruction.Establishing Validity of a Comprehensive Hand Surgical Training and Educational Platform (STEP)
The purpose of this study was to develop and perform the initial validation for the Surgical Training and Educational Platform (STEP), a cost-effective psychomotor training and assessment instrument designed to teach and evaluate fundamental skills considered critical to competency in hand surgery.Flexor Pollicis Longus Tendon Wear Associated With Volar Plating: A Cadaveric Study
This study examined the effect of low-profile volar rim plates (VR), proximally placed standard variable-angle locking plates (pVA-LCP), and distally placed standard variable-angle locking plates (dVA-LCP) on the flexor pollicis longus (FPL) tendon in a cadaver model. We hypothesized that tendons from the VR and pVA-LCP groups would exhibit similar contact pressures, wear patterns, and post-fatigue testing mechanical properties, whereas dVA-LCP tendons would exhibit higher contact pressures, increased tendon wear patterns, and decreased mechanical properties.A Comparative Analysis of 150 Thumb Polydactyly Cases from the CoULD Registry Using the Wassel-Flatt, Rotterdam, and Chung Classifications
Three commonly used classifications for thumb polydactyly are the Wassel-Flatt, Rotterdam, and Chung. The ideal classification system would have high validity and reliability and be descriptive of the thumb anomaly. The purposes of this investigation were to (1) compare the inter- and intrarater reliability of these 3 classifications when applied to a large sample of patients enrolled in the Congenital Upper Limb Differences (CoULD) Registry and (2) determine the prevalence of radial polydactyly types when using the various classifications in a North American population.
