AI and the nature of disagreement.

Litigation is a creature of disagreement. Our essay explores the potential of artificial intelligence (AI) to help reduce legal disagreements. In any litigation, parties disagree over the facts, the law, or how the law applies to the facts.

Growth of the New Thumb Metacarpal After Pollicization for Thumb Hypoplasia.

Purpose: To investigate the radiographic length and width of the new thumb metacarpal in relation to the middle finger proximal phalanx; to assess the incidence of premature physeal closure of the new metacarpal; and to consider whether there is a relationship between growth characteristics and the presence of union or nonunion of the new trapezium to the retained index finger metacarpal base.

Methods: Forty pollicizations were assessed with preoperative or immediate postoperative radiographs and follow-up radiographs to establish the growth characteristics of the new thumb metacarpal. Functional outcomes comprising grip strength, pinch strength, and range of motion were correlated with radiological findings of presence or absence of open physes and presence or absence of union of the new trapezium to the metacarpal base.

Stability of the Basal Joints of the New Thumb After Pollicization for Thumb Hypoplasia.

Purpose: To investigate the presence or absence of union of the new trapezium to the retained metacarpal base after pollicization and to relate this to stability of the new trapezium and the new carpometacarpal joint.

Methods: Thirty-six patients (46 pollicizations) were assessed at clinical review. Mean time from surgery to review was 96 months (range, 9-260 mo).

Cystic eccrine spiradenoma of the finger mimicking a ganglion.

We report a rare case of cystic eccrine spiradenoma in the finger. A 46-year-old man presented with a cystic mass in his left index finger. Clinical assessment along with the investigation pointed toward a diagnosis of a ganglion.

Is ORIF superior to nonoperative treatment in isolated displaced partial articular fractures of the radial head?

Background: While good results have been reported with both nonoperative and operative treatment of isolated displaced partial radial head fractures, there remains considerable disagreement about the role of surgery in the management of these injuries.

Questions/purposes: We (1) compared isolated displaced partial articular radial head fractures treated nonoperatively with open reduction internal fixation (ORIF) in terms of validated outcomes scores, ROM, and strength; (2) assessed whether there were any predictor variables for outcomes; and (3) compared complications between groups.

Methods: We retrospectively compared patients with isolated partial articular radial head fractures displaced greater than 2 mm but less than 5 mm who received either nonoperative treatment (30 patients) or ORIF (30 patients).

Radial head fractures.

Fractures of the radial head are the most common fractures in the elbow, and they frequently have associated ligamentous, cartilaginous, or other bony injuries. Clinical assessment and radiological investigation allow for accurate diagnosis and the formulation of a management plan. Undisplaced or minimally displaced fractures with no rotational block to motion can be treated nonoperatively with excellent results expected.

Management of distal radius fractures from the North American perspective.

In North America, the rate of nonoperative management of displaced distal radius fractures has declined as the rate of internal fixation has increased. Volar locking plate fixation has increased in popularity despite a lack of supportive level 1 evidence. Issues of cost-effectiveness are relevant because there is no best-practice treatment at this stage.

Single versus triple injection ultrasound-guided infraclavicular block: confirmation of the effectiveness of the single injection technique.

Background: The optimal site for local anesthetic placement during ultrasound-guided infraclavicular block remains controversial.

Methods: Patients were randomized to receive lidocaine 2% 30 mL as a single injection posterior to the axillary artery (n = 51) or a triple injection ideally adjacent to each brachial plexus cord (n = 49). Pinprick sensory and motor block (3 = no block, 0 = complete block) were assessed to 20 minutes in the 4 distal nerve territories.