The Impact of COVID-19 on the Surgical Wait Times for Plastic and Reconstructive Surgery in Ontario.

: The aim of this study was to assess the impact of COVID-19 on surgical wait times for Plastic and Reconstructive Surgery (PRS) in Ontario, Canada. : Ontario's wait time data has fourteen reporting categories for PRS. For each category, the mean wait time for consultation and for surgery were reported.

Resilience is associated with cortical gray matter of the antinociceptive pathway in people with chronic pain.

Resilience is an important personal characteristic that influences health and recovery. Previous studies of chronic pain suggest that highly resilient people may be more effective at modulating their pain. Since brain gray matter in the antinociceptive pathway has also been shown to be abnormal in people with chronic pain, we examined whether resilience is related to gray matter in regions of interest (ROIs) of the antinociceptive pathway (rostral and subgenual anterior cingulate cortex (rACC, sgACC), anterior insula (aINS), dorsolateral prefrontal cortex (dlPFC)) normally and in people who are experiencing chronic pain.

Carpal tunnel surgery dampens thalamocortical and normalizes corticocortical functional connectivity.

Carpal tunnel syndrome is the most common entrapment neuropathy and is associated with altered brain function and structure. However, little is understood of the central mechanisms associated with its pain, symptom presentation, and treatment-related resolution. This longitudinal study evaluated carpal tunnel syndrome-related alterations in brain network communication and relationships to behavioural signs of central sensitization before and after carpal tunnel release surgery.

Sex-Specific Abnormalities and Treatment-Related Plasticity of Subgenual Anterior Cingulate Cortex Functional Connectivity in Chronic Pain.

The subgenual anterior cingulate cortex (sgACC) is a key node of the descending antinociceptive system with sex differences in its functional connectivity (FC). We previously reported that, in a male-prevalent chronic pain condition, sgACC FC is abnormal in women but not in men. This raises the possibility that, within a sex, sgACC FC may be either protective or represent a vulnerability to develop a sex-dominant chronic pain condition.

Ontario wait times for delayed surgical treatment of traumatic peripheral nerve injury.

Background: To better understand the occurrence and operative treatment of peripheral nerve injury (PNI) and the potential need for additional resources, it is essential to define the frequency and distribution of peripheral nerve procedures being performed. The objective of this study was to evaluate Ontario's wait times for delayed surgical treatment of traumatic PNI.

Methods: We retrieved data on wait times for peripheral nerve surgery from the Ontario Ministry of Health and Long-Term Care Wait Time Information System.

Evaluation of Cold Sensitivity in Patients With Upper Extremity Nerve Compression Syndromes: A Scoping Review.

Purpose: The aim of this study was to review the literature to determine the prevalence of cold sensitivity in upper extremity nerve compression syndromes and the impact of treating nerve compression syndromes on cold sensitivity.

Methods: Following a standardized scoping review protocol, this study included interventional and observational study designs assessing patients with cold sensitivity and upper extremity nerve compression syndromes. Review articles, case reports, and small case series (n < 5) were excluded.

Peripheral Nerve Focused Ultrasound Lesioning-Visualization and Assessment Using Diffusion Weighted Imaging.

Magnetic resonance-guided focused ultrasound (MRgFUS) is a non-invasive targeted tissue ablation technique that can be applied to the nervous system. Diffusion weighted imaging (DWI) can visualize and evaluate nervous system microstructure. Tractography algorithms can reconstruct fiber bundles which can be used for treatment navigation and diffusion tensor imaging (DTI) metrics permit the quantitative assessment of nerve microstructure .

Canadian Plastic Surgery Resident Operative Experience in Hand Surgery.

Purpose: Core procedural competencies (CPCs) in hand surgery have been previously described. However, it is unknown whether plastic surgery residents receive sufficient operative experience with these procedures. This study aimed to determine whether Canadian plastic surgery residents are receiving adequate exposure to CPCs in hand surgery during residency training.

Factor Structure of the Disabilities of the Arm, Shoulder and Hand Questionnaire in Upper Extremity Nerve Injury.

Background: This study evaluated the validity of the factor structure of the Disabilities of the Arm, Shoulder and Hand questionnaire to assess upper extremity disability in patients with upper extremity nerve injury.

Methods: Data were used from previous cross-sectional studies of patients with upper extremity nerve injuries. Research ethics approval was obtained for secondary data analyses.

Effect of Forearm Warming Compared to Hand Warming for Cold Intolerance Following Upper Extremity Trauma.

Purpose: This study evaluated the effect of forearm or hand warming versus bare hand conditions to improve cold-induced symptoms and skin temperatures in hand trauma patients.

Methods: Adults with symptoms of cold intolerance at least 3 months following hand trauma and age-/sex-matched controls were included. Testing sessions (bare hand, hand warming, forearm warming) were completed in a climate laboratory with continuous temperature monitoring.

Secondary Effects of Radiation Therapy to the Hand for Benign Conditions.

Emerging literature introduces radiation therapy for benign hand conditions. However, hand surgeons are wary recommending radiation therapy for nonmalignant conditions. In our practice, we have used radiation therapy for patients who present with infiltrative or recurrent giant cell tumor of the tendon sheath (GCTTS) since 1998.

Lipomatosis of Nerve: More than a Focal Distal Disease.

Lipomatosis of nerve is a rare, ill-defined, fibrofatty tumor intermingled among nerve fascicles. The classic presentation of lipomatosis of nerve describes focal distal involvement of the median nerve at the wrist. The purpose of this study was to determine the level of proximal lesion extension in cases of upper extremity lipomatosis of nerve using magnetic resonance imaging.

Peripheral nerve injuries, pain, and neuroplasticity.

Introduction: Peripheral nerve injuries (PNIs) cause both structural and functional brain changes that may be associated with significant sensorimotor abnormalities and pain.

Purpose Of The Study: The aim of this narrative review is to provide hand therapists an overview of PNI-induced neuroplasticity and to explain how the brain changes following PNI, repair, and during rehabilitation.

Methods: Toward this goal, we review key aspects of neuroplasticity and neuroimaging and discuss sensory testing techniques used to study neuroplasticity in PNI patients.

Consensus of Leaders in Plastic Surgery: Identifying Procedural Competencies for Canadian Plastic Surgery Residency Training Using a Modified Delphi Technique.

Background: Transitioning to competency-based surgical training will require consensus regarding the scope of plastic surgery and expectations of operative ability for graduating residents. Identifying surgical procedures experts deemed most important in preparing graduates for independent practice (i.e.

A Case of Posterior Tibial Nerve Injury After Arthroscopic Calcaneoplasty.

We report the first case of distal posterior tibial nerve injury after arthroscopic calcaneoplasty. A 59-year-old male had undergone right arthroscopic calcaneoplasty to treat retrocalcaneal bursitis secondary to a Haglund's deformity. The patient complained of numbness in his right foot immediately after the procedure.

Prevalence of cold sensitivity in upper extremity nerve compression syndromes.

Unlabelled: This prospective observational study assessed the prevalence of cold sensitivity in patients with nerve compression using the Cold Intolerance Symptom Severity (CISS) questionnaire. One hundred patients (72 women, 28 men; mean age 59 years) with carpal tunnel syndrome ( n = 95) or cubital tunnel syndrome ( n = 5) were studied. Fifty-two patients reported symptoms of cold sensitivity with a mean CISS score of 50.

A longitudinal study of pain, personality, and brain plasticity following peripheral nerve injury.

We do not know precisely why pain develops and becomes chronic after peripheral nerve injury (PNI), but it is likely due to biological and psychological factors. Here, we tested the hypotheses that (1) high Pain Catastrophizing Scale (PCS) scores at the time of injury and repair are associated with pain and cold sensitivity after 1-year recovery and (2) insula gray matter changes reflect the course of injury and improvements over time. Ten patients with complete median and/or ulnar nerve transections and surgical repair were tested ∼3 weeks after surgical nerve repair (time 1) and ∼1 year later for 6 of the 10 patients (time 2).

Competency-based medical education for plastic surgery: where do we begin?

Background: North American surgical education is beginning to shift toward competency-based medical education, in which trainees complete their training only when competence has been demonstrated through objective milestones. Pressure is mounting to embrace competency-based medical education because of the perception that it provides more transparent standards and increased public accountability. In response to calls for reform from leading bodies in medical education, competency-based medical education is rapidly becoming the standard in training of physicians.

Validity of the Patient Specific Functional Scale in patients following upper extremity nerve injury.

Purpose: This study evaluated the validity of the Patient Specific Functional Scale (PSFS) in patients with upper extremity nerve injury.

Methods: Following Research Ethics Boards (REB) approval, we included English-speaking adults, with greater than 6 months after an upper extremity nerve injury. Patient reported questionnaires included: PSFS, 36-item short-form health survey (SF-36), Disabilities of the Arm, Shoulder and Hand (DASH), McGill Pain Questionnaire, Pain Catastrophizing Scale (PCS) and Pain Disability Index (PDI).

Complete digital amputations undergoing replantation surgery: a 10-year retrospective study.

Background: As a result of growing expertise and skill, replantation surgery has evolved to more than the technical reattachment of an amputated part.

Methods: A retrospective study of complete digital amputations undergoing replantation surgery was conducted for the purpose of assessing trends in these complex cases. All incomplete and partial amputations were excluded.