Evaluation of Patient Education Materials From Large-Language Artificial Intelligence Models on Carpal Tunnel Release.

Background: ChatGPT, an artificial intelligence technology, has the potential to be a useful patient aid, though the accuracy and appropriateness of its responses and recommendations on common hand surgical pathologies and procedures must be understood. Comparing the sources referenced and characteristics of responses from ChatGPT and an established search engine (Google) on carpal tunnel surgery will allow for an understanding of the utility of ChatGPT for patient education.

Methods: A Google search of "carpal tunnel release surgery" was performed and "frequently asked questions (FAQs)" were recorded with their answer and source.

Intramedullary Fixation of Hand Fractures and Arthrodeses.

Intramedullary fixation has long been popular for fracture fixation in the upper extremity from the shoulder through the carpus. Recently, intramedullary fixation in the hand has gained increasing interest, specifically in the metacarpals and phalanges, corresponding with the development of improved cannulated headless screw technology. Along with the advantages of increased operative speed and less surgical dissection, which can promote rapid healing, many benefits exist, supporting their use despite some drawbacks.

Failure of humeral shaft fixation: construct characteristics.

Purpose: Fixation failure following open reduction and internal fixation (ORIF) of humeral shaft fractures can be a challenging complication. We aimed to identify the modes of failure and characteristics of failed fixation constructs.

Methods: We queried our institutional database for patients > 18 years old with fixation failure after ORIF with single plate and screw constructs of humeral shaft fractures from 2006 to 2017.

A 5-Year Update and Comparison of Factors Related to the Sex Diversity of Orthopaedic Residency Programs in the United States.

Unlabelled: Female physicians have been historically underrepresented in orthopaedic surgery residencies. The purpose of this study was to determine whether sex diversity among orthopaedic residency programs and faculty is associated with an increased number of female residents matriculating into that program. In addition, we sought to analyze female resident matriculation trends in the past 5 years.

What Program Characteristics Are Associated with Resident Racial Diversity in Orthopaedic Surgery? An Analysis of Association of American Medical Colleges Data.

Unlabelled: In orthopaedic surgery, there are fewer Black or African American (4%) and Hispanic or Latino (4%) residents compared with general surgery, internal medicine, family medicine, and pediatrics (5%-7% Black residents and 7%-9% Hispanic/Latino residents, respectively). There are also fewer underrepresented in medicine minority (URiM) faculty in orthopaedic surgery (6.1%) compared with general surgery (8.

Interpersonal Interactions and Biases in Orthopaedic Surgery Residency: Do Experiences Differ Based on Gender?

Background: Women residents are underrepresented in orthopaedic surgery. The causes of the deficit of women in orthopaedic surgery are multifactorial, but by identifying the perceptions of women in orthopaedic residency training and comparing them with the perceptions of men, we can improve our understanding of ways to enhance the recruitment of qualified and diverse candidates.

Questions/purposes: (1) What differences exist in the perceived experiences of residents identifying as women and men regarding professional, social, and personal interactions during residency training? (2) Are there differences in the percentage of women and men residents who have experienced harassment or discrimination in preresidency interviews, and are there differences in the type of harassment or discrimination experienced?

Methods: A survey was generated using Academy of Critical Care: Development, Evaluation, and Methodology guidelines.

The effect of COVID-19 on adult traumatic orthopedic injuries: a database study.

Purpose: This study compares orthopedic injuries, procedures, and hospital outcomes of patients presenting to trauma centers in Pennsylvania before and during the COVID-19 pandemic.

Methods: A retrospective review of adult patients presenting to hospitals with Pennsylvania Trauma Systems Foundation (PTSF) designations was performed. All patients 18 years of age and older who presented with orthopedic injuries were included.

The Effect of COVID-19 on Pediatric Traumatic Orthopaedic Injuries: A Database Study.

Introduction: Stay-at-home orders and other social distancing restrictions had a profound effect on the lives of children during the pandemic. This study characterizes pediatric orthopaedic injuries and in-hospital outcomes during the COVID-19 pandemic and compares them with pre-COVID patterns.

Methods: A retrospective review of pediatric patients presenting to hospitals with Pennsylvania Trauma Systems Foundation designations was performed.

Biomechanical Comparison of Dual and Posterior Locking Plates in an Ex Vivo Comminuted Olecranon Fracture Model.

Purpose: Comminuted olecranon fractures are commonly fixed with posterior locking plates (PLPs). Though biomechanically validated, this method comes with risks of symptomatic implant prominence and wound breakdown. Dual locking plates (DLPs) placed on the medial and lateral surfaces of the olecranon theoretically avoid these risks and allow for fixation of proximal fracture fragments in multiple planes.

Relevance of Diagnosed Depression and Antidepressants to PROMIS Depression Scores Among Hand Surgical Patients.

Purpose: 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.

Methods: This cross-sectional study analyzed 351 patients presenting to a tertiary hand center between April 21, 2016, and November 22, 2017.

Orthopaedic Surgery Faculty: An Evaluation of Gender and Racial Diversity Compared with Other Specialties.

Background: The American Academy of Orthopaedic Surgeons has adopted the strategic goal of evolving its culture and governance to become more strategic, innovative, and diverse. Given the charge to increase diversity, a focus on assessing and increasing diversity at the faculty level may help this cause. However, an analysis of gender and racial diversity among orthopaedic faculty has not been performed.

Characteristics and Publication Rates for Podium Presentations at National Hand Surgery Meetings from 2007 to 2012.

The purpose of this study was to evaluate and compare the research presented at the annual meetings of the American Society for Surgery of the Hand (ASSH) and the American Association for Hand Surgery (AAHS). Podium presentation data were extracted from the abstract books of the annual meetings of the ASSH and AAHS from 2007 to 2012. Corresponding publications were identified using searchable online publication databases and an algorithm linking authorship and content.

Analysis of the Sports Medicine Section of the Orthopaedic In-Training Examination: Improvements in Levels of Evidence and Question Taxonomy Over a 12-Year Period.

There has been a recent shift within the orthopedic literature to publish articles with higher levels of evidence. In this investigation, the trends in question taxonomy and the levels of evidence of the references for sports medicine questions on the Orthopaedic In-Training Examination (OITE) during a 12-year period were evaluated. Sports medicine questions were obtained from the OITEs administered between 2005 and 2007 and between 2014 and 2016.

Evaluation of Spanish Language Proficiency and Resources Available in Academic Pediatric Orthopaedic Centers.

Introduction: Given the rapidly increasing population of Spanish-speaking patients in the United States, medical providers must have the capability to effectively communicate both with pediatric patients and their caregivers. The purpose of this study was to query the Spanish language proficiency of pediatric orthopaedic surgeons, assess the educational resources available to Spanish-speaking patients and their families, and identify the barriers to care at academic pediatric orthopaedic centers.

Methods: The Web sites of medical centers within the United States that have pediatric orthopaedic surgery fellowships recognized by the Pediatric Orthopaedic Society of North America (POSNA) were accessed.

Distal Radius Fractures in the Athlete.

Although the technical details of distal radius fracture fixation in athletes are largely similar to the general population, the issues surrounding the injury, desire to return to sport, and rehabilitation require specialized attention. Athletes are generally healthy, with a drive to recover and must balance the risk of long-term consequences of returning to play too early with the potential loss of scholarship, salary, or opportunities for advancement. Outcomes after nonoperative and operative treatment of distal radius fractures are generally excellent in athletes and return to the same level of sport occurs in most patients.

Perceptions of the Educational and Institutional Impact of the Orthopaedic Fellowship Interview Process.

Introduction: The time spent applying and interviewing for an orthopaedic fellowship has notable financial, educational, and workflow consequences on both residents and their respective residency programs. The purpose of this study was to assess the perceptions regarding the fellowship interview process to suggest changes that could be implemented.

Methods: Mixed-response questionnaires were sent to orthopaedic surgery residency program directors (PDs) and PGY-4 to PGY-6 residents at the 164 accredited allopathic orthopaedic surgery residency programs in the United States (August 2017).

Comparison of three fixation techniques for arcuate fractures.

Purpose: Proximal fibula avulsion fractures, or "arcuate fractures", are an often discussed but poorly defined injury pattern which represent a destabilizing injury to the posterolateral corner of the knee. Historical and recent literature discussing reconstruction and repair techniques exist, but there has been little biomechanical evaluation of repair techniques. The purpose of this study was to evaluate the strength of three type of fixation techniques for arcuate fractures: bone tunnels, a screw and washer, and a novel suture anchor technique.

Global variability in orthopedic surgery training.

Medical and orthopedic training varies throughout the world. The pathways to achieve competency in orthopedic surgery in other countries differ greatly from those in the United States. This review summarizes international educational requirements and training pathways involved in the educational development of orthopedic surgeons.

What Patient-related Factors are Associated with an Increased Risk of Surgery in Patients with Stenosing Tenosynovitis? A Prospective Study.

Background: Numerous patient-related risk factors have been identified as contributors to patient progression to operative treatment of stenosing tenosynovitis (STS). Identifying patients most at risk of undergoing surgery after receiving a corticosteroid injection would enable health care providers to identify patients most likely to benefit from nonsurgical treatment.

Questions/purposes: (1) What proportion of prospectively enrolled patients with a new diagnosis of STS did not require further intervention after a first, second, or third injection when offered up to three corticosteroid injections? (2) Which identifiable risk factors present at the initial evaluation in patients with STS are associated with the patient opting for surgical release after a trial of one, two, or three corticosteroid injections?

Methods: One hundred ninety-six patients with a presumed diagnosis of STS were evaluated between March 2014 and June 2015, and 160 patients with 186 affected fingers were prospectively enrolled after a new diagnosis of STS was made during the study period.

Evaluation of Orthopaedic Interest Groups in American Medical Schools.

Background: Orthopaedic interest groups (OIGs) are student-run organizations that can provide medical students with early exposure to orthopaedic surgery. OIGs can serve as venues for musculoskeletal education, clinical experiences, and mentorship to students with otherwise limited access to orthopaedics. The purpose of this study was to evaluate the prevalence and opportunities offered by OIGs.

Geographic Trends in the Orthopedic Surgery Residency Match.

Background: Residency program location may be an important factor for orthopedic surgery residency applicants. More than half of residents locate their practice near the site of their training, and surgical specialties (eg, otolaryngology, plastic surgery, and general surgery) have shown geographic patterns in their residency matches.

Objective: We analyzed geographic trends in the orthopedic surgery Match.

Biomechanical Assessment of Locking Plate Fixation of Comminuted Proximal Olecranon Fractures.

Objectives: To determine if mean ultimate strength or failure mechanism differed between comminuted olecranon fractures created at the proximal 25% or 50% of the trochlear notch and fixed with precontoured posterior locking plates (PLPs).

Methods: Comminuted osteotomies were created in 10 matched pairs of cadaveric upper extremities at either the proximal 25% or 50% of the trochlear notch after quantitative computed tomography scans were performed to evaluate bone mineral density. Variable-angle olecranon PLPs were fixed to the specimens.

Fixation of a Proximal Humerus Fracture Using a Polyaxial Locking Plate and Endosteal Fibular Strut.

Proximal humerus fractures have a bimodal distribution and are most commonly seen in the elderly and are the third most common fracture pattern seen in the elderly. There is also a subset of these fractures that occur in younger patients secondary to higher energy mechanisms. Nonoperative management is often advocated for a majority of patients, but surgical fixation is often pursued for younger patients or active, older patients with significantly displaced and reconstructable fractures.

Utility of Prolotherapy for Upper Extremity Pathology.

Prolotherapy is a method of treatment of painful musculoskeletal conditions whereby a sclerosing agent is injected into an area of tendinosis or osteoarthritis to strengthen and repair painful connective tissue. It is a safe, effective, and relatively inexpensive nonsurgical treatment modality. This article provides a history of prolotherapy, discusses its proposed mechanisms of action, and provides a review of the existing literature on prolotherapy as a treatment for upper extremity pathologies, specifically, hand osteoarthritis, lateral epicondylitis, and rotator cuff disease.

Cost-Effective Management of Stenosing Tenosynovitis.

Purpose: Stenosing tenosynovitis (STS) is a common condition treated by hand surgeons. Limited evidence exists to support the nonsurgical management of STS. The purpose of this study was to prospectively evaluate a cohort of patients with STS, and to determine the strategy for treating patients with this condition that is most cost effective in terms of dollars reimbursed by payers.