Return to play and outcomes of surgically treated upper limb nerve entrapment in athletes: a systematic review.

Purpose: Athletes face a higher risk of upper limb nerve entrapment due to repetitive stress, trauma, and biomechanics. Diagnosis is challenging, and delayed treatment can impair performance. When conservative care fails, surgery may be needed to restore function and enable return to play (RTP).

The Mangled Digit Severity Score: Determining Salvageability of Severe Digital Injuries.

Purpose: The assessment, prognostication, and decision-making for mangled digital injuries can be challenging, even for experienced surgeons. This study aimed to develop a Mangled Digit Severity Score (MDSS) to predict whether a mangled digit should be salvaged.

Methods: An anonymous questionnaire was sent to 67 hand surgeons at seven hand trauma centers as an initial survey panel.

Machine Learning-Aided Diagnosis Enhances Human Detection of Perilunate Dislocations.

Background: Perilunate/lunate injuries are frequently misdiagnosed. We hypothesize that utilization of a machine learning algorithm can improve human detection of perilunate/lunate dislocations.

Methods: Participants from emergency medicine, hand surgery, and radiology were asked to evaluate 30 lateral wrist radiographs for the presence of a perilunate/lunate dislocation with and without the use of a machine learning algorithm, which was used to label the lunate.

Intramedullary nailing for concomitant extra-articular ulnar head fractures in distal radial fractures.

Four adult female patients were treated with an intramedullary Steinmann pin for an unstable extra-articular distal ulnar fracture associated with a distal radial fracture treated with plate osteosynthesis. All showed good radiographic and functional outcomes. One patient required removal of the Steinmann pin.

Economic Evaluation of a Global Reconstructive Surgery Visiting Educator Program.

Objective: The objective of this study was to quantify the cost-effectiveness and economic value of a reconstructive surgery visiting educator trip program in a resource-constrained setting.

Background: Reconstructive surgical capacity remains inadequate in low- and middle-income countries, resulting in chronic disability and a significant economic toll. Education and training of the local surgical workforce to sustainably expand capacity have been increasingly encouraged, but economic analyses of these interventions are lacking.

Automatic Detection of Perilunate and Lunate Dislocations on Wrist Radiographs Using Deep Learning.

Delayed or missed diagnosis of perilunate or lunate dislocations can lead to significant morbidity. Advances in computer vision provide an opportunity to improve diagnostic performance. In this study, a deep learning algorithm was used for detection of perilunate and lunate dislocations on lateral wrist radiographs.

Impact of Adding Carpal Tunnel Release or Trigger Finger Release to Carpometacarpal Arthroplasty on Postoperative Complications.

Background: This study assessed whether adding trigger finger or carpal tunnel release at the time of thumb carpometacarpal (CMC) arthroplasty would increase postoperative opioid use, readmissions, complications, or development of complex regional pain syndrome (CRPS).

Methods: Using the IBM MarketScan Research Databases from 2012 through 2016, the authors identified two CMC arthroplasty groups. The CMC-only group only had a CMC arthroplasty on the day of operation; the multiple-procedures group had a CMC arthroplasty and concurrent carpal tunnel or trigger finger release.

Expansion of Reconstructive Surgical Capacity in Vietnam: Experience from the ReSurge Global Training Program.

Background: Building local surgical capacity in low-income and middle-income countries is critical to addressing the unmet global surgical need. Visiting educator programs can be utilized to train local surgeons, but the quantitative impact on surgical capacity has not yet been fully described. The authors' objective was to evaluate the effectiveness of training utilizing a visiting educator program on local reconstructive surgical capacity in Vietnam.

Lymphatic Microsurgical Preventive Healing Approach (LYMPHA) for Lymphedema Prevention after Axillary Lymph Node Dissection-A Single Institution Experience and Feasibility of Technique.

While surgical options exist to treat lymphedema after axillary lymph node dissection (ALND), the lymphatic microsurgical preventive healing approach (LYMPHA) has been introduced as a preventive measure performed during the primary surgery, thus avoiding the morbidity associated with lymphedema. Here, we highlight details of our operative technique and review postoperative outcomes. For our patients, limb measurements and body composition analyses were performed pre- and postoperatively.

Are we curing by cutting? A call for long-term follow up and outcomes research in global surgery interventions - perspective.

Success in global surgery interventions cannot be claimed until consistent long-term follow up is achieved and corresponding outcomes are studied. However, post-operative outcomes remain inconsistently collected and analyzed in the setting of global surgery, with current efforts largely focused on the delivery of surgical care. Barriers in low- and middle-income countries include patient cost and distance, low surgical workforce capacity, poor patient health literacy, lack of affordable technology availability, inconsistent documentation, and structural deficiencies.

Single-Unit technique for the use of acellular dermal matrix in immediate expander-based breast reconstruction.

Background: The use of acellular dermal matrices (ADMs) in immediate two-stage prosthetic breast reconstruction following mastectomy is now a common practice. The procedure confers several compelling benefits, including coverage of the inferior pole, enhanced definition of the inframammary fold, and reduction of capsular contracture. However, operative techniques used to create the ADM inferolateral sling can be unwieldy in practice, typically involving the placement of the ADM followed by positioning and anchoring of the prosthetic expander.

Assessing the Accuracy of a 3-Dimensional Surface Imaging System in Breast Volume Estimation.

Background: Preoperative prediction of breast volume can guide patient expectations and aid surgical planning in breast reconstruction. Here, we evaluate the accuracy of a portable surface imager (Crisalix S.A.

Pathway Analysis of Gene Expression in Murine Fetal and Adult Wounds.

In early gestation, fetal wounds heal without fibrosis in a process resembling regeneration. Elucidating this remarkable mechanism can result in tremendous benefits to prevent scarring. Fetal mouse cutaneous wounds before embryonic day (E)18 heal without scar.

Comparison of Outcomes of Total Esophageal Reconstruction With Supercharged Jejunal Flap, Colonic Interposition, and Gastric Pull-up.

Background: Esophageal reconstruction following esophagectomy is a complex operation with significant morbidity. Gastric pull-up (GPU) has historically been the first-line operation followed by the colonic interposition (CI) graft, but recently, the use of a pedicled, supercharged jejunal flap (SJF) has reemerged as an alternative. However, comprehensive reports on outcomes of SJFs remain limited, with exceedingly few direct comparisons of outcomes.

Noncoding RNAs in Wound Healing: A New and Vast Frontier.

Wound healing requires a highly orchestrated coordination of processes that are not yet fully understood. Therefore, available clinical therapies are thus far limited in their efficacy in preventing and treating both chronic wounds and scars. Current gene-based therapeutics is largely based on our understanding of the protein-coding genome and proteins involved in known wound healing pathways.

Pathway Analysis of Gene Expression of E14 Versus E18 Fetal Fibroblasts.

Fetuses early in gestation heal skin wounds without forming scars. The biological mechanisms behind this process are largely unknown. Fibroblasts, however, are cells known to be intimately involved in wound healing and scar formation.

Dynamic Rheology for the Prediction of Surgical Outcomes in Autologous Fat Grafting.

Background: Because of the abundance and biocompatibility of fat, lipotransfer has become an attractive method for treating soft-tissue deficits. However, it is limited by unpredictable graft survival and retention. Currently, little is known about the viscoelastic properties of fat after various injection methods.

Validation of a Cognitive Task Simulation and Rehearsal Tool for Open Carpal Tunnel Release.

Background: Carpal tunnel release is one of the most common surgical procedures performed by hand surgeons. The authors created a surgical simulation of open carpal tunnel release utilizing a mobile and rehearsal platform app. This study was performed in order to validate the simulator as an effective training platform for carpal tunnel release.

Magnetic Nanoparticle-Based Upregulation of B-Cell Lymphoma 2 Enhances Bone Regeneration.

Clinical translation of cell-based strategies for tissue regeneration remains challenging because survival of implanted cells within hostile, hypoxic wound environments is uncertain. Overexpression of B-cell lymphoma 2 (Bcl-2) has been shown to inhibit apoptosis in implanted cells. The present study describes an "off the shelf" prefabricated scaffold integrated with magnetic nanoparticles (MNPs) used to upregulate Bcl-2 expression in implanted adipose-derived stromal cells for bone regeneration.

Transversus Abdominis Plane Block and Free Flap Abdominal Tissue Breast Reconstruction: Is There a True Reduction in Postoperative Narcotic Use?

Introduction: The use of the transversus abdominis plane (TAP) block is increasing in abdominally based autologous tissue breast reconstruction as a method to provide postoperative donor site analgesia. The purpose of this study was to evaluate the efficacy of the TAP block in the immediate postoperative period.

Methods: A retrospective analysis of all patients who underwent autologous microsurgical breast reconstruction over a 2-year period (2013-2015) was conducted.

Hospital Transfer of Open Tibial Fractures Requiring Microsurgical Reconstruction Negatively Impacts Clinical Outcomes.

Introduction: Open tibial fractures are orthopedic emergencies that may present with severe soft tissue damage. Free tissue transfer is often required when local tissues are insufficient and patients may require hospital transfer to tertiary care centers for this purpose. Although the negative impact of inter-facility transfer has been well demonstrated in trauma patients, less is known regarding transfers for lower extremity injury patients.

Cleft Lip Standardized Patient Examinations: The Role in Plastic Surgery Resident Education.

Background: Our institution has incorporated the use of objective structured clinical examinations (OSCE) in our residency curriculum. The OSCE provides trainee education and evaluation while addressing the six Accreditation Council for Graduate Medical Education (ACGME) core competencies required within training programs. We report our program's experience with the first cleft OSCE ever conducted.