Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial.

Background: The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) trial found similar ambulation and survival at 60 days with spinal versus general anesthesia for hip fracture surgery. Trial outcomes evaluating pain, prescription analgesic use, and patient satisfaction have not yet been reported.

Objective: To compare pain, analgesic use, and satisfaction after hip fracture surgery with spinal versus general anesthesia.

Scaphoid Excision and Bicolumnar Carpal Fusion with Retrograde Headless Screws.

 Scaphoid excision and partial wrist fusion is used for the treatment of scapholunate advanced collapse/scaphoid nonunion advanced collapse wrist arthritis. The purpose of this study was to report midterm functional and radiographic outcomes in a series of patients who underwent bicolumnar fusion of the lunocapitate and triquetrohamate joints using retrograde headless screws.  Twenty-three consecutive patients (25 wrists) underwent surgery with this technique from January 2014 to May 2017 with a minimum follow-up of 1 year.

Correction: Systematic prospective electrophysiological studies of the median nerve after simple distal radius fracture.

[This corrects the article DOI: 10.1371/journal.pone.

Systematic prospective electrophysiological studies of the median nerve after simple distal radius fracture.

Purpose: To assess whether there is a measurable impairment of median nerve conduction study parameters with uncomplicated distal radius fracture.

Methods: Patients were assessed prospectively at the time of cast removal (visit 1) after a standard 6-8 week immobilization for uncomplicated distal radius fracture. Patients with prior entrapment neuropathy or polyneuropathy were excluded.

Impact of disuse muscular atrophy on the compound muscle action potential.

Background: Disuse atrophy from immobilization is the result of decreased neural activity and muscle unloading.

Methods: We studied the impact of disuse on hand intrinsic compound muscle action potentials (CMAPs) in a cohort of 39 patients with unilateral 6-week immobilization of the hand in a cast, after distal radius fracture. We excluded patients with nerve injury.

The Effect of Dorsal Angulation on Distal Radioulnar Joint Arthrokinematics Measured Using Intercartilage Distance.

 The effects of dorsal angulation deformity on in vitro distal radioulnar joint (DRUJ) contact patterns are not well understood.  The purpose of this study was to utilize intercartilage distance to examine the effects of forearm rotation angle, distal radius deformity, and triangular fibrocartilage complex (TFCC) sectioning on DRUJ contact area and centroid position.  An adjustable implant permitted the creation of simulated intact state and dorsal angulation deformities of 10, 20, and 30 degrees.

The Effect of Dorsally Angulated Distal Radius Deformities on Carpal Kinematics: An In Vitro Biomechanical Study.

Purpose: The purpose was to quantify the effect of distal radius dorsal angulation (DA) on carpal kinematics and the relative roles of the radiocarpal and midcarpal joints during wrist motion.

Methods: Six cadaveric specimens (69 ± 17 y) were mounted at 90° elbow flexion in a custom wrist motion simulator. The wrist was guided through planar passive flexion and extension motion trials (∼ 5°/s).

Arthrokinematics of the Distal Radioulnar Joint Measured Using Intercartilage Distance in an In Vitro Model.

Purpose: Current techniques used to measure joint contact rely on invasive procedures and are limited to statically loaded positions. We sought to examine native distal radioulnar joint (DRUJ) contact mechanics using nondestructive imaging methods during simulated active and passive forearm rotation.

Methods: Testing was performed using 8 fresh-frozen cadaveric specimens that were surgically prepared by isolating muscles involved in forearm rotation.

Biomechanical Evaluation of Carpal Kinematics during Simulated Wrist Motion.

 Flexion and extension of the wrist is achieved primarily at the radiocarpal and midcarpal joints. Carpal kinematics have been investigated, although there remains no consensus regarding the relative contribution of each bone to wrist motion.  To determine the kinematics of the scaphoid, lunate, and capitate during unconstrained simulated wrist flexion/extension and to examine the effect of motion direction on the contribution of each bone.

Effect of Volarly Angulated Distal Radius Fractures on Forearm Rotation and Distal Radioulnar Joint Kinematics.

Purpose: To examine the effect of volar angulation deformities of the distal radius with and without triangular fibrocartilage complex (TFCC) rupture on forearm range of motion and the kinematics of the ulnar head at the distal radioulnar joint (DRUJ) during simulated active forearm rotation.

Methods: Volar angulation deformities of the distal radius with 10° and 20° angulation from the native orientation were created in 8 cadaveric specimens using an adjustable apparatus. Active supination and pronation were performed using a forearm motion simulator.

Volar subluxation of the ulnar head in dorsal translation deformities of distal radius fractures: an in vitro biomechanical study.

Objectives: To quantify the effects of dorsal translation deformities of the distal radius with and without dorsal angulation on volar displacement of the ulnar head during simulated active forearm rotation, both with the triangular fibrocartilage complex (TFCC) intact and sectioned conditions.

Methods: Eight fresh-frozen cadaveric upper extremities were mounted in an active forearm motion simulator, and distal radial deformities of 0, 5, and 10 mm of dorsal translation with 0, 10, 20, and 30 degrees of dorsal angulation were simulated. Volar displacement of the ulnar head at the distal radioulnar joint as a result of each distal radial deformity was quantified during simulated active supination.

Distal radioulnar joint kinematics in simulated dorsally angulated distal radius fractures.

Purpose: To examine the effects of dorsal angulation deformities of the distal radius with and without triangular fibrocartilage complex (TFCC) rupture on the 3-dimensional kinematics of the distal radioulnar joint (DRUJ) during simulated active motion.

Methods: Nine fresh-frozen cadaveric specimens were tested in a forearm simulator that produced active forearm rotation. Dorsal angulation deformities of the distal radius with 10°, 20°, and 30° angulation were created.

A laboratory comparison of computer navigation and individualized guides for distal radius osteotomy.

Purpose: This article presents the results of a multiuser, randomized laboratory trial comparing the accuracy and precision of image-based navigation against individualized guides for distal radius osteotomy (DRO).

Methods: Six surgeons each performed four DROs using image-based navigation and four DROs using individualized guides in a laboratory setting with plastic phantom replicas of radii from patients who had received DRO as treatment for radial deformity. Time required and correction errors of ulnar variance, radial inclination, and volar tilt were measured.

Volume rendering of three-dimensional fluoroscopic images for percutaneous scaphoid fixation: an in vitro study.

Percutaneous fixation of scaphoid fractures offers potential advantages to cast treatment but can be difficult to perform with conventional two-dimensional imaging. This study aimed to evaluate the use of a novel navigation technique using volume-rendered images derived from intraoperative cone-beam computed tomography imaging, without the need for typical patient-based registration. Randomized in vitro trials in which a guidewire was inserted into a scaphoid model were conducted to compare volumetric navigation to conventional fluoroscopic C-arm (n = 24).

Investigating the performance of a wrist stabilization device for image-guided percutaneous scaphoid fixation.

Purpose: Conventional navigated surgery relies on placement of a reference marker on the anatomy of interest. However, placement of such a marker is not readily feasible in small anatomic regions such as the scaphoid bone of the wrist. This study aimed to develop an alternative mechanism for patient tracking that could be used to perform navigated percutaneous scaphoid fixation.

Volume slicing of cone-beam computed tomography images for navigation of percutaneous scaphoid fixation.

Purpose: Percutaneous scaphoid fixation (PSF) is growing in popularity as a treatment option for non-displaced fractures. Success of this procedure demands high-precision screw placement, which can be difficult to achieve with standard 2D imaging. This study aimed to develop and test a system for computer-assisted navigation using volume slicing of 3D cone-beam computed tomography (CBCT).

Calibration and use of intraoperative cone-beam computed tomography: an in-vitro study for wrist fracture.

The standard workflow in many image-guided procedures, preoperative imaging followed by intraoperative registration, can be a challenging process and is not readily adaptable to certain anatomical regions such as the wrist. In this study we present an alternative, consisting of a preoperative registration calibration and intraoperative navigation using 3D cone-beam CT. A custom calibration tool was developed to preoperatively register an optical tracking system to the imaging space of a digital angiographic C-arm.