Prevalence and Risk Factors for Lateral Femoral Cutaneous Nerve Palsy in the Beach Chair Position.

Purpose: To report on the prevalence of lateral femoral cutaneous nerve (LFCN) palsy in patients who had undergone shoulder surgery in the beach chair position and to identify patient and surgical risk factors for its development.

Methods: We retrospectively reviewed the medical records of 397 consecutive patients who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon. Patient demographic and surgical data including age, gender, weight, body mass index (BMI), diabetes, procedure duration, and anesthesia type (general, regional, regional/general) were recorded.

The Science of Quality Improvement.

The manufacturing industry has supplied many quality-improvement methodologies that have been successfully utilized in health-care delivery, such as Plan-Do-Study-Act (PDSA) cycles, Total Quality Management, Six Sigma, and Lean. Many tools of quality improvement, such as PDSA cycles and DMAIC (Design-Measure-Analyze-Improve-Control) of the Six Sigma method, are similar to the scientific method that is familiar to clinicians. Correct identification of the sources and types of process variation within a system is paramount for process improvement.

Plantar forces in flexor hallucis longus versus flexor digitorum longus transfer in adult acquired flatfoot deformity.

Background: Flexor hallucis longus (FHL) and flexor digitorum longus (FDL) tendon transfers are frequently used to restore the function of a deficient tibialis posterior tendon in stage II adult acquired flatfoot deformity (AAFD). Either transfer causes some loss in toe flexion force, although the decision to tenodese the cut tendon to restore associated function remains controversial. This study quantified changes in plantar force before and after tendon transfer and with or without distal tenodesis in a cadaveric model.