Effects of Upper Extremity Elevation on Intra-Cast Pressure and Digital Perfusion in a Fiberglass Short-Arm Cast Model.

The goal of this study was to determine the relationship of digital artery pressure to arm position and forearm skin surface pressure using a short-arm cast experimental setup, to ascertain the safest position for the injured casted upper extremity. A total of 27 volunteers were placed in bilateral short-arm fiber-glass casts with an empty 50-mL bladder bag under the cast and attached to a pressure transducer. Digital systolic pressure (P), and skin surface pressure under the cast (P) were assessed in 4 positions.

Biomechanical Comparison of Titanium Locking Fragment-Specific and Volar Locking Plates for AO B1 and B2 Fractures of the Distal Radius.

Purpose: This biomechanical study compared the stability of volar locking plates (VLPs) and locking fragment-specific (LFS) dorsal and radial styloid plates for the fixation of dorsal (AO 23-B2) and radial styloid (AO 23-B1) shear fractures of the distal radius, respectively.

Methods: Two groups of 6 composite radii were fixed with a VLP or an LFS dorsal plate over a simulated dorsal shear fracture. Two additional groups of 6 radii received the same VLP or an LFS radial plate to fix a radial styloid fracture.

Reliability of Metacarpal Subsidence Measurements after Thumb Carpometacarpal Joint Arthroplasty.

Background: Thumb metacarpal subsidence after trapeziectomy can affect clinical function over time. Methods for measuring subsidence after trapeziectomy have been described, and they rely on an intact thumb metacarpal or proximal phalanx for measurement. The authors evaluated the reliability and reproducibility of measuring the trapezial space ratio, using previously described methods.

Thumb Basal Joint Arthroplasty: Prospective Comparison of Perioperative Analgesia and Opioid Consumption.

Trapeziectomy alone or in combination with a suspensionplasty technique is a common surgical treatment for symptomatic thumb basal joint arthritis. The authors undertook a prospective comparative study to test the hypothesis that peripheral nerve blocks would provide better pain control than local anesthesia with bupivacaine or liposomal bupivacaine regarding pain scores and opioid pill consumption. Patients who elected to undergo basal joint arthroplasty were allocated to 1 of 3 postoperative pain management groups: (1) peripheral nerve block, (2) local anesthesia with bupivacaine, or (3) local anesthesia with liposomal bupivacaine.

Elevated Radiation Exposure Associated With Above Surface Flat Detector Mini C-Arm Use.

This study aims to test the hypothesis that: (1) radiation exposure is increased with the intended use of Flat Surface Image Intensifier (FSII) units above the operative surface compared with the traditional below-table configuration; (2) this differential increases in a dose-dependent manner; and (3) radiation exposure varies with body part and proximity to the radiation source. A surgeon mannequin was seated at a radiolucent hand table, positioned for volar distal radius plating. Thermoluminescent dosimeters measured exposure to the eyes, thyroid, chest, hand, and groin, for 1- and 15-minute trials from a mini C-arm FSII unit positioned above and below the operating surface.

Mini C-Arm Fluoroscopy: Does Its Configuration Matter for Radiation Exposure to the Surgeon?

Background: The risk of occupational radiation exposure to the surgeon associated with the use of a mini C-arm has yet to reach a wide consensus. Using a distal radius fracture surgery model, we tested the hypothesis that radiation exposure to the surgeon's critical body parts is independent of mini C-arm configuration.

Methods: An anthropomorphic mannequin (representing the upper body of a 60" male surgeon) was seated at a hand table as if operating on a volar-plated wrist Sawbone model.