The Greco-Nice-Lag: Lag Screw and Double Nice Knot Fixation for Spiral Proximal Phalanx Fractures-Connecting the Shoulder to the Finger.

A colorful array of fixation options exists for the management of operative long oblique or spiral proximal phalanx fractures. These include lag screws, intramedullary devices, Kirschner wires, dorsal or lateral plating, and cerclage wiring. The "Nice double-suture knot," described by Boileau and colleagues, is a sliding, self-stabilizing knot initially created for tuberosity fixation in the shoulder.

Evaluation of Mid-term Outcomes Following Shoulder Hemiarthroplasty for Avascular Necrosis of the Humeral Head in Patients 40 Years and Younger.

In order to evaluate postoperative function and failure rates among younger patients undergoing hemiarthroplasty for humeral head avascular necrosis (AVN), data from patients < 40 years treated between December 2008 - January 2018 was retrospectively analyzed. Pain was assessed preoperatively and at final follow up using a visual analogue scale (VAS). The American Shoulder and Elbow Surgeons (ASES) standardized assessment, single assessment numeric evaluation (SANE) score, and patient satisfaction were assessed at final follow up, as well as surgical revision rates.

Early to midterm radiographic loosening of the press fit radial head prosthesis.

Background: Radiographic loosening is frequently seen around the radial head (RH) implant. The hypothesis of this study was that radiographic loosening will be more frequent in patients in which the RH prosthesis was implanted due to elbow trauma leading to instability that required lateral collateral ligament repair (LCL).

Materials And Methods: A retrospective review of the patients who had RH implantation between 2012 and 2019 was performed.

Patient Risk Factors Associated With Postoperative Complications After Common Hand Procedures.

Background: Carpal tunnel syndrome (CTS), trigger finger (TF), and De Quervain tenosynovitis (DQ) are 3 common pathologies of the hand often treated with relatively simple surgical procedures. However, outcomes from these procedures can be compromised by postoperative complications. The aim of this study was to evaluate the association between diabetes, tobacco use, and obesity and the incidence of postoperative complications.

Anatomic Reconstruction of the Anterior Oblique and the Dorsoradial Ligaments for Painful Subluxating Carpometacarpal Joint of the Thumb.

Thumb carpometacarpal osteoarthritis (CMC OA) is a common pathology of the hand that is characterized by pain, loss of grip and pinch strength, and deformity. Although conservative management is often preferred in earlier stage of CMC OA, surgical techniques can be used when symptoms are not fully relieved, especially with subluxation. We report a case series of 26 patients (32 operations) with Eaton stage I and II CMC OA who underwent a novel surgical technique that anatomically restores the CMC joint with autologous double ligament reconstruction.

Ulnar Nerve Enlargement at the Medial Epicondyle Negatively Correlates With Nerve Conduction Velocity in Cubital Tunnel Syndrome.

In cubital tunnel syndrome (CuTS), chronic compression often occurs at the origin of the flexor carpi ulnaris at the medial epicondyle. Motor nerve conduction velocity (NCV) across the elbow is assessed preoperatively to corroborate the clinical impression of CuTS. The purpose of this study was to correlate preoperative NCV to the direct measurements of ulnar nerve size about the elbow at the time of surgery in patients with clinical and/or electrodiagnostic evidence of CuTS.

Peripheral Nerve Injury After Elbow Arthroscopy: An Analysis of Risk Factors.

Purpose: To identify risk factors associated with peripheral nerve injury after elbow arthroscopy and provide an updated incidence of those complications.

Methods: The elbow arthroscopies that were performed at our institution between 2006 and 2016 were identified. Over a 10-year period, 253 elbow arthroscopies were performed at our institution.

A randomized trial of diagnostic ultrasound to improve outcomes in focal neuropathies.

Introduction: Neuromuscular ultrasound is valid, reliable, and accurate, but it is not known whether combining it with electrodiagnostic studies leads to better outcomes in individuals with focal neuropathies.

Methods: One hundred twenty individuals with focal neuropathy, based on history, examination, and electrodiagnosis, were enrolled in this study. All patients underwent neuromuscular ultrasound and were randomized to either have their ultrasound results sent to the referring physician or not have them sent.

Randomized comparison of volar locking plates and intramedullary nails for unstable distal radius fractures.

Purpose: To compare minimally invasive intramedullary nails (IMN) and volar locking plates (VLP) for the treatment of unstable distal radius fractures by evaluating postoperative subjective, radiographic, and functional outcomes. The hypothesis was that IMN patients would have less pain and required less pain medication in the early postoperative period and returned to work earlier than VLP patients.

Methods: Sixty patients with closed, displaced, unstable, extra-articular, metaphyseal fractures of the distal radius were randomized to receive a VLP or an IMN for internal fixation.

Morphometric analysis of distal interphalangeal joint and implications for arthrodesis with a headless compression screw.

Using radiographs of a cross section of patients, measurements of phalanges were done to aid in surgical planning for distal interphalangeal joint (DIPJ) arthrodesis using a headless compression screw. Measurements were performed of the distal and middle phalanx of all fingers and the proximal and distal phalanx of the thumb. Three independent reviewers measured 50 patients.

Nonspecific wrist pain in gymnasts and cheerleaders.

Participation in gymnastics and other upper extremity weight-bearing sports frequently requires athletes to bear significant loads through their wrists. This requirement makes wrist pain and injury of significant concern to competitive gymnasts. Athletes' wrist pain, and their ultimate evaluation and treatment, are subject to many variables.

Attrition tendinitis of long head of biceps brachii in relation to humeral head osteonecrosis: case report.

This case report identifies a 41-year-old male patient who developed anterior shoulder pain in the setting of humeral head osteonecrosis. As a consequence of the cartilage degeneration, multiple loose bodies formed and migrated into the bicipital tendon sheath, causing attrition tendinitis, which was a feature of the clinical presentation. The patient was treated by a combination of arthroscopic glenohumeral joint debridement and open tenodesis of the biceps using a suture anchor.

Median nerve changes following steroid injection for carpal tunnel syndrome.

Introduction: Neuromuscular ultrasound is a painless, radiation-free, high-resolution imaging modality for assessment of the peripheral nervous system. The purpose of this study was to use neuromuscular ultrasound to assess the changes that occur in the median nerve after steroid injection for carpal tunnel syndrome (CTS).

Methods: Ultrasound and nerve conduction studies were performed at baseline and 1 week, 1 month, and 6 months after steroid injection in 19 individuals (29 wrists) with CTS.

Consensus statement on shoulder instability.

The understanding and treatment of shoulder instability comprise a rapidly evolving area of interest in orthopaedics. Evaluation methods are becoming more specific in showing the exact pathologies causing the symptoms. Magnetic resonance arthrography and arthroscopy have contributed to this development.

Traumatic valgus instability of the elbow: pathoanatomy and results of direct repair. Surgical technique.

Background: The medial collateral ligament provides valgus stability to the elbow. The purpose of the present study was to describe the pathoanatomy of acute traumatic medial collateral ligament ruptures and to report the rationale and results of direct repair.

Methods: Between 1996 and 2006, eleven athletes presented with acute rupture of the medial collateral ligament of the elbow and no history of dislocation.

Surgical treatment of pediatric trigger thumb with metacarpophalangeal hyperextension laxity.

Between 1994 and 2004, seven patients (nine thumbs) at our institution were treated for trigger thumb with hyperextensible metacarpophalangeal (MP; >60°) anomaly with surgical release of the A1 pulley and proximal advancement of the MP volar plate. There were four girls and three boys (three right, two left, and two bilateral thumbs) with a mean age at surgery of 46 months (range, 26 to 82 months). The mean follow-up was 64 months (range, 1 to 8 years).

Osteonecrosis of the humeral head.

Osteonecrosis of the humeral head is considerably less common than osteonecrosis of the hip. However, as in the hip, the interaction between a genetic predisposition and certain risk factors may lead to increased intraosseous pressure, loss of circulation, and eventual bone death. The most common risk factor remains corticosteroid use, which accounts for most reported cases.

Pediatric scaphoid fractures.

Fractures of the immature carpal scaphoid can be challenging to manage. The diagnosis may be missed or delayed because of absent or minimal symptoms. Once diagnosed, most pediatric scaphoid fractures can be successfully treated with cast immobilization.

Traumatic valgus instability of the elbow: pathoanatomy and results of direct repair.

Background: The medial collateral ligament provides valgus stability to the elbow. The purpose of the present study was to describe the pathoanatomy of acute traumatic medial collateral ligament ruptures and to report the rationale and results of direct repair.

Methods: Between 1996 and 2006, eleven athletes presented with acute rupture of the medial collateral ligament of the elbow and no history of dislocation.

Pronator quadratus space and compartment syndrome after low-energy fracture of the distal radius: a case report.

Acute compartment syndrome following fracture of the distal radius occurs in less than 1% of cases, but if the diagnosis is delayed, the potential consequences may be devastating. The majority of the cases involve high-energy injuries in young patients, and increasing pain "out of proportion to the injury sustained" is a constant finding and constitutes the hallmark of the diagnosis. This case report describes a rare presentation of an acute compartment syndrome in the forearm and wrist after fracture of the distal radius that developed in the absence of acute pain symptoms, in an older individual, and in the context of a low-energy injury.