High-Resolution Ultrasound in the Diagnosis and Surgical Management of Ulnar Neuropathy at the Elbow.

High-resolution ultrasound (HRU) has recently demonstrated the potential to facilitate diagnosis and treatment of upper extremity compression neuropathy. The authors hypothesized that HRU can improve preoperative evaluation of ulnar neuropathy at the elbow (UNE) and that changes in ulnar nerve cross-sectional area (CSA) after cubital tunnel release may correlate with outcomes. Nineteen adult patients diagnosed with UNE who were scheduled for surgical decompression by a single hand surgeon were enrolled.

Cost-Effectiveness of Open Versus Endoscopic Carpal Tunnel Release.

Background: Carpal tunnel syndrome is the most common upper-extremity nerve compression syndrome. Over 500,000 carpal tunnel release (CTR) procedures are performed in the U.S.

Ultrasound of the Median Nerve in the Surgical Treatment of Severe Carpal Tunnel Syndrome.

Background: High-resolution ultrasound (HRU) has demonstrated utility in the diagnosis and treatment of carpal tunnel syndrome (CTS) by measuring the cross-sectional area (CSA) of the median nerve. We investigated whether HRU could be helpful in evaluating outcomes of carpal tunnel release in patients with severe CTS.

Methods: Patients greater than 18 years of age with severe CTS on electrodiagnostic (EDX) studies and scheduled to have carpal tunnel release were enrolled.

Suture Suspension Arthroplasty for the Treatment of Thumb Carpometacarpal Arthritis.

Purpose: Most studies have demonstrated little difference in the outcome of the various techniques proposed for the surgical treatment of thumb carpometacarpal (CMC) arthritis. However, the difficulty and time required to perform each technique vary widely. In addition, the introduction of recent implants has increased the cost of the overall procedure.

Pediatric Supracondylar Humerus Fractures: Does After-Hours Treatment Influence Outcomes?

Objective: To compare the outcomes of pediatric supracondylar humerus fractures treated during daytime hours to those treated after-hours.

Design: Retrospective.

Setting: Academic Level I trauma center.

Surgical techniques for the treatment of carpal ligament injury in the athlete.

Treatment of intercarpal ligament injuries in the athlete requires special attention due to several practical and biomechanical considerations. Optimally, the athlete will maintain as much function and range of motion as possible with return to high-impact and load-bearing activity in a timely fashion. Several cutting-edge techniques have arisen in treatment.

Quality of internet health information on thumb carpometacarpal joint arthritis.

Introduction: The Internet has become a heavily used source of health information. No data currently exists on the quality and characteristics of Internet information regarding carpometacarpal (CMC) arthritis.

Methods: The search terms "cmc arthritis," "basal joint arthritis," and "thumb arthritis" were searched using Google and Bing.

A computer assessment of the effect of hindfoot alignment on mechanical axis deviation.

Lower limb malalignment is a common cause of disability that increases risk of osteoarthritis (OA). Treatment of OA may require an osteotomy or arthroplasty, which mandate accurate evaluation of mechanical loading on the limbs to achieve optimal alignment and minimal implant wear. Surgical planning uses a conventional method of mechanical axis deviation (MADC) measured from the center of the femoral head to the center of the ankle.

Extensive subcutaneous emphysema resembling necrotizing fasciitis.

Necrotizing fasciitis is an aggressive, invasive soft tissue infection. Because it can rapidly progress to patient instability, prompt diagnosis followed by urgent debridement is critical to decreasing mortality. Despite the importance of early diagnosis, necrotizing fasciitis remains a clinical diagnosis, with little evidence in the literature regarding the effectiveness of diagnostic tools or criteria.

Preemptive craniectomy with craniotomy: what role in the management of severe traumatic brain injury?

Background: Patients with severe traumatic brain injury (TBI) require aggressive management to prevent secondary brain injury. "Preemptive" craniectomy (CE)--craniectomy performed as a primary procedure in conjunction with craniotomy--has been used as prophylaxis for secondary injury, but the indications and outcomes of craniectomy used for this purpose are not well defined.

Methods: To evaluate the role of CE in the management of TBI, we retrospectively reviewed 62 consecutive patients who underwent CE in a 78-month period at our level I trauma center.

Small catheter tube thoracostomy: effective in managing chest trauma in stable patients.

Background: Image-guided small catheter tube thoracostomy (SCTT) is not currently used as a first-line procedure in the management of patients with chest trauma. We adopted a practice recommendation to use SCTT as a less invasive alternative in the treatment of chest injuries. We reviewed our trauma registry to evaluate our change in practice and the effectiveness of SCTT.

Early intubation in the management of trauma patients: indications and outcomes in 1,000 consecutive patients.

Background: The Eastern Association for the Surgery of Trauma Practice Management Guidelines identify indications (EI) for early intubation. However, EI have not been clinically validated. Many intubations are performed for other discretionary indications (DI).

The need for immediate computed tomography scan after emergency craniotomy for head injury.

Background: Patients who undergo emergency craniotomy for head injury require vigilant postoperative (postop) care to obtain the best possible outcome. Although repeat head computed tomography (CT) scans are a key component of the management of these patients, there is no consensus on the optimal timing of the initial postop CT.

Methods: We conducted a retrospective registry-based review of the care of 199 consecutive trauma patients who underwent craniotomy for head injury at a Level I trauma center to evaluate the role of postop CT in their management.

The scourge of methamphetamine: impact on a level I trauma center.

Background: Methamphetamine (METH) use is associated with high-risk behavior and serious injury. The aim of this study was to assess the impact of METH use in trauma patients on a Level I trauma center to guide prevention efforts.

Methods: A retrospective registry-based review of 4,932 consecutive trauma patients who underwent toxicology screening at our center during a 3-year period (2003-2005).

What is the role of chest X-ray in the initial assessment of stable trauma patients?

Background: The Advanced Trauma Life Support course advocates the liberal use of chest X-ray (CXR) during the initial evaluation of trauma patients. We reviewed CXR performed in the trauma resuscitation room (TR) to determine its usefulness.

Methods: A retrospective, registry-based review was conducted and included 1,000 consecutive trauma patients who underwent CXR in the TR at a Level I trauma center during a 7-month period.