Peroral Endoscopic Myotomy; Novice Surgeon Learning Curve.

Introduction: Peroral endoscopic myotomy (POEM) is a novel endoscopic procedure used to treat achalasia and other spastic esophageal disorders that is an alternative to Heller myotomy. We seek to define the learning curve of POEM for a foregut surgeon with no formal endoscopic or POEM training by analyzing different intraoperative factors in a single series.

Methods And Procedures: The first 38 consecutive patients undergoing POEM by a single foregut surgeon were included in this retrospective study.

Safety comparison of minimally invasive abdomen-only esophagectomy versus minimally invasive Ivor Lewis esophagectomy: a retrospective cohort study.

Background: We report mortality and post-operative complications from esophageal resection in the treatment of gastroesophageal adenocarcinoma or stricture, comparing a minimally invasive abdomen-only esophagectomy (MIAE) approach with a minimally invasive Ivor Lewis esophagectomy (MIILE) approach.

Methods: A single-center retrospective cohort study of patients with esophageal adenocarcinoma or stricture treated by either MIAE or MIILE was conducted. MIAE was offered for strictures less than five centimeters or cancers that were American Joint Committee on Cancer (AJCC) Stage ≤ T2 without lymphadenopathy.

Review of Common Clinical Conditions of the Proximal Tibiofibular Joint.

Current literature is limited with respect to the proximal tibiofibular joint (PTFJ) and clinical conditions relating to the PTFJ. Diagnosis and treatment of conditions that affect the PTFJ are not well described and are a topic of debate among many physicians. This manuscript aims to review and summarize the most recent literature that relates to traumatic dislocations, fractures, chronic instability, and osteoarthritis, with a focus on both diagnostic and treatment strategies of these conditions.

Community-associated methicillin-resistant Staphylococcus aureus hand infections in an urban setting.

Purpose: The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection appears to be increasing. The purpose of this study was to determine prospectively the incidence of MRSA in community-associated hand infections in an urban hospital.

Methods: Sixty-one patients presented to our institution over a 9-month period with community-acquired hand infections that were evaluated and treated by the hand service.

Locked intramedullary nailing of metacarpal fractures secondary to gunshot wounds.

Purpose: To investigate the results of fixation of 10 metacarpal shaft fractures secondary to low-velocity gunshot wounds with locked intramedullary nails.

Methods: We reviewed the results of 10 patients with locked intramedullary nailing of the metacarpal for low-velocity gunshot wounds. Autogenous bone grafting was used in 9 of the 10 fractures.

Posterior capsular contracture of the shoulder.

Posterior capsular contracture is a common cause of shoulder pain in which the patient presents with restricted internal rotation and reproduction of pain. Increased anterosuperior translation of the humeral head occurs with forward flexion and can mimic the pain reported with impingement syndrome; however, the patient with impingement syndrome presents with normal range of motion. Initial management of posterior capsular contracture should be nonsurgical, emphasizing range-of-motion stretching with the goal of restoring normal motion.

Upper extremity dog bite wounds and infections.

Upper extremity dog bite wounds comprise a large percentage of all mammalian bite wounds. The purpose of the study was to assess the bacteriology of patients presenting with such injuries to the emergency room that required consultation by a hand surgeon. The study also analyzed the effect of delayed intervention on growth of invasive pathogens, on the incidence of multiple pathogens, on treatment interventions, and on length of hospital stay.

Evidence-based guidelines for the management of Lyme disease.

This report, completed in November 2003, is intended to serve as a resource for physicians, public health officials and organizations involved in the evaluation and treatment of Lyme disease.