The aim of this study was to assess the sex differences in enrollment into clinical trials for Dupuytren's disease (DD), treatment efficacy, and complications. Three databases were searched; Ovid MEDLINE, Ovid EMBASE, and EBSCO CINAHL. Included studies were clinical trials on adult patients with DD.
View Article and Find Full Text PDFAm J Phys Med Rehabil
December 2024
The primary objective of this systematic review is to describe the effectiveness of nerve transfers for restoring quadriceps motor function in patients with femoral nerve palsy. MEDLINE, Embase, and CENTRAL were searched from their inception to June 2023 for any English language, primary literature investigating nerve transfers for femoral nerve palsy. Data were extracted for study and intervention characteristics, as well as clinical outcomes, including preoperative and postoperative knee extension strength, electrodiagnostic studies, functional outcomes, adverse events, and donor site morbidity.
View Article and Find Full Text PDFElbow defects have a number of etiologies and present a difficult task for the reconstructive surgeon. A number of reconstructive options have been previously reported. We describe a case of a 54-year-old woman with a recurrent elbow defect secondary to prior trauma, surgical fixation, and infection.
View Article and Find Full Text PDFPurpose: In OA studies, the focus often is on an index-joint; other affected joint sites are often overlooked. In this thumb-base OA study, we documented the frequency of symptomatic non-hand joint sites and investigated whether their count was associated with thumb-specific functional and patient-reported outcome measures.
Design: Patients seeking care for thumb-base OA (conservative or surgical) were included.
Purpose: To critically explore experiences following thumb amputation and delineate elements of an ideal thumb prosthesis from the end user perspective.
Methods: A qualitative study was undertaken with end user stakeholder groups, which included persons with a thumb amputation, rehabilitation professionals, and prosthetists. Analysis proceeded in line with conventional content analysis.
Objectives: Finger amputations can involve different levels of injury complexity, and the success of a finger replantation is further shaped by a variety of factors, including patient characteristics, surgical technique, and postoperative rehabilitation. These variables may interact in complex ways and contribute to heterogeneity that makes it challenging to guide management for individual patients. As such, this systematic review seeks review the outcomes of isolated single digit replantation and compare patient reported outcomes following revision amputation to guide decision making.
View Article and Find Full Text PDFBackground: The number of surgical residents experiencing childbearing during residency training is increasing, and there is an absence of clarity with respect to parental-leave, lactation and return-to-work policies in support of residents. The aim of this review was to examine parental-leave policies during residency training in surgery and the perceptions of these policies by residents, program directors and coresidents, as described in the literature.
Methods: We performed a scoping review of the literature based on the following themes: maternity or parental-leave policies; antepartum work-restriction policies and obstetric complications; accommodations for training absences; support for, and perceptions of, maternity or parental leave during residency training; and challenges upon return to work, namely resident performance and breastfeeding.
Scapholunate (SL) ligament injuries are rarely diagnosed in children. This study reports the outcomes of surgically treated SL ligament injuries in patients younger than 18 years. A retrospective review was performed on 20 pediatric patients with SL ligament injuries.
View Article and Find Full Text PDFBackground: Upper extremity (UE) trauma represents a common reason for emergency department visits, but the longitudinal economic burden of this public health issue is unknown. This study assessed the 3-year attributable health care use and expenditure after UE trauma requiring acute surgical intervention, with specific focus on injuries that affect function of the hand and wrist.
Methods: We conducted an incidence-based, propensity score-matched cohort study (2006-2014) in Ontario, Canada, using linked administrative health care data to identify case patients and matched control patients.
Background: This study aimed to assess the responsiveness of the Trapeziometacarpal Arthrosis Symptoms and Disability (TASD) questionnaire after corticosteroid injections and operative management for trapeziometacarpal osteoarthritis (TMC-OA).
Methods: This longitudinal cohort study included patients with TMC-OA who underwent treatment (corticosteroid injection or surgery). Measurements occurred at baseline and follow-up time points: 6 weeks, 3 months, 6 months, and 1 year.
Background: Although aromatase inhibitors are the first-line treatment in postmenopausal women with hormone receptor-positive breast cancer, there is increasing evidence that they can induce carpal tunnel syndrome and stenosing tenosynovitis. This systematic review summarizes the risk factors, incidence, and management for patients with aromatase inhibitor-induced carpal tunnel syndrome and stenosing tenosynovitis compared to tamoxifen or placebo.
Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided systematic review of PubMed/MEDLINE, Ovid Embase, and the Cochrane Central Register of Controlled Trials was conducted (to March 19, 2020), supplemented with Google Scholar, Plastic and Reconstructive Surgery, and The Journal of Hand Surgery.
Purpose: Non-operative management of trapeziometacarpal osteoarthritis (TMOA) demonstrates only short-term symptomatic alleviation, and no approved disease modifying drugs exist to treat this condition. A key issue in these patients is that radiographic disease severity can be discordant with patient reported pain, illustrating the need to identify molecular mediators of disease. This study characterizes the biochemical profile of TMOA patients to elucidate molecular mechanisms driving TMOA progression.
View Article and Find Full Text PDFBackground: Despite increased public awareness to dispose of unused narcotics, opioids prescribed postoperatively are retained, which may lead to drug diversion and abuse. This study assessed retention of unused opioids among hand surgery patients and describes disposal methods and barriers.
Methods: Participants undergoing hand surgery were given an opioid disposal information sheet preoperatively (N = 222) and surveyed postoperatively to assess disposal or retention of unused opioids, disposal methods, and barriers to disposal.
Background: To better understand the occurrence and operative treatment of peripheral nerve injury (PNI) and the potential need for additional resources, it is essential to define the frequency and distribution of peripheral nerve procedures being performed. The objective of this study was to evaluate Ontario's wait times for delayed surgical treatment of traumatic PNI.
Methods: We retrieved data on wait times for peripheral nerve surgery from the Ontario Ministry of Health and Long-Term Care Wait Time Information System.
Factors associated with failure of digital revascularization and replantation procedures have been well characterized, but studies have not investigated failures occurring beyond the early postoperative period. A single-centre retrospective chart review included 284 patients (434 digits) who underwent digital revascularization or replantation. Patient-, injury- and surgery-related characteristics were compared among successful procedures, digits that failed while in hospital (early failure), and initially viable digits that failed after hospital discharge (late failure).
View Article and Find Full Text PDF➤: Nerve injuries during shoulder arthroplasty have traditionally been considered rare events, but recent electrodiagnostic studies have shown that intraoperative nerve trauma is relatively common.
➤: The brachial plexus and axillary and suprascapular nerves are the most commonly injured neurologic structures, with the radial and musculocutaneous nerves being less common sites of injury.
➤: Specific measures taken during the surgical approach, component implantation, and revision surgery may help to prevent direct nerve injury.
Facial Plast Surg Aesthet Med
February 2022
Systematic reviews have identified the need for a patient-reported outcome measure for facial nerve paralysis (FNP). The aim of this study was to determine the psychometric properties of FACE-Q Craniofacial module scales when used in a combined sample of children and older adults with FNP. Data were collected between December 2016 and December 2019.
View Article and Find Full Text PDFBackground: Since 1965, the practice of digital replantation has seen great technical strides and become commonplace worldwide. However, some American authors have recently reported declining rates of replantation. We set out to characterize the patient population and describe treatment patterns from 2005 to 2016 at a large Canadian regional replantation center.
View Article and Find Full Text PDFBackground: The authors conducted a cost-effectiveness analysis to answer the question: Which motion-preserving surgical strategy, (1) four-corner fusion, (2) proximal row carpectomy, or (3) total wrist arthroplasty, used for the treatment of wrist osteoarthritis, is the most cost-effective?
Methods: A simulation model was created to model a hypothetical cohort of wrist osteoarthritis patients (mean age, 45 years) presenting with painful wrist and having failed conservative management. Three initial surgical treatment strategies-(1) four-corner fusion, (2) proximal row carpectomy, or (3) total wrist arthroplasty-were compared from a hospital perspective. Outcomes included clinical outcomes and cost-effectiveness outcomes (quality-adjusted life-years and cost) over a lifetime.