The cost-effectiveness of nonsurgical versus surgical treatment for carpal tunnel syndrome.

Purpose: To compare direct costs and results for patients with electrodiagnostically proven carpal tunnel syndrome treated with surgery versus nonsurgical care.

Methods: There is a retrospective study of 120 patients divided into 2 groups: subjects in group 1 had chosen nonsurgical treatment, whereas subjects in group 2 had chosen surgery with no nonsurgical treatment. Patients were matched on age, gender, severity of nerve conduction abnormalities, body mass index, smoking history, job category, and insurance coverage.

Early outcome of spherical ceramic trapezial-metacarpal arthroplasty.

Purpose: A retrospective review of 50 ceramic, spherical implants for the treatment of trapezial-metacarpal osteoarthritis in 49 patients assessed clinical and radiographic outcome.

Methods: Thirty-five patients returned for a clinical examination and completed an outcome survey at a mean follow-up of 3 years. A radiographic review was available for all 50 implants with a mean follow-up of 3 years.

Outcomes of carpal tunnel surgery with and without supervised postoperative therapy.

Purpose: To assess if a formal 2-week hand therapy improves outcomes and justifies its expense.

Methods: A prospective randomized study was completed using a contemporary short incision and a 2-week program of therapy. Patients were randomized into 2 treatment groups: one group received instruction on home therapy exercises to be followed after carpal tunnel release, and a second group received the home program in addition to a therapist-directed program for 2 weeks.

Outcome after repair of the scapholunate interosseous ligament and dorsal capsulodesis for dynamic scapholunate instability due to trauma.

Purpose: To retrospectively assess outcomes in 17 patients treated with scapholunate (SL) interosseous ligament repair and capsulodesis for dynamic SL instability due to trauma.

Methods: A retrospective review of 17 consecutive patients included clinical and radiographic examinations to determine outcome after SL interosseous ligament repair and dorsal capsulodesis. The average age at the time of surgery was 36 years, and the postoperative follow-up period averaged 66 months.

Plate removal after ulnar-shortening osteotomy.

Purpose: Ulnar-shortening osteotomy using plate and screw fixation is a reliable method for treating various wrist disorders. In some patients the plate remains as a source of discomfort even after the osteotomy has healed and the preoperative complaints have resolved. There is not a large body of information to guide the surgeon in the timing of plate removal should it be needed to address persistent forearm complaints caused by prominent hardware.

Radiographic analysis of lateral epicondylitis.

Lateral epicondylitis is one of the most commonly diagnosed elbow disorders, but the role of radiographs in clinical evaluation is unclear. The purpose of this study was to review a consecutive series of 294 radiographs in patients diagnosed with lateral epicondylitis to determine whether radiographic findings had an impact on patient management. Standard anteroposterior, lateral, and radiocapitellar views for each elbow were taken at a single upper extremity practice.