Long-Term Patient-Reported Outcomes following Proximal Row Carpectomy.

 Proximal row carpectomy (PRC) is a procedure used for pain relief from arthrosis that preserves some degree of range of motion (ROM). Dorsal capsular interposition (DCI) is an option for cases where some chondral loss of the capitate is present.  The aim of this study is to assess what factors influence long-term patient-reported outcomes following PRC and specifically to evaluate the role of DCI.

Binary Soong grading as a predictor for flexor pollicis longus tendon rupture after distal radial fracture fixation: a retrospective study.

This retrospective cohort study evaluates the concordance between Soong grades classified from radiographs and computed tomography (CT) scans and whether a Soong grade ≥1 is associated with flexor pollicis longus (FPL) injury and reoperation incidence. We included 181 patients with 185 dorsally displaced distal radial fractures treated with anterior locking plates. For the analysis of binary Soong grades, grade 0 was compared with grades 1 and 2.

Teardrop Alignment Changes After Volar Locking Plate Fixation of Distal Radius Fractures With Volar Ulnar Fragments.

Background: We assessed factors associated with change in radiographic teardrop angle following volar locking plate (VLP) fixation of volarly displaced intra-articular distal radius fractures with volar ulnar fragments (VUF) within the ICUC database. The primary outcome was change in radiographic alignment on follow-up imaging, defined as a change in teardrop angle from intra-operative fluoroscopy greater than 5°.

Methods: Patients with distal radius fractures treated with a VLP within the ICUC database, an international collaborative and publicly available dataset, were identified.

The association of ICUC trauma score and quick DASH in a distal radius fracture cohort.

Background: This study evaluates the association between ICUC trauma and short-form Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick DASH) scores among patients who underwent surgery for distal radius fractures.

Methods: This research gathered patient-reported outcomes (PROs) from patients registered in the ICUC database at a single trauma center. The study involved 76 adult patients who underwent surgical treatment for distal radius fractures before 2023.

Soong Classification Using Radiographs Only Moderately Correlates With Distal Radius Plate Position on Computed Tomography.

Background: The Soong classification grades the prominence of volar locking plates used to treat distal radius fractures in relation to the volar rim. The basis of the classification scheme is that increasing plate prominence over the volar rim and distal radius watershed zone is associated with increased likelihood of flexor tendon irritation and need for plate removal. However, recent studies report mixed results on the predictive value of the Soong classification for these outcomes.

The management of elbow trauma from a historical perspective.

The origins of contemporary orthopedics can be traced all the way back to antiquity. Despite the absence of modern imaging techniques, a few bright minds were able to lay the groundwork for understanding these fractures. This historical review will cover the process behind the various treatments for elbow fractures, such as splinting and casting, mobilization, amputation, fracture fixation, arthroplasty, and arthroscopy.

Evidence-Based Surgery: What Can Intra-Operative Images Contribute?

Evidence-based medicine integrates results from randomized controlled trials (RCTs) and meta-analyses, combining the best external evidence with individual clinical expertise and patients' preferences. However, RCTs of surgery differ from those of medicine in that surgical performance is often assumed to be consistent. Yet, evaluating whether each surgery is performed to the same standard is quite challenging.

DRUJ Capsular Release for Forearm Rotational Limitation: Surgical Technique and Case Series.

Background: Forearm stiffness can be caused by distal radioulnar joint (DRUJ) capsular contractures, which can occur after trauma such as a distal radius fracture. In this setting, a DRUJ capsular release may help improve forearm rotation, but the long-term functional outcomes remain unknown. The purpose of this case series is to investigate the short-term improvement in total pronosupination arc range of motion and long-term patient-reported outcomes (PROs) after DRUJ capsular release.

Comparison of distal radius fracture plating surgery under wide-awake local anesthesia no tourniquet technique and balanced anesthesia: a retrospective cohort study.

Background: Distal radius fractures (DRF) are frequently treated with internal fixation under general anesthesia or a brachial plexus block. Recently, the wide-awake local anesthesia with no tourniquet (WALANT) technique has been suggested as a method that results in higher patient satisfaction. This study aimed to evaluate the functional outcomes, complications, and patient-reported outcomes of DRF plating surgery under both the WALANT and balanced anesthesia (BA).

Minimum 5-Year Follow-Up Assessment of Volar Plate Interposition Arthroplasty for Post-Traumatic Osteoarthritis in Proximal Interphalangeal Joints.

This is a retrospective study to evaluate the outcome of volar plate interposition arthroplasty for proximal interphalangeal joint post-traumatic osteoarthritis with a minimum 5-year follow-up. We identified patients receiving volar plate interposition arthroplasty for post-traumatic osteoarthritis in proximal interphalangeal joints. The measurements included the numeric pain scale (on a scale of 0-10), the proximal interphalangeal joint active range of motion, the Michigan Hand Outcomes Questionnaire, the perioperative radiograph of the involved digit, proximal interphalangeal joint stability, and pinch strength.

Functional outcomes and complications after treatment of distal radius fracture in patients sixty years and over: A systematic review and network meta-analysis.

Aim: This network meta-analysis aims to compare functional outcomes and complications between conservative treatment and surgery for distal radius fractures in patients aged 60 years and over.

Methods: We searched the PubMed, EMBASE, and Web of Science databases for randomized controlled trials (RCTs) assessing the effect of conservative treatment and surgery for distal radius fractures in patients aged 60 years and over. Primary outcomes included grip strength and overall complications.

[Carpal Malalignment in Malunited Fractures of the Distal Radius].

Purpose: To evaluate and classify carpal alignment in malunited fractures of the distal radius.

Materials And Methods: On standardized lateral radiographs of the involved wrist of 72 patients with a symptomatic extra-articular malunion of the distal radius, 43 with a dorsal and 29 with a palmar angulation, radius tilt (RT), radiolunate (RL) and lunocapitate angle were measured. Malposition of the radius was defined as RT plus 11° in dorsal malunion and RT minus 11° in palmar malunion.

Joint depression in tibial plateau fractures: To bone graft or not to bone graft?

Tibial plateau fractures with significant joint depression and metaphyseal comminution pose a challenge. In order to prevent the collapse of the articular surface, some authors propose filling the subchondral void created during reduction with bone graft/substitute, which can add further complications. We present two cases of tibial plateau fractures with severe joint depression of the lateral condyle; both treated with a periarticular rafting construct, in one caseadditional bone substitute was used and in the other case no bone graft/substitute was used; their final outcomes were reported.

Homogeneity in Surgical Series: Image Reporting to Improve Evidence.

Good clinical practice guidelines are based on randomized controlled trials or clinical series; however, technical performance bias among surgical trials is under-assessed. The heterogeneity of technical performance within different treatment groups diminishes the level of evidence. Surgeon variability with different levels of experience-technical performance levels even after certification-influences surgical outcomes, especially in complex procedures.

Complete Intra-Operative Image Data Including 3D X-rays: A New Format for Surgical Papers Needed?

Intra-operative 3D X-rays have been confirmed to decrease revision rates and improve optimal screw placement in complex fractures of the distal radius. Compared with traditional surgical publications, another advantage of whole intraoperative clinical imaging can be presented in electronic databases, e.g.

Posteriorly Displaced Radial Head Fractures May Represent the Footprint of an Elbow Dislocation or Subluxation as a Variant of Modified Mason Type 4.

Background: The purpose of this case series is to describe surgical decision making and clinical outcomes in posteriorly displaced radial head fractures with a major fragment (more than 50% of the head) located behind the humeral condyle. We also document the outcome of open reduction and internal fixation of completely displaced radial head fractures.

Methods: A retrospective review of the ICUC® (Integrated Comprehensive Unchanged Complete) database was performed between 2012 and 2020.

An experienced surgeon's take on scapho-lunate diastasis with distal radius fracture: What does this mean? Does this influence functional outcome?

Radiographic evidence of scapho-lunate diastasis associated with a displaced distal radius fracture has been well recognized yet the clinical significance remains in question. If left untreated, will this progress to both radiographic and clinical changes consistent with intercarpal arthritis? Using the accumulated data of over 400 surgically treated distal radius fractures in the ICUC database, 16 cases of untreated scapho-lunate diastasis were followed on an average of 8 years without evidence of progressive functional or radiographic deterioration. In 50% of these cases, incidental findings of similar scapho-lunate diastasis was noted in the opposite uninjured wrist.

Correction: Liu et al. Less Fluctuation in Hemodynamics of the Wide-Awake Local Anesthesia No Tourniquet Technique Than General Anesthesia in Distal Radius Plating Surgery: A Prospective Case-Control Study. 2022, , 1123.

In the original publication [...

Patient-Reported Outcomes After Surgical Treatment of Early Osteoarthritis of the First Carpometacarpal Joint.

Background: The goals of this study are to describe the reoperation rates in patients who underwent Wilson osteotomy compared with patients who underwent carpometacarpal (CMC) arthroplasty for early-stage arthritis and to evaluate the factors influencing the patient-reported outcomes.

Methods: Retrospectively, 52 patients who underwent surgery for stage I/II osteoarthritis of the thumb carpometacarpal were identified, consisting of 17 (33%) patients who underwent Wilson osteotomy and 35 (67%) who underwent carpometacarpal arthroplasty. A total of 28 (55%) patients completed the outcome questionnaires, consisting of 11 (39%) patients who underwent Wilson osteotomy and 17 (61%) patients who underwent carpometacarpal arthroplasty.

Managing Challenges in Thumb Carpometacarpal Arthritis.

Thumb carpometacarpal osteoarthritis is commonly encountered and multifactorial in etiology, and its management is based on the radiographic stage and surgeon preference. A variety of management strategies exist including ligament reconstruction, arthroscopic débridement, extension osteotomy, open versus arthroscopic total and partial trapeziectomy with or without interposition and/or suspensionplasty, arthrodesis, and total or hemi implant arthroplasty. A review of the literature shows each of these management strategies to be effective in pain relief, but no one procedure has been shown to be superior despite theoretic benefits to preserving trapezial height.

Does coracoclavicular augmentation additional to hook plate fixation provide benefits in acute unstable acromioclavicular dislocation? A meta-analysis.

Background: Acromioclavicular joint (ACJ) dislocation is a common shoulder injury. In treating acute unstable ACJ dislocation, a hook plate (HP) is a straightforward and popular option for ensuring proper reduction and rigid fixation while promoting AC and coracoclavicular (CC) ligament healing. Surgeons typically remove the HP to prevent subacromial impingement and acromial osteolysis; however, concerns about redislocation after implant removal remain.