Out-of-Pocket Expenses and Postoperative Therapy After Open Reduction Internal Fixation of a Distal Radius Fracture.

Background: Postoperative hand therapy after surgery for distal radius fractures is associated with improved functional outcomes. However, financial impediments can be a potential barrier to adherence to postoperative care requirements. The aim of this study is to evaluate the relationship among the surgical and therapy out-of-pocket (OOP) expenses and therapy visits after operative treatment of a distal radius fracture.

Financial Toxicity Among Patients With Traumatic Finger Amputation: A Retrospective Study.

Background: Patients face increasing financial toxicity (FT), defined as emotional distress due to the cost of medical treatment. However, little is known regarding FT in the context of upper extremity trauma.

Methods: We surveyed patients who sustained traumatic finger amputation (October 21, 2011-January 1, 2021).

Implementation of postoperative opioid prescribing guidelines after carpal tunnel release: a quality collaborative study.

Opioid prescribing after carpal tunnel release (CTR) is not well understood. We assessed CTR opioid prescribing within a quality collaborative after the dissemination of guidelines. Post guidelines, the odds of receiving a prescription decreased by 67%.

Digital artery flow hemodynamics: An ultrasonographic study.

Background: There is a lack of data regarding the baseline hemodynamic blood flow parameters of the wrist and digits. Therefore, we aimed to quantify the digital and radial artery blood flow parameters using ultrasound and assess the influence of patient characteristics on hemodynamics.

Methods: We analyzed ultrasonographic data from 25 patients (50 hands) between October 2019 and December 2021.

Catastrophic Health Expenditures Associated With Open Reduction Internal Fixation of Distal Radius Fractures.

Purpose: Distal radius fracture is one of the most common upper-extremity traumatic injuries. These injuries result in time off work and potential financial consequences for patients. Therefore, we aimed to understand the risk of catastrophic health expenditures (CHEs) after open reduction and internal fixation of distal radius fractures and examine the association between patient characteristics and the risk of CHE.

Predictors and Variation in Steroid Injection Use for Carpal Tunnel Syndrome from a Multicenter Quality Collaborative.

Background: Steroid injections are commonly used as first-line treatment for carpal tunnel syndrome (CTS); however, research has shown that their benefit is generally short term, and many patients go on to receive carpal tunnel release (CTR). The purpose of this study was to determine the variation in steroid injection use by hand surgeons.

Methods: The authors analyzed data from a nine-center hand surgery quality collaborative.

Cohort study of new off-label gabapentin prescribing in chronic opioid users.

Introduction: Gabapentin is commonly prescribed as an off-label adjunct to opioids because of its safer risk profile. Recent evidence has shown an increased risk of mortality when coprescribed with opioids. Therefore, we aimed to evaluate whether the addition of off-label gabapentin in patients with chronic opioid use is associated with a reduction in opioid dosage.

Racial Disparities in the Cost of Unplanned Hospitalizations after Breast Reconstruction.

Background: Given the national attention to disparities in health care, understanding variation provided to minorities becomes increasingly important. This study will examine the effect of race on the rate and cost of unplanned hospitalizations after breast reconstruction procedures.

Methods: The authors performed an analysis comparing patients undergoing implant-based and autologous breast reconstruction in the Healthcare Cost and Utilization Project.

A Quality Collaborative Study of the Concordance of Electrodiagnostic Scores and Clinical Severity in Carpal Tunnel Syndrome.

Background: Electrodiagnostic studies are commonly used to diagnose carpal tunnel syndrome. However, these examinations are prone to false-positive and false-negative values. The authors evaluated the agreement of electrodiagnostic study severity, clinical assessment scores, and probability of carpal tunnel syndrome [Six-Item Carpal Tunnel Syndrome Evaluation Tool (CTS-6) scores.

Nonsurgical Treatment of Carpal Tunnel Syndrome: A Survey of Hand Surgeons.

Background: The nonsurgical treatment of carpal tunnel syndrome (CTS) consists of multiple modalities: splinting, corticosteroid injections, hand therapy, and oral medications. However, data supporting the effectiveness of these different modalities are varied, thus creating controversy regarding the optimal nonsurgical treatment. It is unknown how current hand surgeons utilize nonsurgical treatments for CTS.

Dissemination of Plastic Surgery Research: An Analysis of and .

Unlabelled: ) recently developed an open access counterpart, ), to increase dissemination of research in an efficient and widespread manner. We aimed to (1) examine the differences in the dissemination of research published in and , and (2) identify differences in the authorship between the journals.

Methods: We extracted data on Altmetric Attention Scores, article mentions, citations, and author characteristics using the Altmetric Explorer Database from January 1, 2018, to January 1, 2020.

Gabapentinoid Prescribing for Carpal Tunnel Syndrome.

Background: Gabapentinoids, including gabapentin and pregabalin, are commonly prescribed for neuropathic pain, but robust evidence recommends against using gabapentinoids for the treatment of carpal tunnel syndrome (CTS). We aimed to quantify national prescribing patterns of gabapentinoids for CTS.

Methods: We performed a retrospective population-based cohort study using claims data of gabapentinoid-naïve patients with a new diagnosis of CTS (2009-2016).

Task-Specific Patient Preferences for Shared Decision-Making in Hand Surgery.

Background: Shared decision-making for surgery can increase patient engagement, satisfaction, and clinical outcomes. However, the level of involvement that patients desire at each step of the decision-making process is unknown.

Methods: The authors surveyed patients at an academic hand surgery clinic to examine the preferred role in decision-making using validated questionnaires (i.

Utilization of Diagnostic Testing for Carpal Tunnel Syndrome: A Survey of the American Society for Surgery of the Hand.

Purpose: In 2016, the American Academy of Orthopaedic Surgeons (AAOS) changed the clinical practice guidelines (CPGs) for the diagnosis of carpal tunnel syndrome, relaxing the recommendation for electrodiagnostic studies (EDS) prior to offering surgery. However, it is unknown how the updated guidelines changed the practice patterns of hand surgeons.

Methods: A web-based multiple-choice survey was sent to the members of the American Society for Surgery of the Hand.

Evaluation of Factors Relevant to Pain Control Among Patients After Surgical Treatment.

Importance: Opioids are often prescribed after elective surgical treatment despite the potential for misuse. Although various pain control regimens exist, patient preferences for acute postoperative pain management are unknown.

Objective: To describe patient-reported key attributes of postoperative pain management.

Trust and Distrust in Opioid Decision-Making: A Qualitative Assessment of Patient-Doctor Relationship.

Purpose: Surgeons often prescribe opioid analgesics for pain management after surgery. However, we understand little about how patients perceive opioid prescribing and make decisions to use opioids for postoperative pain management. In this study, we aimed to gain an understanding of patients' decision-making process on postoperative opioid use.

Opioid Prescribing after Carpal Tunnel Release: Analysis from the Michigan Collaborative Hand Initiative for Quality in Surgery.

Background: Little is known regarding the national practice patterns for postoperative opioid prescribing after carpal tunnel release, which is one of the most common surgical procedures performed. The authors sought to assess the rate of opioid prescribing after carpal tunnel release and patient-, surgeon-, and practice-level predictors of opioid prescriptions after surgery.

Methods: The authors conducted a cohort study from the Michigan Collaborative Hand Initiative for Quality in Surgery, a national consortium of nine practices with 33 surgeons who prospectively collect data for the purpose of quality improvement.

Perceived versus Patient-Reported Significance of Surgeon Gender in Breast Reconstruction.

Background: Previous investigators demonstrated that female patients often prefer female providers. However, these studies have not determined whether there are gender preferences for breast reconstruction surgeons or whether the effects of surgeon gender impacts patient-reported outcomes.

Methods: Adult women were crowdsourced using Amazon Mechanical Turk to characterize societal preferences for the gender of breast and plastic surgeons in a hypothetical scenario.

Trends in Funding and Acquisition of Surgical Practices by Private Equity Firms in the US From 2000 to 2020.

This cross-sectional study examines trends in acquisition and funding of surgical practices and facilities by private equity firms in the US from January 1, 2000, to October 30, 2020.

An Assessment Tool for Hand Surgical Education Needs and Capacity in Resource-Limited Settings.

Background: Hand surgeons have the potential to substantially decrease the surgical disability burden in the developing world through educator trips. The Lancet Commission supports contextually driven educator trips grounded in the needs of local hosts, yet few organizations perform a comprehensive assessment of learning interests or the hosting institutions' surgical capacity before the trips.

Methods: The authors adapted the Personnel, Infrastructure, Procedures, Equipment, and Supplies questionnaire, which was modified from the World Health Organization's validated Tool for Situational Analysis to Assess Emergency and Essential Surgical Care.

The Impact of Community Care Referral on Time to Surgery for Veterans With Carpal Tunnel Syndrome.

Background: The US Department of Veterans Affairs (VA) enacted policies offering Veterans care in the community, aiming to improve access challenges. However, the impact of receipt of community care on wait times for Veterans receiving surgical care is poorly understood.

Objectives: To compare wait times for surgery for Veterans with carpal tunnel syndrome who receive VA care plus community care (mixed care) and those who receive care solely within the VA (VA-only).

A Qualitative Study of Patient Protection against Postoperative Opioid Addiction: A Thematic Analysis of Self-Agency.

Background: Opioids are commonly used following outpatient surgery. However, we understand little about patients' perspectives and how patients decide on postoperative opioid use. This study seeks to investigate aspects of patients' thought processes that most impact their decisions.

Surgical Timing for Carpal Tunnel Syndrome: A Comparison of Health Care Delivery in the Veterans Administration and Private Sector.

Purpose: The U.S. Department of Veterans Affairs (VA) health care system monitors time from referral to specialist visit.

Association of Interfacility Transfer and Patient and Hospital Characteristics With Thumb Replantation After Traumatic Amputation.

Importance: Given that 40% of hand function is achieved with the thumb, replantation of traumatic thumb injuries is associated with substantial quality-of-life benefits. However, fewer replantations are being performed annually in the US, which has been associated with less surgical expertise and increased risk of future replantation failures. Thus, understanding how interfacility transfers and hospital characteristics are associated with outcomes warrants further investigation.

Variation in Use of Electrodiagnostic Testing: Analysis From the Michigan Collaborative Hand Initiative for Quality in Surgery.

Purpose: To evaluate factors that predict the use of electrodiagnostic testing (EDS) for patients undergoing carpal tunnel release (CTR).

Methods: In this cohort study, we analyzed 553 patients who underwent primary CTR from 8 practices between July 1, 2019 and December 1, 2019 by 32 surgeons in the Michigan Collaborative Hand Initiative for Quality in Surgery (M-CHIQS). The M-CHIQS is a collaborative initiative aimed at improving quality in hand surgery.