Helping Surgeons' Hands: A Biomechanical Evaluation of Ergonomic Instruments.

Purpose: "Ergonomic" is a common descriptor for a desk or computer workspace but is a term rarely used to describe a surgical instrument. Instead, surgeons spend many hours in inconvenient positions, often using instruments that are not ergonomic. Improving the ergonomics of surgical instruments may decrease the required force for simple tasks and allow for more efficient surgery.

Concurrent Ring Finger Middle Phalanx Fracture and Jersey Finger in a Rugby Player.

Avulsions of the flexor digitorum profundus (FDP) tendon and phalanx fractures are both common injuries for rugby players, but these concurrent injuries in the same finger have not been previously described. This case describes a 20-year-old female rugby player who sustained a right ring finger comminuted, mildly displaced middle phalanx fracture. The patient was evaluated by a hand surgeon 3 weeks after the injury, and non-operative management with a splint was elected.

Threaded Intramedullary Nails Are Biomechanically Superior to Crossed K-wires for Metacarpal Neck Fractures.

Background: Intramedullary nail (IMN) fixation of metacarpal fractures is an alternative to Kirschner wire (K-wire) fixation. The goal of this study was to compare the biomechanical properties of K-wire fixation with a threaded IMN (InNate; ExsoMed, Aliso Viejo, California).

Methods: The study design was based on previously described biomechanical models for evaluating metacarpal fractures.

Irreducible Volar DRUJ Dislocation with Distal Radius Fracture Dislocation.

 Volar dislocations of the distal radioulnar joint (DRUJ) are rare and often missed during initial evaluation. Chronic dislocations and disability can occur when DRUJ dislocations are unrecognized and not reduced. DRUJ dislocations often occur with other wrist injuries, which may complicate reduction.

A Biomechanical Study of Tuberosity-Based Locked Plate Fixation Compared with Standard Proximal Humeral Locking Plate Fixation for 3-Part Proximal Humeral Fractures.

Background: One of the main shortcomings of current proximal humeral plate designs is their inability to reliably secure the greater tuberosity (GT) or lesser tuberosity, leading to fixation failure, nonunion, and rotator cuff dysfunction. Traditional proximal humeral locking plates (PHLPs) rely on isolated screw fixation or suture repair to maintain reduction of the greater and/or lesser tuberosities. This study evaluates a tuberosity-based plate (TBP) specifically designed to improve tuberosity fixation, which may decrease tuberosity displacement and related clinical sequelae.

Biomechanical Comparison of Flexor Digitorum Profundus Avulsion Repair.

 Multiple repair techniques have been investigated for flexor digitorum profundus (FDP) tendon avulsions. The purpose of this study is to compare the biomechanical characteristics of a new fully threaded titanium suture anchor with previously examined fixation techniques.  Repair of FDP tendon avulsions was performed in 18 fresh-frozen cadavers using one of three implants: Nano Corkscrew FT 1.

Early post-operative outcomes of plate versus nail fixation for humeral shaft fractures.

Introduction: This study was designed to measure early postoperative outcomes of plate vs. nail fixation for humeral shaft fractures.

Patients And Methods: Patients ≥18 years who underwent plate or nail fixation for low-energy humeral shaft fractures between 2005-2016 were identified from the National Surgical Quality Improvement Program (NSQIP).

Plate Fixation With Cancellous Graft for Scaphoid Nonunion With Avascular Necrosis.

Purpose: Currently, there is no consensus on the optimal treatment for scaphoid nonunion with avascular necrosis (AVN). Various techniques, often involving vascularized corticocancellous bone grafting, have been proposed. The authors hypothesized that similar outcomes might be possible with volar plate fixation augmented with autogenous pure cancellous graft.

Outcomes of Unstable Scaphoid Nonunion With Segmental Defect Treated With Plate Fixation and Autogenous Cancellous Graft.

Purpose: Treatment of scaphoid nonunion with a segmental defect presents a challenging clinical problem. Various techniques have been proposed, often involving structural grafting with vascularized and nonvascularized bone. The authors hypothesize that satisfactory clinical and radiographic outcomes are possible with a relatively simplified technique of volar plate fixation with autogenous, purely cancellous graft.

Does Greater Trochanter Decortication Affect Suture Anchor Pullout Strength in Abductor Tendon Repairs? A Biomechanical Study.

Background: Greater trochanter decortication is frequently performed at the time of abductor tendon repair to theoretically increase healing potential. No previous studies have determined the effect that greater trochanter decortication has on the pullout strength of suture anchors. Hypothesis/Purpose: The purpose of this study is to determine whether greater trochanter decortication and bone mineral density affect suture anchor pullout strength in abductor tendon repair.