Meralgia Paresthetica: An Anatomical Review and Surgical Case Presentation Utilizing a Robotic Exoscope.

Background: Meralgia paresthetica (MP) is a neuropathic condition marked by pain, tingling, and numbness in the anterolateral thigh, primarily caused by compression of the lateral femoral cutaneous nerve (LFCN). Although compression often occurs beneath the inguinal ligament, anatomical variations can lead to different entrapment sites. Treatments range from conservative measures to surgical decompression, depending on symptom severity.

Adolescent shoulder reconstruction techniques in brachial plexus birth injury.

Background: Brachial plexus birth injury (BPBI) is common and while most recover, 8%-36% of patients experience permanent impairment. Typically, adolescents with untreated BPBI lack active and passive external rotation (ER) and overhead shoulder function. Limited shoulder function is due to 1) nonoperative BPBI, 2) untreated BPBI, or 3) unrecognized glenohumeral joint dysplasia.

Subpectoral proximal humeral anatomy: Guidance to decrease risk of fracture following subpectoral biceps tenodesis.

Background: Biceps tenodesis is used for a variety of shoulder and biceps pathologies. Humeral fracture is a significant complication of this procedure. This cadaveric anatomy study sought to determine the cortical thickness of the humeral proximal shaft to identify the optimal technique to decrease unicortical drilling and reduce the risk of fracture.

Treatment Options for the Clinical Management of Axillary Breast Tissue.

Background: Axillary breast tissue includes any combination of fat, nipple, areolae, and glandular tissue alongside breasts and affects 2%-6% of women and 1%-3% of men. Patients may experience functional and/or cosmetic concerns due to axillary breast tissue. There are nonsurgical options for its removal, such as CoolSculpting and Kybella, and surgical options such as liposuction, BodyTite liposuction, and excision.

Infectious causes and mimickers of meniere's disease.

Purpose Of Review: To review the evidence of a possible viral etiology of Meniere's disease, the role of antiviral therapy, as well as other infectious disease processes that may mimic Meniere's disease. Better understanding of the etiology of Meniere's disease and the role of various infectious disease processes may allow for more effective diagnosis and management.

Recent Findings: There is evidence that viral infections - to Herpes simplex virus, cytomegalovirus, Epstein Barr virus, influenza, adenovirus, Coxsackie virus B, and Varicella Zoster Virus - may be involved in the development of Meniere's disease, however the evidence is inconsistent and the underlying mechanism remains theoretical.

Successful Use of WALANT in Local and Regional Soft Tissue Flaps: A Case Series.

Unlabelled: The wide awake local anesthesia no tourniquet (WALANT) technique has been proven to be safe and effective for upper extremity surgery. WALANT does not require extensive medical clearance and allows for intraoperative assessment of range of motion. Additionally, it is frequently associated with lower costs and less postoperative pain when compared with traditional methods of anesthesia.

The Impact of Perceived Upper Extremity Severity and Prior Surgery on Patient-Reported Outcomes.

The recently validated Hand Questionnaire (HAND-Q) is a multifaceted patient-reported outcome measure (PROM) for hand/upper extremity (UE) pathology and treatment. Here, we conduct a pilot study utilising data collected as a participating site for the Phase II HAND-Q Pilot Multicenter International Validation Study. We hypothesised that self-reported hand functionality, symptom/disease severity, hand appearance, emotional dissatisfaction and treatment satisfaction would be worse in patients who perceived their disease severity to be more severe but would not differ between patients based on prior surgical history.

Sexual Dissatisfaction after Hand Surgery.

Unlabelled: Using the hand questionnaire (HAND-Q) patient-reported outcome measure, the effects of upper extremity surgery on patients' perception of their sex life were explored. The hand is a uniquely sexual organ, and we hypothesized that self-reported measures of disease severity, quality of life, and emotional impact would correlate with sexual dissatisfaction among patients receiving treatment for hand/upper extremity conditions.

Methods: Patients were prospectively enrolled for hand questionnaire participation.

Negative Ulnar Variance Lessens DRUJ Instability After DRUJ Disruption: A Biomechanical Analysis.

Background: The purpose of this study was to perform a biomechanical investigation on the effect of ulnar variance (UV) on the stability of the distal radioulnar joint (DRUJ) prior to and after DRUJ sectioning.

Methods: Ten cadaveric forearm specimens were included in the study and baseline UV was assessed radiographically. Radial motion relative to the ulna was evaluated using Intel real sense cameras and a custom developed program.

Radiocarpal Contact Pressures Are Not Altered after Scapholunate Ligament Tears.

 The scapholunate interosseous ligament (SLIL) couples the scaphoid and lunate, preventing motion and instability. Prior studies suggest that damage to the SLIL may significantly alter contact pressures of the radiocarpal joint.  The purpose of this study was to investigate the contact pressure and contact area in the scaphoid and lunate fossae of the radius prior to and after sectioning the SLIL.

Proximal Row Carpectomy Does Not Alter Contact Pressures of the Lunate Fossa: A Cadaveric Study.

Background: Previous studies have suggested that proximal row carpectomy (PRC) results in increased contact pressures and decreased contact areas in the radiocarpal joint. Such experiments, however, used older technologies that may be associated with considerable measurement errors. The purpose of this study was to determine whether there was a significant difference in contact pressure and contact area before and after PRC using Tekscan, a newer pressure sensing technology.

WALANT Hand and Upper Extremity Procedures Performed With Minor Field Sterility Are Associated With Low Infection Rates.

Background: The use of minor field sterility in hand/upper extremity cases has been shown to improve workflow efficiency while maintaining patient safety. As this finding has been limited to specific procedures, we investigated the safety of performing a wide array of hand/upper extremity procedures outside the main operating room using minimal field sterility with Wide-Awake Local Anaesthesia No Tourniquet (WALANT) anaesthesia by evaluating superficial and deep infection rates across a diverse series of cases.

Methods: This study was a case series conducted between October 2017 and June 2020.

Proximal Interphalangeal Joint Congruity: A Biomechanical Study.

Background: Surgical approaches to the proximal interphalangeal (PIP) joint often require disruption of soft tissue stabilizers. Additionally, PIP joint injuries frequently result in soft tissue disruption. This study evaluates the necessity of repairing soft tissue stabilizers by assessing their role in maintaining native joint congruity.

A Retrospective Case Series of Peripheral Mixed Nerve Reconstruction Failures Using Processed Nerve Allografts.

Background: Favorable rates of meaningful recovery (≥M3/S3) of processed nerve allografts (PNAs) for mixed and motor nerve injuries have been reported, but there are few reports of patients having complete PNA failure (M0/S0). The purpose of this study was to describe the outcomes, including rate of complete failures, in a case series of patients who underwent PNA for peripheral mixed nerve reconstructions.

Methods: A retrospective review of outcomes between May 2018 to September 2020 was performed.

Effect of Collagen Nerve Wrapping in a Rabbit Peripheral Neuropathy Model.

Background: Collagen nerve wraps (CNWs) theoretically allow for improved nerve gliding and decreased perineural scarring, and create a secluded environment to allow for nerve myelination and axonal healing. The goal of this study was to investigate the effect of CNWs on nerve gliding as assessed by pull-out strength and nerve changes in a rabbit model of peripheral neuropathy.

Methods: Ten New Zealand rabbits were included.

The rate and reporting of fracture after biceps tenodesis: A systematic review.

Background: The purpose of this systematic review was to (1) define the cumulative humerus fracture rate after BT and (2) compare how often fracture rate was reported compared to other complications.

Methods: A systematic review was performed using the PRISMA guidelines.

Results: 39 studies reported complications and 30 reported no complications.

FFF Utilizing an Arteriovenous Vascular Loop of Two Peroneal Venae Comitantes for a PAM.

Vascularized bone grafting is widely used for reconstruction of osseous defects of the forearm. Fibular free flap (FFF) is one option, which relies on harvesting the peroneal artery. This procedure is subject to lower extremity anatomic variants; therefore, some recommend preoperative angiography.

The top 50 most cited articles in both-bone forearm open reduction internal fixation in the skeletally mature patient.

Purpose: Both-bone forearm fractures in the adult population frequently and usually necessitate an operative reduction. The purpose of this study was to identify the 50 most cited publications regarding both-bone ORIF and evaluates their level of evidence to help guide the best treatment and management practices, as well as gauge the current level of inquiry into this topic.

Methods: The Clarivate Analytics Web of Knowledge Database was queried.

Wide-awake Local Anesthesia with No Tourniquet: An Updated Review.

Unlabelled: The wide-awake local anesthesia with no tourniquet (WALANT) technique has become popularized for various hand/upper extremity procedures. Before surgery, patients receive local anesthetic, consisting of lidocaine with epinephrine, and remain awake for the entire procedure. The purpose of this review was to investigate the advantages, diverse application, outcomes, cost benefits, use in challenging environments, patient considerations, and contraindications associated with WALANT.

Outcomes of an aseptic technique for Kirschner wire percutaneous pinning in the hand and wrist.

Introduction: Kirschner wires (K-wires) have been shown to effectively stabilize fractures of the hand and wrist, but are associated with high infection rates, which may limit its use. Previous literature has attributed the risk of infection to many different aspects of a fixation technique. However, we introduce an approach to percutaneous K-wire pinning to mitigate the risk of infection.

The 50 most cited papers in chronic scapholunate reconstruction: a bibliometric analysis.

Purpose: This study identifies the most impactful papers on scapholunate reconstruction and provides a quantitative assessment of the impact of these papers in order to inform future clinical practice, education, and research of this condition.

Methods: The Scopus database was used in May 2020 to identify the 50 most cited clinical articles pertaining solely to chronic scapholunate reconstruction. Citation number and density, publication variables, and Altmetric Attention Scores (AASs) were collected and analyzed.

A Systematic Review of Nonsurgical Vulvovaginal Restoration Devices: An Evidence-Based Examination of Safety and Efficacy.

Background: The efficacy and safety of vulvovaginal restoration devices were called into question in a U.S. Food and Drug Administration statement on July 30, 2018, claiming that women are being harmed by laser and other energy-based devices.

Large and Uneven Bites in End-to-End Anastomosis of the Rat Femoral Artery.

Background:  Successful microvascular anastomosis depends on sutures that adequately oppose both cut vessel edges. Trainees tend to take oversized or uneven bite. To improve early microsurgical skill acquisition using the rat, this study tests the belief that such bites compromise early patency by applying exaggerated bites to end-to-end arterial anastomoses.