Characteristics of Intravenous Fluid Infiltration and Factors Associated With Adverse Events: A Multicenter Retrospective Study.

Background: Peripheral intravenous (PIV) infiltration and extravasation are common complications of intravenous fluid administration. Here, we aim to investigate risk factors associated with major adverse events following PIV infiltration, which may help risk stratify those who require early surgical consultation.

Methods: Retrospectively, patients were identified who had a documented PIV infiltration or extravasation event at 3 academic hospitals between 2015 and 2022.

Unplanned Postoperative Emergency Department Visits After Upper Extremity Fracture Surgery.

Objectives: This study aimed to determine whether outpatient upper extremity fracture surgery was associated with increased postoperative emergency department (ED) visits and identify related risk factors.

Design: Retrospective cohort.

Setting: This multicenter study was conducted within a single academic institution, encompassing two Level 1, two Level 2, and one Level 3 trauma centers.

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.

Social Deprivation is Associated with Increased Pain in Patients Presenting with Neuropathic Pain.

Background: Neuropathic pain following nerve injury can be debilitating and negatively impact quality of life. Targeted muscle reinnervation (TMR) is an efficacious technique for the management of neuropathic pain. However, this technique may be unequally available for many geographical locations.

Psychosocial and functional impact of successful digital replantation - A cohort study of 36 patients with a median follow-up of 6 years.

Introduction: This study aims to evaluate the long-term psychosocial and functional outcomes of successful digital replantation following traumatic amputation.

Methods: Patients that underwent successful replantation (i.e.

PROMIS Global Physical Health Subscale Strongly Correlates and Performs Similarly to the QuickDASH in Hand and Upper Extremity Patients.

Background: The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) is a validated, static hand and upper extremity patient-reported outcome measure (PROM) commonly used. However, with the growth of PROM implementation across orthopedic and plastic surgery clinics, it is beneficial to determine whether a more general PROM can be used to capture the same insights. This would ease implementation broadly.

Quantitative 3-D CT Demonstrates Distal Row Pronation and Translation and Radiolunate Arthritis in the SNAC Wrist.

Background: In scaphoid nonunion advanced collapse (SNAC) wrist arthritis, we analyzed the 3-dimensional (3-D) deformity patterns of carpal alignment secondary to scaphoid nonunion and quantified subchondral arthritis by investigating alterations in bone density.

Methods: We constructed 3-D models of the carpal bones and radius from 51 patients with scaphoid nonunion (nonunion group) and 50 healthy controls (control group). We quantified the differences in 3-D geometric position of the distal carpal row relative to the distal radius in SNAC wrists versus controls.

A Systematic Review and Meta-Analysis of Nerve Gap Repair: Comparative Effectiveness of Allografts, Autografts, and Conduits.

Background: Ideal nerve repair involves tensionless direct repair, which may not be possible after resection. Bridging materials include nerve autograft, allograft, or conduit. This study aimed to perform a systematic literature review and meta-analysis to compare the meaningful recovery (MR) rates and postoperative complications following autograft, allograft, and conduit repairs in nerve gaps greater than 5 mm and less than 70 mm.

Migraine Headaches in Patients with Upper Extremity Compressive Neuropathy.

Background: Upper extremity nerve compression syndromes and migraines caused by nerve entrapment have many similarities, including patient presentation, anatomical findings, and treatment by surgical decompression of affected nerves. Parallels between the two conditions point toward the possibility of shared predisposition. The aim of this study was to evaluate the relationship between migraine and upper extremity nerve compression.

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.

The Performance of Diagnostic Tests for Identifying Periprosthetic Joint Infection After Failed Partial Knee Arthroplasty.

Background: Indications for unicompartmental knee arthroplasty (UKA) and patello-femoral arthroplasty are expanding. Despite the lower published infection rates for UKA and patello-femoral arthroplasty than total knee arthroplasty, periprosthetic joint infection (PJI) remains a devastating complication and diagnostic thresholds for commonly utilized tests have not been investigated recently. Thus, this study evaluated if diagnostic thresholds for PJI in patients who had a failed partial knee arthroplasty (PKA) align more closely with previously reported thresholds specific to UKA or the 2018 International Consensus Meeting on Musculoskeletal Infection.

Factors Related to Neuropathic Pain following Lower Extremity Amputation.

Background: Lower extremity amputations are common, and postoperative neuropathic pain (phantom limb pain or symptomatic neuroma) is frequently reported. The use of active treatment of the nerve end has been shown to reduce pain but requires additional resources and should therefore be performed primarily in high-risk patients. The aim of this study was to identify the factors associated with the development of neuropathic pain following above-the-knee amputation, knee disarticulation, or below-the-knee amputation.

Forearm Plate Fixation: Should Plates Be Removed?

Background: Refracture after both bone forearm fracture fixation may vary with or without plate removal. We tested the null hypothesis that there is no difference in the rate of refracture in patients who have undergone open reduction and internal fixation of a diaphyseal forearm bone who have retained implants versus removed implants. We also studied factors associated with plate removal.

Quantitative Analysis of the Volar Ulnar Corner of the Distal Radius: A Reference for Intraoperative Distal Radius Fracture Reduction.

Purpose: The reduction of distal radius fractures using volar locking plate fixation can be performed by securing the plate to the distal fragments and then levering the plate to the radial shaft. Oblique placement of the plate on the radial shaft may lead to malreduction. The aim of this study was to evaluate parameters that can be used for the assessment of intraoperative distal radius fracture reduction using "distal-first" volar plate fixation, especially the geometry of the ulnar corner.

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.

Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria.

Unlabelled: Prolonged opioid use after surgery has been a contributing factor to the ongoing opioid epidemic. The purpose of this systematic review is to analyze the definitions of prolonged opioid use in prior literature and propose appropriate criteria to define postoperative prolonged opioid use in hand surgery.

Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines 130 studies were included for review.

The Significance of Race/Ethnicity and Income in Predicting Preoperative Patient-Reported Outcome Measures in Primary Total Joint Arthroplasty.

Background: Utilization of total joint arthroplasty (TJA) by minorities is disproportionately low compared to Whites. Contributing factors include poorer outcomes, lower expectations, and decreased access to care. This study aimed to evaluate if race and income were predictive of preoperative patient-reported outcome measures (PROMs) and the likelihood of achieving the minimal clinically important difference (MCID) following TJA.

Reoperation Following Zone II Flexor Tendon Repair.

Background: The goal of zone II flexor tendon surgery is to perform a repair with sufficient strength to withstand the forces encountered during rehabilitation. Postoperative rerupture and adhesion formation may lead to reoperation. This study aimed to determine the factors associated with reoperation after primary zone II flexor tendon repair.

Long-Term Opioid Use Following Surgery for Symptomatic Neuroma.

Background:  Identifying patients at risk for prolonged opioid use following surgery for symptomatic neuroma would be beneficial for perioperative management. The aim of this study is to identify the factors associated with postoperative opioid use of >4 weeks in patients undergoing neuroma surgery.

Methods:  After retrospective identification, 77 patients who underwent surgery for symptomatic neuroma of the upper or lower extremity were enrolled.

Soft-tissue coverage for wound complications following total elbow arthroplasty.

Background: In patients with total elbow arthroplasty (TEA), the soft-tissue around the elbow can be vulnerable to soft-tissue complications. This study aims to assess the outcomes after soft-tissue reconstruction following TEA.

Methods: We retrospectively included nine adult patients who underwent soft-tissue reconstruction following TEA.

A Correlation between Upper Extremity Compressive Neuropathy and Nerve Compression Headache.

Background: Compressive neuropathies of the head/neck that trigger headaches and entrapment neuropathies of the extremities have traditionally been perceived as separate clinical entities. Given significant overlap in clinical presentation, treatment, and anatomical abnormality, the authors aimed to elucidate the relationship between nerve compression headaches and carpal tunnel syndrome, and other upper extremity compression neuropathies.

Methods: One hundred thirty-seven patients with nerve compression headaches who underwent surgical nerve deactivation were included.