Do Social Deprivation and Surgical Volume Influence Outcomes Following Distal Radius Fracture Fixation?

Background: Distal radius fractures account for nearly 25% of fractures in adults, with a trend toward operative fixation. The objective of this study was to assess the relationship between surgeon and hospital volume with complications following distal radius fixation.

Methods: A retrospective study was performed using the New York Statewide Planning and Research Cooperative System database from 2009 to 2015.

In Patients With Rotator Cuff Tears, Female, Hispanic, African American, Asian, Socially Deprived, Federally Insured, and Uninsured Patients Are Less Commonly Treated Surgically.

Purpose: The purpose of the current study was to evaluate socioeconomic factors affecting whether a patient undergoes rotator cuff repair after a diagnosis of a rotator cuff tear.

Methods: From 2009 through 2018, claims for adult (≥18 years of age) patients who were diagnosed with a primary rotator cuff injury were identified in the New York Statewide Planning and Research Cooperative System (SPARCS) database via International Classification of Diseases (ICD)-9th Revision-Clinical Modification (CM) and ICD-10-CM diagnostic codes. SPARCS is a comprehensive all-payer database collecting all inpatient and outpatient pre-adjudicated claims in New York.

Open Versus Percutaneous Fixation of Trigger Finger: Meta-Analysis of Clinical Outcomes.

Purpose: With variable and conflicting results to date, it remains unclear whether the percutaneous or open surgical A1 pulley release technique is superior regarding safety and efficacy. The goal of this meta-analysis was to compare the two techniques.

Methods: PubMed, Cochrane, and Google Scholar (pages 1-20) were searched through August 2023.

Testosterone Replacement Therapy and Associated Rates of Trigger Finger, de Quervain Tenosynovitis, and Their Subsequent Management.

Purpose: Anabolic steroid therapy has been associated with tendon injury, but there is a paucity of evidence associating physiologic testosterone replacement therapy (TRT) with tenosynovitis of the hand, specifically trigger finger and de Quervain tenosynovitis. The purpose of this study was to evaluate the relationship between TRT and tenosynovitis of the hand.

Methods: This was a one-to-one exact matched retrospective cohort study using a large nationwide claims database.

Prevalence of asymptomatic TFCC tears on MRI: A systematic review.

Background: Recent studies show a high prevalence of triangular fibrocartilage complex (TFCC) tears in asymptomatic wrists. While a TFCC tear may be identified when evaluating ulnar sided wrist pain, this could be incidental and not the true cause of pain. The purpose of this review was to (1) examine the frequency of which TFCC tears are diagnosed on MRI in asymptomatic versus symptomatic wrists and (2) determine whether rates of asymptomatic TFCC tears are higher in two important subgroups commonly at risk for this pathology: elderly patients and high-impact athletes.

The Primary Cost Drivers of Outpatient Distal Radius Fracture Fixation: A Cost-Minimalization Analysis of 15,379 Cases.

 Distal radius fractures are the most common fracture of the upper extremity. While some distal radius fractures can be managed with closed reduction and immobilization, operative treatment is the standard of care, with open reduction internal fixation (ORIF) as a predominant operative method.  To investigate how patient and surgical characteristics affect the overall costs of internal fixation of distal radius fractures in adults.

Extensor Carpi Ulnaris Instability: A Comprehensive Review of Pathology and Operative Techniques.

The extensor carpi ulnaris (ECU) is primarily responsible for extension and ulnar deviation at the wrist. Secondary to repetitive loading of, or acute trauma to the flexed, supinated and ulnarly deviated wrist, the ECU tendon can be a common source of ulnar-sided wrist pain. Common pathology includes ECU tendinopathy, tenosynovitis, tendon instability, and tendon rupture.

The Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Femoral Shaft Fractures.

Objectives: The aim of this study was to characterize the case volume dependence of both facilities and surgeons on morbidity and mortality after femoral shaft fracture (FSF) fixation.

Methods: Adults who had an open or closed FSF between 2011 and 2015 were identified in the New York Statewide Planning and Research Cooperative System database. Claims were identified by International Classification of Disease-9, Clinical Modification diagnostic codes for a closed or open FSF and International Classification of Disease-9, Clinical Modification procedure codes for FSF fixation.

Hospital Courses Differ Amongst Hip Fracture Patients With or Without Coronavirus-19 Positive Status Upon Admission.

Introduction: The purpose of this study was to compare the hospital course and disposition of COVID-19 positive versus negative patients following an operatively managed hip fracture.

Materials And Methods: This retrospective cohort study evaluated patients presenting to a university medical center with a hip fracture who underwent surgical management between February 1, 2020 and April 1, 2021. COVID-19 diagnosis was obtained using PCR testing.

Complications and Reoperation Following Surgery for Concurrent Carpal Tunnel and Cervical Spine Compression.

Background: Patients with carpal tunnel syndrome (CTS) may also have cervical radiculopathy (CR) or vice versa, potentially requiring carpal tunnel release (CTR) and anterior cervical discectomy and fusion (ACDF). This study evaluates whether there is an increased risk of complications following CTR or ACDF in patients with concurrent CTS and CR (CTS-CR) compared with those with only CTS or CR.

Methods: A multipayer database was used to identify patients with CTS-CR.

YouTube as a Source of Patient Information for Cubital Tunnel Syndrome: An Analysis of Video Reliability, Quality, and Content.

Background: This study seeks to examine the reliability, quality, and content of YouTube videos on cubital tunnel syndrome, on which there is presently a paucity of information.

Methods: The top 50 unique YouTube videos by relevance resulting from the Boolean search term "cubital tunnel + cubital tunnel syndrome" were identified, with video properties for analysis including source, upload date, duration, views, and comments. Content was assessed using the () criteria, the Global Quality Score (GQS), and a "Cubital Tunnel-Specific Score" (CTSS).

Return to Activity After Arthroscopically Assisted Triangular Fibrocartilage Complex Repair: A Systematic Review.

Objective: To evaluate patients' ability to return to preinjury activity level after arthroscopically assisted triangular fibrocartilage complex (TFCC) repair.

Data Sources: The PubMed electronic library was systematically searched from inception to August 2021 for any eligible articles using a combination of the phrases "TFCC," "return to sport," "return to work," and "athlete."

Results: Studies that evaluated patients who had undergone arthroscopic repair of isolated TFCC injury and reported objective or patient-reported outcome measures were included.

Excessive Derotational K-Wire Angulation Decreases Compression by Headless Compression Screw.

 Scaphoid fracture is the most common carpal bone fracture. Open reduction internal fixation of scaphoid fractures typically undergo stabilization by a single headless compression screw (HCS). During screw insertion, a derotational Kirschner wire (K-wire) is often placed for rotational control of the near and far fragment.

Visual Joint Angle Assessment: Does Accuracy Improve with a Higher Level of Orthopaedic Surgery Training?

Introduction: The purpose of this study was to evaluate the accuracy of visual joint angle assessments by orthopaedic surgery trainees amongst various levels of training.

Methods: Sagittal plane photographs of several joints at various angles were distributed to trainees within an orthopaedic residency program. Joint angles were estimated and compared to those obtained with a goniometer.

Trends and Reported Complications in Ankle Arthroplasty and Ankle Arthrodesis in the State of New York, 2009-2018.

Background: Ankle arthroplasty has emerged as a viable alternative to ankle arthrodesis due in large part to recent advancements in both surgical technique and implant design. This study seeks to document trends of arthroplasty and arthrodesis for ankle osteoarthritis in New York State from 2009-2018 in order to determine if patient demographics play a role in procedure selection and to ascertain the utilization of each procedure and rates of complications.

Methods: Patients 40 years and older from 2009-2018 were identified using and ( and ), () diagnosis and procedure codes for ankle osteoarthritis, ankle arthrodesis, and ankle arthroplasty in the New York statewide planning and research cooperative system database.

Social and Demographic Factors Impact Shoulder Stabilization Surgery in Anterior Glenohumeral Instability.

Purpose: To assess independent predictors of surgery after an emergency department visit for shoulder instability, including patient-related and socioeconomic factors.

Methods: Patients presenting to the emergency department were identified in the New York Statewide Planning and Research Cooperative System database from 2015 to 2018 by diagnosis codes for anterior shoulder dislocation or subluxation. All shoulder stabilization procedures in the outpatient setting were identified using Current Procedural Terminology codes (23455, 23460, 23462, 23466, and 29806).

The Effects of Social and Demographic Factors on High-Volume Hospital and Surgeon Care in Shoulder Arthroplasty.

Introduction: This study seeks to evaluate (1) the relationship between hospital and surgeon volumes of shoulder arthroplasty and complication rates and (2) patient demographics/socioeconomic factors that may affect access to high-volume shoulder arthroplasty care.

Methods: Adults older than 40 years who underwent shoulder arthroplasty between 2011 and 2015 were identified in the New York Statewide Planning and Research Cooperative System database using International Classification of Disease 9/10 and Current Procedural Terminology codes. Medical/surgical complications were compared across surgeon and facility volumes.

Social Disparities in Outpatient and Inpatient Management of Pediatric Supracondylar Humerus Fractures.

Socioeconomic status, race, and insurance status are known factors affecting adult orthopaedic surgery care, but little is known about the influence of socioeconomic factors on pediatric orthopaedic care. The purpose of this study was to determine if demographic and socioeconomic related factors were associated with surgical management of pediatric supracondylar humerus fractures (SCHFs) in the inpatient versus outpatient setting. Pediatric patients (<13 years) who underwent surgery for SCHFs were identified in the New York Statewide Planning and Research Cooperative System database from 2009−2017.

What's New in Pediatric Orthopaedic Health Care Disparities?

Background: Health care disparities are prevalent within pediatric orthopaedics in the United States. Social determinants of health, such as income, race, social deprivation, place of residence, and parental involvement, all play a role in unequal access to care and disparate outcomes. Although there has been some effort to promote health equity both within pediatric orthopaedics and the US health care system altogether, disparities persist.

Postoperative Pain Management Following Orthopedic Spine Procedures and Consequent Acute Opioid Poisoning: An Analysis of New York State From 2009 to 2018.

Objective: Considering the high rates of opioid usage following orthopedic surgeries, it is important to explore this in the setting of the current opioid epidemic. This study examined acute opioid poisonings in postoperative spine surgery patients in New York and the rates of poisonings among these patients in the context of New York's 2016 State legislation limiting opioid prescriptions.

Methods: Claims for adult patients who received specific orthopedic spine procedures in the outpatient setting were identified from 2009 to 2018 in the New York Statewide Planning and Research Cooperative System (SPARCS) database.

Social Disparities in the Management of Trigger Finger: An Analysis of 31 411 Cases.

Background: Cost and compliance are 2 factors that can significantly affect the outcomes of non-operative and operative treatment of trigger finger (TF) and both may be influenced by social factors. The purpose of this study was to investigate socioeconomic disparities in the surgical treatment for TF.

Methods: Adult patients (≥18 years old) were identified using International Classification of Diseases 9 and 10 Clinical Modification diagnostic codes for TF and Current Procedural Terminology (CPT) procedural codes (CPT: 26055) in the New York Statewide Planning and Research Cooperative System database.

Radiocarpal Fusion: Indications, Technique, and Modifications.

Degenerative disorders of the wrist may affect isolated joints and inhibit normal functions of the wrist secondary to pain and stiffness. These processes that affect only the radiocarpal joint may be secondary to posttraumatic osteoarthritis, primary osteoarthritis, or rheumatoid arthritis. Radiocarpal wrist arthrodesis may help preserve some of the native wrist kinematics while alleviating pain and improving the range of motion.