State of the art review. Complications after carpal tunnel release.

Carpal tunnel release (CTR) is the most performed surgery of the upper extremity. It is effective but not without complications. This state-of-the-art review covers most common intra- and postoperative complications after CTR.

From Data to Decisions: How Artificial Intelligence Is Revolutionizing Clinical Prediction Models in Plastic Surgery.

The impact of clinical prediction models within artificial intelligence (AI) and machine learning is significant. With its ability to analyze vast amounts of data and identify complex patterns, machine learning has the potential to improve and implement evidence-based plastic, reconstructive, and hand surgery. In addition, it is capable of predicting the diagnosis, prognosis, and outcomes of individual patients.

Reoperation After Operative Treatment of Open Finger Fractures.

Background: Our primary aim was to develop a prediction model for return to the operating room (OR) after open finger fractures by studying the reoperation rate of open finger fractures based on patient demographics, injury mechanism, injury severity, and type of initial surgical fixation. The secondary aim was to study the predictors for secondary surgery due to nonunion, postoperative infection, and secondary amputation.

Methods: In the retrospective chart review, 1321 open finger fractures of 907 patients were included.

A Threshold QuickDASH Score for Estimating a Diagnosis of Major Depression in Patients With Fingertip Injuries in the American and Dutch Population.

Background: The aim was to determine the threshold Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score that estimates a diagnosis of major depression in patients with fingertip injuries in American and Dutch patients.

Methods: In this observational cross-sectional study, 112 patients with a recent fingertip injury measured symptoms of depression with the Patient Health Questionnaire and upper extremity disability with the QuickDASH.

Results: In the US cohort, 8 of 56 patients had an estimated diagnosis of major depression.

Revision Carpal Tunnel Release: Risk Factors and Rate of Secondary Surgery.

Background: The first aim of this study was to determine the rate of revision carpal tunnel release in five urban hospitals over a period of 14 years. The secondary aim was to assess what demographic, condition-related, and treatment-related factors are associated with revision carpal tunnel release.

Methods: Between 2002 and 2015, 7464 patients underwent carpal tunnel release.

Obesity status is a risk factor for secondary surgery after neurolysis, direct nerve repair or nerve grafting in traumatic brachial plexus injury: a retrospective cohort study.

Background: The objective of the study was to investigate the association between obesity and the presence of secondary surgery following neurolysis, direct nerve repair, or nerve grafting in patients with traumatic brachial plexus injury.

Methods: In this retrospective chart review spanning two Level I medical centers in a single metropolitan area, 57 patients who underwent neurolysis, direct nerve repair, or nerve grafting for brachial plexus injuries between 2002 and 2015 were identified. Risk regression analysis was used to evaluate the association between obesity status and secondary surgery.

Postoperative Dorsal Proximal Interphalangeal Joint Subluxation in Volar Base Middle Phalanx Fractures.

 This study was designed to assess factors associated with postoperative dorsal proximal interphalangeal (PIP) joint subluxation after operative treatment of volar base middle phalanx fractures. Our second purpose was to study the association between postoperative dorsal subluxation with postoperative arthritis.  We identified 44 surgically treated volar base PIP joint fractures with available pre- and postoperative radiographs between 2002 and 2015 at two academic medical systems with a median follow-up of 3.

Dorsal Subluxation of the Proximal Interphalangeal Joint After Volar Base Fracture of the Middle Phalanx.

Treatment decisions regarding volar base fractures of the middle phalanx depend on whether the proximal interphalangeal (PIP) joint is reduced. Our aim was to study the agreement among hand surgeons in determining whether the PIP joint fractures are subluxated and to study the factors associated with subluxation of these fractures. In this retrospective chart review, 413 volar base fractures of the middle phalanx were included.

Reoperation After Operative Fixation of Proximal Interphalangeal Joint Fractures.

The purpose of this study was to determine the reoperation rate and what factors are associated with reoperation of proximal interphalangeal (PIP) joint fractures. We identified 161 surgically treated PIP joint fractures between 2004 and 2015 at 2 academic medical systems. Demographic, injury, radiographic, and treatment data that might be associated with reoperation were collected.

Pathologic Fractures in Benign Neoplasms of the Fingers.

To describe the rate and predictors of pathologic fractures in benign neoplasms of the finger, as variables from prediction models for pathologic fractures of the long bones of the extremities are not necessarily applicable to the bones of the hand. In this retrospective chart review, 69 histologically confirmed neoplasms affecting the bones of the fingers, 49 phalanges and 20 metacarpals, were identified in patients presenting at 2 urban hospitals over a 24-year period. Different variables were studied as possible predictors of pathologic fractures.

Intravenous Drug Use-Related Complications of the Hand and Upper Extremity.

Background: In the last decade, there has been an increase in intravenous drug use (IVDU) and associated medical problems. Users commonly inject into their upper extremities, which can result in infection and other sequelae in this area. The goal of this study was to compare demographics and treatment for upper extremity infections between intravenous drug users and non-intravenous drug users over the past 10 years at 1 level I emergency department (ED).

The Prevalence of Triangular Fibrocartilage Complex Signal Abnormalities on Magnetic Resonance Imaging Relative to Clinical Suspicion of Pathology.

Purpose: To determine the prevalence of triangular fibrocartilage complex (TFCC) signal changes in patients undergoing magnetic resonance imaging (MRI) of the wrist and its relationship to a clinical suspicion of TFCC pathology. The secondary purpose was to study factors that are associated with TFCC signal changes.

Methods: In this retrospective study, we looked for any TFCC signal changes in the reports of MRI findings performed during a 3-year period in 1,134 patients.

Mallet Fractures of the Thumb Compared With Mallet Fractures of the Fingers.

Background: The purpose of this study was to look for differences in mechanism, radiographic findings, and treatment between mallet fractures of the thumb and mallet fractures of the index through small fingers.

Methods: This retrospective study included 24 mallet fractures of the thumb and 392 mallet fractures of other digits. We compared demographics, injury factors (side, dominant hand, time between injury and first visit, and injury mechanism), subluxation, fragment size, treatment, and time from injury to final evaluation between the 2 groups.

Recognizing the elbow prosthesis on conventional radiographs.

The objective of this study was to make an overview that can be useful in determining which type and brand of prosthesis a patient has when visiting the emergency department or outpatient clinic with a periprosthetic fracture, dislocation, or implant failure. The commonly used prostheses in Europe are opted for this list. The radiographs used for this list are obtained either from the company or from our own patients.

Prevalence of and Factors Associated With Major Depression in Patients With Upper Extremity Conditions.

Purpose: To determine the prevalence of an estimated diagnosis of major depression in patients with upper extremity conditions and factors that help identify patients who might benefit from psychological treatment.

Methods: In this observational cross-sectional study, 190 patients completed questionnaires measuring symptoms of depression with the Patient Health Questionnaire, upper extremity disability with the Patient-Reported Outcomes Measurement Information System Upper Extremity, pain interference with the Patient-Reported Outcomes Measurement Information System Pain Interference, and health anxiety with the Short Health Anxiety Inventory.

Results: The estimated prevalence of an estimated diagnosis of major depression (Patient Health Questionnaire 9 ≥ 10) among this group of patients was 12%.

Negative Ulnar Variance and Kienböck Disease.

Purpose: To test the primary null hypothesis that there is no difference in mean ulnar variance (UV) scaled to the length of the capitates between 166 wrists with Kienböck disease and an equal number of matched controls and to test the secondary null hypothesis that mean scaled UV does not vary based on age, sex, or race in both Kienböck and control wrists.

Methods: Ulnar variance was measured on posteroanterior radiographs of the wrist as the distance between a line through the midpoint between the volar and the dorsal edges of the ulnar margin of the radius and a line tangential to the most distal aspect of the carpal surface of the head of the ulna, both perpendicular to the longitudinal axis of the radius. Measurement of UV was scaled to the length of the capitate, resulting in a UV to capitate height (UV:CH) ratio.

The Relationship Between Catastrophic Thinking and Hand Diagram Areas.

Purpose: To evaluate the relationship between the total area marked on pain and numbness diagrams and psychosocial factors (depression, pain catastrophic thinking, and health anxiety).

Methods: A total of 155 patients marked painful and numb areas on separate hand diagrams. Patients also completed demographic, condition-related, and psychosocial (Pain Catastrophizing Scale, Patient-Reported Outcomes Measurement Information System Depression Computer Adaptive Test, and Short Health Anxiety Inventory) questionnaires.