Hand and Wrist Dog-Leash Injuries in the Outpatient Setting: A Review of 443 Cases.

Background: Injuries sustained from dog leashes often result in visits to hand surgeons. This study presents an analysis of dog-leash-related upper-extremity injuries at a single orthopedic practice, including treatment options for these injuries, and guidance for prevention.

Methods: We identified all outpatients who presented to a hand surgeon at a single institution from 2016 to 2021 following an upper-extremity injury related to a dog leash.

The Five-Year Growth of an Orthopedic Urgent Care Center: Identifying Patient and Center Trends.

Introduction: With emergency department utilization rising at a dramatic rate, orthopedic urgent care centers (oUCCs) have become increasingly popular. The financial viability and basic advantages of oUCCs have been described in the literature, but little is known about the characteristics of patients treated and the diagnoses encountered. The purpose of this study is to report and evaluate the patients and diagnoses that are most commonly seen in an oUCC so that future care may be better tailored to the needs of the patients seeking these services.

Does Surgery Improve Healing After Isolated Diaphyseal Ulna Fractures?

Purpose: Isolated diaphyseal ulna fractures can be treated nonsurgically or with open reduction and internal fixation (ORIF). It is unclear whether ORIF provides quicker and/or more predictable healing. The purpose of this study was to compare the healing characteristics of isolated diaphyseal ulna fractures after surgical and nonsurgical treatment.

Incidence of Operating Room Fires During Hand Surgical Procedures.

Background: The purpose of the present study is to report the incidence of operating room fires during hand surgical procedures.

Methods: The clinic and OR electronic medical records of seven fellowship-trained orthopedic hand surgeons at a single, large practice were retrospectively reviewed. All upper extremity procedures performed between June 2014 to June 2019 in both hospital and surgery center settings were included in the review.

Wound Dehiscence Following Cubital Tunnel Surgery.

Purpose: Cubital tunnel syndrome is the second most common upper-extremity compressive neuropathy, and persistent symptoms can necessitate operative treatment. Surgical options include simple decompression and ulnar nerve transposition. The cause of wound dehiscence after surgery is not well known, and the factors leading to the development of these complications have not been previously described.

Three Dimensionally Printed Versus Conventional Casts in Pediatric Wrist Fractures.

Background and objective With significant advancement in the field of biomaterials, alternatives to conventional fiberglass casts such as customized three-dimensional (3D) orthotics have been developed. However, there is a scarcity of reported experience regarding 3D-printed orthoses. The purpose of this study was to compare radiographic outcomes and patient satisfaction with fractures treated with either conventional or 3D-printed casts.

Time to Improvement After Corticosteroid Injection for Trigger Finger.

Purpose Trigger finger is a commonly occurring hand condition that presents with symptoms of pain, clicking, locking, and catching of the finger. A common non-operative management option is corticosteroid injection. The purpose of this study was to evaluate the short-term patient response to corticosteroid injections for trigger finger.

Deep Infection after Distal Radius Open-reduction Internal Fixation: A Case Series.

Background: Given its low incidence, the management of deep infection following distal radius open-reduction internal fixation (ORIF) has not been well reported. In an effort to expand our current understanding, the purpose of this case series is to present the treatment strategies and functional outcomes associated with deep infection after distal radius ORIF.

Methods: All patients with deep infections after distal radius ORIF over a ten-year period were identified and their treatment courses asessed.

Unplanned Office Visits Following Outpatient Hand Surgery.

Background: Returning to the office for an unplanned visit postoperatively can be burdensome to both the patient and provider. The purpose of this study was to quantify the rate of unplanned office visits after common soft tissue hand surgeries and assess the reasons for these unplanned visits.

Methods: Patients who underwent common soft tissue hand surgeries over a 6-month time period were queried from an electronic medical record database.

Nonsurgical Providers Provide the Majority of Postoperative Opioid Prescriptions After Hand Surgery.

Introduction The increased use of Prescription Drug Monitoring Program (PDMP) websites has helped physicians to limit overlapping controlled substance prescriptions and help prevent opioid abuse. Many studies have investigated risk factors for prolonged opioid use after orthopedic surgery, but few studies have investigated who is prescribing opioids to postoperative patients. The purpose of this study is to investigate the types of medical providers prescribing opioids to hand surgery patients postoperatively.

Post-operative Opioid, Benzodiazepine and Sedative Usage in Medicare versus Commercial Insurance Hand Surgery Patients.

Background: Opioid usage has increased in recent years. The purpose of this study is to assess post-operative opioid, sedative, and benzodiazepine usage in a Medicare population.

Methods: Consecutive patients undergoing elbow, wrist, and hand surgery by hand surgeons at one academic outpatient surgical center were prospectively enrolled.

Surgical Outcomes Following Fixation of Peri-Implant Distal Radius Fractures: A Case Series.

Purpose: The purpose of this study was to evaluate surgical outcomes following fixation of peri-implant distal radius fractures.

Methods: A retrospective chart review was conducted of peri-implant distal radius fractures treated surgically at a large academic practice over 18 years. Patients were included if they had previously undergone open reduction and internal fixation of a distal radius fracture; subsequently sustained a fracture at, or adjacent to, the existing hardware; and then undergone revision fixation with the removal of hardware.

Unplanned Return to the Operating Room in Upper-Extremity Surgery: Incidence and Reason for Return.

Purpose: Complications after upper-extremity surgery are generally infrequent. The purpose of this study was to assess the rate of early unplanned return to the operating room (URTO) within 3 months after surgery) in upper-extremity surgical procedures. Our hypotheses were that the rate of URTO in upper-extremity surgery would be low and that surgically treated fractures would be at greatest risk for complications.

A Rare Presentation of Extensor Pollicis Longus Tendon Rupture After Nondisplaced Scaphoid Fracture.

Extensor pollicis longus tendon rupture is a reported complication after nondisplaced distal radius fractures. These are thought to occur secondary to mechanical irritation or compromised blood supply. We present a case of extensor pollicis longus rupture after a healed nondisplaced scaphoid fracture, which may have involved a similar attritional process.

Reliability of Radiographs and Computed Tomography in Diagnosing Scaphoid Union After Internal Fixation.

Purpose: To evaluate the reliability of radiographs (XR) alone versus the combination of XR and computed tomography (CT) in determining scaphoid union following open reduction internal fixation (ORIF) with a headless compression screw.

Methods: We used our imaging database to identify 32 XR and corresponding CTs over a 6-year period (from 2012 to 2018) that were performed to evaluate scaphoid healing following ORIF. Three hand surgeons evaluated the studies to assess (1) healing, (2) if partially healed, the percentage of healing, and (3) the certainty of healing.

Outcomes After Surgically Managed Oblique Extra-Articular Proximal Phalanx Fractures: A Comparison of Closed-Reduction Percutaneous Pinning and Open-Reduction Internal Fixation With Lag Screws.

Background: Long oblique extra-articular proximal phalanx fractures are common orthopedic injuries. When unstable and without substantial comminution, treatment options include closed-reduction percutaneous pinning (CRPP) and open-reduction internal fixation using lag screws (ORIF-screws). The aims of this study are primarily to compare the functional outcomes and complication rates between these techniques and secondarily to assess potential factors affecting outcomes after surgery.

The Clinical Impact of Ambient Operating Room Temperature and Other Perioperative Factors on Patient Comfort during Wide-awake Hand Surgery Using Local Anesthesia.

Background: The prevalence of wide-awake hand surgery using local anesthesia has increased substantially. The full influence of perioperative factors, namely operating room temperature, on patient comfort during these procedures is presently underreported.

Methods: One hundred and fifty-eight patients undergoing wide-awake hand surgery using local anesthesia were prospectively enrolled.

Are Plain X-Rays Necessary in the Diagnosis of De Quervain's Tenosynovitis?

 The routine use of plain radiography represents a significant expenditure and has been proven unnecessary in several orthopedic conditions. The utility of plain radiographs in the diagnosis of De Quervain's tenosynovitis (DeQ) is not clear.  This study evaluates whether plain radiographic findings routinely predict the need for surgery or alter treatment courses in the initial diagnosis of DeQ.

Metacarpal Bony Dimensions Related to Headless Compression Screw Sizes.

 The purpose of this study is to determine the radiographic dimensions of the finger metacarpals and to compare these measurements with headless compression screws commonly used for fracture fixation.  We analyzed computed tomography (CT) scans of the index, long, ring, and small metacarpal bones and measured the metacarpal length, distance from the isthmus to the metacarpal head, and intramedullary diameter of the isthmus. Metacarpals with previous fractures or hardware were excluded.

Outcomes of Type I Open Distal Radius Fractures: A Comparison of Delayed and Urgent Open Reduction Internal Fixation.

Background: Type I open distal radius fractures treated with open reduction internal fixation (ORIF) have demonstrated minimal risk of infection. For this reason, they may not require urgent surgical treatment. The purpose of this study was to evaluate the outcomes of patients with type I open distal radius fractures treated with delayed ORIF compared with urgent ORIF.

Comparison of the Costs of Reusable Versus Disposable Equipment for Endoscopic Carpal Tunnel Release Procedures Using Activity-Based Costing Analysis.

Purpose: Guidelines for sterilization of reusable equipment (eg, arthroscopes, surgical equipment) have recently been established. These guidelines are supported by the U.S.

Variability in Medicaid Reimbursement in Hand Surgery May Lead to Inequality in Access to Patient Care.

Background: Medicare (MCR) and Medicaid (MCD) remain the dominant providers of government-funded health insurance in the United States. The purpose of this study was to evaluate the variability between MCR and MCD reimbursements for common hand and wrist surgical procedures. We hypothesized that MCD reimbursement rates would have substantial variation between states, whereas MCR rates would remain relatively constant.

Evaluation of the Incidence and Etiology of Unplanned Return to Operating Room Following Open Reduction Internal Fixation of Distal Radius Fractures.

Background: Distal radius fractures (DRF) are the most common upper extremity fractures in adults. The purpose of this study was to determine the incidence, causes, and independent predictors for unplanned return to the operating room (URTO) in a single institution within 90 days following distal radius open reduction internal fixation (ORIF).

Methods: A retrospective study of 2933 consecutive patients from January 2015 to December 2019 who underwent distal radius ORIF was undertaken.