Improving Perioperative Preparation for Patients Undergoing Surgical Treatment for Distal Radius Fractures.

Unlabelled: We aimed to review common patient concerns after surgical repair of distal radius fracture (DRF) to identify potential interventions to improve the gap between expectation and education for DRF patients.

Methods: We conducted a retrospective cohort study of 100 consecutive patients who underwent surgical repair of DRF at a level I trauma center. Patient-initiated communication notes were reviewed with thematic analysis to identify the common reasons patients required additional information.

General surgery residency and action toward surgical equity: A scoping review of program websites.

Background: Surgical residents are increasingly concerned about inequities in patient access and outcomes. This study reviews general surgery residency programs websites for educational and community-focused efforts to recognize and intervene on the root causes of structural inequities.

Methods: We reviewed the websites of the 332 ACGME-accredited general surgery residency programs for mission statement, curriculum and research details in addition to diversity, equity and inclusion statements.

Patterns of Upper Extremity Reconstruction for Patients With Tetraplegia Across the United States: A Retrospective Study.

Purpose: The rates of upper extremity reconstruction for patients with tetraplegia remain low. We performed a retrospective study to assess recent reconstruction rates and delineate factors associated with the occurrence of reconstruction.

Methods: We examined the National Inpatient Sample database (2012-2017) for the rate of reconstruction for patients with tetraplegia.

Factors Associated With State-Specific Medicaid Expansion and Receipt of Autologous Breast Reconstruction Among Patients Undergoing Mastectomy.

Importance: Despite demonstrated psychosocial benefits, autologous breast reconstruction remains underutilized. An analysis of the association between Medicaid expansion and autologous breast reconstruction has yet to be performed.

Objective: To compare autologous breast reconstruction rates and determine the association between Medicaid expansion and breast reconstruction.

An Assessment Tool for Hand Surgical Education Needs and Capacity in Resource-Limited Settings.

Background: Hand surgeons have the potential to substantially decrease the surgical disability burden in the developing world through educator trips. The Lancet Commission supports contextually driven educator trips grounded in the needs of local hosts, yet few organizations perform a comprehensive assessment of learning interests or the hosting institutions' surgical capacity before the trips.

Methods: The authors adapted the Personnel, Infrastructure, Procedures, Equipment, and Supplies questionnaire, which was modified from the World Health Organization's validated Tool for Situational Analysis to Assess Emergency and Essential Surgical Care.

Single Center Retrospective Analysis of Cost and Payments for Lymphatic Surgery.

Background: Insurance coverage for microsurgical lymphatic surgery continues to be sporadic, as the procedures continue to be labeled investigational. The objective of this study was to examine the typical payment patterns of our clinical practice for microsurgical lymphatic procedures.

Methods: We performed a single center, single surgeon retrospective case review for all lymphovenous bypass and vascularized lymph node transfer cases preformed from 2018 to 2020.

Cost-Benefit Analysis of Ultrasonography in the Hand Clinic.

Background: Despite previous studies demonstrating the benefit of office-based ultrasonography for musculoskeletal evaluation, many hand surgery clinics have yet to adopt this practice. The authors conducted a cost-benefit analysis of establishing an ultrasound machine in a hand clinic.

Methods: The authors used the Medicare Physician Fee Schedule, Physician/Supplier Procedure Summary, and Physician Compare National Downloadable File databases to estimate provider reimbursement and annual frequency of office-based upper extremity-related ultrasound procedures.

Bayesian Statistics to Estimate Diagnostic Probability of Scaphoid Fractures from Clinical Examinations: A Meta-Analysis.

Background: Management of suspected scaphoid fractures includes repeated evaluation and casting in symptomatic patients with nondiagnostic radiographs. In this systematic review and meta-analysis, the authors compare the diagnostic accuracy of clinical examinations for scaphoid fractures and create a decision guide using Bayesian statistics.

Methods: The MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature databases were queried for studies that evaluated clinical index tests and their diagnostic accuracies for scaphoid fracture.

Education during Surgical Outreach Trips in Vietnam: A Qualitative Study of Surgeon Learners.

Unlabelled: Visiting educator trips teach surgical care in low-resource settings to develop sustainable global surgery. Surgery has been integral in these volunteer activities, but it is unknown whether surgeon learners receive suitable education during these trips. We sought to describe the educational experiences of surgeon learners during a visiting educator trip to better understand the perceptions of surgical outreach education.

Cervical Spine and Craniocervical Junction Reconstruction with a Vascularized Fibula Free Flap.

Background: Long-term stabilization of the cervical spine after extensive multilevel tumor resection is difficult to achieve. The current standard approach of instrumentation combined with allograft or nonvascularized autograft is limited in settings of increased risk of nonunion or delayed union (i.e.

Developing Strategies for Targeted Improvement of Perioperative Education for Postbariatric Surgery Body-Contouring Patients.

Background: The quality of perioperative patient education impacts surgical outcomes, patient experiences, and resources needed to address patient concerns and unplanned visits. We examined patient inquiries and education materials to assess the quality of perioperative education and identify areas of targeted improvement for postbariatric surgery body-contouring procedures.

Methods: We examined 100 consecutive postbariatric procedures at an academic center.

Using Evidence for Hand Surgery: How to Practice Evidence-Based Hand Surgery Care.

Each step of the evidence-based practice process is critical and requires clear understanding for accurate application. To practice evidence-based care, providers must acquire a specific skillset that facilitates translation of a patient problem into an answerable research question. Additional requirements are understanding of electronic databases, critical appraisal of the available evidence, and integration of the findings to generate a specific, individualized treatment plan.

Concepts of Organizational Excellence in Medical Associations.

Professional associations are integral to the field of medicine; every physician becomes affiliated with at least 1 association throughout his/her entire career. Obtaining membership in such groups advances career development, engages in mentorship, and contributes in legislation and advocacy. Numerous studies have reported the benefits of teamwork in health care, but few have thoroughly investigated the characteristics that lead to organizational success.

Psoas Compartment Block vs Periarticular Local Anesthetic Infiltration for Pain Management After Anterior Total Hip Arthroplasty: A Prospective, Randomized Study.

Background: The psoas compartment block (PCB) or periarticular soft-tissue local anesthetic injection are forms of regional anesthesia often used as one of the components in multimodal anesthesia applied during total hip arthroplasty (THA). The most efficacious form of regional anesthesia for THA has yet to be determined.

Methods: In a single-surgeon, prospective, clinical trial, patients undergoing THA via direct anterior approach were randomized to receive an intraoperative periarticular local anesthetic infiltration (periarticular injection) or a PCB.

A Forward Genetic Screen Targeting the Endothelium Reveals a Regulatory Role for the Lipid Kinase Pi4ka in Myelo- and Erythropoiesis.

Given its role as the source of definitive hematopoietic cells, we sought to determine whether mutations initiated in the hemogenic endothelium would yield hematopoietic abnormalities or malignancies. Here, we find that endothelium-specific transposon mutagenesis in mice promotes hematopoietic pathologies that are both myeloid and lymphoid in nature. Frequently mutated genes included previously recognized cancer drivers and additional candidates, such as Pi4ka, a lipid kinase whose mutation was found to promote myeloid and erythroid dysfunction.