Risks of Reoperation in Surgically Treated Fractures of the Proximal Phalanx.

Purpose: The objective of this study was to determine the risk factors and the rate of reoperation after closed reduction percutaneous pinning (CRPP) of isolated closed single-digit proximal phalanx fractures.

Methods: A retrospective cohort study was conducted for patients who underwent CRPP of non-thumb closed proximal phalanx fractures between 2010 and 2020 at two level-I trauma centers and two community teaching hospitals. Demographics, fracture, and treatment characteristics were collected.

A Near-Miss in Clinical Outcomes Research Data Collection.

We present the case of a near-miss in clinical research to illustrate a situation in which errors in data collection would have led to different results in the data analysis, with the potential for drawing incorrect conclusions. Conclusions based on data errors may adversely influence future medical decision-making in patient care. In the interest of presenting this as an educational, nonpunitive, quality-improvement report, the study and the involved researchers remain anonymous, and the specific details and exact number of patients are not reported.

Patient-Perceived Outcomes of Recovery After Trigger Digit Release.

Purpose: Trigger finger release (TFR) is one of the most commonly performed hand surgeries; nevertheless, the time until patients subjectively feel recovered has not been well documented. The limited literature on patient perceptions of recovery after any type of surgery has described that patients and surgeons may have differing views on the time until full recovery. Our primary study question was to determine how long it takes for patients to subjectively feel fully recovered after TFR.

Perioperative Complications Associated With Limited Surgical Fasciectomy After Collagenase Clostridium Histolyticum for Dupuytren Contracture.

Background: The purpose of this study was to determine the perioperative complication rate of surgical fasciectomy following previous treatment with collagenase clostridium histolyticum (CCH) treatment in patients with Dupuytren disease.

Methods: A retrospective review of all patients at a large health system undergoing CCH treatment and subsequent limited surgical fasciectomy for recurrence on the same digit between 2010 and 2020 was performed. Fifty-two patients with 62 affected digits met inclusion criteria, and cases were reviewed for preoperative demographics, treatment characteristics, clinical outcomes, and perioperative complications.

Factors Influencing Patient Preference for Anesthesia in Ambulatory Hand Surgery.

Background: The purpose of this study was to identify factors that influence preoperative patient preferences toward anesthesia in patients in a hand and upper extremity clinic.

Methods: A survey was administered to consecutive patients in a hand and upper extremity orthopedic clinic at an urban tertiary academic institution. The survey addressed presenting clinical complaint, anesthesia preference for minor soft tissue hand and wrist procedures, factors influencing anesthesia preference, and patient history of anesthesia and surgical treatment.

Implicit and Explicit Factors That Influence Surgeons' Decision-Making for Distal Radius Fractures in Older Patients.

Purpose: The purpose of this study was to evaluate factors that influence surgeons' decision-making in the treatment of distal radius fractures in older patients.

Methods: Fourteen clinical vignettes of a 72-year-old patient with a distal radius fracture were sent to 185 orthopedic hand and/or trauma surgeons. The surgeons were surveyed regarding the demographic/practice details, treatment decision (surgical or nonsurgical), and factors that influenced management, including the Charlson Comorbidity Index, functional status, radiographic appearance, and handedness.

Patient Preferences for Limited Fasciectomy Versus Collagenase Treatment for Dupuytren Contracture.

The primary objective of this study was to assess patient preferences for collagenase (CCH) treatment versus limited surgical fasciectomy in a cohort that has undergone both treatments for Dupuytren contracture. We retrospectively identified 68 patients who have undergone both limited surgical fasciectomy and CCH treatment for digital flexion contractures from Dupuytren disease. Patients were contacted by telephone and asked whether they preferred surgery or CCH treatment for their Dupuytren contracture.

The Impact of Coronavirus Disease 2019 Restrictions on an Academic Hand Surgery Practice.

Purpose: The impact of the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) has been felt worldwide. We examined the quantitative impact during the first 4 weeks of hospital system and state-mandated restrictions on an academic, urban hand surgery practice. We hypothesized that the volume of clinic encounters, office procedures, and surgical cases would decrease and that the volume of nonelective care would remain unchanged.

Acute Radial Head Resection for Fracture: are We Likely to Miss an Essex-Lopresti Injury?

Background: Given the current available evidence, surgical treatment of radial head fracture with acute resection is controversial. The aim of this study was to determine whether acute resection of the radial head for a radial head fracture leads to longitudinal forearm instability due to a missed Essex-Lopresti injury.

Material And Methods: A retrospective review was conducted of radial head resections performed for acute radial head fractures at two Level I trauma centers from 2000 to 2018.

The Impact of the Soong Index on Hardware Removal and Overall Reoperation Rates After Volar Locking Plate Fixation of Distal Radius Fractures.

Purpose: This study sought to determine the impact of volar plate prominence on reoperation rates after open reduction and internal fixation of distal radius fractures with volar locking plates and to identify other factors associated with removal of hardware (ROH) or a reoperation.

Methods: A retrospective study of patients who underwent distal radius open reduction and internal fixation between 2012 and 2016 at 2 level I trauma centers was conducted. Plate prominence was evaluated using the Soong index at the first postoperative visit.

Patient Perception and Preferences for Virtual Telemedicine Visits for Hand and Upper Extremity Surgery.

Telemedicine in upper extremity surgery is an evolving modality that provides a viable alternative to the traditional in-person visit for achieving convenient, safe, and cost-effective health care. Our study aimed to identify patient preferences for virtual visits for hand and upper extremity surgery. An institutional review board approved survey was prospectively administered to all patients >18 years of age, presenting for any complaint to an orthopedic hand and upper extremity clinic at a Level I academic trauma center from September to December 2019.

Pronator Quadratus Repair Does Not Affect Reoperation Rates Following Volar Locking Plate Fixation of Distal Radius Fractures.

Background: The purpose of this study was to evaluate the impact of pronator quadratus (PQ) repair on reoperation rates after distal radius open reduction internal fixation (ORIF) using a volar locking plate.

Methods: A retrospective study of all patients undergoing distal radius ORIF with a volar locking plate between January 2012 and December 2016 at 2 urban, academic level I trauma centers was performed. Patient demographics, fracture and procedure characteristics, surgeon subspecialty, PQ repair, and reoperations were recorded.

Long-Term Outcomes and Mortality Following Carpal Tunnel Release in Patients Older Than 80 Years of Age.

Objective: The objectives of this study were 1) to assess the long-term patient-reported outcomes of carpal tunnel release (CTR) in patients 80 years of age or older, and 2) to determine the long-term mortality rate of this population after CTR.

Methods: We performed a retrospective study of 96 patients who underwent CTR at 80 years of age or older from July 2008 to June 2013. Mortality was assessed by medical records, the Social Security Death Index, and telephone contact.

Correlation of Hounsfield Unit Measurements on Computed Tomography of the Shoulder With Dual-Energy X-ray Absorptiometry Scans and Fracture Risk Assessment Tool Scores: A Potential for Opportunistic Screening.

Background: The diagnosis of bone mineral density (BMD) abnormalities involves dual-energy x-ray absorptiometry (DXA), but few patients complete this after a fragility fracture. The assessment of BMD using Hounsfield unit (HU) measurements from computed tomography (CT) scans has been correlated with DXA results in previous studies. We aimed to evaluate the correlation between shoulder CT HU and DXA scores.

Collagenase Treatment of Dupuytren's Disease with Minimum 5-Year Follow-Up: Recurrence, Reintervention, and Satisfaction.

Background: The objective of this study was to determine the rates of patient satisfaction, perceived recurrence of flexion deformity, and additional treatment after collagenase clostridium histolyticum treatment for Dupuytren's contracture at a minimum of 5-year follow-up.

Methods: A retrospective study was performed of 199 digits in 142 patients who underwent collagenase clostridium histolyticum treatments from April of 2010 to December of 2013 with a minimum of 5-year follow-up. Patients were contacted by telephone regarding perceived recurrence, additional treatment, satisfaction, and willingness to undergo this treatment again.

Predictors of Insurance Claim Rejection in Hand and Upper Extremity Surgery.

Introduction: Insurance claim rejections represent a challenge for healthcare providers because of the potential for lost revenue and administrative costs of reworking claims.

Methods: The billing records of five hand and upper extremity surgeons at a tertiary academic center were queried for all patient billing activity over a 1-year period yielding a total of 14,421 unique patient encounters.

Results: A total of 11,839 unique patient encounters were included, and the overall claim rejection rate was 19.

The Early Effect of COVID-19 Restrictions on an Academic Orthopedic Surgery Department.

The SARS-CoV-2 (COVID-19) pandemic has had a global influence on health care. The authors examined the early effect of hospital- and state-mandated restrictions on an orthopedic surgery department and hypothesized that the volume of ambulatory clinic encounters, office and surgical procedures, and cases would dramatically decrease. A retrospective review was performed of all encounters in an orthopedic surgery department at a level I academic trauma center during a 4-week period, from March 16, 2020, to April 12, 2020.

Sex-Based Differences in Optimal Tunnel Placement for Acromioclavicular Joint Reconstruction.

Background: Tunnel placement is important for outcomes after acromioclavicular (AC) joint reconstruction, yet little has been written on sex-based differences in optimal tunnel positioning.

Hypothesis: No sex-based or anatomic differences will be found in ideal tunnel position based on radiographic measurements.

Study Design: Cross-sectional study; Level of evidence, 3.

Patient Satisfaction and Opioid Use With a Postoperative Opioid Protocol After Common Hand Procedures.

Purpose: Given the state of the opioid crisis and national pressure to minimize prescriptions, pain management after common hand procedures can pose a challenge for patients and providers. Despite the volume of recent literature on prescribing protocols and over-the-counter (OTC) medications, patient satisfaction has not been adequately assessed. The purposes of this study were (1) to investigate patient satisfaction with pain management using an opioid prescribing protocol after common hand procedures, and (2) to evaluate medication use in the postoperative period using this opioid prescribing protocol.

Risk Factors for Hardware-Related Complications After Olecranon Fracture Fixation.

The aim of this study was to evaluate risk factors for symptomatic hardware and removal of hardware (ROH) after olecranon open reduction and internal fixation (ORIF) and to assess differences between olecranon locking plate and screws (P&S) or tension band (TB) wire cohorts. The medical records of 331 patients with olecranon fractures treated at two academic level I trauma centers with ORIF from 2012 to 2016 were reviewed. A total of 189 patients were included in the study.

Functional Outcomes After Sauve-Kapandji Arthrodesis.

Purpose: The Sauve-Kapandji procedure (SK) combines a distal radioulnar joint (DRUJ) arthrodesis with the creation of an ulnar pseudarthrosis for the salvage of DRUJ instability or arthritis. Despite several published case series, there are limited data on postoperative functional outcomes. This study evaluates patient-reported outcomes of SK using a validated functional outcomes scale.

Long-term Effects of Skin Tearing on Outcomes After Collagenase Treatment of Dupuytren Contractures.

The objective of this study was to compare the rates of recurrence, additional treatment, patient satisfaction, and willingness to undergo (CCH) treatment again for Dupuytren disease in patients with and without skin tearing at minimum 5-year follow-up. We identified 199 digits in 142 patients who underwent CCH treatments for Dupuytren disease from April 2010 to December 2013 with minimum 5-year follow-up. Patients were contacted by telephone to collect our response variables: perceived recurrence of contracture, additional treatment, satisfaction, and willingness to undergo CCH treatment again.

Evaluating the Online Presence of Orthopaedic Surgeons.

Purpose: The objective of this study was to evaluate and characterize the professional and educational information provided online by US orthopaedic surgeons.

Methods: The American Academy of Orthopaedic Surgeons (AAOS) membership directory was used to randomly select 1% of physicians from each state. Name, sex, state, and date of membership were recorded from the AAOS online public membership directory.