Septic Extensor Tenosynovitis of the Wrist.

(MAI) infections of the hand, wrist, and upper extremity are rare, but potentially devastating atypical mycobacterial infections that can affect tendon, bone, and other soft tissues of the musculoskeletal system. We present an immunocompromised patient presenting with acute swelling and pain in the dorsum of the hand and wrist that underwent a wrist extensor tenosynovectomy with intraoperative cultures revealing infection with MAI. The patient developed severe progression of the infection with osteomyelitis of the distal forearm and carpal bones, multiple subsequent extensor tendon ruptures, and dorsal skin necrosis.

Radially Based Extensor Retinacular Sling Reconstruction for Extensor Carpi Ulnaris Subsheath Injuries.

Purpose: Extensor carpi ulnaris (ECU) subsheath injuries result in ulnar-sided wrist pain and often present concurrently with intrinsic ECU pathology and ulnocarpal compartment injuries. There is a lack of surgical outcome data despite the variety of described ECU subsheath pathologies and reconstructive strategies.

Methods: We retrospectively reviewed our hand-center experience of 33 patients who prospectively underwent radially based extensor retinacular sling ECU subsheath reconstruction by 4 hand surgery-fellowship-trained surgeons between April 2010 and April 2021.

Radially Based Extensor Retinacular Sling Reconstruction for Extensor Carpi Ulnaris Subsheath Injuries in Elite Athletes.

Background: Extensor carpi ulnaris (ECU) subsheath injuries are an increasingly recognized cause of ulnar-sided wrist pain in elite athletes. There is a lack of surgical outcome data in elite athletes, and unique considerations exist for these patients.

Methods: We performed a retrospective review of our hand center experience of 14 elite professional or collegiate athletes who prospectively underwent radially based extensor retinacular sling ECU subsheath reconstruction by 3 hand surgery-fellowship-trained surgeons between April 2011 and April 2021.

Risk Factors for Skin Tears Following Collagenase Clostridium histolyticum to Treat Dupuytren Contractures.

Purpose: Skin tears are an unpleasant complication that may occur after collagenase Clostridium histolyticum (CCH) administration to treat Dupuytren contractures of the fingers. The purpose of this study was to determine risk factors for the development of this complication.

Methods: Over a 6-year period, patients with a measurable metacarpophalangeal or proximal interphalangeal joint Dupuytren contracture and a palpable cord treated with CCH were prospectively observed.

Ulnar Nerve Complications After Ulnar Collateral Ligament Reconstruction of the Elbow: A Systematic Review.

Background: While ulnar collateral ligament reconstruction (UCLR) of the elbow is an increasingly commonly performed procedure with excellent results reported in the published literature, less attention has been paid to specifically on the characterization of postoperative ulnar nerve complications, and it is unclear what operative strategies may influence the likelihood of these complications.

Purpose: The purpose of this study is to examine the prevalence and type of ulnar nerve complications after UCLR of the elbow based on the entirety of previously published outcomes in the English literature. In addition, this study examined how the rate of ulnar nerve complications varied as a function of surgical exposures, graft fixation techniques, and ulnar nerve management strategies.

Pyrolytic Carbon Arthroplasty versus Suspensionplasty for Trapezial-Metacarpal Arthritis.

 This study aims to compare outcomes after pyrolytic carbon implant hemiarthroplasty (PH) versus Thompson suspensionplasty (TS) for trapezial-metacarpal (TM) arthritis.  There were 87 arthritic TM joints in 71 patients treated with PH ( = 47 joints, 37 patients) or TS ( = 40 joints, 34 patients). Patients had significantly longer follow-up in the TS group (86.

Extensor Carpi Ulnaris Subsheath Reconstruction.

Acute extensor carpi ulnaris (ECU) subsheath injury and chronic subsheath insufficiency may result in symptomatic ECU instability at the level of the distal ulna osseous sulcus. Associated ulnocarpal (ie, triangular fibrocartilage complex) and ECU intrinsic tendinopathic changes may accompany subsheath pathologies and require concomitant treatment. Surgical treatment is indicated in refractory cases despite nonoperative treatment and may consist of repair of the torn edge of the ECU subsheath or, more frequently, reconstruction utilizing a radially based extensor retinacular sling.

Extensor Pollicis Longus Rupture after Mini TightRope Suspensionplasty.

Background Arthritis of the first carpometacarpal (CMC) joint has been surgically treated in multiple ways with varying levels of success as measured by subjective and objective measures. Trapeziectomy with numerous variations in suspensionplasty comprises one of the more commonly used surgical procedures. Recently, the Mini TightRope apparatus has been utilized as a new method for achieving suspensionplasty, and as such lacks significant review of use and safety in the literature.

Intra-articular Fractures of the Sigmoid Notch of the Distal Radius: Analysis of Progression to Distal Radial Ulnar Joint Arthritis and Impact on Upper Extremity Function in Surgically Treated Fractures.

Background Studies have established an increased risk of radiocarpal joint posttraumatic arthritis in patients with displaced intra-articular fractures of the distal radius, although this phenomenon has yet to be evaluated in the distal radioulnar joint (DRUJ). Purpose We hypothesized that patients with displaced intra-articular fractures of the sigmoid notch would have a higher prevalence of DRUJ arthritis and greater upper extremity dysfunction after operative treatment of distal radius fractures compared with fractures without sigmoid notch involvement. We also hypothesized that the degree of sigmoid notch incongruity would be correlated with the grade of DRUJ arthritis and the severity of upper extremity dysfunction.

Epidemiology of Medial Ulnar Collateral Ligament Reconstruction: A 10-Year Study in New York State.

Background: Despite an increase in the prevalence of medial ulnar collateral ligament (UCL) reconstruction of the elbow in professional baseball and popularity within the media, there are no population-based studies examining the incidence of UCL reconstruction.

Purpose: To examine the epidemiological trends of UCL reconstruction on a statewide level over a 10-year period. The primary endpoint was the yearly rate of UCL reconstruction over time; secondary endpoints included patient demographics, institution volumes, and concomitant procedures on the ulnar nerve.

Prosthetic Arthroplasty Versus Arthrodesis for Osteoarthritis and Posttraumatic Arthritis of the Index Finger Proximal Interphalangeal Joint.

Purpose: To compare outcomes of prosthetic arthroplasty versus arthrodesis to treat index finger proximal interphalangeal (PIP) joint arthritis.

Methods: Patients with osteoarthritis or posttraumatic arthritis of index finger PIP joints were evaluated. Digit range of motion, grip and pinch strength, patient-rated pain and satisfaction scores, Michigan Hand Questionnaire scores, and complications were recorded.

Tenosynovitis of the wrist and thumb and carpal tunnel syndrome caused by Histoplasma capsulatum: case report and review of the literature.

A patient presenting with acute carpal tunnel syndrome and swelling and pain in the wrist and thumb is presented. An open carpal tunnel release and tenosynovectomy were performed with biopsy specimen revealing infection with Histoplasma capsulatum. The case is discussed in context of the prior scant literature of tenosynovitis of the wrist and hand caused by histoplasmosis.

Dorsal proximal interphalangeal joint fracture-dislocations: evaluation and treatment.

Proximal interphalangeal joint injuries are common and often can be treated nonsurgically. Some dorsal fracture-dislocations, however, require special attention or surgical management to optimize outcomes. Treatment options for dorsal proximal interphalangeal fracture-dislocations include splinting, percutaneous pinning, fracture fixation, external fixation devices, volar plate arthroplasty, and hemihamate arthroplasty.

Safety of open suprapectoral and subpectoral biceps tenodesis: an anatomic assessment of risk for neurologic injury.

Background: Surgical techniques for proximal biceps tenodesis that include penetration of the posterior humeral cortex for fixation may pose risk to the surrounding neurovascular structures.

Hypothesis: The risk of neurologic injury with techniques that involve penetration of the posterior humeral cortex for fixation in proximal biceps tenodesis will increase as the tenodesis site moves proximally from the subpectoral to the suprapectoral location.

Methods: Proximal biceps tenodesis was performed on 10 cadaveric upper extremities with 3 separate techniques.

Trapezium prosthetic arthroplasty (silicone, Artelon, metal, and pyrocarbon).

Trapezium prosthetic arthroplasty has been utilized to treat basal joint arthritis for nearly five decades in an attempt to mitigate some of the potential disadvantages of trapeziectomy while preserving range of motion. Implant arthroplasty seeks to preserve joint biomechanics, avoids metacarpal subsidence, and should provide immediate stability. These benefits may lead to improvements in strength, durability, and a decrease in metacarpophalangeal joint hyperextension which can occur subsequent to metacarpal shortening.

Is there an association between chronicity of patellar instability and patellofemoral cartilage lesions? An arthroscopic assessment of chondral injury.

The purpose of this study was to investigate the association between chronicity of patellar instability on the prevalence, grade, and location of chondral lesions in patients with recurrent patellar instability. Patellofemoral chondral status was documented and graded according to the Outerbridge classification in 38 patients who underwent arthroscopic examination at the time of a medial patellofemoral ligament reconstruction procedure. Chondral lesions of any location were observed in 63.

A functional outcomes survey of elderly patients who sustained distal radius fractures.

Purpose: This study aims to examine the subjective functional outcomes of patients 70 years or older who sustained distal radius fractures through the use of the Disability of the Arm, Shoulder, and Hand (DASH) and Short Form-8 Health (SF-8) surveys.

Methods: Patients at least 70 years old with a distal radius fracture between 2000 and 2004 were identified and their charts reviewed. They were contacted to answer the DASH and SF-8 surveys.

A percutaneous technique to treat unstable dorsal fracture-dislocations of the proximal interphalangeal joint.

Purpose: Unstable dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint are complex injuries that are difficult to treat and usually require operative fixation. There are a number of surgical techniques for treating these injuries but none has emerged as superior. The purposes of this study were to describe a simple percutaneous technique to treat unstable dorsal fracture-dislocations of the PIP joint and to report short-term postoperative results.

Pharmacologic reversal of warfarin-associated coagulopathy in geriatric patients with hip fractures: a retrospective study of thromboembolic events, postoperative complications, and time to surgery.

Purpose: Patients with acute hip fractures who are on maintenance warfarin for anticoagulation present a significant challenge and their management remains controversial. The purpose of this study was to assess thromboembolic and systemic complications associated with pharmacological reversal of warfarin-associated coagulopathy in a population of geriatric patients with hip fractures.

Methods: This retrospective cohort study identified patients with operative hip fractures on oral warfarin therapy who had an international normalized ratio (INR) >1.