Segmental Megaesophagus Secondary to Extraluminal Esophageal Stenosis Caused by Transitional Seventh Cervical Vertebra and Supernumerary Ribs in a Goat.

A 4-year-old Nigerian Dwarf wether presented for chronic regurgitation and cervical swelling of three years duration. Physical examination revealed a large ventral cervical mass. The goat made repeated attempts to swallow and regurgitate, but the mass did not change significantly in size.

Perceptions of sexual assault perpetrators, victims, and event depend on system justification beliefs and perpetrator atonement.

When accused of wrongdoing, a sexual assault perpetrator may express atonement, i.e., he may acknowledge harm done, take responsibility, and make amends.

Neonatal Seizures and Associated Neurobehavioral Profiles in Preschool Age Children.

Background: Neonatal seizures are common with acute brain injury. Up to 25% of survivors develop postneonatal epilepsy. We hypothesized postneonatal epilepsy diagnosed by age 24 months would increase risk for early markers of neurobehavioral disorders than acute provoked neonatal seizures alone.

Unicortical Versus Bicortical Proximal Locking Screw for Prevention of Peri-Implant Fracture: A Biomechanical Analysis of an Osteoporotic Distal Radius Model.

Purpose: Osteoporotic patients are at risk of peri-implant fractures after distal radius fixation. A unicortical screw in the proximal hole of the plate can theoretically decrease stress riser formation by eliminating the hole in the far bone cortex. This construct has been proposed in orthopedic literature to prevent peri-implant fractures but has not been tested in an osteoporotic distal radius model.

A review of virtual reality in radiology.

Virtual reality (VR) is not new to the field of medicine or radiology but has grown exponentially in recent years. Exploration of VR in medicine to augment educational experiences and aid in procedural training began in the 1990s. Surgeons have benefited from VR, both for training and planning purposes.

The Effect of Forearm Shortening on Finger Flexion: A Biomechanical Study.

Purpose: Surgeons may shorten the forearm for many indications. We quantified the impact of shortening on finger flexion with a cadaver model.

Methods: Ten fresh cadaver proximal forearms were pinned to a static block.

Life After Neonatal Seizures: Characterizing the Longitudinal Parent Experience.

Background: Parents of neonates with seizures report persistent symptoms of depression, anxiety, and posttraumatic stress. We aimed to characterize the parent experience of caring for children impacted by neonatal seizures, including longitudinal assessment across childhood.

Methods: This prospective, observational, multicenter study was conducted at Neonatal Seizure Registry (NSR) sites in partnership with the NSR Parent Advisory Panel.

Establishing a Research-Related Patient and Family Advisory Council for a Surgical Specialty.

Engaging patients and family members in formal feedback for health care processes can be impactful, especially when cultivating new care and research protocols. However, most surgical groups lack established systems for enlisting these critical stakeholders. This is a descriptive report of how we built our Patient and Family Advisory Council (PFAC) through a multistep process with patients, providers, research staff, and administrators.

Vertical pelvic movement asymmetry and lameness location in ipsilateral combined forelimb and hindlimb lameness cases.

Background: Compensatory vertical head and pelvis movement asymmetry may occur in trotting horses with a primary cause of lameness in one end of the body due to the weight shifting between limbs, leading to apparent combined forelimb and hindlimb lameness (CFHL). Little is known about CFHL patterns observed with body-mounted inertial sensors (BMIS) and regardless of their underlying mechanisms, compensatory and secondary lameness may complicate the definitive identification of the primary causes of lameness.

Objective: Determine associations between vertical pelvic movement asymmetry and location of primary lameness in ipsilateral CFHL cases where hindlimb lameness is solely impact or push-off type.

Site of Ambulance Origination and Billing for Out-of-Network Services.

Importance: The No Surprises Act implemented in 2022 aims to protect patients from surprise out-of-network (OON) bills, but it does not include ground ambulance services. Understanding ground ambulance OON and balance billing patterns from previous years could guide legislation aimed to protect patients following ground ambulance use.

Objective: To characterize OON billing from ground ambulance services by evaluating whether OON billing risk differs by the site of ambulance origination (home, hospital, nonhospital medical facility, or scene of incident).

Patient Perspectives on Cognitive Behavioral Therapy for Thumb, Hand, or Wrist Pain and Function: A Survey of 98 Patients.

Purpose: Cognitive behavioral therapy (CBT) is an established option to improve pain and function for many orthopedic conditions. Our purpose was to obtain patient perspectives regarding CBT for thumb, hand, or wrist pain and function.

Methods: Between March and April 2022, we distributed an electronic survey via email to patients in our institution's health system with a diagnosis of arthritic or non-specific thumb, hand, or wrist pain.

A Multicenter Prospective Randomized Comparison of Conduits Versus Decellularized Nerve Allograft for Digital Nerve Repairs.

Purpose: While there are advantages and disadvantages to both processed nerve allografts (PNA) and conduits, a large, well-controlled prospective study is needed to compare the efficacy and to delineate how each of these repair tools can be best applied to digital nerve injuries. We hypothesized that PNA digital nerve repairs would achieve superior functional recovery for longer length gaps compared with conduit-based repairs.

Methods: Patients (aged 18-69 years) presenting with suspected acute or subacute (less than 24 weeks old) digital nerve injuries were recruited to prticipate at 20 medical centers across the United States.

Use of Treatments after Recovery from Thumb Carpometacarpal Arthritis Surgery.

Background: Which treatments patients continue to use more than 1 year after primary thumb carpometacarpal arthritis surgery, and how such use relates to patient-reported outcomes, is largely unknown.

Methods: The authors identified patients who had isolated primary trapeziectomy alone or with ligament reconstruction ± tendon interposition and were 1 to 4 years postoperative. Participants completed a surgical site-focused electronic questionnaire about what treatments they still used.

Students with access to 3D study materials are better able to translate spatial relationships between abdominal organs and correctly interpret abnormal radiographic images.

Previous studies have demonstrated evidence that three-dimensional (3D) visualization techniques can be helpful as learning tools. This prospective randomized control study was designed to test the hypothesis that 3D learning tools would have improved translation into interpreting normal and abnormal canine abdominal radiographic images over traditional learning tools. Sagittal and dorsal plane 3D image scenes were created from CT scans, with canine abdominal organs labeled using virtual reality and 3D visualization software tools.

The statistical fragility of studies on rotator cuff repair with graft augmentation.

Background: Clinical decision-making often relies on evidence-based medicine. Our purpose was to determine the fragility index (FI) and fragility quotient (FQ) for studies evaluating rotator cuff repair (RCR) with graft augmentation. A lost to follow-up (LTF) value greater than the FI indicates statistical instability for the reported outcomes and conclusions.

A Meta-Analysis of Biomechanical Studies for Suture Button Pullout Versus Suture Anchor Repair of Flexor Digitorum Profundus Avulsions.

Background: There is no current consensus on which of the two most common flexor digitorum profundus (FDP) avulsion repair constructs, via suture button pullout (SBP) or suture anchor (SA), is biomechanically superior. Our purpose was to compare these repair methods via systematic review and meta-analysis of available literature.

Methods: We performed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review of PubMed, the Cochrane library, and Embase.

All-Suture Anchor Repair of the Flexor Digitorum Profundus Insertion: A Biomechanical Comparison of 2 Suturing Techniques.

Purpose: We compared 2 suturing techniques for reattachment of the flexor digitorum profundus (FDP) via all-suture anchor.

Methods: We used fresh, matched-pair, cadaveric hands. We disarticulated the fingers at the proximal interphalangeal joints, preserving the proximal FDP.

Total Joint Arthroplasty of a Proximal Interphalangeal Joint with Proximal Metal Surface Replacement and Distal Hemi-Hamate Autograft: A Long-Term Follow-Up.

A 28-year-old female recreational athlete presented with middle finger proximal interphalangeal joint pain, stiffness, and ulnar deviation deformity 2 years after internal fixation of a middle phalanx base fracture-dislocation. Radiographs revealed posttraumatic changes on both sides of the proximal interphalangeal joint. Having failed nonsurgical measures, she elected to proceed with surgical reconstruction.

Passive Manipulation for Proximal Interphalangeal Joint Extension Contractures.

Purpose: We investigated closed passive manipulation as an alternative to surgery for certain proximal interphalangeal (PIP) joint extension contractures.

Methods: We retrospectively reviewed all patients with PIP joint extension contractures treated with passive manipulation at our institution between 2015 and 2019. The included patients were a minimum of 12 weeks from their initial injury/surgery (median 179 days; interquartile range: 130-228 days), had plateaued with therapy, and underwent a 1-time passive manipulation.

Comparison of 3 Dynamic External Fixation Devices for Proximal Interphalangeal Joint Dorsal Fracture-Dislocations in a Cadaver Model.

Purpose: Several improvised dynamic external fixation devices are used for treating unstable dorsal proximal interphalangeal (PIP) joint fracture-dislocations. We compared the effectiveness of 3 constructs for simulated dorsal PIP joint fracture-dislocations in a cadaver model.

Methods: We tested 30 digits from 10 fresh-frozen, thawed cadaver hands.

Surprise Out-of-Network Bills for Hand and Upper Extremity Trauma Patients.

Purpose: Patients may receive surprise out-of-network bills even when they present to in-network facilities. Surprise bills are common following emergency care. We sought to characterize and determine risk factors for surprise billing in hand and upper extremity trauma patients in the emergency department (ED).

Thumb Carpometacarpal Arthritis Surgery: The Patient Experience.

Background: Patients with symptomatic recalcitrant thumb carpometacarpal arthritis often undergo surgery. Although most surgical patients do well, the authors anticipated that a substantial portion of their thumb carpometacarpal surgery patients would have unsatisfactory experiences and express unmet expectations, dissatisfaction, and regret, regardless of surgical procedure performed. The authors hypothesized those experiences would correlate with patient-reported outcomes scores.