Publications by authors named "Neal C Chen"
Article Synopsis
- The study aims to determine the prevalence of distal biceps tendinopathy (DBT) in both symptomatic and asymptomatic patients who underwent elbow MRIs.
- Out of 1,180 MRIs analyzed, 23% showed signal changes, but only 10% were diagnosed with tendinopathy, with many being incidental findings.
- While the prevalence of DBT tendinopathy increases with age, there's no significant link between age and incidental cases, suggesting that older adults may experience more symptomatic issues rather than just incidental findings.
Article Synopsis
- This study addresses challenges in determining accurate screw length during surgical fixation of complex distal radius fractures, emphasizing the risk of injuring the extensor pollicis longus with overly long screws.* -
- Researchers evaluated the anatomy of Lister's tubercle using 26 cadaveric arms and 198 CT scans, finding average measurements of 12.6 mm in length and 5.4 mm in width, with specific distances measured from the radial styloid.* -
- Understanding the anatomical details of Lister's tubercle can improve screw placement during surgeries, potentially leading to better patient outcomes in distal radius fracture treatments.*
Objectives: This study aimed to determine whether outpatient upper extremity fracture surgery was associated with increased postoperative emergency department (ED) visits and identify related risk factors.
Design: Retrospective cohort.
Setting: This multicenter study was conducted within a single academic institution, encompassing two Level 1, two Level 2, and one Level 3 trauma centers.
Article Synopsis
- * After three rounds of surveys, 18 out of 68 factors were identified as influential, with stable consensus on factors that favor operative treatment including professional athlete status and specific fracture characteristics.
- * Most disagreement arose regarding treatment for certain injuries, especially those involving an anterolateral coronoid tip fracture, indicating a need for more clarity in treatment guidelines among surgeons.
Article Synopsis
- The study examined trends in surgical treatment for upper extremity fractures from 2008 to 2021, focusing on both inpatient and outpatient procedures and identifying patient factors influencing outpatient surgery.
- Outpatient surgeries increased by an average of 31%, with the most significant growth in humerus and forearm fractures, while older patients and those with higher comorbidities were more likely to require inpatient care.
- The findings suggest a notable shift toward outpatient management, highlighting the need for healthcare providers to consider socioeconomic disparities when making surgical decisions to ensure equitable access to care.
Article Synopsis
- Ganglion excision is a surgical procedure done for pain relief, functionality, or cosmetic improvements, with recurrence rates between 9-20%.
- This study analyzed data from 1,076 patients on their recurrence and reoperation rates after ganglion excision, finding a low reoperation rate of 3.3% and a recurrence rate of 13%.
- Patient-reported outcomes showed good functional scores and minimal ongoing pain, with females reporting slightly higher scores on pain and disability assessments.
Proximal row carpectomy (PRC) is a procedure used for pain relief from arthrosis that preserves some degree of range of motion (ROM). Dorsal capsular interposition (DCI) is an option for cases where some chondral loss of the capitate is present. The aim of this study is to assess what factors influence long-term patient-reported outcomes following PRC and specifically to evaluate the role of DCI.
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- This study compares two methods of treating phalangeal fractures: closed reduction percutaneous pinning (CRPP) and open reduction internal fixation (ORIF), to see which has higher reoperation rates.
- A total of 901 fractures were analyzed, with the majority treated by CRPP, while demographic and complication data were collected for statistical analysis.
- Key findings indicate that ORIF, work-related fractures, and open fractures are linked to a higher likelihood of needing reoperation, which can help inform surgical decisions.
Article Synopsis
- The study evaluated the occurrence and factors related to reoperations after repairing distal radius nonunion in patients at a multicenter academic institution from 2005 to 2021.
- A total of 33 patients (13 males, median age 56) were reviewed, with an average follow-up period of nearly 5 years.
- Results showed that about 24% of patients required unplanned reoperations, mainly due to infection, persistent nonunion, or hardware issues, with complications occurring in 27% of cases.
Introduction: This study aims to evaluate the long-term psychosocial and functional outcomes of successful digital replantation following traumatic amputation.
Methods: Patients that underwent successful replantation (i.e.
Background: The lumbrical muscles comprise 4 intrinsic muscles of the hand and are involved in flexion of the metacarpophalangeal joint (MCPJ) and extension of the proximal interphalangeal and distal interphalangeal joints. The purpose of this study was to investigate the anatomical mechanics of the lumbrical muscles of the index, middle, ring, and small fingers.
Methods: We evaluated 25 cadaver arms and measured the distance between the MCPJ and fingertip, the distance between the MCPJ and lumbrical muscle insertion, and the distance between the MCPJ and the most proximal lumbrical muscle origin.
Background: The lay public is increasingly using ChatGPT (a large language model) as a source of medical information. Traditional search engines such as Google provide several distinct responses to each search query and indicate the source for each response, but ChatGPT provides responses in paragraph form in prose without providing the sources used, which makes it difficult or impossible to ascertain whether those sources are reliable. One practical method to infer the sources used by ChatGPT is text network analysis.
View Article and Find Full Text PDFBackground: This research sought to analyze a cohort of patients with extensor pollicis longus (EPL) ruptures after volar locked plating of a distal radius fracture (DRF) to characterize the incidence of ruptures that are unlikely to be related to dorsal screw prominence.
Methods: This is a retrospective, observational, descriptive cohort study of adults with operative fixation of a closed DRF and an EPL rupture between 2002 and 2022. Eighteen patients with operative fixation using a volar plate of a closed DRF had an EPL rupture.
Purpose: Arthrodesis of the metacarpophalangeal (MCP) joint of the thumb is a common procedure to treat arthritis or instability. Studies reporting hardware complications and nonunion rates after thumb MCP joint arthrodesis report on small sample sizes. We aimed to describe the hardware complication rate, the nonunion rate, and the number of thumbs that achieve union among patients undergoing thumb MCP joint arthrodesis.
View Article and Find Full Text PDFBackground: Forearm stiffness can be caused by distal radioulnar joint (DRUJ) capsular contractures, which can occur after trauma such as a distal radius fracture. In this setting, a DRUJ capsular release may help improve forearm rotation, but the long-term functional outcomes remain unknown. The purpose of this case series is to investigate the short-term improvement in total pronosupination arc range of motion and long-term patient-reported outcomes (PROs) after DRUJ capsular release.
View Article and Find Full Text PDFBackground: In scaphoid nonunion advanced collapse (SNAC) wrist arthritis, we analyzed the 3-dimensional (3-D) deformity patterns of carpal alignment secondary to scaphoid nonunion and quantified subchondral arthritis by investigating alterations in bone density.
Methods: We constructed 3-D models of the carpal bones and radius from 51 patients with scaphoid nonunion (nonunion group) and 50 healthy controls (control group). We quantified the differences in 3-D geometric position of the distal carpal row relative to the distal radius in SNAC wrists versus controls.
Compared with hip and knee arthroplasty, total elbow arthroplasty (TEA) has a higher complication rate and lower survivorship. Modern TEA implants most commonly require revision due to implant loosening, infection, and periprosthetic fracture. Concerns with revision TEA include handling of the soft tissues and possible necessity of flap coverage, triceps management, preservation of bone stock, and management of concurrent infection or fracture.
View Article and Find Full Text PDFBackground: The aims of this study were to evaluate long-term patient-reported outcomes after revision carpal tunnel release (CTR); compare these outcomes with those of patients who had a single CTR and a comparable age, sex, race, type of initial surgery, and follow-up time; and assess which factors are associated with worse patient-reported outcomes after revision CTR.
Methods: The authors retrospectively identified 7351 patients who had a single CTR and 113 patients who had a revision CTR for carpal tunnel syndrome between January of 2002 and December of 2015 at five academic urban hospitals. Of these 113 revision CTR cases, 37 patients completed a follow-up questionnaire including the Boston Carpal Tunnel Questionnaire (BCTQ), the Numerical Rating Scale for Pain Intensity, and satisfaction score.
Aim: This network meta-analysis aims to compare functional outcomes and complications between conservative treatment and surgery for distal radius fractures in patients aged 60 years and over.
Methods: We searched the PubMed, EMBASE, and Web of Science databases for randomized controlled trials (RCTs) assessing the effect of conservative treatment and surgery for distal radius fractures in patients aged 60 years and over. Primary outcomes included grip strength and overall complications.
Epidemiology and Fracture Patterns of Traumatic Phalangeal Fractures.
Plast Reconstr Surg Glob Open
August 2022
Article Synopsis
- * Among 2140 fractures from 1747 patients, the median age of injury was 45, with a predominance of men (65%) and the small finger having the highest fracture rate (26%).
- * The findings highlight that most fractures occurred in the distal and proximal phalanges (39% each) and were primarily caused by blunt trauma; this data can help hand surgeons improve treatment strategies for these injuries.
Background: Demographic information related to phalangeal fractures that undergo simultaneous vascular repair, as well as their complication and reoperation profiles, remain incompletely understood. This study aimed to examine the patient and fracture characteristics influencing the outcomes after these injuries in a large Unites States adult patient cohort and to identify risk factors associated with unplanned reoperation of these fractures.
Methods: A retrospective study was performed, identifying 54 phalangeal fractures in 48 patients; all fractures were also associated with vascular injuries requiring repair.
Radiographic evidence of scapho-lunate diastasis associated with a displaced distal radius fracture has been well recognized yet the clinical significance remains in question. If left untreated, will this progress to both radiographic and clinical changes consistent with intercarpal arthritis? Using the accumulated data of over 400 surgically treated distal radius fractures in the ICUC database, 16 cases of untreated scapho-lunate diastasis were followed on an average of 8 years without evidence of progressive functional or radiographic deterioration. In 50% of these cases, incidental findings of similar scapho-lunate diastasis was noted in the opposite uninjured wrist.
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