Biomechanical Modeling of Connecting Intermetacarpal K-Wires in the Treatment of Metacarpal Shaft Fractures.

Background: Clinical series have been published using the configuration of 2 intercarpal Kirschner wires (K-wires) adjacent to the fracture being connected, but biomechanical analysis is lacking. The objective of this pilot biomechanical study was to model and compare the effects of externally connecting 2 intermetacarpal K-wires for the stabilization of transverse metacarpal shaft fractures. Our research hypothesis was that the connected constructs would be stiffer than the unconnected K-wires.

Outcomes for late presenting lateral condyle fractures of the humerus in children: A case series.

Background: Fractures of lateral condyle of humerus are very common in children. While the management of acute displaced and rotated lateral condyle fracture of humerus with early open reduction and internal fixation yields good results, the results of late treatment are less clear. We conducted this study to analyse the results of operative treatment of late presenting fractures and see if it is dependent on the patient's age, fracture type, or the time until treatment.

Median Nerve Entrapment in the Ulna in a Both-Bone Pediatric Forearm Fracture: Case Report and Review of the Literature.

This case report presents entrapment with subsequent complete disruption of the median nerve in the distal ulna in a both-bone fracture of the forearm in a 9-year-old girl. Closed fractures of the radius and ulna commonly occur in pediatric populations. Postinjury nerve dysfunction is often seen.

The Use of tPA in the Treatment of Frostbite: A Systematic Review.

Background: The use of tissue plasminogen activator (tPA) for the treatment of frostbite has been reported and advocated, but its efficacy has not been well established. We conducted a systematic review to guide physicians on the role of tPA in the treatment of frostbite. Our hypothesis was that the use of tPA improves clinical outcomes, as measured by amputation rate.

Offering the Influenza Vaccine in a Pediatric Hand Surgery Clinic Increases Vaccination Rates.

Purpose: The purpose of this study was to evaluate the utility of providing immediate access to the influenza vaccination for patients seen in a pediatric hand surgery clinic. Our hypothesis was that providing access would increase the rate of vaccination.

Methods: This pilot study was a randomized, controlled, prospective clinical trial that included all patients seen by a single surgeon, on a single day each week, in a hospital-based pediatric hand surgery practice clinic from October 18, 2016, to March 14, 2017.

Can Physical Examination Create a Stener Lesion?

Background: The purpose of this study is to determine whether a Stener lesion can be created while testing stability of the ulnar collateral ligament (UCL) of the thumb. Testing was performed in a manner that reproduced clinical examination.

Methods: Six fresh frozen hand and forearm specimens underwent sequential sectioning of the accessory UCL, the proper UCL, and the ulnar sagittal band.

Complications of Distal Phalanx Fractures in Children.

Purpose: To determine whether the incidence of complications varies between among types of distal phalangeal fractures in a pediatric population.

Methods: We retrospectively reviewed the medical records and radiographs of patients seen in the pediatric hand surgery clinic from 2011 to 2012 with a diagnosis of distal phalanx fracture. Patients were identified by International Classification of Diseases-Ninth Revision code (816.

An Experimental Survey on the Effect of Using the CTS-6 Tool on the Diagnosis of Carpal Tunnel Syndrome by Hand Surgeons.

Background: This controlled randomized experiment tested the research hypothesis that providing the CTS-6 quantitative diagnostic information to hand surgeons affects the diagnosis of carpal tunnel syndrome.

Methods: Surgeon members of American Association for Hand Surgery participated in an online survey. Demographic and practice pattern information was collected.

Epidemiology of Women's Flat Track Roller Derby Injuries in Kansas City.

This cross-sectional descriptive retrospective epidemiological pilot study determined the frequency, circumstances, type, and outcome of injuries in the members of a Kansas City women's flat track roller derby league. Injuries were reported by 79% of the respondents, with 50% having sustained multiple injuries. Medical attention was required by 64%.

Biomechanical Comparison of 2 Methods of Intramedullary K-Wire Fixation of Transverse Metacarpal Shaft Fractures.

Purpose: To determine the relative importance of intramedullary wire (IMW) diameter and IMW number in conferring stability to a metacarpal fracture fixation construct. Our research hypothesis was that the stiffness of IMW fixation for metacarpal shaft fractures using a single 1.6-mm-diameter (0.

Prospective comparison of the six-item carpal tunnel symptoms scale and portable nerve conduction testing in measuring the outcomes of treatment of carpal tunnel syndrome with steroid injection.

Background: We prospectively studied patients clinically diagnosed with carpal tunnel syndrome (CTS) and treated with the injection of corticosteroid into their carpal tunnel in order to compare changes in the six-item CTS symptoms scale and portable nerve conduction study (NCS) parameters as outcome tools. Our pilot study was the first to assess the utility of the six-item CTS symptom scale (CTS-6) with steroid injections as a patient-directed outcome measure for the treatment of CTS.

Methods: We enrolled patients who presented to our county hospital orthopedic surgery clinic from August 2012 through August 2013.

Radiographic indicators of a shared epiphysis in radial polydactyly.

Background: Thumb epiphyses cannot be visualized on radiographs in infants with radial polydactyly, making it difficult to classify by Wassel type. The purpose of this study was to identify radiographic features that distinguish a separate epiphysis from a shared epiphysis. This may assist in operative planning and establishing prognosis.

Frostbite of the hand.

Frostbite is damage caused by the freezing of tissue owing to exposure to extreme cold. Clinically, it is often difficult to identify the severity of frostbite injury. There may be a wide discrepancy between the extent of damage to the skin versus that to the deeper structures.

Polydactyly in the Southwest: art or anatomy-a photo essay.

Rock art in the Four Corners area often includes pictures of hands and feet, which may be representational or symbolic. There is correlation between actual metatarsal bones and carvings of polydactyl feet. No duplicated hand bones have been found, but we postulate petroglyphs of polydactyl hands are a reflection of a real congenital difference.

Upper extremity injuries in Homer's Iliad.

Homer's Iliad remains a fascinating source of medical history. This epic poem, compiled around 800 BCE, describes several weeks of the last year of the 10-year siege of Troy (Ilion) by the Achaeans. Homer composed the epic by combining and formalizing oral poems, legends, customs, and experiences that originated in the later Mycenaean age (1600-1100 bce).

Fibonacci, littler, and the hand: a brief review.

In a landmark paper published in 1973, the eminent hand surgeon J. William Littler, MD, proposed two mathematical relationships between the anatomic and functional geometry of the hand. His proposal that the motion of the tips of the fingers follow an equiangular spiral has been experimentally supported.

Thrombosis of digital arteries associated with tamoxifen use: case report.

Arterial thrombosis in the upper extremity occurs often at the wrist. We report a unique case of thrombosis that involved multiple digital arteries, without radial or ulnar artery involvement, which developed only after using tamoxifen despite chronic occupational blunt percussive hand use. Revascularization was achieved after thrombectomy.

Astley Cooper: his life and surgical contributions.

Sir Astley Paston Cooper (1768-1841) was a successful and influential British surgeon during the early decades of the 19th century. He was a dedicated anatomist, an accomplished researcher, an inspiring teacher, and a skillful surgeon. Cooper published about the cause and treatment of Dupuytren's disease 10 years before Dupuytren.

César Roux and his original 1893 paper.

The Roux-en-Y type of gastrointestinal anastomosis, originated by the Swiss surgeon César Roux, is a valuable technique used in drainage of the stomach, esophagus, and the pancreatico-biliary tree. It is now frequently used in reconstructing the GI tract after resections for a number of diseases, and known by the general public due to its importance in bariatric surgery. This article presents, along with a brief biographical sketch, an English translation and discussion of Roux's original 1893 French report on gastrointestinal surgery that was published in Revue de Chirurgie.