Hand-Specific External Fixation for Treatment of Complex Proximal Interphalangeal Joint Injuries.

Background: Complex proximal interphalangeal joint (PIPJ) fractures are challenging injuries to treat. There are multiple established treatment methods available for these injuries, including dynamic external fixation. This study reports the outcomes of complex PIPJ fractures treated with a hand-specific external fixation device.

Lateral femoral distraction is a safe and necessary adjunct for articulator visualization during the operative treatment of tibial plateau fractures.

Introduction: Recent evidence suggests use of lateral femoral distractor (LFD) to aid in visualization during surgery for tibial plateau fractures (TPF) may result in an unacceptably high rate of iatrogenic peroneal nerve palsy. We sought to evaluate femoral distractor use for open reduction internal fixation (ORIF) of TPF and quantify the incidence of peroneal nerve palsy.

Methods: We retrospectively evaluated all patients undergoing ORIF of TPF between 2014 and 2019 by a single fellowship trained orthopaedic traumatologist at a single Level 1 trauma center.

Risk Factors and Outcomes in Carpal Tunnel Syndrome Following Distal Radius Open Reduction Internal Fixation.

Purpose: Carpal tunnel syndrome (CTS) is a common complication following the operative repair of distal radius fractures. It is unclear who is at risk of developing this complication in the postoperative period. This study sought to identify risk factors for developing CTS and to evaluate patient-reported outcomes in patients who develop postoperative CTS.

Does Surgery Improve Healing After Isolated Diaphyseal Ulna Fractures?

Purpose: Isolated diaphyseal ulna fractures can be treated nonsurgically or with open reduction and internal fixation (ORIF). It is unclear whether ORIF provides quicker and/or more predictable healing. The purpose of this study was to compare the healing characteristics of isolated diaphyseal ulna fractures after surgical and nonsurgical treatment.

Wound Dehiscence Following Cubital Tunnel Surgery.

Purpose: Cubital tunnel syndrome is the second most common upper-extremity compressive neuropathy, and persistent symptoms can necessitate operative treatment. Surgical options include simple decompression and ulnar nerve transposition. The cause of wound dehiscence after surgery is not well known, and the factors leading to the development of these complications have not been previously described.

Three Dimensionally Printed Versus Conventional Casts in Pediatric Wrist Fractures.

Background and objective With significant advancement in the field of biomaterials, alternatives to conventional fiberglass casts such as customized three-dimensional (3D) orthotics have been developed. However, there is a scarcity of reported experience regarding 3D-printed orthoses. The purpose of this study was to compare radiographic outcomes and patient satisfaction with fractures treated with either conventional or 3D-printed casts.

Anterior Interosseous Nerve to Ulnar Nerve Transfers: A Systematic Review.

 There has been an increasing utilization of end-to-end (ETE) and reverse "supercharged" end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfers (NTs) for treatment of high ulnar nerve injury. This study aimed to review the potential indications for, and outcomes of, ETE and SETS AIN-ulnar NT.  A literature review was performed, and 10 articles with 156 patients who had sufficient follow-up to evaluate functional outcomes were included.

Treatment of Distal Radius Fractures in Women Older than 80 Years: A Preliminary Report of Functional and Radiographic Outcomes after Open Reduction and Internal Fixation.

 Distal radius fractures are one of the most common fractures seen in the elderly. The management of distal radius fractures in the elderly, especially patients older than 80 years, has not been well defined. The purpose of this study was to evaluate operative treatment of distal radius fractures in patients older than 80 years to determine functional outcomes and complication rates.

Time to Improvement After Corticosteroid Injection for Trigger Finger.

Purpose Trigger finger is a commonly occurring hand condition that presents with symptoms of pain, clicking, locking, and catching of the finger. A common non-operative management option is corticosteroid injection. The purpose of this study was to evaluate the short-term patient response to corticosteroid injections for trigger finger.

Deep Infection after Distal Radius Open-reduction Internal Fixation: A Case Series.

Background: Given its low incidence, the management of deep infection following distal radius open-reduction internal fixation (ORIF) has not been well reported. In an effort to expand our current understanding, the purpose of this case series is to present the treatment strategies and functional outcomes associated with deep infection after distal radius ORIF.

Methods: All patients with deep infections after distal radius ORIF over a ten-year period were identified and their treatment courses asessed.

Single Assessment Numeric Evaluation Correlates with American Shoulder and Elbow Surgeons Score for Common Elbow Pathology: A Retrospective Cohort Study.

Background: There are currently a variety of patient-reported outcomes (PROs) for elbow pathology, without any established gold standard. The Single Assessment Numeric Evaluation (SANE) is a single question assessment of the patient's perceived overall function compared with normal. The SANE score has been correlated with PROs from the shoulder and knee literature.

Early Retrieval of Spanning Plates Used for Fixation of Complex Fractures of the Distal Radius.

 Spanning plates are being increasingly used for the treatment of complex fractures of the distal radius. The traditional recommendation is to leave the hardware in place for at least 12 weeks.  This study assesses the comparative outcomes of spanning plates removed at or before 10 weeks.

How Does the Presence of a Surgical Trainee Impact Patient Outcomes in Lumbar Fusion Surgery?

Background: While the impact of trainee involvement in other surgical fields is well established, there is a paucity of literature assessing this relationship in orthopaedic spine surgery. The goal of this study was to further elucidate this relationship.

Methods: A retrospective cohort study was initiated on patients undergoing 1-3 level lumbar spine fusion at a single academic center.

Unplanned Return to the Operating Room in Upper-Extremity Surgery: Incidence and Reason for Return.

Purpose: Complications after upper-extremity surgery are generally infrequent. The purpose of this study was to assess the rate of early unplanned return to the operating room (URTO) within 3 months after surgery) in upper-extremity surgical procedures. Our hypotheses were that the rate of URTO in upper-extremity surgery would be low and that surgically treated fractures would be at greatest risk for complications.

The Clinical Impact of Ambient Operating Room Temperature and Other Perioperative Factors on Patient Comfort during Wide-awake Hand Surgery Using Local Anesthesia.

Background: The prevalence of wide-awake hand surgery using local anesthesia has increased substantially. The full influence of perioperative factors, namely operating room temperature, on patient comfort during these procedures is presently underreported.

Methods: One hundred and fifty-eight patients undergoing wide-awake hand surgery using local anesthesia were prospectively enrolled.

Outcomes of Type I Open Distal Radius Fractures: A Comparison of Delayed and Urgent Open Reduction Internal Fixation.

Background: Type I open distal radius fractures treated with open reduction internal fixation (ORIF) have demonstrated minimal risk of infection. For this reason, they may not require urgent surgical treatment. The purpose of this study was to evaluate the outcomes of patients with type I open distal radius fractures treated with delayed ORIF compared with urgent ORIF.

Early loss of fixation after surgical treatment of distal radius fractures: Does the number of screws matter?

Fixation methods in distal radius fractures has been studied biomechanically, but studies evaluating clinical correlation of that data are lacking. We hypothesize that the use of unthreaded pegs and decreased screw number would correlate with an early failure of fixation. There were 50 operatively treated distal radius fractures with initial post-operative radiographs that demonstrated loss of fixation.

Evaluation of the Incidence and Etiology of Unplanned Return to Operating Room Following Open Reduction Internal Fixation of Distal Radius Fractures.

Background: Distal radius fractures (DRF) are the most common upper extremity fractures in adults. The purpose of this study was to determine the incidence, causes, and independent predictors for unplanned return to the operating room (URTO) in a single institution within 90 days following distal radius open reduction internal fixation (ORIF).

Methods: A retrospective study of 2933 consecutive patients from January 2015 to December 2019 who underwent distal radius ORIF was undertaken.

Does Undergoing Outpatient Hand Surgery Lead to Prolonged Opioid Use? A Comparison of Surgical and Nonsurgical Patients.

Background: Orthopedic surgical patients in general have been found to be at higher risk for developing opioid dependence in the postoperative period. However, there is conflicting evidence in the literature whether opioid exposure after hand surgery leads to prolonged use. In the absence of a nonoperative control group, it is not clear whether prolonged opioid use in hand surgical patients is related to undergoing a surgical intervention.

Web-Based, Self-Directed Physical Therapy After Total Knee Arthroplasty Is Safe and Effective for Most, but Not All, Patients.

Background: Recently, self-directed physical therapy (SDPT) programs have gained popularity following total knee arthroplasty (TKA). This study evaluated the safety and efficacy of the routine use of an SDPT program in a nonselect patient population.

Methods: This is a single-surgeon, retrospective study of 296 consecutive patients from August 2016 to October 2017 discharged home after primary, unilateral TKA and enrolled in a web-based SDPT program.

Web-Based, Self-Directed Physical Therapy After Total Hip Arthroplasty Is Safe and Effective for Most, but Not All, Patients.

Background: Recent data suggested that unsupervised, self-directed physical therapy (SDPT) is both safe and efficacious for patients undergoing total hip arthroplasty (THA) and that formal outpatient physical therapy (OPPT) may not be routinely required. The purpose of this study was to evaluate the routine use of an SDPT program in a nonselect patient population.

Methods: This is a multi-surgeon, single-institution, retrospective study of 941 consecutive patients discharged home, from January 2016 to December 2016, after primary, unilateral THA and enrolled in a web-based SDPT program.

Disparities and the American Health Care System.

The United States' health care system is often compared with those of other industrialized countries, and consistently ranks poorly in terms of health care delivery, efficiency, and quality. However, there are several considerations unique to the United States that are often distorted in these analyses, and when considered in the context of the convoluted ethnic and social disparities that persist in the United States, the successes of the American health care system become more apparent.