Central Tendon Tenotomy for Management of Extrinsic Extensor Tightness of the Hand: Surgical Technique and Case Reports.

Case: We present a 67-year-old woman with long finger extrinsic extensor tightness and a 56-year-old man with limited index finger flexion due to extrinsic extensor tightness secondary to tendon transfers for radial nerve palsy. Both patients underwent prior surgical procedures that led to limited range of motion (ROM). Subsequently, they elected for central tendon tenotomy (CTT), which demonstrated postoperative ROM improvement and satisfactory patient outcomes.

Predictors of adequate pain control after outpatient hand and upper extremity surgery.

Purpose: The opioid epidemic has changed practice, though there remains a paucity of data regarding prescribing habits and pain control following outpatient hand surgery. We sought to evaluate patient-related predictors of adequate postoperative pain control.

Methods: A retrospective review was performed of a single-center prospectively collected database of elective outpatient surgery on the elbow, forearm, wrist, and/or hand.

Distribution and Characteristics of Carpal Bone Tumors: A Systematic Review.

 Carpal bone tumors are rare in the literature, making it difficult to identify their clinical presentation.  This systematic review analyzes the characteristics of published carpal bone tumor cases to identify the most frequent patterns in diagnoses. Attention is paid to the carpal bone involved and type, and patient demographics was performed to summarize published findings.

Intercarpal Angles on Hand Versus Wrist Films: Are Hand Radiographs Sufficient for Assessing Intercarpal Angles?

Purpose: Carpal angles traditionally are measured on the lateral projection of a standard wrist series; however, this often necessitates obtaining additional radiographic views resulting in additional radiation exposure and increased cost. We aimed to determine whether carpal angles could be measured accurately on a standard series of hand radiographs when compared to wrist radiographs.

Methods: Carpal indices were measured on lateral wrist and hand radiographs of 40 patients by three orthopedic upper extremity surgeons.

Role of Laser Pointer in Budgeting Fluoroscopy-Time and Radiation Exposure.

Background: Literature on radiation exposure with use of the mini C-arm and value of having built-in laser guidance is limited. The purpose of this study was to determine whether laser guidance use on a mini C-arm fluoroscopy unit can reduce radiation exposure.

Methods: Surgeons (N = 25) performed the same simulated surgical task, which involved obtaining "perfect circle" views of 2 cannulated screws placed into a cadaveric wrist, done with and without C-arm laser guidance.

Self-reported cannabis use is not associated with greater opioid use in elective hand surgery patients.

Background: The purpose of this study was to examine the influence of preoperative marijuana use on postoperative opioid use during the first three postoperative days (POD 1-3) after surgery, and on expectations of pain control, resiliency, and quality-of-life scores.

Methods: All patients presenting to a single institution undergoing elective hand or upper extremity outpatient surgery were asked to complete pre- and postoperative questionnaires. Preoperative questionnaires collected information on demographics, marijuana use, tobacco use, procedure type, self-assessed health, pain control expectations, and EuroQol-5D (EQ-5D) scores.

Swing Type and Batting Grip Affect Peak Pressures on the Hook of Hamate in Collegiate Baseball Players.

Background: Bat swing and grip type may contribute to hook of hamate fractures in baseball players.

Purpose: To compare the effects of swing type and batting grip on the pressure and rate of pressure development over the hook of hamate in collegiate baseball players.

Study Design: Descriptive laboratory study.

Dynamic Nerve Compression of Guyon Canal Secondary to Variation of the Deep Branch of the Ulnar Artery: Etiology, Diagnosis, Treatment, and Outcome.

A patient presented with an ulnar-sided left wrist injury that was sustained while batting. Advanced imaging was obtained to rule out common causes of nerve compression and evaluate the patient's anatomy. Dynamic nerve conduction studies were necessary to confirm a diagnosis of nerve compression.

A Clinical Comparison of Triceps-Sparing and Triceps-Detaching Approaches for Revision Total Elbow Arthroplasty.

Purpose: Triceps-sparing (TS) approaches have been reported to provide improved triceps strength, better patient outcomes, and a lower incidence of complications in primary total elbow arthroplasty (TEA). It remains unclear whether the advantages of this approach are similar in the revision setting, especially in cases with prior triceps detachment. The purpose of this study was to compare triceps strength and clinical outcomes between TS and triceps-detaching (TD) approaches in revision TEA.

Outcomes of Revisions for Failed Trapeziometacarpal Joint Arthritis Surgery.

Purpose: We compare outcomes of revision surgery for trapeziometacarpal (TM) arthritis with outcomes for both primary and revision surgery for TM arthritis reported in the literature. We hypothesized that patients undergoing revision surgery for TM arthritis would demonstrate pain and functional outcome scores that were worse than those of patients undergoing primary TM surgery.

Methods: A retrospective analysis of all patients undergoing revision TM surgery at a single institution from 1995 to 2015 was performed.

Cannulated Self-Drilling, Self-Tapping Pins for Displaced Extra-articular Distal Radius Fractures.

Displaced unstable extra-articular radius fractures are common and frequently treated with open reduction and internal fixation with a fixed-angle volar plate. Although this treatment yields good results, it might be more invasive than necessary for management of this often relatively simple fracture. In this article, we present the technique of using a cannulated self-drilling, self-tapping (CSDT) construct that can be employed in a minimally invasive fashion.

Interosseous Membrane of the Forearm.

Background: Injuries of the interosseous membrane (IOM) of the forearm are frequently unrecognized, difficult to treat, and can result in a devastating sequelae for the wrist and elbow.

Purpose: The purpose of this review article is to evaluate the dignosis, biomechanics, clinical results, and propose a treatment approach to this rare complex entity.

Methods: The biomechanical and clinical literature is reviewed.