Visualization of Median Nerve Entrapment After Reduction of an Elbow Fracture Dislocation Using 3-Dimensional Magnetic Resonance Imaging: A Case Report.

Case: A 10-year-old girl presented after closed reduction of an elbow fracture dislocation. She demonstrated intact vascularity but a dense median nerve palsy. Preoperative magnetic resonance neurography (MRN) precisely mapped the median nerve entrapped within the medial epicondylar fracture.

Partial Flexor Tendon Injury Causing Locking: Illustration of the Utility of Dynamic Ultrasound.

Clinical diagnosis of partial flexor tendon lacerations is challenging because tendon function may be preserved. Although some partial flexor tendon tears can be managed conservatively, pain, stiffness, and triggering/locking may result, requiring surgical management. The mechanism by which this occurs has been investigated in animal and cadaver studies but has not been demonstrated in patients with real-time, in vivo imaging.

Early Results of 3-Dimensional Planning and Customized Cutting Guides for the Treatment of Severe Madelung Deformity.

Purpose: Surgical treatment of Madelung deformity can present challenges due to a need for multiplanar correction. Developing customized cutting guides for osteotomies may improve surgical outcomes by enhancing the surgeon's understanding and surgical correction.

Methods: All patients who underwent forearm osteotomies for Madelung deformity using computed tomography planning with 3-dimensional-printed customized cutting guides were retrospectively reviewed (n = 8).

Polydactyly a review and update of a common congenital hand difference.

Purpose Of Review: The purpose of this review is to describe various forms of hand polydactyly and their different treatment approaches. Hand polydactyly is commonly classified as ulnar (small finger) or radial (thumb). Polydactyly can be sporadic, genetic, and/or associated with syndromic conditions.

Incidence of Nerve Repair Following Endoscopic Carpal Tunnel Release Is Higher Compared to Open Release in New York State.

Background: Carpal tunnel release (CTR) has traditionally been performed through an open approach, although in recent years endoscopic CTR has gained in popularity.

Questions/purposes: We sought to assess whether a difference exists between the rates of nerve repair surgery following open versus endoscopic CTR in New York State (NYS).

Methods: Patients undergoing endoscopic and open CTR from 1997 to 2013 were identified from the Statewide Planning and Research Cooperative System (SPARCS) database from the NYS Department of Health using Current Procedural Terminology, 4th Revision (CPT-4) codes 29848 and 64721, respectively.

The Effect of Distal Radius Fracture Location on Distal Radioulnar Joint Stability: A Cadaveric Study.

Purpose: To investigate whether the location of distal radius osteotomy/shortening relative to the radial insertion of the distal interosseous membrane (DIOM) is correlated with distal radioulnar joint (DRUJ) instability. We hypothesized that distal radius osteotomy and shortening proximal to the DIOM insertion would result in increased DRUJ instability because of induced laxity in the DIOM.

Methods: Osteotomies of the distal radius were performed proximal and distal to the DIOM insertion in 14 fresh-frozen cadaveric specimens.

Arthroscopic treatment of triangular fibrocartilage complex injuries in paediatric and adolescent patients.

We assessed outcomes of 43 paediatric and adolescent patients (44 wrists) undergoing arthroscopic triangular fibrocartilage complex surgery by a single surgeon between 2003 and 2016. Medical records were reviewed for clinical, imaging, and operative data. Preoperatively, 49% of patients had additional diagnoses and mean QuickDASH was 47.

Decreasing Unexpected Returns to Orthopedic Hand Clinic: Improving Efficiency of Health Care Delivery.

Purpose: An unexpected return to clinic (URTC) visit can place a substantial financial burden on patients and families while stressing the health care system. Our SMART aim was to decrease the rate of URTC visits from 1.8 per 100 patient follow-up visits by 50% using quality improvement methodology.

Technical Pearls of Tendon Transfers for Upper Extremity Spasticity.

Tendon transfers are an important surgical option when treating patients with muscular imbalance due to upper extremity spasticity. A successful surgical outcome requires a thorough preoperative clinical evaluation, an understanding of tendon transfer biomechanics, appropriate donor and recipient muscle selection, technical execution, and postoperative rehabilitation. This article reviews the principles, biomechanics, and techniques for commonly performed tendon transfers in patients with upper extremity spasticity.

Online Patient Ratings Are Not Correlated with Total Knee Replacement Surgeon-Specific Outcomes.

Background: Despite potential concerns regarding their validity, physician-rating websites continue to grow in number and utilization and feature prominently on major search engines, potentially affecting patient decision-making regarding physician selection.

Questions/purposes: We sought to determine whether patient ratings on public physician-rating websites correlate with surgeon-specific outcomes for high-volume total knee replacement (TKR) surgeons in New York State (NYS) from 2010 to 2012.

Methods: Online patient ratings were compared to surgeon-specific outcomes from the Statewide Planning and Research Cooperative System (SPARCS) database from the NYS Department of Health.

An Alternative Macrophage Activation Pathway Regulator, CHIT1, May Provide a Serum and Synovial Fluid Biomarker of Periprosthetic Osteolysis.

Background: Periprosthetic osteolysis (PPO) is a frequent indication for total hip replacement (THR) failure. Currently, PPO diagnosis occurs in advanced stages that often necessitate complex revisions due to bone loss. PPO biomarkers could facilitate earlier diagnosis.

Arthroscopic Diagnosis of the Triangular Fibrocartilage Complex Foveal Tear: A Cadaver Assessment.

Purpose: To determine whether the arthroscopic hook and trampoline tests are accurate and reliable diagnostic tests for foveal triangular fibrocartilage complex (TFCC) detachment.

Methods: Wrist arthroscopy was performed on 10 cadaveric upper extremities. Arthroscopic hook and trampoline tests were performed and videos recorded (baseline).

At Home Photography-Based Method for Measuring Wrist Range of Motion.

 To determine the reliability of wrist range of motion (WROM) measurements based on digital photographs taken by patients at home compared with traditional measurements done in the office with a goniometer.  Sixty-nine postoperative patients were enrolled in this study at least 3 months postoperatively. Active and passive wrist flexion/extension and radial/ulnar deviation were recorded by one of the two attending surgeons with a 1-degree resolution goniometer at the last postoperative office visit.

Functional Outcomes of Modular Conversion of Hemiarthroplasty or Total to Reverse Total Shoulder Arthroplasty.

Background: The advent of modular shoulder arthroplasty systems has allowed the conversion of hemiarthroplasty or total shoulder arthroplasty to reverse total shoulder arthroplasty (RTSA) without removing a well-fixed stem.

Questions/purposes: To determine the feasibility, functional outcome, and complication profile of RTSA modular conversion.

Methods: A prospective shoulder arthroplasty registry was queried for consecutive patients scheduled for a modular conversion from January 1, 2007, to April 1, 2015.

The Prevalence of Pisotriquetral Arthritis in the Setting of Scapholunate Advanced Collapse.

 Previous authors have reported pisotriquetral pain and subsequent pisiform excision following partial or total wrist fusion in patients with scapholunate advanced collapse (SLAC). Prior studies have not considered the potential role of SLAC biomechanics on pisotriquetral osteoarthritis (PT OA) development preoperatively.  To determine the prevalence and severity of PT OA in patients with SLAC as compared with a control population.

Rating a Sports Medicine Surgeon's "Quality" in the Modern Era: an Analysis of Popular Physician Online Rating Websites.

Background: Consumer-driven healthcare and an increasing emphasis on quality metrics have encouraged patient engagement in the rating of healthcare. As such, online physician rating websites have become mainstream and may play a potential role in future healthcare policy.

Questions/purposes: The purpose of this study was to evaluate online patient ratings for US sports medicine surgeons, determine predictors of positive ratings and analyze for inter-website scoring correlation.

Risk Factors for 30-Day Postoperative Complications Following Open Reduction Internal Fixation of Proximal Ulna Fractures.

Purpose: Fractures of the proximal ulna are common injuries in the elderly population. These fractures can be managed nonsurgically or with open reduction internal fixation (ORIF). Whereas nonsurgical management may lead to a relative loss of elbow extension and to nonunion, ORIF carries a risk of complications.

Interventional radiology fellowship website content: what is the relevance to potential applicants?

Purpose: To assess the accessibility and content of query Interventional Radiology (IR) fellowship program websites and determine the impact of these websites on applicants.

Materials And Methods: All IR fellowship programs were individually evaluated, and all IR fellowship applicants to our institution were surveyed.

Results: In 2015, 44.

Radiographic Results and Complications of 3 Guided Growth Implants.

Background: Temporary, implant-mediated hemiepiphysiodesis (ie, guided growth) is an effective and popular treatment method for lower extremity angular deformities. The purpose of this study was to retrospectively evaluate the safety profile of 3 different implants used to correct lower extremity angular deformities in pediatric patients.

Methods: We retrospectively reviewed a consecutive series of pediatric patients with lower extremity angular deformities who underwent implant-mediated guided growth by 2 surgeons at our institution between 2004 and 2014.

New Joints, Same Old Weight: Weight Changes After Total Hip and Knee Arthroplasty.

Obesity is a well-known risk factor for postoperative complications following total joint arthroplasty. However, because the operation is often successful, orthopedic surgeons continue to operate on obese individuals, and many surgeons do so under the assumption that patients will lose weight after they are able to walk and exercise without pain. In this article, we review a recent study by Ast et al.

Nerve Repair and Nerve Grafting.

Direct repair and nerve autografting are primary options in the treatment of upper extremity peripheral nerve injuries. Deciding between these surgical options depends on the mechanism of injury, time since injury, and length of repair defect. Principles of direct repair and nerve autografting are reviewed.

Online Patient Ratings: Why They Matter and What They Mean.

The increasing focus on patient satisfaction and consumer-driven health care, combined with the recent rise in online social media, have resulted in the growing trend of patients rating physicians on publicly accessible Web sites. The number and use of such Web sites continue to grow despite potential concerns about the validity of these ratings and negative physician perception. These Web sites can influence patient decision making regarding physician selection.

Online Patient Ratings of Hand Surgeons.

Purpose: To evaluate factors associated with positive online patient ratings and written comments regarding hand surgeons.

Methods: We randomly selected 250 hand surgeons from the American Society for Surgery of the Hand member directory. Surgeon demographic and rating data were collected from 3 physician review Web sites (www.