Florid reactive periostitis of the hand.

Florid reactive periostitis is a relatively rare lesion that most often develops in the tubular bones of the hands and feet. This lesion can easily be confused with malignant or infectious processes. Correlation of physical examination and radiographic findings with histologic findings usually is diagnostic.

Metacarpophalangeal joint dislocation.

Traumatic dislocation of the metacarpophalangeal joint is a relatively uncommon injury. The dislocation may be easily reducible (ie, simple) or require surgical intervention (ie, complex). The flexor tendons, lumbrical muscle, natatory ligament, and superficial transverse metacarpal ligament combine with the displaced volar plate to create a tight noose, preventing reduction.

The role of prophylactic antibiotics in elective hand surgery.

The current literature has poorly defined the role of antibiotic agents in elective hand surgery. The reason for this may be due to a small number of well-designed studies specifically addressing the efficacy of antibiotics in hand surgery. Our purpose is to critically review the current literature in an attempt to more precisely define the role of prophylactic antibiotics in elective hand surgery.

Resident selection: how we are doing and why?

Selection of the best applicants for orthopaedic residency programs remains a difficult problem. Most quantifiable factors for residency selection evaluate test-taking ability and grades rather than other aspects, such as patient care, professionalism, moral reasoning, and integrity. Four current department members on our resident selection committee ranked four consecutive classes of orthopaedic residents interviewed for residency.

Septic arthritis of the shoulder, elbow, and wrist.

Septic arthritis of the shoulder, elbow, or wrist is not commonly described in the literature. We evaluated the micro- biology of these infections and the diagnostic role of joint aspirate findings. This retrospective study includes 52 patients, diagnosed from 1994 to 2004, with septic arthritis of the shoulder (n = 17), elbow (n = 23), or wrist (n = 12).

Functional capacity before and after simulated thumb carpometacarpal joint fusion.

Lateral pinch strength, grooved pegboard test time, and 22 activities of daily living (ADLs) were assessed in 10 asymptomatic patients initially without and then with splinting of the thumb carpometacarpal (CMC) joint (simulating thumb CMC fusion). Before immobilization, all patients rated a perfect total score of 88 on the 22 ADLs. After immobilization, mean total score dropped to 78.

Fixation of distal radius fractures using a fragment-specific system.

Unlabelled: Operative treatment for distal radius fractures continues to evolve, but small-fragment fixation has some advantages compared with previous methods. We assessed two groups of patients. Group 1 was an initial series of patients treated with small-fragment fixation at a large institution in the United States, and Group 2 was a review of patients treated in Lund, Sweden.

Retrieving tendon ends in zone II flexor tendon injuries.

Suturing the tendons to the catheter often leads to a bulky mass that makes passage through the pulleys difficult.

Negative pressure dressings as an alternative technique for the treatment of infected wounds.

Coverage of wounds caused by infection and subsequent treatment often are variable because of the location of the wound and wound size. Although much research has been done to expand the indications of negative pressure wound treatment systems, little investigation has been done to quantify the reduction of wound size for vacuum-assisted closure treatment in the presence of infection. In this series, 14 patients who had wounds caused by infections were treated with the vacuum-assisted wound closure system.

New onset diabetes mellitus in patients presenting with extremity infections.

Although a relationship between diabetes and extremity infections has been established, the current literature notes little regarding the initial diagnosis of a patient's diabetic condition being made at the time of presentation with an extremity infection. The current study is an analysis of patients with extremity infections being diagnosed with diabetes for the first time. A chart review of 1166 patients who were admitted to the orthopaedic infection service revealed 385 patients with an admission glucose of 120 mg/dL or greater.