Publications by authors named "Steve K Lee"

Purpose: Historically, infraclavicular brachial plexus injuries (IBPIs) were considered neuropraxic injuries that would improve with nonsurgical intervention. However, more recent studies suggest that these injuries may benefit from surgical intervention. The aims of this retrospective study were to (1) describe injury patterns and associated injuries of isolated, traumatic IBPIs, (2) evaluate the concordance of preoperative ultrasound and magnetic resonance neurography with surgical findings of patients who underwent surgical intervention for IBPIs, and (3) describe outcomes of surgical intervention for these injuries.

View Article and Find Full Text PDF

Purpose: The surgical management of adult traumatic brachial plexus injuries (BPI) is challenging, with no consensus on optimal strategies. This study aimed to gather preferred reconstructive strategies from BPI surgeons for actual cases from a multicenter cohort to identify areas of agreement.

Methods: Four case files (history, physical examination, and imaging and electrodiagnostic testing results) were distributed to eight self-designated Level IV expert BPI surgeons in the United States.

View Article and Find Full Text PDF

Background: Hamstring tendon grafts are commonly utilized tendon autografts; however, the harvesting procedure can result in saphenous nerve injury due to its proximity to the semitendinosus and gracilis tendons. Injury to the main branch of the saphenous nerve is a less commonly reported and understood injury during these procedures.

Purpose: This case report aimed to identify and present cases of iatrogenic injury to the main branch of the saphenous nerve during hamstring tendon graft harvesting.

View Article and Find Full Text PDF
Article Synopsis
  • Pain after brachial plexus injury (BPI) is significant, and the study aimed to understand how factors like depression, anxiety, and muscle function relate to pain interference in daily life.
  • In a cohort study, researchers measured pain interference, emotional health, and physical function in 37 BPI patients before and one year after surgery using standardized questionnaires.
  • Results showed that pain interference scores remained high one year post-surgery, with strong correlations to pain symptoms and emotional recovery, highlighting the ongoing impact of pain in BPI patients' lives.
View Article and Find Full Text PDF

To address an inconsistency in the nomenclature of the anatomy and compressive syndromes of the deep branch of the radial nerve, we advocate for a single compression syndrome that presents along a spectrum from pain to posterior interosseous nerve palsy.

View Article and Find Full Text PDF

Purpose: With trapeziometacarpal osteoarthritis (TMC OA), the relationship between disease severity and pretreatment dysfunction, patient expectations, and preferred patient treatment and management remains unclear. This study aimed to assess the association between functional status, pretreatment expectations, and demographic and clinical characteristics of TMC OA patients who decide to undergo operative management.

Methods: Patients diagnosed with TMC OA (n = 96) were administered the Thumb Arthritis Expectations Survey and the Brief Michigan Hand Questionnaire (bMHQ) during their initial office visit.

View Article and Find Full Text PDF

Multiple techniques exist to reconstruct the scapholunate interosseous ligament, though none have demonstrated superiority. This study compares 1-year radiographic outcomes of the three-ligament tenodesis and the anatomical front and back reconstruction. All patients who underwent reconstruction of their scapholunate interosseous ligament at one institution with either anatomical front and back reconstruction or three-ligament tenodesis between 2011 and 2020 were retrospectively reviewed.

View Article and Find Full Text PDF

 The purpose of this study was to develop and test a patient-derived expectations survey for wrist arthritis surgery. We hypothesized that preoperative patient expectations are higher in people with greater functional impairment and that postoperative fulfilment of patient expectations correlates with functional improvement.  The study was conducted in four phases.

View Article and Find Full Text PDF
Article Synopsis
  • Psychosocial factors like depression and anxiety significantly impact pain, recovery, and overall disability in patients with traumatic brachial plexus injury (BPI) before surgery.
  • A study involving 34 BPI patients showed that higher preoperative depressive symptoms correlated with greater disability and higher expectations for improvement, regardless of injury severity.
  • The findings suggest that screening for depressive symptoms could help medical teams identify patients who might need additional support preoperatively to improve recovery outcomes.
View Article and Find Full Text PDF

The aim of the present cadaveric study was to assess resistance to first metacarpal subsidence of three techniques of suspensionplasty after trapeziectomy. In total, 18 forearms (mean age 60 years [range 20-89]) were used with six specimens per surgical technique: palmar oblique ligament reconstruction with tendon interposition (LRTI), abductor pollicis longus (APL) suspensionplasty, or suture suspensionplasty. There was no significant difference in mean trapezial space height after trapeziectomy and suspensionplasty compared to the preoperative trapezial height.

View Article and Find Full Text PDF

Purpose: Traumatic brachial plexus injuries (BPI) are devastating, time-sensitive conditions that often require definitive treatment at academic tertiary care centers. Delays to presentation and surgery have been associated with inferior outcomes. In this study, we evaluate referral patterns associated with delayed presentation and late surgery in traumatic BPI patients.

View Article and Find Full Text PDF

Background: Painful neuromas remain a challenge for both patients and surgeons. Despite numerous described treatments, they are often unreliable with variable outcomes. This study evaluated the use of processed nerve allografts for the treatment of painful lower extremity neuromas by either reconstruction or transposition into muscle.

View Article and Find Full Text PDF

Purpose: The extensor retinaculum of the wrist, a thickening of the deep forearm fascia, is often used as do- nor graft material for annular pulley reconstructions and bone-retinaculum-bone grafts for ligament reconstructions. The purpose of our study was to identify the relationships between the radial and ulnar styloids, readily recogniz- able topographic landmarks of the wrist, and the anatomic boundaries of the retinaculum.

Methods: The extensor retinacula of 12 preserved, right cadaver wrists (3 male and 9 female) were studied by gross dissection using 3.

View Article and Find Full Text PDF
Article Synopsis
  • A study shows that high-resolution ultrasound (US) is more effective than MRI in diagnosing radial nerve injuries near metallic hardware due to MRI's limitations from susceptibility artifacts.
  • The research involved analyzing 13 cases of radial nerve injuries from January 2015 to December 2019, where US accurately identified the injuries in 100% of the cases compared to MRI's 57% accuracy in 7 cases evaluated by both methods.
  • In 92% of the cases, nerve injuries were found adjacent to metallic hardware, and MRI's effectiveness was compromised in 85% of cases due to artifacts caused by the metal.
View Article and Find Full Text PDF

: Assessing the extent and specific location of brachial plexus injuries can be difficult given the variety of mechanisms of injury and anatomic complexity of the plexus. We developed a program to accurately assess the location of a patient's neurologic injury based on electromyographic data. : We sought to test our hypothesis that the location of traumatic brachial plexopathies could be accurately assessed with a novel program that processed electromyogram (EMG) and mechanism of injury data.

View Article and Find Full Text PDF

Purpose: Case reports of nerve injuries following arthroscopic capsulolabral repair emphasize the proximity of major nerves to the glenoid. This study describes preoperative localization using nerve-sensitive magnetic resonance imaging in a small cohort of patients with iatrogenic nerve injuries following arthroscopic capsulolabral repair and the outcomes of nerve repair in these patients.

Methods: Cases of iatrogenic nerve injury following arthroscopic capsulolabral repair referred to 2 surgeons from January 2017 to December 2019 were identified.

View Article and Find Full Text PDF

Background: Ulnar shortening osteotomy (USO) is an effective treatment for ulnar impaction syndrome. However, there have been reports of osteoarthritis (OA) at the distal radioulnar joint (DRUJ) when USO was performed on patients with a reverse oblique sigmoid notch. This study aimed to evaluate the radiographic and functional outcomes following USO in patients with a reverse oblique sigmoid notch.

View Article and Find Full Text PDF

Purpose: The purpose of the study was to evaluate the utility of the levator scapulae motor nerve (LSN) as a donor nerve for brachial plexus nerve transfer. We hypothesized that the LSN could be transferred to the suprascapular nerve (SSN) or long thoracic nerve (LTN) with a reliable tension-free coaptation and appropriate donor-to-recipient axon count ratio.

Methods: Twelve brachial plexus dissections were performed on 6 adult cadavers, bilaterally.

View Article and Find Full Text PDF

Background: Patients undergoing casting for upper or lower extremity injuries may present with recalcitrant pain without an identifiable physiologic etiology, which increases the likelihood of more frequent or unscheduled office visits, insomnia, decreased patient satisfaction, unnecessary investigative procedures or treatments, and-in some cases-cast intolerance. The exact causes of cast intolerance are not well studied, although claustrophobia and associated fears of suffocation and restriction may be underlying causes.

Questions/purposes: We sought to explore the association between claustrophobic tendencies and cast intolerance.

View Article and Find Full Text PDF

Objective: We evaluated the performance of ultrasound in the detection of neuropathy of the suprascapular nerve (SSN), long thoracic nerve (LTN), spinal accessory nerve (SAN), and phrenic nerve and compared this performance with MRI.

Methods: A retrospective review of 56 patients who had undergone ultrasound imaging of the SSN, LTN, SAN, and phrenic nerve was performed. Diagnoses made by ultrasound, MRI, EMG reports, and clinical and operative notes were recorded.

View Article and Find Full Text PDF

 Dorsal scaphoid translation (DST) has been demonstrated to occur in patients with complete scapholunate interosseous ligament (SLIL) tears. Radiographs and magnetic resonance imaging (MRI) have demonstrated ability to detect DST in patients with documented complete scapholunate (SL) disruption, but the relevance of this parameter to outcomes of reconstruction has not been determined.  The purpose of this article is to determine how radiographic parameters of SL dissociation correlate with postoperative pain and functional outcomes of SLIL reconstruction.

View Article and Find Full Text PDF

Purpose: Wide variability in the recovery of patients affected by neuralgic amyotrophy (NA) is recognized, with up to 30% experiencing residual motor deficits. Using magnetic resonance imaging and ultrasound (US), we identified hourglass constrictions (HGCs) in all affected nerves of patients with chronic motor paralysis from NA. We hypothesized that chronic NA patients undergoing microsurgical epineurolysis and perineurolysis of constrictions would experience greater recovery compared with patients managed nonsurgically.

View Article and Find Full Text PDF

Forearm fractures are common injuries in pediatric patients. We present a case of median nerve tethering as a complication of both-bone forearm fracture in a child, with an emphasis on MRI as an appropriate and important complement to clinical and electrodiagnostic examination. Early intervention is essential because delayed surgical management of median nerve tethering can result in poor clinical outcomes as a result of irreversible muscle denervation.

View Article and Find Full Text PDF

Synopsis of recent research by authors named "Steve K Lee"

  • - Steve K. Lee's recent research primarily focuses on the understanding and management of neurological injuries, particularly those associated with the brachial plexus and upper extremity conditions, exploring the impact of psychosocial factors on surgical outcomes.
  • - Several studies by Lee investigate pain interference and the factors influencing surgical decision-making in patients suffering from conditions like traumatic brachial plexus injury and trapeziometacarpal osteoarthritis, highlighting the role of psychological well-being and patient expectations.
  • - His work includes the development of diagnostic tools and validation of assessment surveys for surgical outcomes, as well as biomechanical analyses of surgical techniques, contributing significantly to clinical practices and treatment strategies in hand surgery and nerve injury management.