Perioperative Patient Experience in Office-Based Wide-Awake Hand Surgery.

Purpose: Office-based surgery, is a safe, well-tolerated option associated with high patient satisfaction. However, some patients remain hesitant due to concerns of being awake during surgery. Preoperative anxiety may be linked to poorer postoperative outcomes.

Comparing the Intensity of Pain and Incidence of Flare Reaction Following Trigger Finger Injections Using Betamethasone and Methylprednisolone: A Double-Blinded, Randomized Controlled Trial.

Background: Considerable evidence supports corticosteroid injection as an effective treatment for trigger finger. One common side effect, the flare reaction, is a well-documented phenomenon of increased pain following steroid injections. Its incidence and intensity may be related to steroid composition.

Distal Ulna Fracture Fixation with the Specialized Threaded Pin.

Purpose: Distal ulna fractures can often be treated nonsurgically; however, many surgeons consider significant displacement or instability, especially following fixation of an associated distal radius fracture, an indication for surgical fixation because of potential problems associated with malunion of these fractures. Traditionally, these fractures have been addressed with plate fixation but hardware in this location is often prominent and associated with a high rate of symptomatic hardware and subsequent hardware removal. We proposed a method of intramedullary fixation using a specialized threaded pin.

Online youth concussion resources for Canadian teachers and school staff: A systematic search strategy.

Introduction: Teachers and school staff (i.e., principals, coaches, trainers, educational assistants, guidance counselors, school healthcare professionals, etc.

Threaded Pin and Volar Plate Fixation of Distal Radius Fractures: Early Functional Recovery.

Purpose: To assess the results of threaded pin fixation and volar plate fixation of extra-articular distal radius fractures.

Methods: A retrospective case comparison study of patients undergoing operative fixation of distal radius fracture and postoperative therapy at 1 hand clinic was performed. Clinical variables included implant type along with the assessment of the volar tilt; radial height; postoperative wrist flexion, extension, pronation, and supination; key pinch; and grip strength.

Obstetric Emergencies Requiring Rapid Response Team Activation: A Retrospective Cohort Study in a High-Risk Tertiary Care Centre.

Objective: The purpose of this study was to better understand obstetric codes requiring rapid response team activation by examining their incidence, indications, team response, and patient outcomes.

Methods: This was a retrospective study in peripartum women who required activation of the following codes during hospitalization between January 2014 and May 2018: "Code 77 (C77)" (obstetric emergency), "Code Blue (CB)" (cardiopulmonary compromise) or "Code Omega (CO)" (massive transfusion). Hospital database and health records were searched to identify and review cases.

Excision of a Rare Triquetral Body Fracture Nonunion.

Aside from the more common dorsal avulsion fractures, isolated triquetral body fractures are a rare injury and often missed. When they are identified, conservative treatment via immobilization is often the standard of care for initial treatment. Rarely, triquetral body fractures can develop into symptomatic nonunions, causing considerable pain and disability.

Dorsal Coaptation for the Treatment of Digital Neuroma.

Purpose: The formation of a symptomatic neuroma after digital tip amputation presents a vexing problem. There is currently no procedure that completely and consistently prevents hypersensitive neuroma formation. This report presents the results of a technique designed to limit axon regeneration and mechanical irritation by neuroma excision, dorsal transposition, and coaptation with the corresponding digital nerve.

Percutaneous Threaded Pin Fixation of Distal Radius Fracture in the Athlete.

Background: The purpose of this study was to examine the outcomes and return to play with early rehabilitation in athletes who sustained unstable extra-articular distal radius fractures treated with a purpose-designed threaded pin technique.

Methods: This prospective study examined athletes with displaced and unstable distal radius fractures treated surgically with purpose-designed threaded pins. Patients were enrolled in an early rehabilitation protocol, with formal therapy initiated on postoperative days 1 to 3.

Identification of early childhood caries in primary care settings.

Early childhood caries (ECC) is the most common chronic disease affecting young children in Canada. ECC may lead to pain and infection, compromised general health, decreased quality of life and increased risk for dental caries in primary and permanent teeth. A multidisciplinary approach to prevent and identify dental disease is recommended by dental and medical national organizations.

Rapid Cycle Deliberate Practice in Medical Education - a Systematic Review.

Rapid Cycle Deliberate Practice (RCDP) is a novel simulation-based education model that is currently attracting interest, implementation, exploration and research in medical education. In RCDP, learners rapidly cycle between deliberate practice and directed feedback within the simulation scenario until mastery is achieved. The objective of this systematic review is to examine the literature and summarize the existing knowledge on RCDP in simulation-based medical education.

The use of indomethacin in the prevention of postoperative radioulnar synostosis after distal biceps repair.

Background: This study evaluated the incidence of symptomatic radioulnar synostosis/heterotopic ossification after distal biceps tendon repair in patients receiving indomethacin prophylaxis. We hypothesized that indomethacin use postoperatively would decrease the occurrence of symptomatic synostosis.

Methods: A single-center retrospective record review identified 124 patients undergoing distal biceps repair between 2011 and 2014.

The cost effectiveness of transesophageal echocardiography for pediatric cardiac surgery: a systematic review.

Background: Intraoperative transesophageal echocardiography (ITEE) for pediatric cardiac surgery has been described as clinically efficacious and cost-effective. There are a small number of publications supporting these claims.

Aims: The objectives were to assess the quality of the research, the variability of results across studies and, if possible, to make a consensus statement based on the results.

Distal Radius Fracture Fixation With the Specialized Threaded Pin Device.

This study investigated the outcomes of extra-articular distal radius fractures and simple intra-articular radial styloid fractures stabilized with a novel threaded cannulated device. This was a retrospective study of 24 distal radius fractures treated with the T-Pin device (Union Surgical LLC, Philadelphia, Pennsylvania), with a minimum of 1 year of postoperative follow-up. Outcome data included wrist range of motion, grip strength, and pinch strength.

Acceptability of bone antiresorptive therapy among HIV-infected adults at different stages of antiretroviral therapy.

Purpose: Both HIV infection and antiretroviral therapy (ART) are associated with significant decreases in bone mineral density (BMD) and increased fracture rates. To prepare for a randomized controlled trial of prophylactic bone antiresorptive therapy during ART initiation, we assessed the acceptability of this strategy, bone health knowledge, and fracture risk among HIV-infected adults.

Methods: HIV-infected adults with no history of osteoporosis were recruited from one tertiary and one primary care HIV clinic.

Radial nerve motor palsy following seasonal influenza vaccination: a case report.

This case report describes the course of a 26-year-old male who developed a dense motor palsy of the radial nerve after receiving a seasonal influenza vaccination. The palsy developed within 12 to 16 hours of inoculation and demonstrated no clinical recovery until 5 months postinjury. Electromyographic and nerve conduction studies obtained at six weeks postinjury were consistent with complete motor denervation.

Speech and language support: How physicians can identify and treat speech and language delays in the office setting.

Unlabelled: Failure to recognize and intervene early in speech and language delays can lead to multifaceted and potentially severe consequences for early child development and later literacy skills. While routine evaluations of speech and language during well-child visits are recommended, there is no standardized (office) approach to facilitate this. Furthermore, extensive wait times for speech and language pathology consultation represent valuable lost time for the child and family.

Allograft reconstruction for digital nerve loss.

Purpose: To investigate the outcomes of digital nerve repairs using processed nerve allograft for defects measuring 30 mm or less.

Methods: Seventeen patients with 21 digital nerve lacerations in the hand underwent reconstruction with processed nerve allograft. Outcome data for 14 patients with 18 digital nerve lacerations were available for analysis.

Reconstruction of digital nerves with collagen conduits.

Purpose: Digital nerve reconstruction with a biodegradable conduit offers the advantage of providing nerve reconstruction while providing a desirable environment for nerve regeneration. Many conduit materials have been investigated, but there have been few reports of human clinical trials of purified type I bovine collagen conduits.

Methods: We report a prospective study of 22 isolated digital nerve lacerations in 19 patients reconstructed with a bioabsorbable collagen conduit.

New concepts in the treatment of distal radius fractures.

Fracture of the distal radius is the type of fracture most commonly seen in emergency departments. The understanding of nonsurgical and surgical care of distal radius fractures is evolving with recently developed methods of fixation. It is worthwhile to review some new methods of treatment, the role of bone grafting and synthetic substitutes, the principles of complex fracture management, and the treatment of common complications of distal radius fractures.

Treatment of distal radius fractures.

The clinical practice guideline is based on a systematic review of published studies on the treatment of distal radius fractures in adults. None of the 29 recommendations made by the work group was graded as strong; most are graded as inconclusive or consensus; seven are graded as weak. The remaining five moderate-strength recommendations include surgical fixation, rather than cast fixation, for fractures with postreduction radial shortening >3 mm, dorsal tilt >10 degrees , or intra-articular displacement or step-off >2 mm; use of rigid immobilization rather than removable splints for nonsurgical treatment; making a postreduction true lateral radiograph of the carpus to assess dorsal radial ulnar joint alignment; beginning early wrist motion following stable fixation; and recommending adjuvant treatment with vitamin C to prevent disproportionate pain.