Comparison of Patient-Reported Outcomes With or Without Prophylactic Carpal Tunnel Release After Distal Radius Fracture Stabilization.

Distal radius fractures (DRFs) are frequently complicated by acute carpal tunnel syndrome (CTS), which, if unrecognized, can cause permanent median neuropathy. Some surgeons recommend "prophylactic" carpal tunnel release (CTR) during open reduction and internal fixation (ORIF) of DRF. Patient-reported outcomes (PROs) and safety data regarding prophylactic vs symptomatic CTR strategies during DRF fixation are lacking.

Radiographic evaluation of partial articular radial head fractures: assessment of reliability.

Background: Historically, treatment of partial articular radial head fractures has hinged on radiographic assessment and application of the Mason classification. The inter- and intra-rater reliability of radiographic assessment and classification of radial head fractures may be lower than previously reported. We hypothesized that radiographic assessment leads to an underestimation of the number of fragments, percentage of articular surface involved, and displacement in millimeters.

Elbow Fracture-Dislocations: Determining Treatment Strategies.

Elbow dislocations represent common injuries. A quarter of these injuries involve at least 1 fracture. The sequel of elbow fracture-dislocations can be fraught with complications, including recurrent instability, posttraumatic arthritis, elbow contracture, and poor functional results.

Management of Periprosthetic Joint Infection in Total Elbow Arthroplasty.

Periprosthetic joint infection (PJI) is a potentially devastating complication after total elbow arthroplasty (TEA) that can lead to significant morbidity for the patient as well as increased health care-related costs. Despite the potential morbidity associated with TEA PJI, evidence is limited regarding an optimal treatment algorithm. Initial management typically consists of either irrigation and debridement or 2-stage revision.

Atraumatic, Progressive, and Painful Elbow Contracture From a Ganglion Cyst.

Ganglion cysts are benign soft tissue tumors that often occur adjacent to joints or tendons. We report a case of an elbow joint ganglion cyst in a patient who presented with a painful, progressive elbow contracture. The patient was successfully treated with resection of the subbrachialis ganglion cyst combined with an anterior capsular release and an ulnar nerve decompression to recover elbow motion.

A Novel Method to Prevent Terminal Appositional Overgrowth Following Pediatric Below Knee Amputations A Case Series and Review of the Literature.

The terminal overgrowth of the tibia following pediatric transtibial amputation is a common problem leading to pain, disability, and repeat surgical procedures. We present three patients who underwent transtibial amputation due to sarcoma of the lower extremity followed by compress osseointegration prosthesis fixation. The minimum follow-up was 1 year.

Hypoalbuminemia Is Associated With Increased Postoperative Mortality and Complications in Hand Surgery.

Malnutrition has been associated with increased perioperative morbidity and mortality in orthopedic surgery. This study was designed with the hypothesis that preoperative hypoalbuminemia, a marker for malnutrition, is associated with increased complications after hand surgery. A retrospective cohort study of 208 hand-specific codes was conducted with the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2013.

Physician Extenders in Hand Surgery: The Patient's Perspective.

Background: Physician extenders, such as physician assistants (PAs) and nurse practitioners (NPs), have been incorporated into health systems in response to the rising demand for care. There is a paucity of literature regarding patient perspectives toward physician extenders in hand surgery.

Methods: We anonymously surveyed 939 consecutive new patients before their clinic visit.

Distal Radius Allograft Reconstruction Utilizing a Step-Cut Technique After En Bloc Tumor Resection.

En bloc resection of the distal radius is a common treatment for advanced and recurrent giant cell tumors and less commonly for sarcoma. Various reconstructive options exist, including ulnar transposition, osteoarticular autograft and allograft, and allograft arthrodesis. We present a technique of reconstruction using a distal radius bulk allograft with a step-cut to allow for precise restoration of proper length and to promote bony union.

Continuous Adductor Canal Blocks Provide Superior Ambulation and Pain Control Compared to Epidural Analgesia for Primary Knee Arthroplasty: A Randomized, Controlled Trial.

Background: Adductor canal blocks (ACBs) are an alternative to femoral nerve blocks that minimize lower extremity weakness. However, it is unclear whether this block will provide analgesia that is equivalent to techniques, such as epidural analgesia. The purpose of this randomized controlled trial was to compare continuous ACBs with epidural analgesia for primary total knee arthroplasty.

Fixation of proximal pole scaphoid nonunion with non-vascularized cancellous autograft.

Unlabelled: We present 20 patients with established proximal pole scaphoid nonunions treated with curettage and cancellous autograft from the distal radius and screw fixation. Fractures with significant proximal pole fragmentation were excluded. Patients were treated at a mean of 26 weeks after injury (range 12-72).

Radial head replacement with a bipolar system: an average 10-year follow-up.

Background: We report the long-term results of a cohort of patients after radial head replacement with a bipolar design and a smooth cementless stem at a mean follow-up of 10.4 years.

Methods: Of 17 possible patients from a previous minimum 2-year follow-up study, 16 were available for review.

Are the hamstrings from the drive leg or landing leg more active in baseball pitchers? An electromyographic study.

Background: Ulnar collateral ligament reconstruction (UCLR) has become a common procedure among baseball players of all levels. There are several graft choices in performing UCLR, one of which is a hamstring (gracilis or semitendinosus) autograft. It is unclear whether the hamstring muscle from a pitcher's drive leg (ipsilateral side of the UCLR) or landing leg (contralateral side of the UCLR) is more active during the pitching motion.

Thirty-Year Experience With ACL Reconstruction Using Patellar Tendon: A Critical Evaluation of Revision and Reoperation.

Background: During the preoperative discussion prior to anterior cruciate ligament reconstruction (ACLR), patients are often interested in data regarding rates of revision reconstruction, reoperation, concomitant pathologic changes, and future contralateral ACL injury.

Purpose: To analyze a single surgeon's experience with primary and revision ACLR over a 30-year interval, focusing on incidence and risk factors for revision and reoperation.

Study Design: Case series; Level of evidence, 4.

Have Residents Produced More Research Since the Inception of the 80-Hour Workweek?

Background: This study hypothesizes that resident involvement in research has increased since institution of the maximum 80-hour workweek in 2002.

Methods: All 571 papers published in the Journal of Bone and Joint Surgery (JBJS) in 1997 and 2007 (five years before and after the start of the 80-hour workweek) were reviewed. To identify resident authors, a search was performed in the American Board of Orthopaedic Surgery (ABOS) database for any U.

Arm pain in youth baseball players: a survey of healthy players.

Background: Overuse injury in youth baseball players is increasing in prevalence, and these injuries have been correlated to pitching mechanics and pitch counts/types. Prior studies regarding arm pain in these athletes have focused simply on presence or absence of pain during the season rather than on detailed factors related to arm pain with respect to frequency, severity, and associated performance and psychosocial effect.

Hypothesis/purpose: The goal of this study was to investigate frequency, quality, and effect of arm pain in healthy youth baseball players.

Influence of Rotator Cuff Tear Size and Repair Technique on the Creation and Management of Dog Ear Deformities in a Transosseous-Equivalent Rotator Cuff Repair Model.

Background: Redundancies in the rotator cuff tissue, commonly referred to as "dog ear" deformities, are frequently encountered during rotator cuff repair. Knowledge of how these deformities are created and their impact on rotator cuff footprint restoration is limited.

Purpose: The goals of this study were to assess the impact of tear size and repair method on the creation and management of dog ear deformities in a human cadaveric model.